Adaptive goal setting and financial incentives

a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity

Marc Adams, Jane C. Hurley, Michael Todd, Nishat Bhuiyan, Catherine L. Jarrett, Wesley J. Tucker, Kevin E. Hollingshead, Siddhartha Angadi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA). Methods: A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome. Results: Participants (N = 96) were mainly female (77%), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed. Conclusions: Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA. Trial Registration: ClinicalTrials.gov ID: NCT02053259 registered prospectively on January 31, 2014.

Original languageEnglish (US)
Pages (from-to)1-16
Number of pages16
JournalBMC Public Health
Volume17
Issue number1
DOIs
StatePublished - Mar 29 2017

Fingerprint

Motivation
Randomized Controlled Trials
Reward

Keywords

  • Adaptive interventions
  • Fitbit
  • Goals
  • mHealth
  • Pedometer
  • Reward
  • Text messaging

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Adaptive goal setting and financial incentives : a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity. / Adams, Marc; Hurley, Jane C.; Todd, Michael; Bhuiyan, Nishat; Jarrett, Catherine L.; Tucker, Wesley J.; Hollingshead, Kevin E.; Angadi, Siddhartha.

In: BMC Public Health, Vol. 17, No. 1, 29.03.2017, p. 1-16.

Research output: Contribution to journalArticle

Adams, Marc ; Hurley, Jane C. ; Todd, Michael ; Bhuiyan, Nishat ; Jarrett, Catherine L. ; Tucker, Wesley J. ; Hollingshead, Kevin E. ; Angadi, Siddhartha. / Adaptive goal setting and financial incentives : a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity. In: BMC Public Health. 2017 ; Vol. 17, No. 1. pp. 1-16.
@article{404d7eaf1a8b416685b761b2e00b1d6f,
title = "Adaptive goal setting and financial incentives: a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity",
abstract = "Background: Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA). Methods: A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome. Results: Participants (N = 96) were mainly female (77{\%}), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed. Conclusions: Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA. Trial Registration: ClinicalTrials.gov ID: NCT02053259 registered prospectively on January 31, 2014.",
keywords = "Adaptive interventions, Fitbit, Goals, mHealth, Pedometer, Reward, Text messaging",
author = "Marc Adams and Hurley, {Jane C.} and Michael Todd and Nishat Bhuiyan and Jarrett, {Catherine L.} and Tucker, {Wesley J.} and Hollingshead, {Kevin E.} and Siddhartha Angadi",
year = "2017",
month = "3",
day = "29",
doi = "10.1186/s12889-017-4197-8",
language = "English (US)",
volume = "17",
pages = "1--16",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Adaptive goal setting and financial incentives

T2 - a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity

AU - Adams, Marc

AU - Hurley, Jane C.

AU - Todd, Michael

AU - Bhuiyan, Nishat

AU - Jarrett, Catherine L.

AU - Tucker, Wesley J.

AU - Hollingshead, Kevin E.

AU - Angadi, Siddhartha

PY - 2017/3/29

Y1 - 2017/3/29

N2 - Background: Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA). Methods: A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome. Results: Participants (N = 96) were mainly female (77%), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed. Conclusions: Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA. Trial Registration: ClinicalTrials.gov ID: NCT02053259 registered prospectively on January 31, 2014.

AB - Background: Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA). Methods: A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome. Results: Participants (N = 96) were mainly female (77%), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed. Conclusions: Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA. Trial Registration: ClinicalTrials.gov ID: NCT02053259 registered prospectively on January 31, 2014.

KW - Adaptive interventions

KW - Fitbit

KW - Goals

KW - mHealth

KW - Pedometer

KW - Reward

KW - Text messaging

UR - http://www.scopus.com/inward/record.url?scp=85016270353&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016270353&partnerID=8YFLogxK

U2 - 10.1186/s12889-017-4197-8

DO - 10.1186/s12889-017-4197-8

M3 - Article

VL - 17

SP - 1

EP - 16

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

ER -