A Hybrid Type 1 Effectiveness-Implementation Study of Social Incentives Strategies to Increase Physical Activity

项目摘要 更高水平的身体活动已被发现可以改善健康，减少认知能力下降， 成年人变老，但在美国超过一半的成年人没有达到他们的活动目标。 有规律的身体活动与许多健康益处有关，其中一种身体活动是 广泛适用于所有年龄段的人的是步行。增加步行的计划在广泛的范围内都是可行的， 安全，不需要特殊的培训或专门的设备。步行也是可测量的， 与健康改善相关的可识别的个人目标。 本研究将使用混合型1有效性实施设计来适应和测试 有效性，两个成功的社会激励为基础的干预措施，以增加身体活动。社会 基于激励的干预措施可以利用和加强个人的社会网络，以增加身体健康。 活动，并且可以比财务激励更可持续和可扩展。这两个干预措施是一个 游戏化战略和代表参与者向慈善机构捐赠的经济激励。在最初的 社区参与调整两项经验证的社会激励干预战略的阶段， 将对225个家庭进行三组、整群随机试验，以评估这两种社会激励措施 在社区的干预。研究的目的包括： 1.调整我们先前的工作，以改善社区干预措施的实施， 包括至少一名老年人的家庭。 2.评估两种社会激励干预措施在家庭中增加身体健康的有效性， 相对于控制家庭。 3.进行一次强有力的进程评价，提供关于执行进程的信息。 4.从社会角度评估每种干预措施的成本，并比较成本 每种干预措施和对照措施之间相对于有效性的差异， 体力活动的增加。 5.利用成效试验、过程评价和成本分析的结果（目标2、3和4）， 扩大和传播供地方和国家社区组织使用的工具和产品。 这项研究的重点是可扩展的方法，以解决身体活动的健康差距， 与低收入和少数民族社区的社区组织合作，利用行为经济学， 部署低成本的社会激励措施，并应用实施科学框架， 干预研究综合框架（CFIR），以改善采用和传播。一个 有效性实施研究设计将最大限度地促进科学，公共卫生实践， 减少健康差距。

PROJECT SUMMARY Higher levels of physical activity have been found to improve health and to reduce cognitive decline as adults become older, but more than half of all adults in the United States do not meet their activity goals. Regular physical activity is associated with numerous health benefits and one type of physical activity that is broadly applicable to people of all ages is walking. Programs to increase walking are both broadly feasible and safe, and do not require unique training or specialized equipment. Walking is also measurable, with clearly identifiable individual targets that are associated with health improvements. This study will use a Hybrid Type 1 effectiveness-implementation design to adapt, and test the effectiveness of, two successful social incentive-based interventions to increase physical activity. Social incentive-based interventions can harness and enhance an individual's social network to increase physical activity, and can be more sustainable and scalable than financial incentives. The two interventions are a gamification strategy and financial incentives donated to charity on the participant's behalf. Following an initial phase of community-participatory adaptation of the two proven social-incentive intervention strategies, a three-arm, cluster-randomized trial of 225 families will be conducted to evaluate the two social incentive interventions in the community. The study aims include: 1. To adapt our prior work to improve the implementation of interventions in the community among families that include at least one older adult. 2. To evaluate the effectiveness of two social-incentive interventions among families to increase physical activity relative to control families. 3. To conduct a robust process evaluation that will provide information on the implementation process. 4. To assess the cost of each of the interventions from a societal perspective and compare cost differences between each intervention and control relative to the effectiveness measured by incremental increases in physical activity. 5. To use findings from the effectiveness trial, process evaluation and cost analysis (Aims 2, 3 and 4) to scale-up and disseminate tools and products for use by community organizations locally and nationally. This study focuses on scalable approaches to address health disparities in physical activity by partnering with community organizations in low-income and minority neighborhoods, using behavioral economics to deploy low-cost social incentive interventions, and applying implementation science frameworks from the Consolidated Framework for Intervention Research (CFIR) to improve adoption and dissemination. An effectiveness-implementation study design will maximize contributions to science, public health practice, and reduction of health disparities.