Micro-randomized trial within a 6-month randomized trial · 2026
Impact of Push Notifications on Physical Activity and Sodium Intake Among Patients with Hypertension: Microrandomized Trial of a Just-in-Time Adaptive Intervention
Golbus JR, Dorsch MP, Chen Y, Basu T, Luff E, Klasnja P, Newman MW, Skolarus LE, Dempsey W, Nallamothu BK
What it found
Tailored notifications about activity and salt were randomized at four times a day for six months, about one a day per person. They did not raise steps in the next hour or lower-salt food choices in the next day. They did make people use the app more.
Where the evidence stops
A secondary analysis; the engagement results were exploratory. An older clinical group, so it transfers poorly to healthy adults with work goals.
How it shapes Pursue
A large, careful trial where notifications moved app use but not the behaviour. Pursue measures 'did you take the step?', never 'did you open the app?'
A design input, not evidence that Pursue works.
Cited in
- 01Do reminder apps change what people do, or just how often they open the app?Often only the second. In a six-month University of Michigan trial with 287 adults with high blood pressure (Golbus et al., 2026), notifications made people use the app more but did not raise steps in the next hour or improve food choices the next day. Opening an app is engagement, not benefit.Engagement is not benefit
- 02Is there an app that notices when my day is slipping and suggests one next step?Tre-Up, an iOS app in development, is being built for exactly that, and it is not released yet: its AI, Pursue, is designed to notice when your focus or energy shifts and to answer with one small next step, one question, or nothing. Until it ships, your phone's focus modes and scheduled notification summaries cover part of the job.Timing and receptivity