Breaking News
January 22, 2019 - Better mouse model built to enable precision-medicine research for Alzheimer’s
January 22, 2019 - Molecular profiling of precancerous lung lesions could lead to early detection and new treatments
January 22, 2019 - Genetic factors influence where fat is stored in our bodies
January 22, 2019 - The Psychology Behind Sticking to Your New Year’s Resolutions
January 22, 2019 - Scientists aim to find genetic causes of developmental abnormalities in the vagina and uterus
January 22, 2019 - Looming Global Crisis Means People’s Diets Must Change: Experts
January 22, 2019 - Excessive social media use is comparable to drug addiction
January 22, 2019 - Researchers show how mechanical stress affects bone development
January 22, 2019 - Study takes a step closer to understanding the body’s response to opioid painkillers
January 22, 2019 - Unexpected connection found between feeding and memory centers of the brain
January 22, 2019 - A revolutionary approach transforms bone trauma treatment
January 22, 2019 - Early studies and recent clinical trials on nerve growth factor
January 22, 2019 - Dry Mouth and Older Adults: Information for Caregivers
January 22, 2019 - Are your grandparents getting tipsy at the holiday party?
January 22, 2019 - New machine learning algorithms identify early symptoms of urinary tract infections
January 22, 2019 - Young women skipping the Pap smear test due to embarrassment
January 22, 2019 - A global influenza pandemic high on the WHO’s agenda
January 22, 2019 - Amgen Makes All Repatha (evolocumab) Device Options Available In The US At A 60 Percent Reduced List Price
January 22, 2019 - Elastronics—hydrogel-based microelectronics for localized low-voltage neuromodulation
January 22, 2019 - Branched-chain amino acids in tumors can be targeted to prevent and treat cancer
January 22, 2019 - Fueling macrophages with energy to attack and eat cancer cells
January 22, 2019 - Amgen And UCB Receive Positive Vote From FDA Advisory Committee In Favor Of Approval For Evenity (romosozumab)
January 22, 2019 - Does being bilingual make children more focused? Study says no
January 22, 2019 - Study reveals new genes and biological pathways linked to osteoarthritis
January 22, 2019 - FSU study provides better understanding of spinal cord injuries
January 22, 2019 - Delaying bath for newborn babies increases breastfeeding rates, finds study
January 21, 2019 - WHO identifies non-communicable diseases as major threat to human health
January 21, 2019 - Many parents still try non-evidence-based cold prevention methods for children
January 21, 2019 - High Levels of Activity, Motor Ability Linked to Better Cognition
January 21, 2019 - Killer blows? Knockout study of pair of mouse MicroRNA provides cancer insight
January 21, 2019 - Buffalo researchers receive grant to quicken development of generic equivalents of contraceptives
January 21, 2019 - One-third of pregnant women do not believe cannabis is harmful to their fetus
January 21, 2019 - Fiderstat could be used as chemopreventative drug for intestinal cancers caused by APC gene mutations
January 21, 2019 - Modifying healthcare delivery practices may improve discussions between youth and healthcare providers
January 21, 2019 - UNIST researcher named as recipient of Merck’s 2018 Life Science Awards
January 21, 2019 - How Getting a Flu Shot Could Save Your Life
January 21, 2019 - Surgical adhesions can be treated, prevented in mice
January 21, 2019 - Increased physician-targeted marketing associated with higher opioid overdose deaths
January 21, 2019 - Researchers uncover specific microbial signatures of intestinal disease
January 21, 2019 - Researchers discover new blood vessel system in bones
January 21, 2019 - Simple blood test reliably detects signs of Alzheimer’s damage before symptoms
January 21, 2019 - Study to investigate new targeted oral treatments for severe asthma
January 21, 2019 - Plan Your Plate | NIH News in Health
January 21, 2019 - Fecal occult blood test may improve CRC outcomes in some
January 21, 2019 - Blood test detects Alzheimer’s disease years before symptoms develop
January 21, 2019 - Mount Sinai joins with Paradigm and ReqMed to repurpose drug for treatment of MPS
January 21, 2019 - FDA Advisory Committee Votes on Zynquista (sotagliflozin) as Treatment for Adults with Type 1 Diabetes
January 21, 2019 - The causes and complications of snoring
January 21, 2019 - Placenta adapts and compensates when pregnant mothers have poor diets or low oxygen
January 21, 2019 - New implant could restore the transmission of electrical signals in injured central nervous system
January 21, 2019 - Rapid-acting fentanyl test strips found to be effective at reducing overdose risk
January 21, 2019 - Coronary Artery Calcium May Help Predict CVD in South Asians
January 21, 2019 - The mystery of the super-ager
January 21, 2019 - Scientists develop smart microrobots that can change shape depending on their surroundings
January 21, 2019 - Keep Moving to Keep Brain Sharp in Old Age
January 21, 2019 - Despite progress, gay fathers and their children still structurally stigmatized
January 21, 2019 - New drug for treating liver parasites in vivax malaria
January 21, 2019 - Merck recognized with 2018 Life Science Industry Award for best use of social media
January 21, 2019 - Coeur Wallis equips the canton of Valais with 260 SCHILLER defibrillators
January 21, 2019 - Scientists propose quick and pain-free method for diagnosing kidney cancer
January 21, 2019 - Signs of memory loss could point to hearing issues
January 21, 2019 - HeartFlow Analysis shows highest diagnostic performance for detecting coronary artery disease
January 21, 2019 - How Much Caffeine is Too Much?
January 21, 2019 - Take a timeout before you force your child to apologize
January 21, 2019 - Scientists design two AI algorithms to improve early detection of cognitive impairment
January 21, 2019 - Novel therapy for children with chronic hormone deficiency provides lifeline for parents
January 21, 2019 - Bioethicists call for oversight of poorly regulated, consumer-grade neurotechnology products
January 21, 2019 - Study shows hereditary hemochromatosis behind many cancers and joint diseases
January 21, 2019 - Short bouts of stairclimbing throughout the day can improve cardiovascular health
January 20, 2019 - Liver Transplant Survival May Improve With Race Matching
January 20, 2019 - Study implicates hyperactive immune system in aging brain disorders
January 20, 2019 - Cancer Diagnosis May Quadruple Suicide Risk
January 20, 2019 - Parkinson’s disease experts devise a roadmap
January 20, 2019 - Research brings new hope to treating degenerative brain diseases
January 20, 2019 - Scientists pinpoint a set of molecules that wire the body weight center of the brain
January 20, 2019 - Researchers get close to developing elusive blood test for Alzheimer’s disease
January 20, 2019 - UCLA researchers demonstrate new technique to develop cancer-fighting T cells
January 20, 2019 - Researchers discover how cancer cells avoid genetic meltdown
January 20, 2019 - Exercise makes even the ‘still overweight’ healthier: study
January 20, 2019 - University of Utah to establish first-of-its-kind dark sky studies minor in the US
Combining financial incentives and goal-setting with wearables may encourage heart patients to exercise

