An adaptive physical activity intervention for overweight adults: a randomized controlled trial.
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Date
2013-12-18
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Abstract
BACKGROUND Physical activity PA interventions typically include components or doses that are static across participants Adaptive interventions are dynamic components or doses change in response to short term variations in participant s performance Emerging theory and technologies make adaptive goal setting and feedback interventions feasible OBJECTIVE To test an adaptive intervention for PA based on Operant and Behavior Economic principles and a percentile based algorithm The adaptive intervention was hypothesized to result in greater increases in steps per day than the static intervention METHODS Participants N 20 were randomized to one of two 6 month treatments 1 static intervention SI or 2 adaptive intervention AI Inactive overweight adults 85 women M 36 9 9 2 years 35 non white in both groups received a pedometer email and text message communication brief health information and biweekly motivational prompts The AI group received daily step goals that adjusted up and down based on the percentile rank algorithm and micro incentives for goal attainment This algorithm adjusted goals based on a moving window an approach that responded to each individual s performance and ensured goals were always challenging but within participants abilities The SI group received a static 10 000 steps day goal with incentives linked to uploading the pedometer s data RESULTS A random effects repeated measures model accounted for 180 repeated measures and autocorrelation After adjusting for covariates the treatment phase showed greater steps day relative to the baseline phase pUnder 001 and a group by study phase interaction was observed p 017 The SI group increased by 1 598 steps day on average between baseline and treatment while the AI group increased by 2 728 steps day on average between baseline and treatment a significant between group difference of 1 130 steps day Cohen s d 74 CONCLUSIONS The adaptive intervention outperformed the static intervention for increasing PA The adaptive goal and feedback algorithm is a behavior change technology that could be incorporated into mHealth technologies and scaled to reach large populations TRIAL REGISTRATION ClinicalTrials gov NCT01793064
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Keywords
Adult, At risk for a particular disease or infection, Client, Access to information or data, Diversity of treatment options, Alignment with local norms, Low adherence to treatments, Pilot, Effectiveness, Randomized, Obesity, Health education or promotion, Treatment adherence, Disease management, SMS, Text