# Content Validation and Perceived Value of Text Messages to Promote Physical Activity Among U.S. Older Adults and Care Partners

## TL;DR

This study validates motivational text messages to encourage physical activity in older adults and their care partners, showing they are equally effective for both groups.

## Contribution

The study introduces nine content-validated text messages that are equally motivating for older adults and care partners.

## Key findings

- Nine motivational text messages were validated with high content validity (item content validity index 0.86–1.00).
- Older adults and care partners reported similar perceived motivational value for the messages.
- Messages can be integrated into digital interventions to improve physical activity in aging populations.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Physical inactivity among older adults is linked to functional decline, falls, and chronic disease.This study addresses the need for scalable, low-cost strategies to promote physical activity in aging populations and their care partners.

Physical inactivity among older adults is linked to functional decline, falls, and chronic disease.

This study addresses the need for scalable, low-cost strategies to promote physical activity in aging populations and their care partners.

Public health significance—Why is this work of significance to public health?
By validating motivational text messages, this work establishes evidence-based tools that can be integrated into digital interventions to increase activity levels in older adults.The finding that messages are equally motivating for both older adults and care partners highlights the potential for dyadic approaches to improving health behaviors.

By validating motivational text messages, this work establishes evidence-based tools that can be integrated into digital interventions to increase activity levels in older adults.

The finding that messages are equally motivating for both older adults and care partners highlights the potential for dyadic approaches to improving health behaviors.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Practitioners and health systems can incorporate these validated messages into remote monitoring platforms or fall-prevention programs to support routine physical activity.Policymakers and researchers can use this foundation to develop and test scalable, technology-enabled interventions that address physical inactivity among older adults.

Practitioners and health systems can incorporate these validated messages into remote monitoring platforms or fall-prevention programs to support routine physical activity.

Policymakers and researchers can use this foundation to develop and test scalable, technology-enabled interventions that address physical inactivity among older adults.

Background: Motivational text messages can encourage increased physical activity. This study aimed to validate motivational text messages among older adults and care partners and to assess differences in perceived motivational value between the two groups. Methods: We designed nine motivational text messages to capture nine distinct physical activity scenarios. For this cross-sectional observational study, we enrolled 14 content experts, 310 older adults, and 305 care partners. Content experts assessed the relevance, while the older adults and care partners assessed the perceived motivational value of each text message on a 5-point Likert scale. We computed the item content validity index and assessed differences in perceived motivational value among older adults and care partners using quantile regression while adjusting for sociodemographic and health characteristics. Results: The item content validity index ranged from 0.86 to 1.00. The median (interquartile range) perceived motivational value for each text message was 4.0 (3.0–5.0), and there were no statistically significant differences in reported motivational values between older adults and care partners. Conclusion: We present nine content-validated text messages with high motivational value for older adults and care partners that can be integrated into technology-based intervention studies and may improve physical activity behavior in both groups.