Incentivizing Lifestyle Modification to Reduce Disease Burden.

Intervention Group:

After successfully passing the screening criteria, name, address, contact information, body weight (in light outdoor clothes and without shoes), height (without shoes), body fat percentage, BMI, waist circumference, age, and sex will be noted. Only the questions about medical history that are pertinent to determining the eligibility (as described above), will be asked. There will be a two week lead-in time period during which grocery store receipts will be collected and the participants will wear a Fitbit Flex pedometer at all times. This is to track food purchasing and consumption patterns and a method of determining a baseline activity level, respectively. The participants will meet with the researcher at the beginning of this two week period in order to give the participants the Fitbit Flexes. These receipts will be collected at the end of the two week time period.

After this lead-in, the participants will begin their four week testing period. Body weight and body fat will be determined on day 0 by using a bioimpedance measurement scale. This is a scale like the bathroom scale on which a person stands and holds onto two handles connected to the base by cables, while the machine reads body weight and body fat content (by passing a mild electric current through the body, similar to an electrocardiogram). Body weight and fat content will be determined once per week, for 4 weeks. The last body weight and body fat measurements will be at the end of the 4 week walking period. The four week testing period will include meeting at an agreed upon community center location and time convenient for both the participant and the researcher. During these meetings, the participants will engage in indoor walking under the supervision of the researcher. This is to ensure accurate walking distance recording and also to monitor the participants for any potential adverse events. The participants will have the option of walking as long or short as they please, so long that it is less than 20 miles per week. This is to protect the participants from exhaustion or overexertion. This process will continue for four weeks. At the end of each week, grocery store receipts will be collected to reflect food purchasing and consumption. The Fitbit Flex will remain worn by the participants at all times in order to track activity changes, outside of the supervised walking. At the end of this four week testing period, the total number of miles will be calculated (maximum of 80 miles). For every mile walked, the participants will earn dollar points. The money earned by each participant will be split between their utility payments and healthy food at a local grocery store. The research team will provide a list of healthful foods to the participants. It will include healthful foods such as fruits (and 100% juices), vegetables (and 100% juices), non-fat or low fat dairy products, low-fat whole grain products (bread, bagels, breakfast cereals, muffins), and uncooked fish and chicken.

During week 1, nutrition information will be provided. This will consist of brief nutrition information sessions and a grocery store tour to assist with selection of foods available with program coupons. The tour will be aimed at helping the subjects identify healthier food choices and to suggest alternatives and options to high-fat and/or low nutrient-dense foods.

After this four week testing period, there will be a secondary four week follow-up period. This will be the same as the four week testing period, minus the supervised walking and earning of money based on miles walked. This follow-up period is purposed to record food purchasing and consumption patterns along with everyday activity after their intervention. The participants will remain wearing their Fitbit Flexes and turning in their grocery store receipts.