Acceptability of a Walking Intervention Among Inactive Adults Using a Smartphone-Based Gaming Application

Abstract

Routine physical activity and maintenance of a normal body mass are critical for cardiovascular health. However, most adults do not meet the ACSM recommendations for physical activity. Previous research has shown that adding video games to traditional exercise programs may increase adherence. In recent years, smartphones allow much of the population to utilize games while engaging in exercise, particularly walking, and have a great potential for public health impact. PURPOSE: This study tested the acceptability of a 12-week walking intervention that used an active game delivered on a smartphone among community-dwelling adults. METHODS: Forty adults were randomized to receive the intervention or a wait list control. The 20 randomized to the intervention (18 females, age 46.9 ± 13.4 years, BMI 33.1 ± 9.37 kg/m2, 70% Caucasian) chose an activity goal starting at ≥ 60 mins/week, increasing it over the 12-week duration to ≥ 150 mins/week. They were instructed to use the smartphone game “Zombies, Run!” while walking due to its popularity and low-cost, and received weekly brief phone counseling to assist with adjusting goals, problem solving, and relapse prevention. Acceptability of the intervention was determined using satisfaction scales that evaluated the smartphone interface, game application, and technical issues; a Likert-scale rating of > 4 (from 1 to 5) was the threshold for acceptability. RESULTS: Satisfaction of the smartphone hardware was 4.25 ± 0.63, with 2 participants indicating that the device was overly complicated; satisfaction of the gaming application was 4.37 ± 0.75, although 2 participants found the zombie game disinteresting; and, avoidance of technical issues was 4.11 ± 0.74, with 2 participants reporting problems with either the game or device. CONCLUSION: Among our target population, a smartphone-based gaming intervention was acceptable over a 12-week walking program. This intervention has the potential to be a valuable tool in promoting routine physical activity among a large population of individuals who desperately need a lifestyle modification, although adding alternate game choices may be beneficial in future studies. Supported by American Heart Association grant #13BGIA17110021.