Using Behavioral Economics to Improve Mobility for Adults With Stroke
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Pennsylvania
- Enrollment
- 34
- Locations
- 1
- Primary Endpoint
- Daily step counts
Study Overview
Brief Summary
In this pilot, randomized controlled trial, the investigators will compare the preliminary effectiveness of a gamification with social incentives 8 week intervention to increase physical activity for adults with stroke.
Detailed Description
In this 2 arm randomized trial, the investigators will compare the preliminary effectiveness of a social incentive-based gamification intervention to increase physical activity relative to a control arm among adults with stroke. All participants will use a Fitbit wearable device to establish a baseline step count, select a step goal increase of 33% to 50% above their baseline and then participate in an 8 week intervention. The gamification arm will be entered into a game with points and levels designed using insights from behavioral economics. They will be asked to select a social support partner who will receive weekly updates on their progress in the game.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- Double (Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •History of ischemic or hemorrhagic stroke (confirmed with ICD-10 or DRG code) at least 3 months prior to enrollment
- •Ability to provide informed consent
- •Life Space Assessment mobility level 3
- •Ability to ambulate outside of their home (self-reported)
- •Owns a smartphone or tablet compatible with required applications for the wearable tracking device
- •Sufficient cognitive ability to participate (5-minute Montreal Cognitive Assessment Score ≥ 11 points)
Exclusion Criteria
- •Inability to provide informed consent, illiteracy or inability to speak, read, and write English
- •Self-reported history of falls within the last 3 months
- •Severe cognitive impairment (MoCA score ≤ 10 points)
- •Medical condition that may limit participation in physical activity program (e.g. metastatic cancer, end-stage renal disease)
- •Currently institutionalized in skilled nursing or long-term care facility
- •Baseline step count > 7500/day
- •Currently receiving physical therapy services
Arms & Interventions
Control arm
Participants will wear the Fitbit device and record their daily step counts during the baseline and 8 week intervention period. Participants will complete study surveys at baseline and the end of the 8 week intervention.
Gamification arm
Participants will wear the Fitbit device and record their daily step counts during the baseline and 8 week intervention period. Participants will have a weekly step goal they are encouraged to meet. Participants will engage in a social incentive-based gamification based on points and levels that leverages loss aversion, which has been demonstrated to motivate behavior change more effectively with losses than gains. Participants will receive daily feedback for the step counts and weekly feedback for levels. Participants will be asked to identify a support partner, who will receive weekly reports with the the participant's points and levels balance.
Intervention: Gamification with social incentives (Behavioral)
Outcomes
Primary Outcomes
Daily step counts
Time Frame: Intervention weeks 1-8
Change in mean daily steps from baseline
Secondary Outcomes
- Daily step counts(Intervention weeks 1-8)