Abstract
Lower Conscientiousness is associated with cognitive decline, unemployment, and poorer health outcomes in both neurological and aging populations. This study evaluated a smartphone-based intervention to enhance Conscientiousness in people with multiple sclerosis (PwMS) and healthy aging (HA) adults. Initially, 38 PwMS and 22 HA participants completed baseline assessments (cognitive, personality, depression, and anxiety measures). Attrition and disease factors left 24 PwMS and 20 HA adults at the 12-week follow-up. Participants randomly assigned to the intervention arm received the "Conscientiousness Coach" app, which combined value identification, SMART goal development, smartphone-based tracking, and scheduled telehealth coaching sessions, whereas controls were wait-listed. ANCOVA for baseline scores showed a significant treatment effect on NEO-FFI Conscientiousness (p = 0.015) that remained after substituting age for diagnosis (p = 0.029). A lack of significant effects for group (PwMS vs. HA) and age indicated that treatment impact was consistent across both samples. Within the intervention group, paired-sample t-tests revealed large gains in the Conscientiousness domain (d = 0.93, p < 0.001) and moderate improvements in the Orderliness (d = 0.67, p = 0.007) and Dependability (d = 0.52, p = 0.030) facets, with no change in wait-list controls. No treatment effects emerged for Neuroticism, depression, or anxiety, underscoring the trait-specific nature of the intervention. Results suggest that targeted digital interventions can favorably impact personality and enhance quality of life. Future study will examine use of AI to replace the behavioral coaching component of this intervention and its long-term impact on personality.