Incentives for Physical Activity for Older Adults

January 4, 2024 updated by: Anya Samek, University of California, San Diego

Incentives for Physical Activity - An RCT With Older Adults

Inactivity is the fourth leading risk factor for global mortality, leading to chronic diseases. Much of the world's population is inactive, and older adults are at highest risk. Incentive-based interventions show promise for improving activity levels. The investigators propose to conduct a study to evaluate the impact of incentives on physical activity of older adults (55 and above). Half the participants will receive additional incentives for walking throughout the study. Their step count and physical/mental health will be compared to a control group. The investigators will track the physical activity of participants using Fitbits and will encourage physical activity through making meal donations on behalf of participants (prosocial incentives) and giving them gift cards that can be redeemed at local businesses (personal incentives). Physical and mental health before and after the study will also be assessed using a written survey.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Inactivity is the fourth leading risk factor for global mortality, leading to chronic diseases (e.g., heart disease, diabetes) and contributing to the obesity epidemic. Much of the world's population is inactive and older adults are at highest risk. Inactivity in older adults is linked to age-related diseases and cognitive decline. Inactivity also imposes social costs through increased medical expenses, which are already high among the growing older adult population in the US.

Incentive-based interventions have gained popularity among behavioral scientists and policymakers as a tool for improving health-related behaviors. But there are drawbacks - first, monetary incentives are often not cost-effective, and therefore scalability is limited. Second, behaviors often return to baseline when monetary incentives are removed, i.e., healthy habits are hard to maintain when incentives are limited in duration. Third, there is a concern that monetary incentives crowd out intrinsic motivation to engage in health-promoting behaviors.

In light of the limited success of incentive-based behavior change programs, the investigators propose to design and evaluate alternative incentives that address these challenges of scalability, habit formation and crowd-out. The investigators will aim to encourage physical activity through alternative incentives - by making a meal donations on behalf of participants (prosocial incentives) and give participants monetary incentives (personal incentives). Both types of incentives have underpinnings in behavioral economics.

Meal donations harness prosocial preferences, which may be more powerful and less likely to reduce intrinsic motivation than equivalent monetary incentives.

The overall aim is to evaluate the impact of alternative incentives on step count of older adults in the short-term and long-term. Exploratory analysis will also evaluate the impact on physical and mental health. The investigators will recruit 200 older adults and randomize half of them to receive additional prosocial and personal incentives for their walking behavior. The other half will not receive these incentives. The investigators will track step count of these two groups for 8 weeks using a Fitbit device. Under the treatment functionality, participants accrue a meal donation and a point for Feeding America for each day that they meet the step goal.

The investigators plan to recruit older adults ages 55 and above at grocery stores and other locations around San Diego, CA. Recruitment will be on a rolling basis. PI Samek has recruited participants at grocery stores in prior studies, hence the investigators believe this is feasible. Participation will be limited to individuals who own a smart phone (61% of older adults in the US own a smart phone, and the investigators expect this number to grow as the population ages). Studies have shown that older adults are open to using app-based technologies, for example older adults are accepting of mindfulness apps.

The research team will be given access to participants' Fitbit data through Fitabase, a research platform that collects data from internet connected consumer activity devices. The investigators identified 7,500 steps as an appropriate goal as studies show older adults walk 4,000 steps on average. For the treatment group, meals will be donated by the research team to Feeding America for each day they meet the step goal of 7,500 steps. They will also receive money for each day they meet the step goal of 7,500 steps a day, for up to 5 days a week. The control group will not receive these incentives for their walking behavior, but their daily step count data will be collected.

Participants will receive a Fitbit upon enrollment. The investigators will collect their physical activity data for 1 week, as their baseline physical activity. After 1 week, individuals who on average less than 6000 per day, will be randomized to the treatment group, which receives the incentives for 5 weeks, or to a control group which does not.

The investigators will also collect follow up data for 2 weeks.

Individuals who on average walk more than 6000 steps per day during the 1 week baseline period will be dropped from the study.

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • 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

  • United States
    • California
      • San Diego, California, United States, 92113
        • Recruiting
        • Northgate Market Barrio Logan
        • Contact:
      • San Diego, California, United States, 92113
        • Recruiting
        • Northgate Market National City
        • Contact:

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria

  • 55 years old or older
  • own a smartphone
  • can walk independently
  • how often they walked outside their home or yard for fun or exercise in the past week - Never, Seldom (1-2 days), Sometimes (3-4 days), or Often (5-7 days)? They can participate if they respond never or seldom.

Exclusion Criteria

  • below 55 years
  • do not own a smartphone
  • unable to walk independently
  • how often they walked outside their home or yard for fun or exercise in the past week
  • Never, Seldom (1-2 days), Sometimes (3-4 days), or Often (5-7 days)? They can not participate if they respond sometimes or often.

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: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Treatment
Fitabase collects data from Fitbits worn by the participants. Under the treatment functionality, participants earn a meal donation for each day that they meet the step goal and a monetary incentive for each day they meet the step goal (for upto 5 days a week). The investigators identified 7,500 steps as an appropriate goal as studies show older adults walk 4,000 steps on average. Meals are donated by the investigators on behalf of participants.
Other: Incentives for Physical Activity
Participants earn a meal donation and monetary incentives for each day that they reach 7,500 steps. Meals are donated by the investigators on behalf of participants.
No Intervention: Control
The control group will not have the functionality to earn meal donations or monetary incentives by walking, and will only be asked to wear their Fitbit so that step count data can be collected.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in step count
Time Frame: Week 1 and week 8.
Indicator of change in physical activity, recorded daily using Fitabase and averaged across a week. A baseline step count at the beginning of the study will be compared to the step count at the end of the study.
Week 1 and week 8.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in CES-D (Center for Epidemiologic Studies Depression Scale) Score
Time Frame: Week 1 and week 8.
Measured during baseline and endline survey, indicator of mental health. CES-D scores range from 0-60, with higher scores being more indicative of depression.
Week 1 and week 8.

Collaborators and Investigators

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

Sponsor

University of California, San Diego

Collaborators

National Institute on Aging (NIA)
University of Southern California

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)

November 3, 2023

Primary Completion (Estimated)

April 1, 2024

Study Completion (Estimated)

May 1, 2024

Study Registration Dates

First Submitted

March 28, 2023

First Submitted That Met QC Criteria

July 7, 2023

First Posted (Actual)

July 17, 2023

Study Record Updates

Last Update Posted (Estimated)

January 8, 2024

Last Update Submitted That Met QC Criteria

January 4, 2024

Last Verified

January 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • 805439
  • P30AG024968 (U.S. NIH Grant/Contract)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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