Increasing Steps Per Day in Rural Veterans
Condition: Obesity; Overweight
MeSH terms: Overweight
Study type: Interventional

Summary: 
      VA MapTrek is a mobile-phone-based web application that allows participants to take a virtual
      walk in interesting locations around the world while tracking their progress against the
      progress of other veterans on an interactive map. Steps are counted using a
      commercially-available triaxial accelerometer (e.g., Fitbit), and users see their progress
      overlaid on Google Maps. The objective of this study is to report activity levels to
      veterans, thereby encouraging them to walk more. Once participants know how to text and use
      Google maps, no additional training is needed. VA MapTrek does not require a special app, so
      there are no logins or passwords to remember. Simply registering one's Fitbit and mobile
      phone at an initial enrollment meeting suffices.
    

Detailed description: 
      All consented participants will be provided with a Fitbit and instructed to wear it all day,
      every day for the next 9 weeks (The first few participants may require an additional week or
      two of wear as we will not begin the first MapTrek race until we have at least 5 participants
      enrolled in the study. They will be told this upon enrollment.). The enrollment process is
      expected to take anywhere from 15 to 45 minutes, depending on group assignment and
      participant familiarity with using Fitbits.

      This, plus an exit survey (given via text message or phone, whichever the participant
      prefers), will be the extent of participation for the control group.

      Members of the intervention group will be instructed on how to use MapTrek, the virtual
      walking race, and will also be given an instruction packet to refer to later. Data collected
      during the first week from the Fitbit will be used to compute baseline activity level. This
      baseline data will be used to place participants into an appropriate initial race group.
      Participants are placed into groups with other individuals who are active at a similar level,
      so that groups will be competitive.

      Each virtual walking race will begin on Monday morning and end on Saturday night. Results of
      each race will be announced on Sundays. Depending on their performance each week, group
      assignment may change. Participants will compete in 8 week-long races over the course of the
      study.

      Participants will receive 2-4 text messages per day including a daily status report and a
      link to view the race. They will also periodically receive challenge messages. If a
      participant completes a challenge, they will be awarded bonus steps to help move them along
      the route quicker.

      To win a race, a participant must be furthest along on the route at 11:59 pm on Saturday.
      There is a leaderboard within MapTrek that helps participants determine their standing within
      each race. Participants are allowed to choose the screen name displayed on the leaderboard so
      that they may remain anonymous if desired.

      At baseline, the following data will be collected about all participants: first and last
      name, last 4 of social security number (for consent documentation and to look up records in
      CPRS), age, sex, race, ethnicity, marital status, height, weight, body mass index, blood
      pressure, zip code, current medications, and comorbidities.

      At the end of the study (9 weeks), the following data will be collected about all
      participants: height, weight, body mass index, blood pressure, current medications, and
      comorbidities.

      At the end of the study (9 weeks), participants will be contacted via text message or phone
      call (based on their preference at baseline) to complete an exit survey. This survey will
      take approximately 10 minutes to complete. All participants will be contacted up to 3 times
      to complete the exit survey. If they cannot be reached, they will be considered lost to
      follow up.
    

Intervention name(s): VA MapTrek; Fitbit Only
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The objective is to report activity levels in our virtual environment to Veterans, thereby encouraging them to walk more.; Fitbit Only
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Veterans