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Published on: March 7, 2019
A cluster randomized controlled trial of an incentive-based outdoor physical activity program
Eric A Finkelstein1, Yock-Theng Tan, Rahul Malhotra
1Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore. eric.finkelstein@duke-nus.edu.sg
Insights
Incentive programs encouraging children to meet step goals significantly increased daily steps. Future trials need higher targets and longer follow-up to confirm health benefits.
Area of Science:
- Pediatric health
- Behavioral science
- Public health interventions
Background:
- Childhood obesity is a growing concern, necessitating effective interventions to promote physical activity.
- Understanding the impact of incentive-based programs on children's activity levels is crucial for public health strategies.
Purpose of the Study:
- To assess the effectiveness of an incentive-based intervention designed to boost physical activity and fitness in children.
- To evaluate the intervention's impact over a 9-month period using a cluster randomized controlled trial design.
Main Methods:
- A 9-month cluster randomized controlled trial involving children aged 6-12 years.
- The intervention group received incentives for meeting pedometer-determined step targets and participated in structured weekend outdoor activities.
- Outcomes measured included pedometer steps, 6-minute walk test, body mass index, and parent-reported Pediatric Quality of Life Inventory.
Main Results:
- Children in the intervention group achieved significantly more steps daily, on weekdays, and on weekends compared to the control group.
- Activity trajectories revealed groups that increased but didn't sustain activity, met targets, and surpassed targets.
- Trends indicated improvements in 6-minute walk test times and quality of life scores, though not statistically significant.
Conclusions:
- Incentives effectively increased children's daily step counts, demonstrating a positive impact on physical activity.
- While not statistically significant, trends suggest potential benefits in fitness and quality of life.
- Future research should incorporate higher step targets and extended follow-up periods to establish long-term health effects.
Objective:
To evaluate an incentive-based physical activity intervention to increase physical activity and fitness among children in a 9-month cluster randomized controlled trial.
Study Design:
Children aged 6-12 years were randomized to control (n = 138 from 106 families) or intervention arm (n = 147 from 106 families). The intervention included incentives for meeting step targets as measured by pedometers and structured weekend outdoor activities. Outcomes included trends in activity for the intervention group and between-group differences in pedometer steps, 6-minute walk test, body mass index, and parent-reported Pediatric Quality of Life Inventory.
Results:
At follow-up, children in the intervention group recorded significantly more pedometer steps than controls over the entire week (8660 vs 7767; P = .010), on weekdays (8646 vs 7826; P = .041), and on weekends (8779 vs 7684; P = .018). Three different trajectory classes were identified. The first group increased activity but was not sustained, the second group met the target step levels, and the third group significantly surpassed the step goals. The intervention group showed trends toward longer 6-minute walk test times and higher Pediatric Quality of Life Inventory scores, but the differences were not statistically significant.
Conclusion:
Incentives for increased step activity were effective in producing greater steps and showed a (nonsignificant) trend toward improvements in other health outcomes. Thus, future incentive trials should be incorporate greater step targets and longer follow-up periods to provide evidence of the long-term effect of these incentives on children's health.
