Harnessing technology and gamification to increase adult physical activity: a cluster randomized controlled trial of the Columbia Moves pilot

Courtney M Monroe; Bo Cai; Sarah Edney; Danielle E Jake-Schoffman; Keith Brazendale; Agnes Bucko; Bridget Armstrong; Chih-Hsiang Yang; Gabrielle Turner-McGrievy

doi:10.1186/s12966-023-01530-1

Harnessing technology and gamification to increase adult physical activity: a cluster randomized controlled trial of the Columbia Moves pilot

Int J Behav Nutr Phys Act. 2023 Nov 3;20(1):129. doi: 10.1186/s12966-023-01530-1.

Authors

Courtney M Monroe¹, Bo Cai², Sarah Edney³, Danielle E Jake-Schoffman⁴, Keith Brazendale⁵, Agnes Bucko⁶, Bridget Armstrong⁷, Chih-Hsiang Yang⁸, Gabrielle Turner-McGrievy⁹

Affiliations

¹ Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1 Building, Suite 403G, 915 Greene Street, Columbia, SC, 29208, USA. cmmonroe@mailbox.sc.edu.
² Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, Discovery 1 Building, Room 460, 915 Greene Street, Columbia, SC, 29208, USA.
³ Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building (Block MD1), 12 Science Drive 2, #11-01, Singapore, 117549, Singapore.
⁴ College of Health and Human Performance, Department of Health Education and Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA.
⁵ College of Health Professions and Sciences, Department of Health Sciences, University of Central Florida, HS II, Room 210A, 12805 Pegasus Drive, Orlando, FL, 32816, USA.
⁶ College of Health and Human Services, University of North Carolina-Charlotte, 8844 Craver Road, Charlotte, NC, 28223, USA.
⁷ Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Public Health Research Center, Room 132, 921 Assembly Street, Columbia, SC, 29208, USA.
⁸ Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Discovery 1 Building, Room 403E, 915 Greene Street, Columbia, SC, 29208, USA.
⁹ Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1 Building, Room 552, 915 Greene Street, Columbia, SC, 29208, USA.

Abstract

Background: The use of health technologies and gamification to promote physical activity has increasingly been examined, representing an opportunistic method for harnessing social support inherent within existing social ties. However, these prior studies have yielded mixed findings and lacked long-term follow-up periods. Thus, a pilot cluster randomized controlled trial was conducted to gauge the feasibility and preliminary efficacy of a digital gamification-based physical activity promotion approach among teams of insufficiently active adults with existing social ties.

Methods: Teams (N = 24; 116 total participants) were randomized to either a 12-week intervention (Fitbit, step goals, app, feedback; TECH) or the same program plus gamification (TECH + Gamification). Mixed effects models were used to compare group differences in treatment adherence, and changes in social support, steps, and moderate-to-vigorous physical activity at 12 weeks and 52 weeks from baseline, adjusted for sociodemographic characteristics and team size.

Results: TECH had a lower mean number of days of Fitbit self-monitoring versus TECH + Gamification during the intervention (adjusted difference: -.30; 95% CI, -.54 to -.07; P = .01). Post-intervention, TECH had 47% lower odds of self-monitoring 7 days per week versus TECH + Gamification (.53; 95% CI, .31 to .89; P = .02). No differences were observed between TECH + Gamification and TECH in increases in social support (0.04; 95% CI, -.21 to .29; P = .76), ActiGraph-measured daily steps (-425; 95% CI, -1065 to 215; P = .19), or moderate-to-vigorous physical activity minutes (-3.36; 95% CI, -8.62 to 1.91; P = .21) from baseline to 12 weeks or in the regression of these improvements by 1 year (Ps > .05). Although not significant in the adjusted models (Ps > .05), clinically meaningful differences in Fitbit-measured daily steps (TECH, 7041 ± 2520; TECH + Gamification, 7988 ± 2707) and active minutes (TECH, 29.90 ± 29.76; TECH + Gamification, 36.38 ± 29.83) were found during the intervention.

Conclusions: A gamified physical activity intervention targeting teams of adults with existing social ties was feasible and facilitated favorable, clinically meaningful additive physical activity effects while in place but did not drive enhanced, long-term physical activity participation. Future investigations should explore optimal team dynamics and more direct ways of leveraging social support (training teams; gamifying social support).

Trial registration: Clinicaltrials.gov ( NCT03509129 , April 26, 2018).

Keywords: Gamification; Physical activity; Social support; e/mHealth.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Data Collection
Exercise*
Gamification*
Humans
Technology

Associated data

ClinicalTrials.gov/NCT03509129