Effect of Gamification, Financial Incentives, or Both to Increase Physical Activity Among Patients at High Risk of Cardiovascular Events: The BE ACTIVE Randomized Controlled Trial
Authors' conclusion
Behaviorally designed gamification, loss-framed financial incentives, and the combination of both increased physical activity compared with control over a 12-month intervention period, with the largest effect in gamification+financial incentives.
Study context
- Population
- Patients with clinical atherosclerotic CVD or 10-year risk of MI, stroke or CV death ≥7.5% (Pooled Cohort equation)
- Participants
- 1,062 patients
- Comparison
- Gamification, financial incentives, or both vs control
- Controln = 151reference
- Gamificationn = 304
- Financial incentivesn = 302
- Gamification+financial incentivesn = 305
- Primary endpoint
- Change in mean daily steps from baseline
- Follow-up
- Through the 12-month intervention period
Methodological detailspragmatic, attention control
- Pragmatic
- Attention control
Primary result
As reported in the abstract
Change in mean daily steps · 12-month intervention
Each group vs controlAdjusted difference (95% CI)P value
Gamification
538.0(186.2–889.9)
P = 0.0027Financial incentives
491.8(139.6–844.1)
P = 0.0062Gamification+financial incentives
868.0(516.3–1219.7)
P < 0.0001Further findings
| Outcome | Adjusted difference (95% CI) | P value | |
|---|---|---|---|
| Physical activity (mean daily steps) · 6-month postintervention follow-upGamification+financial incentives vs Control · significant · after adjustment for multiple comparisons | 576.2 (198.5–954) | P = 0.0028 | |
| Physical activity (mean daily steps) · 6-month postintervention follow-upGamification vs Control · not significant after adjustment for multiple comparisons · after adjustment for multiple comparisons | 459.8 (82.0–837.6) | P = 0.0171 | |
| Physical activity (mean daily steps) · 6-month postintervention follow-upFinancial incentives vs Control · after adjustment for multiple comparisons | 327.9 (−50.2 to 706) | P = 0.09 | |
| −50005001000Difference (linear scale) |
Original publication
Effect of Gamification, Financial Incentives, or Both to Increase Physical Activity Among Patients at High Risk of Cardiovascular Events: The BE ACTIVE Randomized Controlled Trial. Circulation. Published 7 April 2024. doi:10. 1161/ circulationaha. 124. 069531
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