Intern Health Study 2021

Study Overview
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Brief Summary
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The aim of this study is to evaluate the efficacy of gamified competition (delivered through a smartphone) for improving the physical activity and sleep of medical interns.

Detailed Description
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Due to their high-stress workloads, medical interns tend to have lower sleep and decreased physical activity. The goal of this study is to evaluate the efficacy of gamified competition (delivered through a smartphone) for improving the physical activity and sleep of medical interns. During the study, they are teamed up by programs and institutions and compete with other teams, which aim to motivate them to have more physical activity and sleep duration during their internship year. The primary aim of this study is to investigate whether introducing competition mechanisms into mobile health (mHealth) interventions can improve a medical intern's activity-related behavioral outcomes: daily step counts and sleep duration. The first secondary aim is to assess the time-varying competition effect on their behavioral outcomes. The first exploratory aim is to assess the competition effect on study engagement and the second exploratory aim is to evaluate the competition effect on mental outcome, mood score.

Official Title
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Intern Health Study: 2021 Micro-Randomized Trial

Conditions
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Telemedicine

Intervention / Treatment
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* Behavioral: Intern Health Study competition-related mobile notification
* Behavioral: Intern Health Study mobile app
* Behavioral: Intern Health Study mobile app competition scoreboard and history


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Medical intern during the 2021-2022 internship year Enrolled in study by the start of internship (7/1/22) Exclusion Criteria: None
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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomization scheme
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Competition group<br>Programs with at least five interns were grouped into program-based teams. Interns within the same residency institution in programs that did not meet this criterion were grouped into institution-based teams, with a minimum of five participants per team. For each week, an eligible team is randomized to either a steps competition or non-competition group with 50/50 chance. For those randomized to competition arm, teams were assigned an opponent team by total randomization, by which the opponent team was assigned regardless of institution and specialty. | Behavioral: Intern Health Study competition-related mobile notification<br>* Participants will receive three types of push notifications: 1. Alert of competition type (steps or sleep) and opponent (Sunday 9pm), 2. Competition score status update (Wednesday 9pm, Saturday 11am), and 3. Competition final results (Monday 12pm).<br>Behavioral: Intern Health Study mobile app<br>* The Intern Health Study mobile app is able to conduct a daily mood survey. It also aggregates and visualizes historical data on intern mood, activity, and sleep.<br>Behavioral: Intern Health Study mobile app competition scoreboard and history<br>* Participant can view their current competition scoreboard and competition history at any time via the study app.<br>|
| Experimental: Non-competition group<br>For each week, an eligible team is randomized to either competition or non-competition group with 50/50 chance. | Behavioral: Intern Health Study mobile app<br>* The Intern Health Study mobile app is able to conduct a daily mood survey. It also aggregates and visualizes historical data on intern mood, activity, and sleep.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average daily step count | Participants' daily step counts are recorded through a Fitbit or an apple watch. High step counts are considered a positive outcome as it indicates more physical activity. For teams randomized into competition arm and randomized to compete on step count, their average daily step count is compared with the average step count of the opponent team. | Daily, throughout intern year (1 year) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average daily mood score | Through the study mobile app, participants enter a mood score (scale 1-10) every day of the study. 1 corresponds to lowest mood and 10 corresponds to highest mood. | Daily, throughout intern year (1 year) |