Reframing Expectations about aging – Physical Activity and Inclusive Reappraisal (RE-PAIR): Protocol of a randomized intervention promoting positive self-perceptions of aging and physical activity in older couples

Background: Ageism and negative self-perceptions of aging have a detrimental impact on the health of older individuals, and on the healthcare and economic systems. Although existing psychoeducational and behavioral interventions have effectively increased positive self-perceptions of aging, often their beneficial effects have been investigated with short follow-ups or faded over time. This may be due to interventions having been delivered at the individual level without sufficient attention to social context, but individuals' self-perceptions of aging are likely influenced by the age-related beliefs and behaviors of people close to them. Objective: We aim to deliver a 12-week multicomponent intervention promoting positive self-perceptions of aging and physical activity to investigate (1) whether it promotes significant change in primary (i.e., self-perceptions of aging and physical activity) and secondary (i.e., self-directed and other-directed ageism, subjective views of couple's joint aging, perceived age-related changes in one's partner, anxiety and depressive symptoms, physical fitness, and executive function) intervention outcomes; (2) whether observed change in intervention outcomes is greater when the intervention is delivered to couples compared to when it is delivered to one partner alone; (3) the extent to which the effect of the intervention is extended from one partner who undertakes the intervention to the other partner who does not undertake it. Methods: We will adopt a three-arm randomized controlled trial (RCT) design with pre, immediate post-intervention, and three- and six-months follow-up assessments. The sample will be divided into three groups, each comprising 60 spouses, cohabiting partners, or long-standing partners aged ≥ 65 years. In the first group, partners will undertake together the intervention, comprising a psychoeducational and a behavioral component. In the second group, only one partner will undertake the same intervention. In the third/control group none of the partners will undertake the intervention during data collection. Self-perceptions of aging, physical activity, ageism, subjective views of couple's joint aging, perceived age-related changes in one's partner, and anxiety and depressive symptoms will be assessed via questionnaires whereas physical fitness, executive function, and attention will be objectively assessed in person. Conclusion: This project will provide evidence on whether targeting couples could enhance/facilitate promotion of positive self-perceptions of aging and physical activity in older age. Trial registration: ClinicalTrials.gov: NCT07113860. Release date: 03-07-2025. Protocol version 3: 1-3-2026.