Breaking News
May 3, 2019 - Vaping and Smoking May Signal Greater Motivation to Quit
May 3, 2019 - Dementia looks different in brains of Hispanics
May 3, 2019 - Short-Staffed Nursing Homes See Drop In Medicare Ratings
May 3, 2019 - Study of teens with eating disorders explores how substance users differ from non-substance users
May 3, 2019 - Scientists develop new video game that may help in the study of Alzheimer’s
May 3, 2019 - Arc Bio introduces Galileo Pathogen Solution product line at ASM Clinical Virology Symposium
May 3, 2019 - Cornell University study uncovers relationship between starch digestion gene and gut bacteria
May 3, 2019 - How to Safely Use Glucose Meters and Test Strips for Diabetes
May 3, 2019 - Anti-inflammatory drugs ineffective for prevention of Alzheimer’s disease
May 3, 2019 - Study tracks Pennsylvania’s oil and gas waste-disposal practices
May 3, 2019 - Creating a better radiation diagnostic test for astronauts
May 3, 2019 - Vegans are often deficient in these four nutrients
May 3, 2019 - PPDC announces seed grants to develop medical devices for children
May 3, 2019 - Study maps out the frequency and impact of water polo head injuries
May 3, 2019 - Research on Reddit identifies risks associated with unproven treatments for opioid addiction
May 3, 2019 - Good smells may help ease tobacco cravings
May 3, 2019 - Medical financial hardship found to be very common among people in the United States
May 3, 2019 - Researchers develop multimodal system for personalized post-stroke rehabilitation
May 3, 2019 - Study shows significant mortality benefit with CABG over percutaneous coronary intervention
May 3, 2019 - Will gene-editing of human embryos ever be justifiable?
May 3, 2019 - FDA Approves Dengvaxia (dengue vaccine) for the Prevention of Dengue Disease in Endemic Regions
May 3, 2019 - Why Tonsillitis Keeps Coming Back
May 3, 2019 - Fighting the opioid epidemic with data
May 3, 2019 - Maggot sausages may soon be a reality
May 3, 2019 - Deletion of ATDC gene prevents development of pancreatic cancer in mice
May 2, 2019 - Targeted Therapy Promising for Rare Hematologic Cancer
May 2, 2019 - Alzheimer’s disease is a ‘double-prion disorder,’ study shows
May 2, 2019 - Reservoir bugs: How one bacterial menace makes its home in the human stomach
May 2, 2019 - Clinical, Admin Staff From Cardiology Get Sneak Peek at Epic
May 2, 2019 - Depression increases hospital use and mortality in children
May 2, 2019 - Vicon and NOC support CURE International to create first gait lab in Ethiopia
May 2, 2019 - Researchers use 3D printer to make paper organs
May 2, 2019 - Viral infection in utero associated with behavioral abnormalities in offspring
May 2, 2019 - U.S. Teen Opioid Deaths Soaring
May 2, 2019 - Opioid distribution data should be public
May 2, 2019 - In the Spotlight: “I’m learning every single day”
May 2, 2019 - 2019 Schaefer Scholars Announced
May 2, 2019 - Podcast: KHN’s ‘What The Health?’ Bye-Bye, ACA, And Hello ‘Medicare-For-All’?
May 2, 2019 - Study describes new viral molecular evasion mechanism used by cytomegalovirus
May 2, 2019 - SLU study suggests a more equitable way for Medicare reimbursement
May 2, 2019 - Scientists discover first gene involved in lower urinary tract obstruction
May 2, 2019 - Researchers identify 34 genes associated with increased risk of ovarian cancer
May 2, 2019 - Many low-income infants receive formula in the first few days of life, finds study
May 2, 2019 - Global study finds high success rate for hip and knee replacements
May 2, 2019 - Taking depression seriously: What is it?
May 2, 2019 - With Head Injuries Mounting, Will Cities Put Their Feet Down On E-Scooters?
May 2, 2019 - Scientists develop small fluorophores for tracking metabolites in living cells
May 2, 2019 - Study casts new light into how mothers’ and babies’ genes influence birth weight
May 2, 2019 - Researchers uncover new brain mechanisms regulating body weight
May 2, 2019 - Organ-on-chip systems offered to Asia-Pacific regions by Sydney’s AXT
May 2, 2019 - Adoption of new rules drops readmission penalties against safety net hospitals
May 2, 2019 - Kids and teens who consume zero-calorie sweetened beverages do not save calories
May 2, 2019 - Improved procedure for cancer-related erectile dysfunction
May 2, 2019 - Hormone may improve social behavior in autism
May 2, 2019 - Alzheimer’s disease may be caused by infectious proteins called prions
May 2, 2019 - Even Doctors Can’t Navigate Our ‘Broken Health Care System’
May 2, 2019 - Study looks at the impact on criminal persistence of head injuries
May 2, 2019 - Honey ‘as high in sugars as table sugar’
May 2, 2019 - Innovations to U.S. food system could help consumers in choosing healthy foods
May 2, 2019 - FDA Approves Mavyret (glecaprevir and pibrentasvir) as First Treatment for All Genotypes of Hepatitis C in Pediatric Patients
May 2, 2019 - Women underreport prevalence and intensity of their own snoring
May 2, 2019 - Concussion summit focuses on science behind brain injury
May 2, 2019 - Booker’s Argument For Environmental Justice Stays Within The Lines
May 2, 2019 - Cornell research explains increased metastatic cancer risk in diabetics
May 2, 2019 - Mount Sinai study provides fresh insights into cellular pathways that cause cancer
May 2, 2019 - Researchers to study link between prenatal pesticide exposures and childhood ADHD
May 2, 2019 - CoGEN Congress 2019: Speakers’ overviews
May 2, 2019 - A new strategy for managing diabetic macular edema in people with good vision
May 2, 2019 - Sagent Pharmaceuticals Issues Voluntary Nationwide Recall of Ketorolac Tromethamine Injection, USP, 60mg/2mL (30mg per mL) Due to Lack of Sterility Assurance
May 2, 2019 - Screen time associated with behavioral problems in preschoolers
May 2, 2019 - Hormone reduces social impairment in kids with autism | News Center
May 2, 2019 - Researchers synthesize peroxidase-mimicking nanozyme with low cost and superior catalytic activity
May 2, 2019 - Study results of a potential drug to treat Type 2 diabetes in children announced
May 2, 2019 - Multigene test helps doctors to make effective treatment decisions for breast cancer patients
May 2, 2019 - UNC School of Medicine initiative providing unique care to dementia patients
May 2, 2019 - Nestlé Health Science and VHP join forces to launch innovative COPES program for cancer patients
May 2, 2019 - Study examines how our brain generates consciousness and loses it during anesthesia
May 2, 2019 - Transition Support Program May Aid Young Adults With Type 1 Diabetes
May 2, 2019 - Study shows how neutrophils exacerbate atherosclerosis by inducing smooth muscle-cell death
May 2, 2019 - Research reveals complexity of how we make decisions
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

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