The STEP 4Life Trial
Condition: Alzheimer Disease, At Risk; Alzheimer Disease, Protection Against; Dementia
MeSH terms: Alzheimer Disease
Study type: Interventional

Summary: 
      The objective of this study is to test the feasibility of using behavioral economic
      interventions (gamification with social incentives) targeting daily step counts to prevent or
      delay the development of Alzheimer's Disease and Related Dementias (ADRD).
    

Detailed description: 
      Increased physical activity by walking further or more vigorously may prevent or delay the
      development of Alzheimer's Disease and Related Dementias (ADRD) but reaching higher levels of
      activity and maintaining it as a long-term habit is difficult to do. This project will use
      concepts from behavioral science to create a game older adults can play in order to increase
      their levels of activity while having fun doing it. The game is played with a support partner
      who is a spouse, family member, or close friend who provides feedback and encouragement to
      help the game-player reach activity goals and maintain them as habits over time. Participants
      in the game will use their own smartphone and a wristwatch that tracks activity (such as a
      FitBit, provided by this study) to set goals, get feedback, and play the game for 12 weeks.
      Participants will be asked to continue wearing the wristwatch for another 6 weeks to track
      activity after the game is over. To determine the effectiveness of this game, investigators
      will randomly assign 50 people to the game and 50 people to only get the wristwatch but no
      game component. All participants in this study will be recruited from an online registry of
      adults age 55-75 who have not been diagnosed with Alzheimer's (GeneMatch) which offers
      genetic testing on risk for ADRD to all participants. Investigators will recruit participants
      who have elevated genetic risk as well as those without specific genetic risks for the study
      to see if either group responds differently to the game.
    

Intervention name(s): Gamification
Intervention type(s): Behavioral
Intervention description(s): Each participant signs a pre-commitment contract agreeing to try their best to achieve their daily step goal. Each week over the 12 week intervention period, participants are endowed 70 points (10/day). Participants are informed they will lose 10 points for each day the step goal is not met. Points are replenished at the start of the week. At the end of the week, if the participant has 40 points or more, he/she will advance one level, or drop one level if they have less than 40 points. The levels include: blue (lowest), bronze, silver, gold, platinum (highest). Each participant begins in the middle (silver). Each participant will also select a spouse, family member, or friend that they see often to serve as a supportive sponsor that receives a weekly email participants progress including points, game level, and average step countThis supportive sponsor will help to enhance social incentives to motivate the individual towards his or her goal.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This is a 2-arm, randomized, controlled trial over 12 weeks with 6 weeks of follow-up (18 weeks total) that compares a control group that uses a wearable device to track physical activity to an intervention group that uses the same wearable devices and receives a supportive social incentive-based gamification intervention to adhere to a step goal program.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: Alzheimers Disease; Gamification; Physical activity; Behavioral Science