Abstract
Background: Social networks can influence individual health behaviors, but interventions that leverage social incentives within these networks to change health behaviors have not been well examined. The objective of this study was to test the effectiveness of a social incentive-based gamification intervention to increase physical activity in the community. Methods: The Behavioral Economics Framingham Incentive Trial (BE FIT) was a randomized clinical trial that recruited 206 adults comprising 97 groups of two or three family members in the Framingham Heart Study and occurred between December 2015 and August 2016. Participants used a wearable device or smartphone application to establish a baseline step count and selected a step goal increase for a 12-week primary intervention period and a 12-week follow-up period. Participants in both the control and intervention arms received daily feedback on their performance for 24 weeks. During the first 12 weeks, participants in the intervention arm played a game (including points, levels, and lifelines) with their family members that was designed using insights from behavioral economics to enhance social incentives such as peer support, accountability, and collaboration. The primary outcome was the mean proportion of participant-days the step goal was achieved during the primary intervention period. Secondary outcomes included the mean proportion of participant-days the step goal was achieved during the follow-up period and mean daily steps during the intervention and follow-up periods. Results: Participants in the intervention arm achieved step goals on a greater proportion of participant-days and had greater mean daily steps than the control arm during the intervention and follow-up periods (TABLE). Conclusions: Among groups of family members in a community, a social incentive-based gamification intervention was effective at increasing physical activity during the 12-week intervention period and effects were sustained during the 12-week follow-up period.
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