Machine-based Algorithm for Increased Physical Activity and Sustained User Engagement

April 21, 2025 updated by: Western University, Canada

Machine-based Algorithm for Adjusting Activity Targets to Increase Physical Activity and Sustain User Engagement Among Telus Wellbeing Users

A cohort analytic study (i.e., observational study following a cohort over time to compare outcomes between those exposed and unexposed to an intervention) was conducted over a 17-week period (March 7, 2022 to June 30, 2022). The study consisted of a five-week baseline period (March 7, 2022 to April 10, 2022). During the baseline, Telus Wellbeing users earned FI for meeting personalized but static daily step goals. A 12-week intervention period followed (April 11, 2022 to June 30, 2022). During the intervention period, users were randomized by a senior Telus Wellbeing software engineer into either control (i.e., continuing with their personalized static goal) or intervention groups (i.e., testing the new ML-driven 'Smart Mode' feature offering personalized and adaptive daily step goals) using a random number generator in Python (version 3.9; i.e., non-pi package random binomial). The randomization ratio was about 1:2 in favour of the intervention group. Both groups were informed they would be testing a new 'Smart Mode' feature at intervention onset, however, only those allocated to the intervention group received ML-driven goals. Notably, the study sample consisted of more highly engaged users (e.g., registered on the app at least five weeks prior to the intervention, took initiative to synchronize their activity trackers with the app). The Strengthening the reporting of observational studies in epidemiology (STROBE) statement flow chart and checklist for cohort studies is provided.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

We partnered with Telus Health Inc. to begin to examine the effectiveness of a supervised ML algorithm integrated into their Telus Wellbeing corporate wellness app (iOS and Android versions), formerly known as "Sprout-At-Work". As of April 29, 2025, Telus Wellbeing was the employee wellness solution for more than 50 companies across 70 countries (i.e., approximately 90% of users registered within USA). At the time they reported over 400,000 registered users and about 100,000 monthly active users (MAUs; i.e., users who engage with the platform at least once a month). Download and use of the app is voluntary and of no financial cost to employees. The multi-component app is rooted in the core components of the three-layer Behaviour Change Wheel (BCW), a comprehensive framework for designing and evaluating behaviour change interventions.

Telus Wellbeing operationalizes the COM-B model, for example, by providing educational content and PA self-monitoring opportunities to build knowledge and skills (i.e., capability), offering features like peer-to-peer sharing and team challenges to foster social support (i.e., opportunity), and using FI (i.e., motivation) to drive goal achievement (see Supplementary File A for more details). Telus Wellbeing also addresses structural barriers (e.g., built environment), systemic challenges (e.g., socioeconomic disparities), and contextual factors (e.g., social norms) through the integration of promising BCTs. For example, by offering offline functionality (i.e., environment restructuring [12.1]), subsidies for wellness programs (i.e., material incentive [6.1]), and connecting users to local health services (i.e., social support [3.1]), Telus Wellbeing supports diverse user needs (Supplementary File A).

After downloading Telus Wellbeing, users can open the app and navigate through the landing and home page. On the home page, the number of steps completed that day and the users daily step goal are shown. Participants can click on two icons at the top of the home page. If the users click on the left icon, the history page is displayed. The history page allows participants to track their performance over the past week by showing their daily steps and daily goals on a color-coded bar graph. The green bar indicates the accomplishment of achieving the step goal on the corresponding day, and the red bar indicates failure to achieve the step goal on the corresponding day. The built-in health chip in the iPhone and Android devices collects the step data, and the accuracy of step counts collected by the iPhone and Android health chip has been validated in a number of studies to have comparable accuracy to an ActiGraph. The push notification for the app is also activated (if activated by the user), and the standard iOS and Android push notification is used. The push notification is visible in the landing page and in the recent notifications tab on the phone.

Eligible participants will start a five-week run-in period after downloading the app. The purpose of the run-in period is to collect baseline daily steps, and assess if the participant is able to comply with the requirements needed to regularly use the Telus Wellbeing app. During the run-in period, all participants in the control and the intervention groups will receive a traditional personalized daily step goal based on their historical step data. The machine learning algorithm will not be used to compute step goals for participants in the intervention group during the run-in period. Dynamically increasing step goals will be used in the run-in period to engage participants in using the app regularly. In addition, all participants will receive a push notification at 8:00 AM that provides the day's step goal, and if the participant accomplishes the goal before 8:00 PM, then another push notification will be sent to congratulate that participant on reaching their step goal for the day. The identical goals between the 2 groups during the run-in period is used to establish a reference level of initial physical activity, which will be used in the statistical analyses to compare the difference in daily steps between run-in and 12 weeks for the 2 groups. Data collected during the run-in period will be used by the machine learning algorithm to compute step goals for the intervention period. This is a valid approach because run-in data will be indicative of the preference of different participants. All participants will have been placed into one of two groups. The allocation of app users to groups will be implemented by Telus Health after the run-in period. After the five-week run-in period, participants in the control group will be provided with a personalized static daily step goal hrough the Telus Wellbeing app. Participants will receive a push notification at 8:00 AM every day that provides that day's step goal (10,000 steps), and if the participant achieves the goal before 8:00 PM, then another push notification will be sent to congratulate the participant on reaching their step goal (of 10,000 steps) for the day.

