Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.

Participants often vary in their response to behavioral interventions, but methods to identify groups of participants that are more likely to respond are lacking. In this secondary analysis of a randomized clinical trial, we used baseline characteristics to group participants into distinct behaviora...

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Main Authors: Xisui Shirley Chen, Sujatha Changolkar, Amol S Navathe, Kristin A Linn, Gregory Reh, Gregory Szwartz, David Steier, Sarah Godby, Mohan Balachandran, Joseph D Harrison, Charles A L Rareshide, Mitesh S Patel
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0239288
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author Xisui Shirley Chen
Sujatha Changolkar
Amol S Navathe
Kristin A Linn
Gregory Reh
Gregory Szwartz
David Steier
Sarah Godby
Mohan Balachandran
Joseph D Harrison
Charles A L Rareshide
Mitesh S Patel
author_facet Xisui Shirley Chen
Sujatha Changolkar
Amol S Navathe
Kristin A Linn
Gregory Reh
Gregory Szwartz
David Steier
Sarah Godby
Mohan Balachandran
Joseph D Harrison
Charles A L Rareshide
Mitesh S Patel
author_sort Xisui Shirley Chen
collection DOAJ
description Participants often vary in their response to behavioral interventions, but methods to identify groups of participants that are more likely to respond are lacking. In this secondary analysis of a randomized clinical trial, we used baseline characteristics to group participants into distinct behavioral phenotypes and evaluated differential responses to a physical activity intervention. Latent class analysis was used to segment participants based on baseline participant data including demographics, validated measures of psychosocial variables, and physical activity behavior. The trial included 602 adults from 40 U.S. states with body mass index ≥25 who were randomized to control or one of three gamification interventions (supportive, collaborative, or competitive) to increase physical activity. Daily step counts were monitored using a wearable device for a 24-week intervention with 12 weeks of follow-up. The model segmented participants into three classes named for key defining traits: Class 1, extroverted and motivated; Class 2, less active and less social; Class 3, less motivated and at-risk. Adjusted regression models were used to test for differences in intervention response relative to control within each behavioral phenotype. In Class 1, only participants in the competitive arm increased their mean daily steps during the intervention (adjusted difference, 945; 95% CI, 352-1537; P = .002), but it was not sustained during follow-up. In Class 2, participants in all three gamification arms significantly increased their mean daily steps compared to control during the intervention (supportive arm adjusted difference 1172; 95% CI, 363-1980; P = .005; collaborative arm adjusted difference 1119; 95% CI, 319-1919; P = .006; competitive arm adjusted difference 1179; 95% CI, 400-1957; P = .003) and all three had sustained impact during follow-up. In Class 3, none of the interventions had a significant effect on physical activity. Three behavioral phenotypes were identified, each with a different response to the interventions. This approach could be used to better target behavioral interventions to participants that are more likely to respond to them.
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spelling doaj.art-afaae0fd05fc4206a172d6a2a1c700022022-12-21T23:30:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011510e023928810.1371/journal.pone.0239288Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.Xisui Shirley ChenSujatha ChangolkarAmol S NavatheKristin A LinnGregory RehGregory SzwartzDavid SteierSarah GodbyMohan BalachandranJoseph D HarrisonCharles A L RareshideMitesh S PatelParticipants often vary in their response to behavioral interventions, but methods to identify groups of participants that are more likely to respond are lacking. In this secondary analysis of a randomized clinical trial, we used baseline characteristics to group participants into distinct behavioral phenotypes and evaluated differential responses to a physical activity intervention. Latent class analysis was used to segment participants based on baseline participant data including demographics, validated measures of psychosocial variables, and physical activity behavior. The trial included 602 adults from 40 U.S. states with body mass index ≥25 who were randomized to control or one of three gamification interventions (supportive, collaborative, or competitive) to increase physical activity. Daily step counts were monitored using a wearable device for a 24-week intervention with 12 weeks of follow-up. The model segmented participants into three classes named for key defining traits: Class 1, extroverted and motivated; Class 2, less active and less social; Class 3, less motivated and at-risk. Adjusted regression models were used to test for differences in intervention response relative to control within each behavioral phenotype. In Class 1, only participants in the competitive arm increased their mean daily steps during the intervention (adjusted difference, 945; 95% CI, 352-1537; P = .002), but it was not sustained during follow-up. In Class 2, participants in all three gamification arms significantly increased their mean daily steps compared to control during the intervention (supportive arm adjusted difference 1172; 95% CI, 363-1980; P = .005; collaborative arm adjusted difference 1119; 95% CI, 319-1919; P = .006; competitive arm adjusted difference 1179; 95% CI, 400-1957; P = .003) and all three had sustained impact during follow-up. In Class 3, none of the interventions had a significant effect on physical activity. Three behavioral phenotypes were identified, each with a different response to the interventions. This approach could be used to better target behavioral interventions to participants that are more likely to respond to them.https://doi.org/10.1371/journal.pone.0239288
spellingShingle Xisui Shirley Chen
Sujatha Changolkar
Amol S Navathe
Kristin A Linn
Gregory Reh
Gregory Szwartz
David Steier
Sarah Godby
Mohan Balachandran
Joseph D Harrison
Charles A L Rareshide
Mitesh S Patel
Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.
PLoS ONE
title Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.
title_full Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.
title_fullStr Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.
title_full_unstemmed Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.
title_short Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.
title_sort association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives secondary analysis of the step up randomized clinical trial
url https://doi.org/10.1371/journal.pone.0239288
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