Behavioral Economics and Mobility After Stroke (BE Mobile)

Study Overview
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Brief Summary
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In this pilot, randomized controlled trial, the investigators will compare the preliminary effectiveness of a gamification with social incentives 8 week intervention to increase physical activity for adults with stroke.

Detailed Description
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In this 2 arm randomized trial, the investigators will compare the preliminary effectiveness of a social incentive-based gamification intervention to increase physical activity relative to a control arm among adults with stroke. All participants will use a Fitbit wearable device to establish a baseline step count, select a step goal increase of 33% to 50% above their baseline and then participate in an 8 week intervention. The gamification arm 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.

Official Title
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Using Behavioral Economics to Improve Mobility for Adults With Stroke

Conditions
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Stroke

Intervention / Treatment
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* Behavioral: Gamification with social incentives


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of ischemic or hemorrhagic stroke (confirmed with ICD-10 or DRG code) at least 3 months prior to enrollment Ability to provide informed consent Life Space Assessment mobility level 3 Ability to ambulate outside of their home (self-reported) Owns a smartphone or tablet compatible with required applications for the wearable tracking device Sufficient cognitive ability to participate (5-minute Montreal Cognitive Assessment Score ≥ 11 points) Exclusion Criteria: Inability to provide informed consent, illiteracy or inability to speak, read, and write English Self-reported history of falls within the last 3 months Severe cognitive impairment (MoCA score ≤ 10 points) Medical condition that may limit participation in physical activity program (e.g. metastatic cancer, end-stage renal disease) Currently institutionalized in skilled nursing or long-term care facility Baseline step count > 7500/day Currently receiving physical therapy services

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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control arm<br>Participants will wear the Fitbit device and record their daily step counts during the baseline and 8 week intervention period. Participants will complete study surveys at baseline and the end of the 8 week intervention. | |
| Experimental: Gamification arm<br>Participants will wear the Fitbit device and record their daily step counts during the baseline and 8 week intervention period. Participants will have a weekly step goal they are encouraged to meet. Participants will engage in a social incentive-based gamification based on points and levels that leverages loss aversion, which has been demonstrated to motivate behavior change more effectively with losses than gains. Participants will receive daily feedback for the step counts and weekly feedback for levels. Participants will be asked to identify a support partner, who will receive weekly reports with the the participant's points and levels balance. | Behavioral: Gamification with social incentives<br>* Participants will select a step goal that is 33%, 40%, or 50% above their baseline step value. Participants in this group will participate in a game with points and levels to help motivate participants to meet their daily step goal. Additionally, all participants will identify a support partner to receive weekly updates on their performance and offer positive encouragement to help the participant meet their step goal.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily step counts | Change in mean daily steps from baseline | Intervention weeks 1-8 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily step counts | Proportion of days participants in the gamification arm met their daily step goal | Intervention weeks 1-8 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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physical activity, wearable, gamification