Background: Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA).
Methods: A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome.
Results: Participants (N = 96) were mainly female (77%), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed.
Conclusions: Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA.
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- Adaptive Goal Setting and Financial Incentives: A 2 × 2 Factorial Randomized Controlled Trial to Increase Adults’ Physical Activity
- Adams, Marc (Author)
- Hurley, Jane (Author)
- Todd, Michael (Author)
- Bhuiyan, Nishat (Author)
- Jarrett, Catherine (Author)
- Tucker, Wesley (Author)
- Hollingshead, Kevin (Author)
- Angadi, Siddhartha (Author)
- College of Health Solutions (Contributor)
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Digital object identifier: 10.1186/s12889-017-4197-8
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Identifier TypeInternational standard serial numberIdentifier Value1471-2458
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The electronic version of this article is the complete one and can be found online at: http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4197-8
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Adams, M. A., Hurley, J. C., Todd, M., Bhuiyan, N., Jarrett, C. L., Tucker, W. J., . . . Angadi, S. S. (2017). Adaptive goal setting and financial incentives: a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity. BMC Public Health, 17(1). doi:10.1186/s12889-017-4197-8