Promoting Contextually Cued PA Habits

Promoting Contextually Cued Physical Activity Habits: A Pilot Study Using Cue-Contingent Financial Incentives for Daily Walking

The primary goal of this two-month pilot study is to measure the behavioral change induced by targeted habit formation reminders that are surfaced via an iPhone app and financial incentives that were offered conditional on using a personalized contextual cue for a daily walking habit. The data and user feedback collected during this study will also be used to optimize the design and content of the iPhone app, which will be tested in future, larger scale experimental research.

Study Overview

• Status: Completed
• Conditions: Exercise
• Intervention / Treatment: Behavioral: App use instructions; Behavioral: Non-cue-contingent weekly incentives; Behavioral: Habit Coaching; Behavioral: Cue-contingent weekly incentives

Detailed Description

Subjects for this research are recruited on campus at Rensselaer Polytechnic Institute and the State University of New York at Albany, and their participation was incentivized. After meeting the eligibility criterion (including have at least some intrinsic motivation for increasing physical activity), downloading the project's iPhone app, and signing the project consent form, all participants will have their step count data recorded for an 8-week study period.

Existing interventions that have successfully improved study participants' health-related behaviors typically find that behavioral changes do not persist beyond 3 months after the intervention period. Fortunately, novel habit formation interventions from the psychology literature offer the potential for building long-term behavioral change and avoiding the common "relapse triangles" observed in these existing behavioral interventions. These new methods are based on the theory that habits are formed through the repetition of the same behavior in response to a stable, environmental cue. After an initial period of repetition, automaticity is formed, and the behavioral response becomes more effortlessly/unconsciously induced by the environmental cue. Behavioral reminders that reinforce a specific behavioral routine-environmental cue pair have been shown to support this initial period of habit formation; however, given the individualized nature of these reminders, a generalizable intervention method has not been developed and empirically tested. This research will use an iPhone app to examine the role of both general informational on contextually cued habits and the use of personalized reminders and financial incentives for using a daily physical activity contextual cue on the persistence of physical activity behavior after the intervention tools are withdrawn.

• Study Type: Interventional
• Enrollment (Actual): 137
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Troy, New York, United States, 12180
      • Rensselaer Polytechnic Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• 18+ years of age
• Have an existing wellness goal related to increasing physical activity
• Access to an iPhone with iOS 10 or above (in order to use the app)
• Proficiency in speaking and reading English

Exclusion Criteria:

• Have a major visual impairment
• Pregnancy
• Expected surgery
• A chronic or acute health condition that affects their ability to perform basic mobility tasks or light-aerobic exercise (e.g. heart disease, injured or missing limb, etc.)

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group; One fourth of participants were assigned to the Control Group, and received a basic training with the StepUp app and were asked to contact the study team with any problems or questions they encountered during the eight-week study period. No other intervention tools or app reminders were provided to the Control Group.	Behavioral: App use instructions; Received a basic training with the StepUp app
Experimental: Treatment Group 1; Additionally eligible to receive weekly $5 Amazon gift cards over the first four weeks of the study for performing a ≥10-minute walk (i.e. non-cue-contingent incentives)	Behavioral: App use instructions; Received a basic training with the StepUp app; Behavioral: Non-cue-contingent weekly incentives; Eligible to win $5 Amazon gift card conditional on completing a daily ≥10-minute walk at any time of day
Experimental: Treatment Group 2; Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit, then they were similarly eligible weekly for $5 Amazon gift cards over the first four weeks conditional on completing a ≥10-minute walk at any time of day (i.e. non-cue-contingent incentives)	Behavioral: App use instructions; Received a basic training with the StepUp app; Behavioral: Non-cue-contingent weekly incentives; Eligible to win $5 Amazon gift card conditional on completing a daily ≥10-minute walk at any time of day; Behavioral: Habit Coaching; Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit
Experimental: Treatment Group 3; Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit, then they were eligible weekly for $5 Amazon gift cards over the first four weeks conditional on completing a ≥10-minute walk at any the pre-specified time of their chosen contextual cue (i.e. cue-contingent incentives)	Behavioral: App use instructions; Received a basic training with the StepUp app; Behavioral: Habit Coaching; Received an instructional video on the benefits of contextual-cue-dependent habits and instructions on how to identify an optimal personalized cue that would consistently trigger their ≥10-minute walking habit; Behavioral: Cue-contingent weekly incentives; Eligible to win $5 Amazon gift card conditional on completing a daily ≥10-minute walk within a +/-1 hour window of the pre-specified time of their chosen contextual walking cue

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Daily Step Count	Full study period analyses	8 weeks
Daily Step Count	Follow-up period	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Habitual daily walking	Whether walking occurred within +/- 1 hour of contextual cue; full study period	8 weeks
Habitual daily walking	Whether walking occurred within +/- 1 hour of contextual cue; follow-up period	4 weeks
10,000 daily step	Likelihood of reaching 10,000 daily steps, follow-up period	4 weeks

Collaborators and Investigators

• Sponsor: Arizona State University

Publications and helpful links

General Publications

• Stawarz, Cox, and Blandford. 2015. "Beyond self-tracking and reminders: designing smartphone apps that support habit formation." Proceedings of the 33rd annual ACM conference on human factors in computing systems, ACM.
• Lally, Phillippa, et al. 2010. "How are habits formed: Modelling habit formation in the real world." European journal of social psychology 40(6): 998-1009.
• Wood W, Neal DT. A new look at habits and the habit-goal interface. Psychol Rev. 2007 Oct;114(4):843-63. doi: 10.1037/0033-295X.114.4.843.
• Wood and Neal. 2016. "Healthy through habit: Interventions for initiating & maintaining health behavior change." Behavioral Science & Policy 2(1): 71-83.
• Adriaanse MA, Gollwitzer PM, De Ridder DT, de Wit JB, Kroese FM. Breaking habits with implementation intentions: a test of underlying processes. Pers Soc Psychol Bull. 2011 Apr;37(4):502-13. doi: 10.1177/0146167211399102. Epub 2011 Feb 11.

Study record dates

Study Major Dates

• Study Start (Actual): February 28, 2019
• Primary Completion (Actual): August 21, 2019
• Study Completion (Actual): August 21, 2020

Study Registration Dates

• First Submitted: December 28, 2020
• First Submitted That Met QC Criteria: December 28, 2020
• First Posted (Actual): December 31, 2020

Study Record Updates

• Last Update Posted (Actual): July 20, 2023
• Last Update Submitted That Met QC Criteria: July 19, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Physical activity; mHealth; Financial incentives
• Other Study ID Numbers: 1698

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No