SBM poster_review_03222016
1
Method What types of incentives elicit weight control in adults?: A systematic review of behavioral interventions Zakkoyya H. Lewis BS, Maria C. Swartz PhD, MPH, Elizabeth J. Lyons PhD, MPH The University of Texas Medical Branch, Galveston TX Background Conclusions Results cont. ZHL is supported by a Predoctoral Fellowship Grant from the American Heart Association (16PRE27090012). MCS is supported by the Cancer Prevention and Research Institute of Texas, Comparative Effectiveness Research on Cancer in Texas (RP140020) and the National Institute on Disability, Independence Living and Rehabilitation Research, Department of Education (90AR5009). EJL is supported by a Mentored Research Scholar Grant in Applied and Clinical Research, MRSG-14-165-01-CPPB, from the American Cancer Society and by a Beginning Grant-in-Aid, 13BGIA17110021, from the American Heart Association. The funding agencies had no role in the study design; data collection, management, analysis, or interpretation; and does not hold ultimate authority over these activities. Zakkoyya Lewis, BS, ATC PhD Candidate American Heart Association Fellow 301 University Blvd, Galveston, TX, 77551 Division of Rehabilitation Sciences O 409.772.2576 E [email protected] References Acknowledgements • Incentives are often provided in weight control interventions, but they may inhibit autonomous motivation • Weight-control incentives have been evaluated under dimensions of operant conditioning 1 • Gamification is an alternative incentive structure that may better support autonomous motivation and result in weight maintenance • The purpose of this review was to characterize different incentive structures (operant conditioning, gamification) and synthesize evidence of their effectiveness in weight control interventions 1. Burns RJ, Donovan AS, Ackermann RT, et al.: A Theoretically Grounded Systematic Review of Material Incentives for Weight Loss: Implications for Interventions. Annals of Behavioral Medicine. 2012, 44:375-388. 2. Björk S, Holopainen J: Patterns in Game Design. Hingham, Massachusetts: Charles River Media, Inc., 2005. • Relevant articles were retrieved from Medline OVID, Medline Pubmed, Web of Science, CINAHL, Cochrane Central, PsycINFO, and reference searching • The following search terms were used: o Weight, obesity, obese, overweight, or body mass index o Reward*, incentive*, reinforc*, gamif*, motivat*, encourag*, or entic* o Interven* or randomiz* o Diet or activit* o Behavio* • Out of the 2,130 retrieved, 14 studies (15 articles) were included Results Reference Study duration, follow-up Incentive type Incentive structure Game elements 2 Reference Study duration, follow-up Incentive type Incentive structure Game elements 2 Almeida, 2015 6 mo., 6 mo. Monetary Positive- fixed Social interaction, symmetric information Morgan, 2011* 14 wk. Gift voucher Positive- fixed Collaborative action, competition, cooperation, social interaction, team balance, team play, tradeoffs Faghri, 2014* 16 wk., 12 wk. Monetary Positive- , positive/ negative- fixed Arithmetic rewards, betting, risk/reward, social interaction Morgan, 2014 ᵻ 3 mo., 3 mo. Personally selected Positive- variable Player decided results, social interaction Finkelstein, 2007* 3 mo.,, 3 mo. Monetary Positive- fixed none Petry, 2011* 12 wk. Prizes Positive- variable Collection, luck, perceived chance, score Galbo, 2011* 16 wk., 3 mo. Monetary Positive-, positive/ negative- fixed Arithmetic rewards, betting, investments, risk/reward Pope, 2014 12 wk., 12 wk. Monetary Positive/ negative- fixed Red Queen dilemma, symmetric information Garcia, 2014 12 wk. Points/ prizes Positive- variable Budget action, collecting, collection, immersion, luck, perceived chance, score, social interaction, tradeoffs Racette, 2015 1 yr. Prizes Positive- fixed Collecting, collection, save points, score, social interaction Jeffery, 2003 ᵻ 12 mo., 6 mo. Monetar y Positive- fixed Social interaction Ratliff, 2012* 8 wk. Monetary Positive- fixed Social interaction John, 2011 24 wk., 36 wk. Monetary Positive/ negative- fixed Arithmetic reward, betting, investments, risk/reward, time limits Volpp, 2008* 16 wk., 3 mo. Monetary Positive- variable; positive/ negative- fixed Arithmetic rewards, betting, collection, investments, luck, perceived chance, risk/reward, score, time limits *significant weight change in the intervention group compared to the control group at the end of the intervention significant weight change in the intervention group compared to the control group at follow-up ᵻ • Incentives were awarded for change in diet, exercise, and weight • Most interventions were less than 1 year • Interventions were “gamified” by providing a median of 4 game elements (range 0-9) • Nine studies found a significant group difference at the end of the intervention, and two found significant group difference at follow-up • Incentives appear to be effective in the short-term but their effect in the long term is inconclusive • Although the interventions were not classified as “gamified”, nearly all studies incorporated game elements • Gamified incentives may result in maintained weight loss but more research is needed
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Transcript of SBM poster_review_03222016
Method
What types of incentives elicit weight control in adults?: A systematic review of behavioral interventions
Zakkoyya H. Lewis BS, Maria C. Swartz PhD, MPH, Elizabeth J. Lyons PhD, MPH
The University of Texas Medical Branch, Galveston TX
Background
ConclusionsResults cont.
