Gamification improves physical activity not blood sugar control in diabetes: JAMA
Gamification is the use of game design elements, such as points and levels, that has increasingly been used to engage individuals in health promotion efforts. Many employers commonly use gamification in workplace wellness programs, and game design elements exist in about two-thirds of the most popular health and fitness mobile applications. Although gamification is used widely, designs often do not fully leverage insights from fields such as behavioral economics that could better address predictable barriers to behavior change.
According to research findings published in JAMA Network Open,among adults with uncontrolled type 2 diabetes, a behaviorally designed gamification intervention significantly increased physical activity over a 1-year period when designed to enhance either support or competition but not collaboration. Further, no differences between intervention and control groups were found for other outcomes like blood sugar control or weight loss.
Gamification is increasingly being used to promote healthy behaviors. However, it has not been well tested among patients with chronic conditions and over longer durations.So,researchers undertook the current study to test the effectiveness of behaviorally designed gamification interventions to enhance support, collaboration, or competition to promote physical activity and weight loss among adults with uncontrolled type 2 diabetes.
For the study design, a 4-arm randomized clinical trial with a 1-year intervention was conducted from January 23, 2017, to January 27, 2020, with remotely monitored intervention. Analyses were conducted between February 10 and October 6, 2020. Participants included 361 adults with type 2 diabetes with hemoglobin A1c levels greater than or equal to 8% and body mass index greater than or equal to 25.All participants received a wearable device, smart weight scale, and laboratory testing. Participants in the control group received feedback from their devices but no other interventions. Participants in the gamification arms conducted goal setting and were entered into a 1-year game designed using insights from behavioral economics with points and levels for achieving step goals and weight loss targets. The game varied by trial arm to promote either support, collaboration, or competition.
Co-primary outcomes included daily step count, weight, and hemoglobin A1c level. Secondary outcome was low-density lipoprotein cholesterol level. Intention-to-treat analysis was used.
Results highlighted some interesting facts.
- Participants had a mean (SD) age of 52.5 (10.1) years; hemoglobin A1c level, 9.6% (1.6%); daily steps, 4632 (2523); weight, 107.4 kg (20.8 kg); and body mass index, 37.1 (6.6). Of the 361 participants, 202 (56.0%) were women, 143 (39.6%) were White, and 185 (51.2%) were Black; with 87 (24.1%) randomized to control; 92 (25.4%) randomized to gamification with support and intervention; 95 (26.3%) randomized to gamification with collaboration; and 87 (24.1%) randomized to gamification with competition.
- Compared with the control group over 1 year, there was a significant increase in mean daily steps from baseline among participants receiving gamification with support (adjusted difference relative to control group, 503 steps; 95% CI, 103 to 903 steps; P = .01) and competition (606 steps; 95% CI, 201 to 1011 steps; P = .003) but not collaboration (280 steps; 95% CI, −115 to 674 steps; P = .16).
- All trial arms had significant reductions in weight and hemoglobin A1c levels from baseline, but there were no significant differences between any of the intervention arms and the control arm.
- There was only 1 adverse event reported that may have been related to the trial (arthritic knee pain).
"In a remotely monitored randomized clinical trial of adults with overweight or obesity and uncontrolled type 2 diabetes, gamification interventions that encouraged social support or competition led to significant increases in physical activity relative to the control group during the 1-year intervention, but an intervention that encouraged collaboration among people who did not know each other did not."observed the research team.
For full article follow the link: 10.1001/jamanetworkopen.2021.10255
Primary source: JAMA