Behavioral Economic Approaches to Increase Physical Activity among Patients with Elevated Risk for Cardiovascular Disease

增加心血管疾病风险高患者体力活动的行为经济学方法

• 批准号: 10013284
• 负责人: Mitesh S. Patel
• 金额: $ 105.48万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10013284
• 关键词: Achievement; Address; Adult; Atherosclerosis; Behavior; Body Weight decreased; Cardiovascular system; Clinical Trials; Computer software; Control Groups; Data; Diabetes Mellitus; Effectiveness; Elements; Employee; Event; Family; Feedback; Funding; Goals; Head; Health; Health Benefit; Health Insurance; Health behavior; Heterogeneity; Human; Hypertension; Incentives; Individual; Intervention; Investigation; Measures; Monitor; Morbidity - disease rate; Myocardial Ischemia; Obesity; Participant; Patients; Performance; Physical activity; Randomized; Randomized Controlled Trials; Regrets; Research; Risk; Risk Assessment; Series; Technology; Testing; United States; United States National Institutes of Health; Use Effectiveness; Work; arm; atherosclerosis risk; base; behavior change; behavioral economics; cardiovascular disorder risk; cardiovascular risk factor; cohort; comparative cost effectiveness; compare effectiveness; comparison intervention; copayment; cost effective; design; digital; effectiveness evaluation; financial incentive; follow-up; handheld mobile device; improved; incentive program; innovation; insight; interest; intervention effect; medication compliance; moderate-to-vigorous physical activity; mortality; primary outcome; research study; secondary outcome; smoking cessation; theories; therapy design; treatment arm; wearable device

PROJECT SUMMARY/ABSTRACT Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in the United States (US). Regular physical activity has been demonstrated to reduce the risk of ASCVD and is associated with a number of other health benefits. Yet, less than 50% of adults in the US achieve enough physical activity to actually obtain these benefits. This level of inactivity in the US has been mostly unchanged for the past decade; innovative and scalable approaches that achieve sustained increases in physical activity are needed. Insights from behavioral economics have been shown to both better reflect the `predictable irrationality' of humans and to be effective in designing interventions that achieve sustained improvements in health behavior. Our prior work has demonstrated that interventions using financial incentives and gamification can leverage principles from behavioral economics to increase physical activity during 3-month interventions and sustain effects in 3-month follow-up periods. These findings warrant further investigation of longer-term effects. In this study, we propose to conduct a four-arm randomized, controlled trial with a 12-month intervention and then a 6- month follow-up period to address the following aims: Aim 1: To evaluate the effectiveness of gamification, financial incentives, or both approaches combined on increasing physical activity relative to control during a 12-month intervention among individuals at elevated risk for atherosclerotic cardiovascular events. Aim 2: To evaluate the sustainability of the three interventions (gamification, financial incentives, or both combined) in increasing physical activity during a 6-month follow-up period. Aim 3: To compare the cost-effectiveness of using each of the intervention approaches relative to control in increasing physical activity. We will test a scalable intervention by using wearable devices to monitor physical activity levels and an automated research technology platform to deliver interventions remotely.

项目概要/摘要 动脉粥样硬化性心血管疾病 (ASCVD) 是美国 (US) 发病和死亡的主要原因。 规律的体力活动已被证明可以降低 ASCVD 的风险，并且与许多其他疾病相关 健康益处。然而，只有不到 50% 的美国成年人进行了足够的体力活动来真正获得这些益处。 美国的这种不活跃程度在过去十年中基本没有变化；创新且可扩展的方法 需要持续增加体力活动。 行为经济学的见解已被证明可以更好地反映人类的“可预测的非理性” 有效设计可实现健康行为持续改善的干预措施。我们之前的工作有 证明使用经济激励和游戏化的干预措施可以利用行为原则 在 3 个月的干预期间增加体力活动并在 3 个月的随访期间维持效果。 这些发现值得进一步研究长期影响。 在这项研究中，我们建议进行一项四臂随机对照试验，先进行 12 个月的干预，然后进行 6 个月的干预。 一个月的后续期，以实现以下目标： 目标 1：评估游戏化、财务 在 12 个月的干预期间，采取激励措施或两种方法相结合，增加相对于控制的体力活动 动脉粥样硬化性心血管事件风险较高的个体。目标 2：评估项目的可持续性 在 6 个月内增加体力活动的三种干预措施（游戏化、经济激励或两者结合） 随访期。目标 3：比较使用每种干预方法的成本效益 控制增加体力活动。我们将通过使用可穿戴设备来监测身体状况来测试可扩展的干预措施 活动水平和自动化研究技术平台，以远程提供干预措施。