ZHL is supported by a Predoctoral Fellowship Grant from the American Heart Association (16PRE27090012). MCS is supported by the Cancer Prevention and Research Institute of Texas, Comparative Effectiveness Research on Cancer in Texas (RP140020) and the National Institute on Disability, Independence Living and Rehabilitation Research, Department of Education (90AR5009). EJL is supported by a Mentored Research Scholar Grant in Applied and Clinical Research, MRSG-14-165-01-CPPB, from the American Cancer Society and by a Beginning Grant-in-Aid, 13BGIA17110021, from the American Heart Association. The funding agencies had no role in the study design; data collection, management, analysis, or interpretation; and does not hold ultimate authority over these activities.
Zakkoyya Lewis, BS, ATCPhD Candidate
American Heart Association Fellow301 University Blvd, Galveston, TX,
77551Division of Rehabilitation Sciences
O 409.772.2576E [email protected]
References
Acknowledgements
• Incentives are often provided in weight control interventions, but they may inhibit autonomous motivation
• Weight-control incentives have been evaluated under dimensions of operant conditioning1
• Gamification is an alternative incentive structure that may better support autonomous motivation and result in weight maintenance
• The purpose of this review was to characterize different incentive structures (operant condit ioning, gamification) and synthesize evidence of their effectiveness in weight control interventions
1. Burns RJ, Donovan AS, Ackermann RT, et al.: A Theoretically Grounded Systematic Review of Material Incentives for Weight Loss: Implications for Interventions. Annals of Behavioral Medicine. 2012, 44:375-388.
2. Björk S, Holopainen J: Patterns in Game Design. Hingham, Massachusetts: Charles River Media, Inc., 2005.
• Relevant articles were retrieved from Medline OVID, Medline Pubmed, Web of Science, CINAHL, Cochrane Central, PsycINFO, and reference searching
• The following search terms were used:o Weight, obesity, obese, overweight, or body mass index o Reward*, incentive*, reinforc*, gamif*, motivat*, encourag*,
or entic*o Interven* or randomiz*o Diet or activit*o Behavio*
• Out of the 2,130 retrieved, 14 studies (15 articles) were included
Results
ReferenceStudy
duration, follow-up
Incentive type
Incentive structure
Game elements2 ReferenceStudy
duration, follow-up
Incentive type
Incentive structure
Game elements2
Almeida, 2015
6 mo., 6 mo.
MonetaryPositive-
fixedSocial interaction, symmetric
informationMorgan, 2011* 14 wk. Gift voucher Positive-
fixed
Collaborative action, competition, cooperation, social interaction,
team balance, team play, tradeoffs
Faghri, 2014*
16 wk., 12 wk. Monetary
Positive- , positive/ negative-
fixed
Arithmetic rewards, betting, risk/reward, social interaction
Morgan, 2014 ᵻ
3 mo., 3 mo.
Personally selected
Posit ive-variable
Player decided results, social interaction
Finkelstein, 2007*
3 mo.,,3 mo. Monetary Positive-
fixed none Petry, 2011* 12 wk. Prizes Positive-
variableCollection, luck, perceived chance,
score
Galbo, 2011*
16 wk., 3 mo. Monetary
Positive-, positive/ negative-
fixed
Arithmetic rewards, betting, investments, risk/reward
Pope, 2014
12 wk., 12 wk.
MonetaryPositive/ negative-
fixed
Red Queen dilemma, symmetric information
Garcia, 2014
12 wk.Points/ prizes
Positive-variable
Budget action, collecting, collection, immersion, luck,
perceived chance, score, social interaction, tradeoffs
Racette, 2015
1 yr. PrizesPositive-
fixedCollecting, collection, save points,
score, social interaction
Jeffery, 2003 ᵻ
12 mo., 6 mo.
Monetary
Posit ive-fixed
Social interactionRatliff, 2012* 8 wk. Monetary Positive-
fixed Social interaction
John, 201124 wk., 36 wk.
MonetaryPositive/ negative-
fixed
Arithmetic reward, betting, investments, risk/reward, time
limits
Volpp, 2008*
16 wk., 3 mo. Monetary
Positive-variable; positive/ negative-
fixed
Arithmetic rewards, betting, collection, investments, luck,
perceived chance, risk/reward, score, time limits
*significant weight change in the intervention group compared to the control group at the end of the intervention significant weight change in the intervention group compared to the control group at fol low-upᵻ
• Incentives were awarded for change in diet, exercise, and weight
• Most interventions were less than 1 year• Interventions were “gamified” by providing
a median of 4 game elements (range 0-9)• Nine studies found a significant group
difference at the end of the intervention, and two found significant group difference at follow-up
• Incentives appear to be effective in the short-term but their effect in the long term is inconclusive
• Although the interventions were not classified as “gamified”, nearly all studies incorporated game elements
• Gamified incentives may result in maintained weight loss but more research is needed
