社会激励和游戏化促进减肥：LOSE IT 随机对照试验。
Social Incentives and Gamification to Promote Weight Loss: The LOSE IT Randomized, Controlled Trial.
机构信息
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Penn Medicine Nudge Unit, Philadelphia, PA, USA.
出版信息
J Gen Intern Med. 2018 Oct;33(10):1669-1675. doi: 10.1007/s11606-018-4552-1. Epub 2018 Jul 12.
BACKGROUND
Social networks influence obesity patterns, but interventions to leverage social incentives to promote weight loss have not been well evaluated.
OBJECTIVE
To test the effectiveness of gamification interventions designed using insights from behavioral economics to enhance social incentives to promote weight loss.
DESIGN
The Leveraging Our Social Experiences and Incentives Trial (LOSE IT) was a 36-week randomized, controlled trial with a 24-week intervention and 12-week follow-up.
PARTICIPANTS
One hundred and ninety-six obese adults (body mass index ≥ 30) comprising 98 two-person teams.
INTERVENTIONS
All participants received a wireless weight scale, used smartphones to track daily step counts, formed two-person teams with a family member or friend, and selected a weight loss goal. Teams were randomly assigned to control or one of two gamification interventions for 36 weeks that used points and levels to enhance collaborative social incentives. One of the gamification arms also had weight and step data shared regularly with each participant's primary care physician (PCP).
MAIN OUTCOME MEASURES
The primary outcome was weight loss at 24 weeks. Secondary outcomes included weight loss at 36 weeks.
KEY RESULTS
At 24 weeks, participants lost significant weight from baseline in the control arm (mean: - 3.9 lbs; 95% CI: - 6.1 to - 1.7; P < 0.001), the gamification arm (mean: - 6.6 lbs; 95% CI: - 9.4 to - 3.9; P < 0.001), and the gamification arm with PCP data sharing (mean: - 4.8 lbs; 95% CI: - 7.4 to - 2.3; P < 0.001). At 36 weeks, weight loss from baseline remained significant in the control arm (mean: - 3.5 lbs; 95% CI: - 6.1 to - 0.8; P = 0.01), the gamification arm (mean: - 6.3 lbs; 95% CI: - 9.2 to - 3.3; P < 0.001), and the gamification arm with PCP data sharing (mean: - 5.2 lbs; 95% CI: - 8.5 to - 2.0; P < 0.01). However, in the main adjusted model, there were no significant differences in weight loss between each of the intervention arms and control at either 12, 24, or 36 weeks.
CONCLUSIONS
Using digital health devices to track behavior with a partner led to significant weight loss through 36 weeks, but the gamification interventions were not effective at promoting weight loss when compared to control.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: 02564445.
背景
社交网络影响肥胖模式，但利用社交激励促进减肥的干预措施尚未得到很好的评估。
目的
测试使用行为经济学洞察设计的游戏化干预措施的有效性，以增强促进减肥的社交激励。
设计
利用我们的社交经验和激励试验（LOSE IT）是一项 36 周的随机对照试验，干预期为 24 周，随访期为 12 周。
参与者
196 名肥胖成年人（体重指数≥30），包括 98 对两人小组。
干预措施
所有参与者都使用了无线体重秤，使用智能手机来跟踪日常步数，并与家庭成员或朋友组成两人小组，选择减肥目标。小组被随机分配到对照组或两种游戏化干预组中的一种，持续 36 周，使用积分和等级来增强协作社交激励。其中一种游戏化干预组还定期与每位参与者的初级保健医生（PCP）共享体重和步数数据。
主要结果测量
主要结果是 24 周时的体重减轻。次要结果包括 36 周时的体重减轻。
主要结果
在 24 周时，对照组（平均：-3.9 磅；95%置信区间：-6.1 至-1.7；P<0.001）、游戏化干预组（平均：-6.6 磅；95%置信区间：-9.4 至-3.9；P<0.001）和游戏化干预组与 PCP 数据共享（平均：-4.8 磅；95%置信区间：-7.4 至-2.3；P<0.001）的参与者体重从基线显著减轻。在 36 周时，对照组（平均：-3.5 磅；95%置信区间：-6.1 至-0.8；P=0.01）、游戏化干预组（平均：-6.3 磅；95%置信区间：-9.2 至-3.3；P<0.001）和游戏化干预组与 PCP 数据共享（平均：-5.2 磅；95%置信区间：-8.5 至-2.0；P<0.01）的体重减轻仍然显著。然而，在主要调整模型中，在 12、24 或 36 周时，每个干预组与对照组相比，体重减轻均无显著差异。
结论
使用数字健康设备与伴侣一起跟踪行为可导致 36 周内显著减肥，但与对照组相比，游戏化干预措施在促进减肥方面效果不佳。
试验注册
clinicaltrials.gov 标识符：02564445。
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