Jeffrey T Kullgren1, Kristin A Harkins2, Scarlett L Bellamy3, Amy Gonzales4, Yuanyuan Tao3, Jingsan Zhu3, Kevin G Volpp3, David A Asch5, Michele Heisler6, Jason Karlawish3. 1. VA Ann Arbor Healthcare System, Ann Arbor, MI, USA University of Michigan, Ann Arbor, MI, USA jkullgre@med.umich.edu. 2. University of Pennsylvania, Philadelphia, PA, USA. 3. University of Pennsylvania, Philadelphia, PA, USA Leonard Davis Institute of Health Economics Center for Health Incentives and Behavioral Economics, Philadelphia, PA, USA Penn CMU Roybal P30 Center on Behavioral Economics and Health, Philadelphia, PA, USA. 4. Indiana University, Bloomington, IN, USA. 5. University of Pennsylvania, Philadelphia, PA, USA Leonard Davis Institute of Health Economics Center for Health Incentives and Behavioral Economics, Philadelphia, PA, USA Penn CMU Roybal P30 Center on Behavioral Economics and Health, Philadelphia, PA, USA Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA. 6. VA Ann Arbor Healthcare System, Ann Arbor, MI, USA University of Michigan, Ann Arbor, MI, USA.
Abstract
BACKGROUND:Financial incentives and peer networks could be delivered through eHealth technologies to encourage older adults to walk more. METHODS: We conducted a 24-week randomized trial in which 92 older adults with a computer and Internet access received apedometer, daily walking goals, and weekly feedback on goal achievement. Participants were randomized to weekly feedback only (Comparison), entry into a lottery with potential to earn up to $200 each week walking goals were met (Financial Incentive), linkage to four other participants through an online message board (Peer Network), or both interventions (Combined). Main outcomes were the proportion of days walking goals were met during the 16-week intervention and 8-week follow-up. We conducted a content analysis of messages posted by Peer Network and Combined arm participants. RESULTS: During the 16-week intervention, there were no differences in the proportion of days walking goals were met in the Financial Incentive (39.7%; p = .78), Peer Network (24.9%; p = .08), and Combined (36.0%; p = .77) arms compared with the Comparison arm (36.0%). During 8 weeks of follow-up, the proportion of days walking goals were met was lower in the Peer Network arm (18.7%; p = .025) but not in the Financial Incentive (29.3%; p = .50) or Combined (24.8%; p = .37) arms, relative to the Comparison arm (34.5%). Messages posted by participants focused on barriers to walking and provision of social support. CONCLUSIONS:Financial incentives and peer networks delivered through eHealth technologies did not result in older adults walking more.
RCT Entities:
BACKGROUND: Financial incentives and peer networks could be delivered through eHealth technologies to encourage older adults to walk more. METHODS: We conducted a 24-week randomized trial in which 92 older adults with a computer and Internet access received a pedometer, daily walking goals, and weekly feedback on goal achievement. Participants were randomized to weekly feedback only (Comparison), entry into a lottery with potential to earn up to $200 each week walking goals were met (Financial Incentive), linkage to four other participants through an online message board (Peer Network), or both interventions (Combined). Main outcomes were the proportion of days walking goals were met during the 16-week intervention and 8-week follow-up. We conducted a content analysis of messages posted by Peer Network and Combined arm participants. RESULTS: During the 16-week intervention, there were no differences in the proportion of days walking goals were met in the Financial Incentive (39.7%; p = .78), Peer Network (24.9%; p = .08), and Combined (36.0%; p = .77) arms compared with the Comparison arm (36.0%). During 8 weeks of follow-up, the proportion of days walking goals were met was lower in the Peer Network arm (18.7%; p = .025) but not in the Financial Incentive (29.3%; p = .50) or Combined (24.8%; p = .37) arms, relative to the Comparison arm (34.5%). Messages posted by participants focused on barriers to walking and provision of social support. CONCLUSIONS: Financial incentives and peer networks delivered through eHealth technologies did not result in older adults walking more.
Authors: Christina Matz-Costa; Elizabeth P Howard; Carmen Castaneda-Sceppa; Antonia Diaz-Valdes Iriarte; Margie E Lachman Journal: Gerontologist Date: 2019-11-16
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