Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial
Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial
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DOI：
10.1016/s2213-8587(16)30284-4
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发表时间：
2016-12-01
影响因子：
44.5
通讯作者：
Evenson, Kelly R.
中科院分区：
文献类型：
--
作者：
Finkelstein, Eric A.;Haaland, Benjamin A.;Evenson, Kelly R.
尽管活动跟踪器越来越受欢迎，但几乎没有证据表明它们可以改善健康结果。我们的目的是调查是否使用活动跟踪器，单独或与现金奖励或慈善捐款相结合，导致增加体力活动和改善健康outcome.Methods在这个随机对照试验中，员工从13个组织在新加坡随机分配（1：1：1：1）与计算机生成的分配时间表控制（无跟踪器或激励），Fitbit Zip活动跟踪器，跟踪器加慈善激励，或跟踪器加现金激励。参与者必须是会说英语的全职员工，年龄在21-65岁之间，能够连续行走至少10步，并且没有怀孕。激励措施与每周的步数有关，主要结果是每周中等至剧烈的身体活动（MVPA），通过密封的加速计测量，并在6个月（干预结束）和12个月（干预后6个月随访期后）的意向治疗基础上进行评估。其他结果指标包括步数，参与者达到每周70000步的目标，以及健康相关的结果，包括体重，血压和生活质量指标。该试验在ClinicalTrials.gov上注册，编号为NCT 01855776。结果在2013年6月13日至2014年8月15日期间，招募了800名参与者，并随机分配到对照组（n=201），Fitbit组（n=203），慈善组（n=199）和现金组（n=197）。在6个月时，与对照组相比，现金组每周多记录了29次MVPA（95% CI 10-47; p=0.0024），慈善组每周额外21次MVPA（2-39; p=0.0310）;仅Fitbit和对照之间的差异不显著（每周16次MVPA回合[-2至35; p=0.0854]）。现金组和慈善组每周MVPA回合分钟数的增加并没有显著高于Fitbit组。在12个月时，与对照组相比，Fitbit组每周额外记录37次MVPA回合分钟（19-56; p=0.0001），慈善组每周额外记录32次MVPA回合分钟（12-51; p=0.0013）;现金和对照组之间的差异不显著（每周15次MVPA回合分钟[-5至34; p=0.1363]）。当将现金组与Fitbit组进行比较时，每周的体力活动减少了-23 MVPA回合分钟（95% CI -42至-4; p=0.0184）。有没有改善任何健康结果（体重，血压等）在either assessment.Interpretation的现金奖励是最有效的增加MVPA回合分钟每星期在6个月，但这种效果并没有持续6个月后，激励措施被中止。在12个月时，有或没有慈善激励的活动跟踪器有效地阻止了对照组中每周MVPA回合分钟的减少，但我们没有艾德任何证据表明健康结果有所改善，无论有或没有激励，都质疑这些设备对健康促进的价值。虽然其他激励策略可能会产生更大的增加步活动和改善健康结果，激励措施可能需要长期到位，以避免任何潜在的减少身体活动造成的中断。
Background Despite the increasing popularity of activity trackers, little evidence exists that they can improve health outcomes. We aimed to investigate whether use of activity trackers, alone or in combination with cash incentives or charitable donations, lead to increases in physical activity and improvements in health outcomes.Methods In this randomised controlled trial, employees from 13 organisations in Singapore were randomly assigned (1:1:1:1) with a computer generated assignment schedule to control (no tracker or incentives), Fitbit Zip activity tracker, tracker plus charity incentives, or tracker plus cash incentives. Participants had to be English speaking, full-time employees, aged 21-65 years, able to walk at least ten steps continuously, and non-pregnant. Incentives were tied to weekly steps, and the primary outcome, moderate-to-vigorous physical activity (MVPA) bout min per week, was measured via a sealed accelerometer and assessed on an intention-to-treat basis at 6 months (end of intervention) and 12 months (after a 6 month post-intervention follow-up period). Other outcome measures included steps, participants meeting 70 000 steps per week target, and health-related outcomes including weight, blood pressure, and quality-of-life measures. This trial is registered at ClinicalTrials.gov,number NCT01855776.Findings Between June 13, 2013, and Aug 15, 2014, 800 participants were recruited and randomly assigned to the control (n=201), Fitbit (n=203), charity (n=199), and cash (n=197) groups. At 6 months, compared with control, the cash group logged an additional 29 MVPA bout min per week (95% CI 10-47; p=0.0024) and the charity group an additional 21 MVPA bout min per week (2-39; p=0.0310); the difference between Fitbit only and control was not significant (16 MVPA bout min per week [-2 to 35; p=0.0854]). Increases in MVPA bout min per week in the cash and charity groups were not significantly greater than that of the Fitbit group. At 12 months, the Fitbit group logged an additional 37 MVPA bout min per week (19-56; p=0.0001) and the charity group an additional 32 MVPA bout min per week (12-51; p=0.0013) compared with control; the difference between cash and control was not significant (15 MVPA bout min per week [-5 to 34; p=0.1363]). A decrease in physical activity of -23 MVPA bout min per week (95% CI -42 to -4; p=0.0184) was seen when comparing the cash group with the Fitbit group. There were no improvements in any health outcomes (weight, blood pressure, etc) at either assessment.Interpretation The cash incentive was most effective at increasing MVPA bout min per week at 6 months, but this effect was not sustained 6 months after the incentives were discontinued. At 12 months, the activity tracker with or without charity incentives were effective at stemming the reduction in MVPA bout min per week seen in the control group, but we identifi ed no evidence of improvements in health outcomes, either with or without incentives, calling into question the value of these devices for health promotion. Although other incentive strategies might generate greater increases in step activity and improvements in health outcomes, incentives would probably need to be in place long term to avoid any potential decrease in physical activity resulting from discontinuation.