Comparative Effectiveness of Two Walking Interventions on Participation, Step Counts, and Health

Smith‐McLallen, Aaron; Heller, Debbie; Vernisi, Kristin; Gulick, Diana; Cruz, Samantha; Snyder, Richard L.

doi:10.1177/0890117116658012

Cited by 18 publications

(25 citation statements)

References 31 publications

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“…Multilevel models were used to identify significant predictors for differences in step count changes for intervention and control groups [ 7 , 30 , 57 , 58 ]. A feasibility study on classroom-based physical activity was analysed, adjusting for within cluster correlation at three different levels, namely student, classroom and school, using random effects for school, classroom and subject and assuming fixed effects for grade, gender, outdoor recess and physical education [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

Statistical methods to model and evaluate physical activity programs, using step counts: A systematic review

2018

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BackgroundPhysical activity reduces the risk of noncommunicable diseases and is therefore an essential component of a healthy lifestyle. Regular engagement in physical activity can produce immediate and long term health benefits. However, physical activity levels are not as high as might be expected. For example, according to the global World Health Organization (WHO) 2017 statistics, more than 80% of the world’s adolescents are insufficiently physically active. In response to this problem, physical activity programs have become popular, with step counts commonly used to measure program performance. Analysing step count data and the statistical modeling of this data is therefore important for evaluating individual and program performance. This study reviews the statistical methods that are used to model and evaluate physical activity programs, using step counts.MethodsAdhering to PRISMA guidelines, this review systematically searched for relevant journal articles which were published between January 2000 and August 2017 in any of three databases (PubMed, PsycINFO and Web of Science). Only the journal articles which used a statistical model in analysing step counts for a healthy sample of participants, enrolled in an intervention involving physical exercise or a physical activity program, were included in this study. In these programs the activities considered were natural elements of everyday life rather than special activity interventions.ResultsThis systematic review was able to identify 78 unique articles describing statistical models for analysing step counts obtained through physical activity programs. General linear models and generalized linear models were the most popular methods used followed by multilevel models, while structural equation modeling was only used for measuring the personal and psychological factors related to step counts. Surprisingly no use was made of time series analysis for analysing step count data. The review also suggested several strategies for the personalisation of physical activity programs.ConclusionsOverall, it appears that the physical activity levels of people involved in such programs vary across individuals depending on psychosocial, demographic, weather and climatic factors. Statistical models can provide a better understanding of the impact of these factors, allowing for the provision of more personalised physical activity programs, which are expected to produce better immediate and long-term outcomes for participants. It is hoped that this review will identify the statistical methods which are most suitable for this purpose.

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Section: Resultsmentioning

confidence: 99%

Statistical methods to model and evaluate physical activity programs, using step counts: A systematic review

2018

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“…lower A1C) in individuals living with type 2 diabetes. 15,48 Higher step counts in general are also associated with improved mood and overall health ratings, and are inversely related to systolic blood pressure. 15,49 From a public health perspective, a 1% reduction in the number of Canadians classi ed as "physically inactive" (fewer than 5,000 daily steps) would yield annual healthcare savings of $2.1 billion CAD.…”

Section: Discussionmentioning

confidence: 99%

“…15,48 Higher step counts in general are also associated with improved mood and overall health ratings, and are inversely related to systolic blood pressure. 15,49 From a public health perspective, a 1% reduction in the number of Canadians classi ed as "physically inactive" (fewer than 5,000 daily steps) would yield annual healthcare savings of $2.1 billion CAD. 50 With nearly half of the Carrot Rewards users in general accumulating less than 5,000 steps per day, a mere 500 to 1,000 step increase from baseline values could have broad implications.…”

Section: Discussionmentioning

confidence: 99%

Adding Team-Based Financial Incentives to the Carrot Rewards App Increases Daily Step Count on a Population Scale: A 24-Week Matched Pairs Study

Pearson

Prapavessis

Higgins

et al. 2020

Preprint

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Background Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements. Methods A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1–12; intervention: weeks 13–24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (± 500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week). Results The main analysis included 61,170 users (mean age = 32yrs; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day. Conclusion Despite an explosion of physical activity app interest (100,000 + published apps), low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

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“…lower A1C) in individuals living with type 2 diabetes. 15,51 Higher step counts in general are also associated with improved mood and overall health ratings, and are inversely related to systolic blood pressure. 15,52 From a public health perspective, a 1% reduction in the number of Canadians classi ed as "physically inactive" (fewer than 5,000 daily steps) would yield annual healthcare savings of $2.1 billion CAD.…”

Section: Discussionmentioning

confidence: 99%

“…15,51 Higher step counts in general are also associated with improved mood and overall health ratings, and are inversely related to systolic blood pressure. 15,52 From a public health perspective, a 1% reduction in the number of Canadians classi ed as "physically inactive" (fewer than 5,000 daily steps) would yield annual healthcare savings of $2.1 billion CAD. 53 With nearly half of the Carrot Rewards users in general accumulating less than 5,000 steps per day, a mere 500 to 1,000 step increase from baseline values could have broad implications.…”

Section: Discussionmentioning

confidence: 99%

Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: A 24-week matched case control study

Pearson

Prapavessis

Higgins

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements. Methods: A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1-12; intervention: weeks 13-24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (±500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week). Results: The main analysis included 61,170 users (mean age=32yrs; % female=64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p<0.0001; ηp2=0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2=0.699) with each new STC corresponding to approximately 200 more steps per day. Conclusion: Despite an explosion of physical activity app interest, low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

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Comparative Effectiveness of Two Walking Interventions on Participation, Step Counts, and Health

Abstract: An enhanced walking program significantly increases participation rates and daily step counts, which were associated with weight loss and reductions in body mass index.

Cited by 18 publications

References 31 publications

Statistical methods to model and evaluate physical activity programs, using step counts: A systematic review

Statistical methods to model and evaluate physical activity programs, using step counts: A systematic review

Adding Team-Based Financial Incentives to the Carrot Rewards App Increases Daily Step Count on a Population Scale: A 24-Week Matched Pairs Study

Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: A 24-week matched case control study

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