Promoting Contextually Cued PA Habits

Study Overview
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Brief Summary
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The primary goal of this two-month pilot study is to measure the behavioral change induced by targeted habit formation reminders that are surfaced via an iPhone app and financial incentives that were offered conditional on using a personalized contextual cue for a daily walking habit. The data and user feedback collected during this study will also be used to optimize the design and content of the iPhone app, which will be tested in future, larger scale experimental research.

Detailed Description
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Subjects for this research are recruited on campus at Rensselaer Polytechnic Institute and the State University of New York at Albany, and their participation was incentivized. After meeting the eligibility criterion (including have at least some intrinsic motivation for increasing physical activity), downloading the project's iPhone app, and signing the project consent form, all participants will have their step count data recorded for an 8-week study period. Existing interventions that have successfully improved study participants' health-related behaviors typically find that behavioral changes do not persist beyond 3 months after the intervention period. Fortunately, novel habit formation interventions from the psychology literature offer the potential for building long-term behavioral change and avoiding the common relapse triangles observed in these existing behavioral interventions. These new methods are based on the theory that habits are formed through the repetition of the same behavior in response to a stable, environmental cue. After an initial period of repetition, automaticity is formed, and the behavioral response becomes more effortlessly/unconsciously induced by the environmental cue. Behavioral reminders that reinforce a specific behavioral routine-environmental cue pair have been shown to support this initial period of habit formation; however, given the individualized nature of these reminders, a generalizable intervention method has not been developed and empirically tested. This research will use an iPhone app to examine the role of both general informational on contextually cued habits and the use of personalized reminders and financial incentives for using a daily physical activity contextual cue on the persistence of physical activity behavior after the intervention tools are withdrawn.

Official Title
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Promoting Contextually Cued Physical Activity Habits: A Pilot Study Using Cue-Contingent Financial Incentives for Daily Walking

Conditions
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Exercise

Intervention / Treatment
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* Behavioral: Non-cue-contingent weekly incentives
* Behavioral: Cue-contingent weekly incentives
* Behavioral: Habit Coaching
* Behavioral: App use instructions


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18+ years of age Have an existing wellness goal related to increasing physical activity Access to an iPhone with iOS 10 or above (in order to use the app) Proficiency in speaking and reading English Exclusion Criteria: Have a major visual impairment Pregnancy Expected surgery A chronic or acute health condition that affects their ability to perform basic mobility tasks or light-aerobic exercise (e.g. heart disease, injured or missing limb, etc.)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control Group<br>One fourth of participants were assigned to the Control Group, and received a basic training with the StepUp app and were asked to contact the study team with any problems or questions they encountered during the eight-week study period. No other intervention tools or app reminders were provided to the Control Group. | Behavioral: App use instructions<br>* Received a basic training with the StepUp app<br>|
| Experimental: Treatment Group 1<br>Additionally eligible to receive weekly $5 Amazon gift cards over the first four weeks of the study for performing a ≥10-minute walk (i.e. non-cue-contingent incentives) | Behavioral: Non-cue-contingent weekly incentives<br>* Eligible to win $5 Amazon gift card conditional on completing a daily ≥10-minute walk at any time of day<br>Behavioral: App use instructions<br>* Received a basic training with the StepUp app<br>|
| Experimental: Treatment Group 2<br>Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit, then they were similarly eligible weekly for $5 Amazon gift cards over the first four weeks conditional on completing a ≥10-minute walk at any time of day (i.e. non-cue-contingent incentives) | Behavioral: Non-cue-contingent weekly incentives<br>* Eligible to win $5 Amazon gift card conditional on completing a daily ≥10-minute walk at any time of day<br>Behavioral: Habit Coaching<br>* Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit<br>Behavioral: App use instructions<br>* Received a basic training with the StepUp app<br>|
| Experimental: Treatment Group 3<br>Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit, then they were eligible weekly for $5 Amazon gift cards over the first four weeks conditional on completing a ≥10-minute walk at any the pre-specified time of their chosen contextual cue (i.e. cue-contingent incentives) | Behavioral: Cue-contingent weekly incentives<br>* Eligible to win $5 Amazon gift card conditional on completing a daily ≥10-minute walk within a +/-1 hour window of the pre-specified time of their chosen contextual walking cue<br>Behavioral: Habit Coaching<br>* Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit<br>Behavioral: App use instructions<br>* Received a basic training with the StepUp app<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily Step Count | Full study period analyses | 8 weeks | 
| Daily Step Count | Follow-up period | 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Habitual daily walking | Whether walking occurred within +/- 1 hour of contextual cue; full study period | 8 weeks | 
| Habitual daily walking | Whether walking occurred within +/- 1 hour of contextual cue; follow-up period | 4 weeks | 
| 10,000 daily step | Likelihood of reaching 10,000 daily steps, follow-up period | 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Physical activity, Financial incentives, mHealth