Self-monitoring Activity: a Randomized Trial of Game-oriented Applications
Condition: Breast Cancer; Obesity
Study type: Interventional

Summary: 
      The purpose of this study is to compare an enhanced intervention that includes narrative and
      game components to a standard intervention that only targets self-monitoring. These
      approaches will be tested among postmenopausal breast cancer survivors who are sedentary and
      overweight.
    

Detailed description: 
      Habitual physical activity decreases risk of multiple negative health outcomes, including
      breast cancer recurrence and mortality. It is also associated with better quality of life and
      reducing negative effects of cancer and cancer treatment. However, most breast cancer
      survivors do not engage in sufficient physical activity. Behavior change interventions
      produce short-term increases in activity but have difficulty motivating sustained active
      lifestyles over longer periods and are not equally effective in women of different
      races/ethnicities. The purpose of this study is to test a novel intervention that uses video
      games and storytelling to increase motivation. Video game mechanics increase enjoyment and
      feelings of autonomy (control), competence, and relatedness to others. All of these feelings
      are associated with motivation for activity and, in turn, sustained activity over time.
      Additionally, narrative storytelling is an effective method of persuading individuals to
      change their behavior. We propose that play of active video games that include compelling
      storylines will increase physical activity among a diverse sample of postmenopausal breast
      cancer survivors.

      To test this hypothesis, we will conduct a clinical trial that compares the enhanced
      intervention (story-based video games) to a standard intervention in 90 sedentary, overweight
      postmenopausal breast cancer survivors. Participants in the enhanced group will receive a
      mobile device and accessories with two story-based video game applications installed. The
      games incorporate behavior change strategies such as self-monitoring and feedback while also
      using game mechanics and a lengthy storyline to motivate physical activity. Participants in
      the standard group will receive the same mobile device with an electronic activity monitor
      and its companion feedback application. Both groups will receive brief weekly telephone
      counseling. By comparing two groups that both receive typical behavior change intervention
      components (counseling) and a novel electronic intervention, we will be able to investigate
      the specific effects of game mechanics and storytelling on motivation and physical activity.
      We will measure changes in physical activity, fitness, function, and quality of life from the
      beginning of the study to 6 months. We will also investigate further changes during an
      additional 6 month follow-up period in which participants keep their intervention tools but
      do not receive any counseling, to measure maintenance of activity. This project will develop
      and test a promising, innovative intervention that has the potential to be used on a
      widespread basis in clinical and community settings.
    

Intervention name(s): Game intervention; Standard intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The game will target motivation via narrative and game mechanics. It will also encourage self-regulation by providing monitoring and feedback of activity. Counseling will be adapted to specifically reference concepts related to narrative and games.; The electronic activity monitor will monitor steps, and the mobile device will provide basic feedback on progress toward goals. Counseling will be standard and concentrate on self-regulatory skill-building.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: video game; narrative; story; survivorship; cancer survivor; mhealth; physical activity; women; women's health