BackgroundGamification and deposit contracts (a financial incentive in which participants pledge their own money) can enhance effectiveness of mobile behavior change interventions. However, to... Show moreBackgroundGamification and deposit contracts (a financial incentive in which participants pledge their own money) can enhance effectiveness of mobile behavior change interventions. However, to assess their potential for improving population health, research should investigate implementation of gamified deposit contracts outside the research setting. Therefore, we analyzed data from StepBet, a smartphone application originally developed by WayBetter, Inc.ObjectiveTo perform a naturalistic evaluation of StepBet gamified deposit contracts, for whom they work best, and under which conditions they are most effective to help increase physical activity.MethodsWayBetter provided data of StepBet participants that participated in a stepcount challenge between 2015 and 2020 (N = 72,974). StepBet challenges were offered on the StepBet smartphone application. The modal challenge consisted of a $40 deposit made prior to a 6-week challenge period during which participants needed to reach daily and weekly step goals in order to regain their deposit. Participants who met their goals also received additional earnings which were paid out from the money lost by those who failed their challenge. Challenge step goals were tailored on a 90-day historic step count retrieval that was also used as the baseline comparison for this study. Primary outcomes were increase in step count (continuous) and challenge success (dichotomous).ResultsOverall, average daily step counts increased by 31.2 % (2423 steps, SD = 3462) from 7774 steps (SD = 3112) at baseline to 10,197 steps (SD = 4162) during the challenge. The average challenge success rate was 73 %. Those who succeeded in their challenge (n = 53,281) increased their step count by 44.0 % (3465 steps, SD = 3013), while those who failed their challenge (n = 19,693) decreased their step count by −5.3 % (−398 steps, SD = 3013). Challenges started as a New Year's resolution were slightly more successful (77.7 %) than those started during the rest of the year (72.6 %).DiscussionIn a real-world setting, and among a large and diverse sample, participating in a gamified deposit contract challenge was associated with a large increase in step counts. A majority of challenges were successful and succeeding in a challenge was associated with a large and clinically relevant increase in step counts. Based on these findings, we recommend implementing gamified deposit contracts for physical activity where possible. An interesting avenue for future research is to explore possible setback effects among people who fail a challenge, and how setbacks can be mitigated. Show less
Ciharova, M.; Cuijpers, P.; Amanvermez, Y.; Riper, H.; Klein, A.M.; Bolinski, F.; ... ; Karyotaki, E. 2023
Background: Short-term mindsets interfere with the consideration of future consequences and therefore predict negative behaviors. We developed a smartphone-based intervention aiming to increase a... Show moreBackground: Short-term mindsets interfere with the consideration of future consequences and therefore predict negative behaviors. We developed a smartphone-based intervention aiming to increase a future-oriented mindset and personal goal attainment by strengthening future self-identification and stimulating episodic future thinking. The aims of the study are 1) to examine users' experiences with the application and their treatment adherence, 2) to examine the effectiveness of the intervention, and 3) to explore which intervention modules generate the strongest changes in key outcomes. Methods: First-year university students (N = 166) will be randomly assigned to two conditions: 1) the smartphone-based intervention, or 2) a goal-setting control group. The intervention consists of three week-long modules. Data will be collected at the start of the intervention, at weekly intervals during the intervention, immediately after the intervention, and at 3-month follow-up (and at parallel time points for the control group). We will assess users' experiences, application usage data, primary intervention outcomes (e.g., self-defeating behavior, future orientation, future self-identification), and secondary intervention outcomes (e.g., psychosocial wellbeing, self-efficacy). Discussion: The study will provide information about users' experiences with the application, the intervention's general effectiveness, and which intervention modules show most promise. This information will be used to further develop the application and optimize this novel intervention. Trial registration: The trial is registered in the Netherlands Trial Register (number: NL9671) on 16 August 2021. Show less
Terpstra, J.A.; Vaart, R. van der; Beugen, S. van; Eersel, R.A. van; Gkika, I.; Erdős, D.; ... ; Evers, A.W.M. 2022
Context: Rheumatic conditions have a large impact on both patients and society. Many patients experience adjustment problems, such as symptoms of anxiety and depression and sleep problems,... Show moreContext: Rheumatic conditions have a large impact on both patients and society. Many patients experience adjustment problems, such as symptoms of anxiety and depression and sleep problems, contributing to high healthcare costs. Internet-based cognitive-behavioral therapy (iCBT) has shown to support patients with somatic conditions in coping with their disease, with therapist-guided iCBT usually showing larger effects than unguided iCBT. However, the specific relevance of guided iCBT for rheumatic conditions has not been reviewed yet, which could have important implications for implementation. Objectives: The objective of our review was to give an overview of evaluations of guided iCBT for rheumatic conditions, including physical, psychological, and impact on daily life outcomes. Methods: This review is registered with PROSPERO with registration number CRD42020154911. The review followed PRISMA guidelines and included an assessment of risk of bias. PubMed, PsycINFO, Embase, Cochrane Library, Web of Science, and Emcare were searched until 5 October 2020. Inclusion criteria were: patients >= 18 years old with a rheumatic condition, randomized controlled trial, accessible full-text English article, original data, inclusion of psychological, and/or physical and/or impact outcomes, and therapist-guided iCBT. Study and sample characteristics, as well as clinical variables were extracted. Results: A systematic search identified 6089 studies, of which 8 trials were included, comprising of 1707 participants in total. Significant medium to large between-group effects were found for psychological outcomes (depression, anxiety, catastrophizing, self-efficacy) and impact on daily life outcomes (impact on daily life, quality of life), whilst results for physical outcomes (pain intensity, fatigue) were mixed. Conclusion: Whilst more research is warranted, for instance regarding physical outcomes, cost-effectiveness, safety of the intervention, and moderators of iCBT success, our results show that guided iCBT could be an important addition to medical treatment for rheumatic conditions. Guided iCBT can improve psychological and impact on daily life outcomes in patients with rheumatic conditions, which is promising for iCBT implementation in clinical practice. Show less
Terpstra, J.A.; Vaart, R. van der; Ding, H.J.; Kloppenburg, M.; Evers, A.W.M. 2021