After the five-week run-in period, participants in the intervention group will receive adaptively personalized step goals through the Telus Wellbeing app. The daily step goals will be computed using machine learning on the complete history (past steps and goals) of the user. Machine learning will be applied every day to reduce variance in future steps and goals. Participants will receive a push notification at 8:00 AM every day that provides today's step goal, and if the participant accomplishes the goal before 8:00 PM, then another push notification will be sent to congratulate the participant on reaching their step goal for that day. Machine learning will adaptively compute personalized step goals that are predicted to maximize future physical activity for each participant based on all their past steps' data and goals of each participant. Machine learning is applied to each participant individually, and it consists of two main steps. The first step is to use all of the participant's data to construct a quantitative model that predicts how many steps the participant will take in the future, given a prescribed set of step goals, and an important aspect of the model is a component that describes how achieving goals in the present can increase the likelihood of achieving goals in the future. The second step is to use this quantitative model to select a sequence of step goals that maximizes the predicted future number of steps. To make the process of updating step goals adaptive, machine learning is applied each day (using all the users' past data) to generate step goals for the coming day. Moreover, the step goals computed by machine learning for the coming day are not constant but increase or decrease based on the model prediction. The Telus Wellbeing app will automatically track the participants' step counts each day and will provide goals regardless of their level of engagement within the app over the 12-week study period. As the data is being analyzed retrospectively, no "end of study" letter will be provided to participants. However, upon registering for the studies procedures, all users provided written informed consent for their data to be collected and analyzed.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
1249

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Ontario
      • London, Ontario, Canada
        • Western University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Adults aged 18 years or older
  • User intent to become physically active in the next 12 weeks
  • Own a smartphone device
  • Willing to install and use the Telus Wellbeing app (which requires Internet connection) every day for 12 weeks
  • Ability to speak and read English

Exclusion Criteria:

  • Known medical conditions or physical problems that require special attention in a physical activity program
  • Planning an international trip during the next 3 months, which could interfere with daily server uploads of mobile phone data
  • Pregnant or gave birth during the past 6 months
  • Current participation in lifestyle modification programs or research studies that may confound study results

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Adaptive Step Goal (Intervention)
The 'Smart Mode' feature used a propriety ML algorithm to generate 16 user clusters based on daily step count patterns from approximately 100,000 global Telus Wellbeing users over the previous two years (March 1, 2020 to March 1, 2022; characteristics of these users unknown). The algorithm then compared time series data from participants' five-week baseline against the repository of 16 user cluster patterns to determine to which cluster they would be assigned. Once assigned, a difference in proportions was calculated (ratio of previous week's average daily step count over the step count goal for that week vs. ratio of average daily step count from two weeks prior over step count goal for that week [e.g., 8000 steps/7500 steps=1.067 vs. 8000 steps/9500 steps=0.8421]). Chi-square testing was used to assess statistical significance of the difference (p<0.05). This was done to determine whether the next calculated goal would go up, down, or stay the same.
Behavioral: Adaptive Step Goal (Intervention)
Receiving automated personalized daily step goals,
Active Comparator: Static Step Goal (Control)
Over the course of the 12-week intervention period controls continued with their static daily step goal, equivalent to their baseline period weekly average daily step count. Control participants received an out-of-app push notification at 8:00 a.m. each Monday during the intervention period reminding them of their static daily step goal. If the participant achieved their daily step goal before 8:00 p.m. on any day a push notification was sent to congratulate them on reaching their goal for the day. No notifications were sent past 8:00 p.m. Participants achieving daily step goals were rewarded with FI in the form of points (i.e., "SproutBucks"). They could redeem "SproutBucks" either "on-platform" (e.g., gift cards to StarbucksTM, BestBuyTM, iTunesTM, VisaTM) or "off-platform" (e.g., employer specific rewards like vouchers for fitness membership discounts). The value of "SproutBucks" was unique to companies, ranging from $0.00 to $1.00 USD per daily goal achieved.
Behavioral: Static Step Goal (Control)
Receiving personalized static daily step goals.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Step count
Time Frame: 17 weeks
Relative change in daily steps from the 5 week run-in period to the 12-week follow-up, in groups receiving adaptive daily step goals versus those receiving non-adaptive goals.
17 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Number of app opens, total time spent on app, number of pages opened
Time Frame: 12 weeks
Difference in level of engagement (described in title) within the adaptive goals group compared to non-adaptive goals throughout the 12-week follow-up period.
12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Western University, Canada

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 1, 2023

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 1, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 24, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 29, 2023

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 24, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 29, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 21, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
April 1, 2024

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 123632

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

All data is un-identifiable and only results will be presented.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Conditions

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