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      Gamifying Accelerometer Use Increases Physical Activity Levels of Sedentary Office Workers

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          Abstract

          Background

          Sedentary work is hazardous. Over 80% of all US jobs are predominantly sedentary, placing full‐time office workers at increased risk for cardiovascular and metabolic morbidity and mortality. Thus, there is a critical need for effective workplace physical activity interventions. MapTrek is a mobile health platform that gamifies Fitbit use for the purpose of promoting physical activity. The purpose of this study was to test the efficacy of MapTrek for increasing daily steps and moderate‐intensity steps over 10 weeks in a sample of sedentary office workers.

          Methods and Results

          Participants included 146 full‐time sedentary office workers aged 21 to 65 who reported sitting at least 75% of their workday. Each participant received a Fitbit Zip to wear daily throughout the intervention. Participants were randomized to either a: (1) Fitbit‐only group or 2) Fitbit + MapTrek group. Physical activity outcomes and intervention compliance were measured with the Fitbit activity monitor. The Fitbit + MapTrek group significantly increased daily steps (+2092 steps per day) and active minutes (+11.2 min/day) compared to the Fitbit‐only arm, but, on average, participants’ steps declined during the study period.

          Conclusions

          MapTrek is an effective approach for increasing physical activity at a clinically meaningful level in sedentary office workers, but as with accelerometer use alone, the effect decreases over time.

          Clinical Trial Registration

          URL: https://www.clinicaltrials.gov. Unique identifier: NCT03109535.

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          Most cited references26

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          Approximate Inference in Generalized Linear Mixed Models

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            Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis

            Background Electronic activity monitors (such as those manufactured by Fitbit, Jawbone, and Nike) improve on standard pedometers by providing automated feedback and interactive behavior change tools via mobile device or personal computer. These monitors are commercially popular and show promise for use in public health interventions. However, little is known about the content of their feedback applications and how individual monitors may differ from one another. Objective The purpose of this study was to describe the behavior change techniques implemented in commercially available electronic activity monitors. Methods Electronic activity monitors (N=13) were systematically identified and tested by 3 trained coders for at least 1 week each. All monitors measured lifestyle physical activity and provided feedback via an app (computer or mobile). Coding was based on a hierarchical list of 93 behavior change techniques. Further coding of potentially effective techniques and adherence to theory-based recommendations were based on findings from meta-analyses and meta-regressions in the research literature. Results All monitors provided tools for self-monitoring, feedback, and environmental change by definition. The next most prevalent techniques (13 out of 13 monitors) were goal-setting and emphasizing discrepancy between current and goal behavior. Review of behavioral goals, social support, social comparison, prompts/cues, rewards, and a focus on past success were found in more than half of the systems. The monitors included a range of 5-10 of 14 total techniques identified from the research literature as potentially effective. Most of the monitors included goal-setting, self-monitoring, and feedback content that closely matched recommendations from social cognitive theory. Conclusions Electronic activity monitors contain a wide range of behavior change techniques typically used in clinical behavioral interventions. Thus, the monitors may represent a medium by which these interventions could be translated for widespread use. This technology has broad applications for use in clinical, public health, and rehabilitation settings.
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              Meta-analysis of workplace physical activity interventions.

              Most adults do not achieve adequate physical activity levels. Despite the potential benefits of worksite health promotion, no previous comprehensive meta-analysis has summarized health and physical activity behavior outcomes from such programs. This comprehensive meta-analysis integrated the extant wide range of worksite physical activity intervention research. Extensive searching located published and unpublished intervention studies reported from 1969 through 2007. Results were coded from primary studies. Random-effects meta-analytic procedures, including moderator analyses, were completed in 2008. Effects on most variables were substantially heterogeneous because diverse studies were included. Standardized mean difference (d) effect sizes were synthesized across approximately 38,231 subjects. Significantly positive effects were observed for physical activity behavior (0.21); fitness (0.57); lipids (0.13); anthropometric measures (0.08); work attendance (0.19); and job stress (0.33). The significant effect size for diabetes risk (0.98) is less robust given small sample sizes. The mean effect size for fitness corresponds to a difference between treatment minus control subjects' means on VO2max of 3.5 mL/kg/min; for lipids, -0.2 on the ratio of total cholesterol to high-density lipoprotein; and for diabetes risk, -12.6 mg/dL on fasting glucose. These findings document that some workplace physical activity interventions can improve both health and important worksite outcomes. Effects were variable for most outcomes, reflecting the diversity of primary studies. Future primary research should compare interventions to confirm causal relationships and further explore heterogeneity.
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                Author and article information

                Contributors
                lucas-carr@uiowa.edu
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                02 July 2018
                03 July 2018
                : 7
                : 13 ( doiID: 10.1002/jah3.2018.7.issue-13 )
                : e007735
                Affiliations
                [ 1 ] Department of Health and Human Physiology University of Iowa Iowa City IA
                [ 2 ] Signal Center for Health Innovation University of Iowa Health Ventures Iowa City IA
                [ 3 ] Department of Computer Science University of Iowa Iowa City IA
                [ 4 ] Department of Pharmacy Practice and Science University of Iowa Iowa City IA
                [ 5 ] Department of Internal Medicine and Epidemiology University of Iowa Iowa City IA
                Author notes
                [*] [* ] Correspondence to: Lucas J. Carr, PhD, Department of Health and Human Physiology, University of Iowa, 225 S. Grand Avenue, Iowa City, IA, 52242. E‐mail: lucas-carr@ 123456uiowa.edu
                Article
                JAH33330
                10.1161/JAHA.117.007735
                6064890
                29967221
                26b9e0ac-f2d8-475c-90e8-35d74d1eab42
                © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 13 October 2017
                : 04 June 2018
                Page count
                Figures: 5, Tables: 4, Pages: 12, Words: 8407
                Funding
                Funded by: UI Health Ventures
                Funded by: University of Iowa Hospitals and Clinics
                Funded by: National Heart, Lung and Blood Institute at the National Institutes of Health
                Award ID: K25HL122305
                Funded by: National Institute of Diabetes and Digestive and Kidney Diseases
                Award ID: DK108019‐01A1
                Categories
                Original Research
                Original Research
                Epidemiology
                Custom metadata
                2.0
                jah33330
                03 July 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.1.1 mode:remove_FC converted:03.07.2018

                Cardiovascular Medicine
                intervention,lifestyle,physical exercise,exercise,primary prevention
                Cardiovascular Medicine
                intervention, lifestyle, physical exercise, exercise, primary prevention

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