A Randomized Trial of Behaviorally Designed Gamification and Social Incentives to Increase Physical Activity Among Overweight and Obese Veterans

行为设计的游戏化和社会激励的随机试验，以增加超重和肥胖退伍军人的体力活动

• 批准号: 10626711
• 负责人: Scott Ryan Greysen
• 金额: --
• 依托单位: PHILADELPHIA VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10626711
• 关键词: Address; Award; Behavioral; Behavioral trial; Blood Pressure; Caring; Characteristics; Chronic; Clinical; Clinical Trials; Collaborations; Control Groups; Cost Analysis; Cost Effectiveness Analysis; Counseling; Data; Decision Making; Development; Diabetes Mellitus; Effectiveness; Elements; Enrollment; Family; Family member; Feedback; Future; General Population; Health; Health Benefit; Health Promotion; Health Status; Health behavior; Health system; Heart; Heterogeneity; Human; Human Resources; Hypertension; Incentives; Intervention; Interview; Investigation; Learning; Medical; Medical center; Mental Health; Methodology; Methods; Minority Groups; Monitor; Obesity; Outcome; Overweight; Persons; Philadelphia; Physical activity; Pilot Projects; Qualitative Evaluations; Quantitative Evaluations; Randomized; Randomized, Controlled Trials; Risk Reduction; Sampling; Sleep; Social Network; Subgroup; Techniques; Testing; Translational Research; US State; Underrepresented Minority; United States Department of Veterans Affairs; Use Effectiveness; Veterans; Veterans Health Administration; Videoconferencing; Visit; Weight; Wellness Program; Woman; Work; Workplace; adult obesity; arm; attentional control; behavioral economics; cardiovascular disorder risk; cohort; compare effectiveness; connected care; cost; cost effectiveness; demographics; design; digital; digital health; disorder prevention; effectiveness evaluation; ethnic minority; experience; follow-up; health application; high risk; implementation cost; implementation efforts; implementation facilitators; improved; innovation; insight; machine learning method; mobile computing; moderate-to-vigorous physical activity; mortality; participant interview; personalized approach; personalized intervention; process evaluation; programs; racial minority; randomized trial; randomized, clinical trials; recruit; remote monitoring; social; statistical and machine learning; technology platform; therapy design; treatment effect; wearable device

PROJECT SUMMARY/ABSTRACT Background: Gamification is the use of game design elements such as points and levels in non-game contexts. Gamification is used commonly within workplace wellness programs and digital health applications; however, its effectiveness has been limited. A significant opportunity is to incorporate principles from behavioral economics, which have been effective in informing intervention designs that achieve sustained improvements in health behavior by addressing the ‘predictable irrationality’ of humans. Our group has conducted two successful clinical trials using gamification and either collaboration or competition to increase physical activity in other settings. We have conducted three pilot studies with Veterans to tailor these approaches to their specific needs and experiences. Significance: Higher levels of regular physical activity are associated with reduced risk of cardiovascular disease, diabetes, hypertension, obesity, and mortality. Despite this, more than half of Veterans do not achieve enough physical activity to obtain these benefits. Innovation and Impact: This will be one of the first clinical trials to incorporate behavioral economic principles and social incentives within the design of gamification to increase physical activity among obese Veterans with hypertension. It will also be one of the first to directly examine the impact of these interventions on clinical outcomes associated with increased physical activity and examine cost-effectiveness To improve scalability and decrease burden on Veterans, the entire study will be conducted completed remotely including enrollment and interventions. Moreover, we will use state-of-the-art statistical and machine learning techniques to examine personalization of interventions. Specific Aims: Aim 1: To evaluate the effectiveness of gamification with collaboration or competition to increase physical activity . Aim 2: To evaluate the effectiveness of gamification to improve clinical outcomes. Aim 3: To conduct a qualitative process evaluation and implementation analysis to inform implementation efforts within VA. Aim 4: To conduct a quantitative evaluation of Veteran characteristics related to demographics, past experiences, social networks, and other factors to identify heterogeneity in treatment effects. Aim 5: To assess the cost-effectiveness of the gamification interventions. Methodology: Obese Veterans with hypertension will be enrolled into a three-arm randomized, controlled trial comprised of a 6-month intervention and a 3-month follow-up. Wearable devices will be used to passively monitor physical activity levels. Clinical outcomes will be captured by digital weight scales and blood pressure cuffs through video conferencing. Interventions will be deployed using Way to Health, a technology platform that we have demonstrated is feasible to use within the VA Health System. Outcomes will include physical activity in steps (primary), minutes of moderate-to-vigorous physical activity (secondary), changes in clinical outcomes of weight and systolic blood pressure (secondary), change in minutes of sleep (exploratory), and cost of implementation (exploratory). Next Steps/Implementation: Our implementation analysis, which includes cost-effectiveness analysis and qualitative interviews with Veterans and key VA stakeholders, will inform implementation of the program in VA. We have support from the following three operational partners to implement key learnings into existing VA programs: VA National Center for Health Promotion and Disease Prevention including MOVE!, VA Office of Connected Care, and the VA Chief Improvement and Analytics Officer.

项目总结/文摘