Exploring the use of physical activity loyalty cards for behaviour change in public health: randomised controlled trial

• Published in: The Lancet (British edition) 2012, Vol.380, p.S4-S4
• Main Authors: Hunter, Ruth F, Dr, Tully, Mark A, PhD, Davis, Michael, MSc, Stevenson, Michael, BSc, Kee, Frank, Prof
• Format: Article
• Language: English
• Subjects: adults; Alzheimer disease; behavior change; biotechnology; buildings; business enterprises; diabetes; economic incentives; employment; general practitioners; governance; Internal Medicine; Internet; learning; logging; monitoring; public health; questionnaires; randomized clinical trials; scientists; stroke; trails; walking; women; working conditions
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(13)60360-8

Abstract Background Physical inactivity is a major public health concern, and more innovative approaches are urgently needed to address it. The UK Government supports the use of incentives and so-called nudges to encourage healthy behaviour changes, and has encouraged business sector involvement in public health through the Public Health Responsibility Deal. To test the effectiveness of provision of incentives to encourage adults to increase their physical activity, we recruited 406 adults from a workplace setting (office-based) to take part in an assessor-blind randomised controlled trial. Methods We developed the physical activity loyalty card scheme, which integrates a novel physical activity tracking system with web-based monitoring ( palcard ). Participants were recruited from two buildings at Northern Ireland's main government offices and were randomly allocated (grouped by building [n=2] to reduce contamination) to either incentive group (n=199) or no incentive group (n=207). We included participants aged 16–65 years, based at the worksite 4 days or more per week and for 6 h or more per day, and able to complete 15 min of moderate-paced walking (self-report). Exclusion criteria included having received specific advice by a general practitioner not to exercise. A statistician not involved in administration of the trial prepared a computer-generated random allocation sequence. Random assignments were placed in individually numbered, sealed envelopes by the statistician to ensure concealment of allocation. Only the assessor was masked to assignment. Sensors were placed along footpaths and the gym in the workplace. Participants scanned their loyalty card at the sensor when undertaking physical activity (eg, walking), which logged activity. Participants in the incentive group monitored their physical activity, collected points, and received rewards (retail vouchers) for minutes of physical activity completed over the 12-week intervention. Rewards were vouchers sponsored by local retailers. Participants in the no incentive group used their loyalty card to self-monitor their physical activity but were not able to earn points or receive rewards. The primary outcome was change in minutes of moderate to vigorous physical activity with the Global Physical Activity Questionnaire, measured at baseline, week 12, and 6 months. Activity was objectively measured with the tracking system over the 12-week intervention. Mann Whitney U tests were done to assess change b