Combining financial incentives and goal-setting with wearables may encourage heart patients to exercise

image_pdfDownload PDFimage_print

Combining financial incentives and personalized goal-setting with wearable devices may be an effective way of encouraging patients with heart disease to increase their physical activity. In patients with heart disease, regular physical activity has been shown to decrease the risk of a future heart attack, but getting these patients into a regular exercise program such as cardiac rehab has remained a challenge. Results of a clinical trial led by researchers at Penn Medicine, and published today in the Journal of the American Heart Association (JAHA), show that a home based program offering payment upfront with money taken away if step goals were not met – a design that leverages the concept of loss aversion – increases activity levels and may help to form a more long-lasting habit.

“Regular exercise and cardiac rehab has shown to have significant benefit in those with heart disease but participation in such programs is extremely low for various reasons including patient motivation and access to exercise facilities. There is interest in developing creative remote strategies to engage patients in exercise programs but there is little research for guidance,” said Neel Chokshi, MD, MBA, medical director of the Penn Sports Cardiology and Fitness Program and assistant professor of Clinical Medicine in Cardiology. “In this clinical trial, we tested a scalable approach combining wearables and principles from behavioral economics to show significantly increased activity levels even after incentives were stopped.”

The study enrolled 105 patients into a home-based, remotely monitored program using the Misfit Shine wearable device for a 24-week period to determine the impact of personalized feedback with goals coupled to financial incentives for the first 16 weeks. Patients in the control arm received the wearable but no other interventions. In the intervention group, patients were given personalized step goals and allocated $14 at the beginning of each week for 16 weeks ($224 in total). Each day the step goal was not met, $2 was taken away. During the main intervention period (weeks 9 to 16), patients in the intervention had an increase in their physical activity by 1368 steps per day more than patients in control. After 16 weeks, financial incentives were stopped and patients were followed for another 8 weeks. During the 8-week follow-up period, patients in the intervention still had an increase of 1154 steps per day more than patients in control.

“While many are hopeful that wearable devices can motivate high-risk patients, we found that wearables alone did not increase physical activity levels,” said Mitesh Patel, MD, MBA, MS, an assistant professor of Medicine and Health Care Management, and director of the Penn Medicine Nudge Unit. “However, framing rewards as a loss – a technique from behavioral economics – led to a meaningful difference in behavior. During the 6-month trial, the average patient in the intervention arm had step counts that totaled about 100 miles more than the average patient in control.”

All participants were given a wearable device with a two week startup period to establish baseline step counts. The intervention group then received weekly increases in step goals with daily feedback via text message or email on their performance. Progress was divided in two phases; during the “ramp-up incentive” phase (weeks 1-8), daily step goals increased from baseline by 15 percent each week with a maximum goal of 10,000 steps per day. After 8 weeks, step goals remained fixed and participants moved into the “maintenance incentive” phase (weeks 9-16), followed by an 8-week follow-up phase without incentives (weeks 17-24). During the 16-week intervention, participants in this arm were offered a loss-framed financial incentive. Each week, participants were informed that $14 was allocated to a virtual account. Each day the patient achieved his or her step goal, the balance remained unchanged, but each day the step goal was not achieved, the participant was informed that $2 had been deducted. The balance was refreshed with $14 every week on Monday.

Chokshi and team suggest that additional studies should be conducted to evaluate the sustainability of incentive effects over longer-term periods, to compare incentive designs that vary in magnitude, duration, or frequency, and to evaluate financial incentives and personalized feedback independently to assess effects. This study was supported in part by Grant Number UL1TR000003 from the National Center for Advancing Translational Science. The study was also supported in part by the Institute for Translational Medicine and Therapeutics (ITMAT) and the University of Pennsylvania Health System through the Penn Medicine Nudge Unit.

Source:

https://www.pennmedicine.org/news/news-releases/2018/june/getting-heart-disease-patients-to-exercise-study

Tagged with:

About author

Related Articles