Effect of a Game-Based Intervention Designed to Enhance Social Incentives to Increase Physical Activity Among Families: The BE FIT Randomized Clinical Trial

In JAMA Internal Medicine, Mitesh Patel and colleagues, including Kevin Volpp and Dylan Small, tested the effectiveness of a gamification intervention designed using insights from behavioral economics to increase physical activity. The researchers piloted the Behavioral Economics Framingham Incentive Trial (BE FIT), a randomized clinical trial with a 12-week intervention period and a 12-week follow-up period, among 200 adults (comprising 94 families) enrolled in the Framingham Heart Study.

All participants received daily feedback on whether or not they had achieved their step goal on the prior day. The control arm received no other intervention. Participants in the gamification arm had the opportunity to earn points and progress through levels as they achieved physical activity goals. The game design was meant to enhance collaboration, accountability, and peer support. The researchers found that participants in the gamification arm achieved their step goals more often and had a significantly greater increase in mean daily steps compared with baseline (approximately 1700 steps, which is an additional mile per day) than did the control arm. During the 12-week follow-up period, physical activity levels among participants in the gamification arm declined over time but overall remained significantly greater than those in the control arm. These findings demonstrate the potential for leveraging incentives within social networks to change health behaviors. The use of wearable devices and smartphones may offer a scalable approach to deliver these types of interventions on a broader scale.