Abstract

Background: Nearly 60% of Veterans are overweight or obese, and overweight is a leading risk factor for mortality and morbidity. MOVE! is the primary program available to overweight Veterans in VHA, and the centerpiece of the MOVE! program is the weekly MOVE! group meetings in which a cohort of 10-15 Veterans meet over a period of 8-16 weeks. These group meetings offer an ideal environment to design and test novel interventions that leverage group dynamics to help participants meet their weight loss and physical activity goals. The striking results of the recent BE FIT trial suggests that interventions based on gamification are worth exploring. Gamification is the application of game design elements in nongame contexts. Typical game elements include assigning goals, earning points or badges for meeting goals, and using social incentives to increase motivation and engagement. The BE FIT trial enrolled teams of family members. Each week a family was giving 70 points, and each day, a family risked losing 10 points if a randomly chosen person did not meet his/her walking target for that day. This simple game yielded substantial increases in the percent of days on which step goals were achieved, and a 2.6-fold increase in mean daily steps over a control group. The goal of this pilot study is to develop similar group-based gamified interventions that are appropriate for the VHA and could be tested in a large-scale trial using MOVE! group meetings as the experimental unit. The aims are: Aim 1: Develop the games that will constitute the intervention using principles of human-centered design. A workshop to design the games will be facilitated by an expert in human-centered design, and attended by researchers, MOVE! participants from VA Puget Sound, MOVE! coordinators from three VA Medical Centers, and the National Director of MOVE!. Aim 2. Pilot test the games through an iterative testing, refining, and retesting process. We will test the games for feasibility in the five MOVE! groups currently occurring in the Puget Sound VAMC, and assess the acceptability of the games to MOVE! participants and coordinators. Aim 3. Pilot test the data collection process. We will build tools to initiate a game for MOVE! participants, to assign points achieving goals, and to monitor the progress of the games. We will pilot test the collection of physical activity from walking apps on participants smartphones. Methodology: We will conduct a human-centered design workshop to design the games, and quantitative and qualitative methods to assess the games for feasibility in a larger trial. Expected results: The result will be protocols for games that can be tested in a group-randomized trial. Next steps: If the games prove feasible and acceptable to MOVE! participants and MOVE! coordinators we will submit a grant proposal to test these games in a pragmatic, group-randomized trial of gamification using MOVE! group meetings as experimental units. Significance: Maintaining a healthy diet and an active lifestyle is good for you and hard. This pilot study is about building an evidence-base around gamified interventions appropriate for a group-based weight loss programs like MOVE! that can help make difficult tasks engaging and fun. If games could increase engagement and participation in MOVE!, they might also make MOVE! more effective. Innovation: Gamification in health research is an emerging field, and mostly focused on phone apps and video games for pediatric populations. The use of analog games for weight loss and physical activity is novel. Effect of study in other areas: This pilot study would be a first step toward the VA becoming a leader in developing and testing novel gamified applications for improving a variety of health behaviors in group settings. HSR&D Priority areas: This research aligns with the HSR&D Patient-centered Care, Care Management, and Health Promotion priority areas.

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DRA: Diabetes and Other Endocrine Disorders

DRE: Treatment - Efficacy/Effectiveness Clinical Trial, TRL - Applied/Translational

Keywords: Health Promotion and Education

MeSH Terms: None at this time.