Effect of Gamification With and Without Financial Incentives to Increase Physical Activity Among Veterans Classified as Having Obesity or Overweight
| Autor: | Kimberly J. Waddell, Ai Leen Oon, Chalanda N. Evans, Mitesh S. Patel, Anish K. Agarwal, Rachel Djaraher, Tory O. Harrington, Dylan S. Small |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Psychological intervention Overweight Body Mass Index law.invention Social support Randomized controlled trial law medicine Humans Obesity Exercise health care economics and organizations Aged Veterans Original Investigation Philadelphia Motivation business.industry Research Nutrition Obesity and Exercise Social Support General Medicine Middle Aged medicine.disease Gamification humanities Online Only Health promotion Incentive Physical therapy Female medicine.symptom business Body mass index |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question What is the effect of gamification with social support and loss-framed financial incentives on the promotion of physical activity among veterans with overweight and obesity? Findings In this randomized clinical trial of 180 veterans with overweight and obesity, gamification with social support and loss-framed financial incentives modestly increased physical activity during the 12-week intervention period, but the effect was not sustained during an 8-week follow-up period. Meaning These findings suggest that gamification with social support, when combined with loss-framed financial incentives, can modestly increase physical activity among veterans with obesity and overweight, but future investigations should be conducted with a more representative sample of veterans and may need to be combined with other approaches to increase and sustain changes in physical activity. This randomized clinical trial examines the effectiveness of gamification with social support, with and without a loss-framed financial incentive, to increase physical activity among veterans with overweight and obesity. Importance Gamification is increasingly being used for health promotion but has not been well tested with financial incentives or among veterans. Objective To test the effectiveness of gamification with social support, with and without a loss-framed financial incentive, to increase physical activity among veterans classified as having overweight and obesity. Design, Setting, and Participants This 3-group randomized clinical trial had a 12-week intervention period and an 8-week follow-up period. Participants included veterans with a body mass index greater than or equal to 25 who were receiving care from a single site in Philadelphia, Pennsylvania. Participants underwent a remotely monitored intervention from March 19, 2019, to August 9, 2020. Data analyses were conducted between October 1, 2020, and November 14, 2020. Interventions All participants received a wearable device to track step counts and selected a step goal. The control group received feedback from their devices only. Participants in the 2 gamification groups were entered into a 12-week game with points and levels designed using behavioral economic principles and selected a support partner to receive weekly updates. Participants in the loss-framed financial incentive group had $120 allocated to a virtual account and lost $10 if weekly goals were not achieved. Main Outcomes and Measures The primary outcome was the change in mean daily steps from baseline during the intervention. Secondary outcomes include proportion of days goals were achieved and changes during follow-up. Results A total of 180 participants were randomized, 60 to the gamification with social support group, 60 to the gamification with social support and loss-framed financial incentives group, and 60 to the control group. The participants had a mean (SD) age of 56.5 (12.9) years and a mean (SD) body mass index of 33.0 (5.6); 71 participants (39.4%) were women, 90 (50.0%) were White, and 67 (37.2%) were Black. During the intervention period, compared with control group participants, participants in the gamification with financial incentives group had a significant increase in mean daily steps from baseline (adjusted difference, 1224 steps; 95% CI, 451 to 1996 steps; P = .005), but participants in the gamification without financial incentives group did not (adjusted difference, 433 steps; 95% CI, −337 to 1203 steps; P = .81). The increase for the gamification with financial incentives group was not sustained during the follow-up period, and the step count was not significantly different than that of the control group (adjusted difference, 564 steps; 95% CI, −261 to 1389 steps; P = .37). Compared with the control group, participants in the intervention groups had a significantly higher adjusted proportion of days meeting their step goal during the main intervention and follow-up period (gamification with social support group, adjusted difference from control, 0.21 participant-day; 95% CI, 0.18-0.24 participant-day; P |
| Databáze: | OpenAIRE |
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