Information & Electronics Research Institute, Korea Advanced Institute of Science & Technology, Daejeon, Republic of Korea.
School of Computing, Korea Advanced Institute of Science & Technology, Daejeon, Republic of Korea.
JMIR Mhealth Uhealth. 2023 Jan 27;11:e41660. doi: 10.2196/41660.
BACKGROUND: A growing body of evidence shows that financial incentives can effectively reinforce individuals' positive behavior change and improve compliance with health intervention programs. A critical factor in the design of incentive-based interventions is to set a proper incentive magnitude. However, it is highly challenging to determine such magnitudes as the effects of incentive magnitude depend on personal attitudes and contexts. OBJECTIVE: This study aimed to illustrate loss-framed adaptive microcontingency management (L-AMCM) and the lessons learned from a feasibility study. L-AMCM discourages an individual's adverse health behaviors by deducting particular expenses from a regularly assigned budget, where expenses are adaptively estimated based on the individual's previous responses to varying expenses and contexts. METHODS: We developed a mobile health intervention app for preventing prolonged sedentary lifestyles. This app delivered a behavioral mission (ie, suggesting taking an active break for a while) with an incentive bid when 50 minutes of uninterrupted sedentary behavior happened. Participants were assigned to either the fixed (ie, deducting the monotonous expense for each mission failure) or adaptive (ie, deducting varying expenses estimated by the L-AMCM for each mission failure) incentive group. The intervention lasted 3 weeks. RESULTS: We recruited 41 participants (n=15, 37% women; fixed incentive group: n=20, 49% of participants; adaptive incentive group: n=21, 51% of participants) whose mean age was 24.0 (SD 3.8; range 19-34) years. Mission success rates did not show statistically significant differences by group (P=.54; fixed incentive group mean 0.66, SD 0.24; adaptive incentive group mean 0.61, SD 0.22). The follow-up analysis of the adaptive incentive group revealed that the influence of incentive magnitudes on mission success was not statistically significant (P=.18; odds ratio 0.98, 95% CI 0.95-1.01). On the basis of the qualitative interviews, such results were possibly because the participants had sufficient intrinsic motivation and less sensitivity to incentive magnitudes. CONCLUSIONS: Although our L-AMCM did not significantly affect users' mission success rate, this study configures a pioneering work toward adaptively estimating incentives by considering user behaviors and contexts through leveraging mobile sensing and machine learning. We hope that this study inspires researchers to develop incentive-based interventions.
背景:越来越多的证据表明,经济激励可以有效地加强个人的积极行为改变,并提高健康干预计划的依从性。基于激励的干预设计的一个关键因素是设定适当的激励幅度。然而,确定这种幅度是极具挑战性的,因为激励幅度的效果取决于个人的态度和背景。
目的:本研究旨在举例说明基于损失框架的自适应微连续管理(L-AMCM),并介绍一项可行性研究的经验教训。L-AMCM 通过从定期分配的预算中扣除特定费用来阻止个人的不良健康行为,其中费用是根据个人对不同费用和环境的先前反应进行自适应估计的。
方法:我们开发了一款用于预防长时间久坐不动生活方式的移动健康干预应用程序。当发生 50 分钟不间断的久坐行为时,该应用程序会提供一个行为任务(即建议休息一会儿进行积极活动),并提供一个激励出价。参与者被分配到固定(即每次任务失败扣除单调费用)或自适应(即每次任务失败扣除由 L-AMCM 估计的不同费用)激励组。干预持续了 3 周。
结果:我们招募了 41 名参与者(n=15,37%为女性;固定激励组:n=20,49%的参与者;自适应激励组:n=21,51%的参与者),平均年龄为 24.0(SD 3.8;范围 19-34)岁。按组计算,任务成功率没有统计学上的显著差异(P=.54;固定激励组平均值为 0.66,SD 0.24;自适应激励组平均值为 0.61,SD 0.22)。对自适应激励组的后续分析表明,激励幅度对任务成功率的影响没有统计学意义(P=.18;优势比 0.98,95%CI 0.95-1.01)。基于定性访谈,结果可能是因为参与者有足够的内在动机,对激励幅度的敏感性较低。
结论:尽管我们的 L-AMCM 没有显著影响用户的任务成功率,但本研究通过利用移动感应和机器学习来考虑用户行为和环境,配置了一种通过自适应估计激励来实现的开创性工作。我们希望这项研究能激发研究人员开发基于激励的干预措施。
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