Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial

BackgroundChronic (ie, long-term) elevated stress is associated with a number of mental and physical health conditions. Mindfulness meditation mobile apps are a promising tool for stress self-management that can overcome several barriers associated with in-person intervention...

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Main Authors: Chad Stecher, Sara Cloonan, Sebastian Linnemayr, Jennifer Huberty
Format: Article
Language:English
Published: JMIR Publications 2023-04-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2023/1/e39930
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author Chad Stecher
Sara Cloonan
Sebastian Linnemayr
Jennifer Huberty
author_facet Chad Stecher
Sara Cloonan
Sebastian Linnemayr
Jennifer Huberty
author_sort Chad Stecher
collection DOAJ
description BackgroundChronic (ie, long-term) elevated stress is associated with a number of mental and physical health conditions. Mindfulness meditation mobile apps are a promising tool for stress self-management that can overcome several barriers associated with in-person interventions; however, to date, poor app-based intervention adherence has limited the efficacy of these mobile health tools. Anchoring, or pairing, a new behavior with an existing routine has been shown to effectively establish habits that are maintained over time, but this strategy typically only works for those with high initial motivation and has yet to be tested for maintaining meditation with a mobile app. ObjectiveThis study will test novel combinations of behavioral economics–based incentives with the anchoring strategy for establishing and maintaining adherence to an effective dose of meditation with a mobile app. MethodsThis 16-week study will use a 5-arm, parallel, partially blinded (participants only), randomized controlled design. We will implement a fractional factorial study design that varies the use of self-monitoring messages and financial incentives to support participants’ use of their personalized anchoring strategy for maintaining adherence to a ≥10 minute-per-day meditation prescription during an 8-week intervention period, followed by an 8-week postintervention observation period. Specifically, we will vary the use of self-monitoring messages of either the target behavior (ie, meditation tracking) or the outcome associated with the target behavior (ie, mood symptom tracking). We will also vary the use of financial incentives conditional on either meditation at any time of day or meditation performed at approximately the same time of day as participants’ personalized anchors. ResultsContinuous meditation app use data will be used to measure weekly meditation adherence over the 16-week study period as a binary variable equal to 1 if participants complete ≥10 minutes of meditation for ≥4 days per week and 0 otherwise. We will measure weekly anchoring plan adherence as a binary variable equal to 1 if participants complete ≥10 minutes of meditation within +1 or −1 hour of the timing of their chosen anchor on ≥4 days per week and 0 otherwise. In addition to these primary measures of meditation and anchoring plan adherence, we will also assess the secondary measures of stress, anxiety, posttraumatic stress disorder, sleep disturbance, and meditation app habit strength at baseline, week 8, and week 16. ConclusionsThis study will fill an important gap in the mobile health literature by testing novel intervention approaches for establishing and maintaining adherence to app-based mindfulness meditation. If successful, this study will identify an accessible and scalable stress self-management intervention that can help combat stress in the United States. Trial RegistrationClinicalTrials.gov NCT05217602; https://clinicaltrials.gov/ct2/show/NCT05217602 International Registered Report Identifier (IRRID)DERR1-10.2196/39930
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spelling doaj.art-21ea60d2d8694286bdae6cbad3d262762023-08-28T23:58:46ZengJMIR PublicationsJMIR Research Protocols1929-07482023-04-0112e3993010.2196/39930Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled TrialChad Stecherhttps://orcid.org/0000-0003-2218-3306Sara Cloonanhttps://orcid.org/0000-0001-8221-7737Sebastian Linnemayrhttps://orcid.org/0000-0002-6945-5279Jennifer Hubertyhttps://orcid.org/0000-0002-0276-4640 BackgroundChronic (ie, long-term) elevated stress is associated with a number of mental and physical health conditions. Mindfulness meditation mobile apps are a promising tool for stress self-management that can overcome several barriers associated with in-person interventions; however, to date, poor app-based intervention adherence has limited the efficacy of these mobile health tools. Anchoring, or pairing, a new behavior with an existing routine has been shown to effectively establish habits that are maintained over time, but this strategy typically only works for those with high initial motivation and has yet to be tested for maintaining meditation with a mobile app. ObjectiveThis study will test novel combinations of behavioral economics–based incentives with the anchoring strategy for establishing and maintaining adherence to an effective dose of meditation with a mobile app. MethodsThis 16-week study will use a 5-arm, parallel, partially blinded (participants only), randomized controlled design. We will implement a fractional factorial study design that varies the use of self-monitoring messages and financial incentives to support participants’ use of their personalized anchoring strategy for maintaining adherence to a ≥10 minute-per-day meditation prescription during an 8-week intervention period, followed by an 8-week postintervention observation period. Specifically, we will vary the use of self-monitoring messages of either the target behavior (ie, meditation tracking) or the outcome associated with the target behavior (ie, mood symptom tracking). We will also vary the use of financial incentives conditional on either meditation at any time of day or meditation performed at approximately the same time of day as participants’ personalized anchors. ResultsContinuous meditation app use data will be used to measure weekly meditation adherence over the 16-week study period as a binary variable equal to 1 if participants complete ≥10 minutes of meditation for ≥4 days per week and 0 otherwise. We will measure weekly anchoring plan adherence as a binary variable equal to 1 if participants complete ≥10 minutes of meditation within +1 or −1 hour of the timing of their chosen anchor on ≥4 days per week and 0 otherwise. In addition to these primary measures of meditation and anchoring plan adherence, we will also assess the secondary measures of stress, anxiety, posttraumatic stress disorder, sleep disturbance, and meditation app habit strength at baseline, week 8, and week 16. ConclusionsThis study will fill an important gap in the mobile health literature by testing novel intervention approaches for establishing and maintaining adherence to app-based mindfulness meditation. If successful, this study will identify an accessible and scalable stress self-management intervention that can help combat stress in the United States. Trial RegistrationClinicalTrials.gov NCT05217602; https://clinicaltrials.gov/ct2/show/NCT05217602 International Registered Report Identifier (IRRID)DERR1-10.2196/39930https://www.researchprotocols.org/2023/1/e39930
spellingShingle Chad Stecher
Sara Cloonan
Sebastian Linnemayr
Jennifer Huberty
Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial
JMIR Research Protocols
title Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial
title_full Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial
title_fullStr Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial
title_full_unstemmed Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial
title_short Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial
title_sort combining behavioral economics based incentives with the anchoring strategy protocol for a randomized controlled trial
url https://www.researchprotocols.org/2023/1/e39930
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