Social and Financial Incentives to Increase Physical Activity Among Overweight and Obese Veterans

Study Overview
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Brief Summary
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In this randomized, controlled trial the investigators will compare the use of social and financial incentive-based interventions to increase physical activity among overweight and obese Veterans during a 12-week intervention with 8 weeks of follow-up.

Detailed Description
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In this 3-arm randomized trial, the investigators will compare the effectiveness of a social incentive-based gamification intervention with and without loss-framed financial incentives to increase physical activity relative to a control among overweight and obese adults Veterans. All Veterans will use a Fitbit wearable device to establish a baseline step count, select a step goal increase of 33% to 50% above baseline and then participate in a 12-week intervention and 8-week follow-up period. The two intervention arms will be entered into a game with points and levels designed using insights from behavioral economics. They will be asked to select a social support partner who will receive weekly updates on their progress in the game. Veterans in one arm will also receive loss-framed financial incentives allocated to an account each week during the intervention and financial incentives taken away each day the step goal was not achieved.

Official Title
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Evaluating Connected Health Approaches to Improving the Health of Veterans (CDA 15-065)

Conditions
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Physical Activity

Intervention / Treatment
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* Behavioral: Social Incentive Gamification
* Behavioral: Support Sponsor
* Behavioral: Financial Incentive


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Veterans Body mass index of 25 or greater Access to smartphone or tablet to sync wearable device data Interest in participating in a 20-week physical activity program Exclusion Criteria: Already participating in a physical activity research study Unable to provide informed consent Unsafe or infeasible to participate No access to smartphone or table to sync wearable device data

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Parallel 3-arm randomized, controlled trial
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>This arm serves as control and uses a wearable device to track daily step counts | |
| Experimental: Social Incentive Gamification<br>This arm uses a wearable device to track daily step counts, is entered into social incentive gamification, and selects a support sponsor | Behavioral: Social Incentive Gamification<br>* Game-based intervention with points and levels<br>Behavioral: Support Sponsor<br>* Participants select a support sponsor to receive weekly updates on progress in the game<br>|
| Experimental: Social Incentive Gamification and Financial Incentive<br>This arm uses a wearable device to track daily step counts, is entered into social incentive gamification, selects a support sponsor, and receives a financial incentive | Behavioral: Social Incentive Gamification<br>* Game-based intervention with points and levels<br>Behavioral: Support Sponsor<br>* Participants select a support sponsor to receive weekly updates on progress in the game<br>Behavioral: Financial Incentive<br>* Participants receive a loss-framed financial incentive allocated upfront each week and financial incentives taken away each day the goal is not met<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Mean Daily Steps From Baseline Relative to Control | Daily steps counts | Intervention period of weeks 5 to 12 which excludes the 4-week ramp-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Mean Daily Steps From Baseline Relative to Control | Daily step counts | Follow-up period of weeks 13 to 20 | 
| Proportion of Participant-days Step Counts Were Achieved Relative to Control | Proportion of days for a participants that their step goal target was achieved | Intervention period of weeks 5 to 12 which excludes the 4-week ramp-up | 
| Proportion of Participant-days Step Counts Were Achieved | Proportion of days for a participants that their step goal target was achieved | Follow-up period of weeks 13 to 20 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Physical activity, Incentive, Wearable device, Gamification