PDF(Pubmed)
Abstract：
BACKGROUND: Digital interventions integrating gamification features hold promise to promote daily steps. However, results regarding the effectiveness of this type of intervention are heterogeneous and not yet confirmed in real-life contexts.
OBJECTIVE: This study aims to examine the effectiveness of a gamified intervention and its potential moderators in a large sample using real-world data. Specifically, we tested (1) whether a gamified intervention enhanced daily steps during the intervention and follow-up periods compared to baseline, (2) whether this enhancement was higher in participants in the intervention than in nonparticipants, and (3) what participant characteristics or intervention parameters moderated the effect of the program.
METHODS: Data from 4819 individuals who registered for a mobile health Kiplin program between 2019 and 2022 were retrospectively analyzed. In this intervention, participants could take part in one or several games in which their daily step count was tracked, allowing individuals to play with their overall activity. Nonparticipants were people who registered for the program but did not take part in the intervention and were considered as a control group. Daily step counts were measured via accelerometers embedded in either commercial wearables or smartphones of the participants. Exposure to the intervention, the intervention content, and participants\' characteristics were included in multilevel models to test the study objectives.
RESULTS: Participants in the intervention group demonstrated a significantly greater increase in mean daily steps from baseline than nonparticipants (P<.001). However, intervention effectiveness depended on participants\' initial physical activity. The daily steps of participants with <7500 baseline daily steps significantly improved from baseline both during the Kiplin intervention (+3291 daily steps) and the follow-up period (+945 daily steps), whereas participants with a higher baseline had no improvement or significant decreases in daily steps after the intervention. Age (P<.001) and exposure (P<.001) positively moderated the intervention effect.
CONCLUSIONS: In real-world settings and among a large sample, the Kiplin intervention was significantly effective in increasing the daily steps of participants from baseline during intervention and follow-up periods compared to nonparticipants. Interestingly, responses to the intervention differed based on participants\' initial steps, with the existence of a plateau effect. Drawing on the insights of self-determination theory, we can assume that the effect of gamification could depend of the initial motivation and activity of participants.
OBJECTIVE: This study aims to examine the effectiveness of a gamified intervention and its potential moderators in a large sample using real-world data. Specifically, we tested (1) whether a gamified intervention enhanced daily steps during the intervention and follow-up periods compared to baseline, (2) whether this enhancement was higher in participants in the intervention than in nonparticipants, and (3) what participant characteristics or intervention parameters moderated the effect of the program.
METHODS: Data from 4819 individuals who registered for a mobile health Kiplin program between 2019 and 2022 were retrospectively analyzed. In this intervention, participants could take part in one or several games in which their daily step count was tracked, allowing individuals to play with their overall activity. Nonparticipants were people who registered for the program but did not take part in the intervention and were considered as a control group. Daily step counts were measured via accelerometers embedded in either commercial wearables or smartphones of the participants. Exposure to the intervention, the intervention content, and participants\' characteristics were included in multilevel models to test the study objectives.
RESULTS: Participants in the intervention group demonstrated a significantly greater increase in mean daily steps from baseline than nonparticipants (P<.001). However, intervention effectiveness depended on participants\' initial physical activity. The daily steps of participants with <7500 baseline daily steps significantly improved from baseline both during the Kiplin intervention (+3291 daily steps) and the follow-up period (+945 daily steps), whereas participants with a higher baseline had no improvement or significant decreases in daily steps after the intervention. Age (P<.001) and exposure (P<.001) positively moderated the intervention effect.
CONCLUSIONS: In real-world settings and among a large sample, the Kiplin intervention was significantly effective in increasing the daily steps of participants from baseline during intervention and follow-up periods compared to nonparticipants. Interestingly, responses to the intervention differed based on participants\' initial steps, with the existence of a plateau effect. Drawing on the insights of self-determination theory, we can assume that the effect of gamification could depend of the initial motivation and activity of participants.
摘要：
背景：整合游戏化功能的数字干预有望促进日常步骤。然而,有关此类干预措施有效性的结果具有异质性,尚未在现实生活中得到证实.
目的：本研究旨在使用真实数据在大样本中检验游戏化干预措施的有效性及其潜在的调节者。具体来说,我们测试了（1）与基线相比，游戏化干预是否在干预和随访期间增强了每日步数，(2)干预参与者的这种增强是否高于非参与者，(3)什么参与者特征或干预参数调节了程序的效果。
方法：对2019年至2022年间注册移动健康Kiplin计划的4819名患者的数据进行了回顾性分析。在这次干预中，参与者可以参加一个或几个游戏，在其中跟踪他们的每日步数，允许个人玩他们的整体活动。非参与者是注册参加该计划但未参加干预的人，被视为对照组。通过嵌入在参与者的商业可穿戴设备或智能手机中的加速度计测量每日步数。接触干预，干预内容,和参与者的特征被纳入多水平模型以检验研究目标.
结果：干预组的参与者表现出比非参与者的平均每日步幅显著增加（P<.001）。然而,干预效果取决于参与者的初始体力活动。基线每日步数<7500的参与者在Kiplin干预期间（每日步数+3291步）和随访期间（每日步数+945步），均比基线显著改善。而基线水平较高的参与者在干预后每日步数无改善或显著减少.年龄（P<.001）和暴露（P<.001）正调节干预效果。
结论：在现实世界中，在大样本中，与非参与者相比,Kiplin干预在干预期间和随访期间从基线开始增加参与者的每日步数方面显著有效.有趣的是,对干预的反应因参与者的初始步骤而异，存在高原效应。借鉴自决理论的见解，我们可以假设游戏化的效果可能取决于参与者的初始动机和活动。
目的：本研究旨在使用真实数据在大样本中检验游戏化干预措施的有效性及其潜在的调节者。具体来说,我们测试了（1）与基线相比，游戏化干预是否在干预和随访期间增强了每日步数，(2)干预参与者的这种增强是否高于非参与者，(3)什么参与者特征或干预参数调节了程序的效果。
方法：对2019年至2022年间注册移动健康Kiplin计划的4819名患者的数据进行了回顾性分析。在这次干预中，参与者可以参加一个或几个游戏，在其中跟踪他们的每日步数，允许个人玩他们的整体活动。非参与者是注册参加该计划但未参加干预的人，被视为对照组。通过嵌入在参与者的商业可穿戴设备或智能手机中的加速度计测量每日步数。接触干预，干预内容,和参与者的特征被纳入多水平模型以检验研究目标.
结果：干预组的参与者表现出比非参与者的平均每日步幅显著增加（P<.001）。然而,干预效果取决于参与者的初始体力活动。基线每日步数<7500的参与者在Kiplin干预期间（每日步数+3291步）和随访期间（每日步数+945步），均比基线显著改善。而基线水平较高的参与者在干预后每日步数无改善或显著减少.年龄（P<.001）和暴露（P<.001）正调节干预效果。
结论：在现实世界中，在大样本中，与非参与者相比,Kiplin干预在干预期间和随访期间从基线开始增加参与者的每日步数方面显著有效.有趣的是,对干预的反应因参与者的初始步骤而异，存在高原效应。借鉴自决理论的见解，我们可以假设游戏化的效果可能取决于参与者的初始动机和活动。
