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April 7, 2024
3 minute read
Important points:
- Gamification and financial incentives increased daily step counts in participants at high 10-year ASCVD risk.
- Gamified thinking and monetary rewards were especially effective when combined compared to daily text messages.
ATLANTA — In a behavioral economics study, researchers reported the benefits of gamification and financial incentives to increase daily step counts in patients at high risk for CVD.
Results from the BE ACTIVE randomized controlled trial, which enrolled participants who took fewer than 7,500 steps per day and were at high risk for 10-year atherosclerotic CVD, were presented at the American College of Cardiology Scientific Sessions and presented simultaneously . Circulation.
“The CDC currently recommends 150 minutes of moderate-to-vigorous physical activity per week, but we know that few people exercise that much, especially older adults, who are at highest risk for cardiovascular disease. ” alexander Fanarov,medical doctor, Perelman, an assistant professor of medicine at the University of Pennsylvania School of Medicine, said in a recent clinical trial presentation. “Short-term studies of both gamification and financial incentives increase physical activity, but it is unclear how long these events lasted or which approach is better.” That’s why we conducted the BE ACTIVE randomized controlled trial.”
alexander Fanarov
Fanaroff et al. evaluated strategies including behaviorally designed gamification, loss-aware financial incentives, and a combination of both to identify patients with high 10-year ASCVD risk or established vascular disease. compared those strategies with daily text messaging aimed at increasing physical activity in adults with disabilities.
The BE ACTIVE trial required participants to have a primary care physician at Penn Medicine. Own a smartphone or tablet that can transmit data from a researcher-provided wearable device (Fitbit). Baseline daily step count is less than 7,500.
Overall, 950 volunteers completed the 12-month intervention followed by a 6-month follow-up period (mean age 67 years, 25% Black).
The average baseline step count was 5,000 steps per day, and the goal was to increase by 1,500 steps.
The gamification included a point system in which participants lost points every time they took less than 7,500 steps. Participants received a daily text message with updated scores and a weekly email to a designated support partner of the participant’s choice.
During the 12-month intervention, gamification increased the number of steps per day by an average of 1,954 steps over the baseline average and 538 steps per day compared to the control. During a 6-month follow-up, gamification increased his daily step count by an average of 1,708 steps and increased his daily step count by 460 steps from baseline compared to controls.
The financial incentive intervention included adding $14 to participants’ virtual accounts each week. For each day he missed his goal of 7,500 steps, $2 was deducted.
During the intervention period, the financial incentive intervention increased the number of steps per day by an average of 1,915 steps over the baseline average and by 492 steps per day compared to the control. During the follow-up period, the financial incentive intervention increased step count by an average of 1,576 days and 328 steps per day from baseline compared to controls. Researchers also tested interventions that combined both gamification and financial incentives.
During the intervention period, the combination intervention increased the number of steps per day by an average of 2,297 steps over the baseline average and 868 steps per day compared to the control. During the follow-up period, the combined intervention increased step count by an average of 1,831 days and 576 steps per day from baseline compared to controls.
“In observational studies, there is an inverse association between steps per day and outcomes, mortality, and cardiovascular events. Based on the changes observed in this study, the number of steps per day increased from 5,000 steps per day to 1,700 steps per day. An increase in average step count should be associated with an increase in life expectancy of 1.2 years,” Fanarov said in his presentation. “We believe these highly scalable, automatically delivered interventions have the potential to increase physical activity over time and improve outcomes in patients at high risk for cardiovascular events.”
References:
Information source/disclosure information
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Fanarov A et al. Latest Clinical Trials II. Presented at: American College of Cardiology Scientific Sessions. April 6-8, 2024. Atlanta.
Disclosure: Mr. Fanaroff reports receiving consulting fees and honoraria from Abbott Laboratories, Anthos Therapeutics, Aleteia, and Intercept Pharmaceuticals, and research grants from Abbott and Prolocore.
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