Project Step: A Randomized Controlled Trial Investigating the Effects of Frequent Feedback and Contingent Incentives on Physical Activity

Abstract

Background: Financial incentives and feedback on behavior offer promise for promoting physical activity. However, evidence for the effect of each of these techniques is inadequate. The present study evaluated the effects of daily versus weekly feedback and incentives contingent on reaching a daily walking goal versus noncontingent incentives in a 2 × 2 trial. Methods: Participants (N = 57) had a body mass index >25 kg/m2 and were insufficiently active. Participants received a daily walking goal that adapted weekly. Results: Participants receiving daily feedback increased daily steps (P = .03) more than those receiving weekly feedback. Participants receiving contingent incentives did not significantly increase steps (P = .12) more than those receiving noncontingent incentives. A trend-level effect (P = .09) suggested that there may be an interaction such that the combination of daily feedback and contingent incentives is most effective. Conclusions: Results indicate that feedback is an important component of remotely delivered PA interventions and that evaluating each component of low-intensity interventions may help to improve efficacy. Moreover, results indicate that possible synergistic effects of feedback and rewards should be investigated further to help optimize interventions.

Impact of feedback generation and presentation on self-monitoring behaviors, dietary intake, physical activity, and weight: a systematic review and meta-analysis

“…Dietary behaviors reported comprised energy intake [ 27 , 41 , 47 , 54 ], percent carbohydrates, protein, fat, and saturated fat from total daily energy intake, sodium intake, total fiber, added sugar [ 54 ], percent saturated, monounsaturated and polyunsaturated fats from daily energy intake [ 27 ], daily vegetable and fruit portions, weekly consumption of sweetened beverages and ultraprocessed foods [ 43 ], and achievement of diet goals [ 40 ]. Regarding physical activity, studies investigated total minutes of physical activity [ 50 ], daily minutes of moderate to vigorous physical activity [ 43 , 51 ], steps [ 25 , 26 , 36 , 46 ], walking lengths [ 47 ], physical activity energy expenditure [ 41 , 44 ], metabolic equivalents [ 24 , 48 ], accelerometer counts [ 52 ], activity data [ 45 ], time spend standing [ 26 ], sedentary time [ 26 , 53 ], achievement of physical activity goals [ 50 ] (see raw data provided on the OSF).…”

“…Regarding physical activity, studies investigated total minutes of physical activity [ 50 ], daily minutes of moderate to vigorous physical activity [ 43 , 51 ], steps [ 25 , 26 , 36 , 46 ], walking lengths [ 47 ], physical activity energy expenditure [ 41 , 44 ], metabolic equivalents [ 24 , 48 ], accelerometer counts [ 52 ], activity data [ 45 ], time spend standing [ 26 ], sedentary time [ 26 , 53 ], achievement of physical activity goals [ 50 ] (see raw data provided on the OSF).…”

“…The majority of studies included samples with a mean age between 30 and 50 [ 27 , 28 , 40 – 42 , 44 , 46 , 51 , 52 ] who were predominantly female [ 25 , 27 – 29 , 36 , 40 – 44 , 46 , 48 , 51 , 52 ] and White [ 26 – 29 , 41 , 42 , 44 , 46 , 51 , 53 ] (although ethnicity or race was not reported in 7 publications). Studies were conducted in the United States ( n = 10, 52.6%; [ 27 – 29 , 41 , 42 , 46 , 47 , 51 – 53 ], Brazil ( n = 1, 5.3% [ 43 ]), the Netherlands ( n = 1, 5.3% [ 40 ]), Finland ( n = 1, 5.3% [ 24 ]), Thailand ( n = 1, 5.3% [ 25 ]), China ( n = 1, 5.3% [ 45 ]), and the United Kingdom ( n = 4, 21.1% [ 26 , 36 , 44 , 48 ]. Study duration ranged from 2 days to 24 months, although most interventions ( n = 11) were shorter than 12 weeks.…”

“…Feedback was often graphical, such as a history of physical activity data, or reduced to numerical indicators for activity units or steps (e.g., [ 25 , 48 ]). Some studies provided feedback on goal attainment (e.g., [ 43 , 46 ]) or positive reinforcement (e.g., [ 29 , 40 ]). Most studies, especially if published recently, provided feedback on digital devices such as PDAs (e.g., [ 27 ]), smartphone apps (e.g., [ 51 ]), or smartwatches [ 45 ].…”

“…Frequency of feedback varied, the majority of studies provided feedback continuously (3 studies; [ 25 , 26 , 45 ]), daily (or multiple times daily) (5 studies; [ 28 , 29 , 42 , 47 , 48 ]), or weekly (3 studies; [ 36 , 41 , 53 ]). Other studies had varied feedback frequency throughout the study (i.e., decreasing frequency) [ 27 ], randomization to different frequencies [ 46 ], or did not describe the frequency of feedback [ 24 , 40 , 43 , 51 ].…”