Physical ActivityNCT01855776
A Randomized Trial of Economic Incentives to Promote Walking Among Full Time Employees
A study testing Fitbit, Cash Incentives and Charitable Incentives in people with Physical Activity, run by Duke-NUS Graduate Medical School at 1 site in Singapore.
Trial summary
This study aims to assess the uptake, effectiveness, and cost-effectiveness of a scalable walking programme for full-time employees both with and without incentives. Read more about this study
- Who is it for?
- Ages 21 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Physical Activity
- What is being tested?
- Fitbit, Cash Incentives and Charitable Incentives
- Type of treatment
- Medical device, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 800 participants
- Where
- 1 siteSingapore
- Study dates
- May 2013to Aug 2015
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Full-time employees living in Singapore
- Aged between 21-65
Who cannot join
- report difficulty doing 10 minutes of aerobic activities without stopping
- report difficulty walking up 10 stairs without stopping
- report difficulty performing basic activities of daily living
- have any medical conditions that limit their ability to walk as a means of physical activity
- self-identify medical conditions that limit ability to walk AND do not have medical consent
- answer 'YES' to any PAR-Q questions
Trial locations and contacts
1 site in 1 country.
About this study
This study aims to assess the uptake, effectiveness, and cost-effectiveness of a scalable walking programme for full-time employees both with and without incentives.
Read the detailed description
The first part of this study comprises an in-home face-to-face survey with 950 full-time employees in Singapore. The survey aims to identify what an optimal programme might look like and to quantify the potential uptake of the programme, if offered. Stated preference conjoint analysis, which assesses individual preferences for attributes of specific programmes, will be used.
The second part of this study is a Randomised Controlled Trial (RCT) of a 12-month walking programme. Up to 800 full-time employees will be recruited and allocated to one of four research arms: Control Group, Programme Only Group, Cash Incentive Group and Charitable Incentive Group. Participants in the intervention arms will be asked to track their physical activities using Fitbit Zip, a wireless pedometer, which automatically uploads the data to a custom website. Those in the incentive arms will earn money or raise money for charities if they meet weekly exercise targets. Those in the control and Programme Only groups with receive a weekly payment for participation. Incentives and participation payment will be provided from months 1 - 6, after which they will be withdrawn.
The key outcome variable of the RCT is defined as bouts (in minutes) of moderate to vigorous physical activity ("MVPA bouts") as measured via accelerometry. Data will be collected at baseline and month 6 and 12 assessments.
Findings from the RCT will also be used to determine the cost to employers of implementing each programme and the incremental cost-effectiveness of the incentive programmes compared to the basic programme without incentives. The primary hypotheses are that the basic programme will have lower costs per person than the cash or charity programmes, but that the incentive programmes will be more cost-effective relative to the less expensive and less effective basic programme.
- Conditions
- Physical Activity
- Being tested
- Fitbit, Cash Incentives, Charitable Incentives, Usual Care
- Keywords
- Physical Activity/Walking, Full-time employees, RCT, Incentives, Wireless pedometer
- Medical subject headings
- Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FitbitDevice
Also called Fitbit Zip; Wireless pedometer; Physical activity tracker;
Fitbit Zip is a wireless pedometer that tracks steps of participants, and will be offered in conjunction with a tailored website with customized information for participants, employers, and/or charities.
Cash IncentivesBehavioural
Also called Money, Cash, Financial Incentives
Incentives will be awarded to participants for meeting specified weekly step goals as measured by a pedometer.
Charitable IncentivesBehavioural
Also called Donations, Charity
Incentives will be awarded to charities selected by participants should the latter meet specified weekly step goals measured by a pedometer.
Usual CareOther
Also called Educational Programme; Health Promotion Board
The "usual care" programme consists of educational materials designed by the Singapore Health Promotion Board. It includes material on how to stay active, walking programmes, and healthy eating.
| Study group | Role | What they receive |
|---|---|---|
| Control Group | Other | The control group will receive a "usual care" educational programme at baseline created by the Singapore Health Promotion Board. This guide describes the importance of physical activity and illustrates one possible physical activity programme. It also discusses strategies for adopting a healthy lifestyle. They will not receive the Fitbit Zip wireless pedometer from the study team. However, they will receive $4 per week, regardless of physical activity levels. Receives: Other: Usual Care |
| Programme Only Group | Experimental | This group receives the Fitbit Zip, and access to the Fitbit website. Fitbit Zip counts the number of steps walked, calories burned, and distance travelled. Participants can set goals for their physical activity levels, and will have access to personalised feedback from Fitbit. This group will also receive $4 per week, regardless of physical activity levels. Receives: Device: Fitbit; Other: Usual Care |
| Cash Incentive Group | Experimental | This group receives the Fitbit Zip and the opportunity to earn money each week based on the number of steps logged on the pedometer during that week. We will offer the following incentive schedule:
* $0 SGD for less than 50,000 steps during the week
* $15 SGD for 50,000 - 69,999 steps during the week (max of 20,000 steps per day)
* $30 SGD for 70,000 or more steps during the week (max of 20,000 steps per day) Participants will receive monthly payments in cash after their physical activity is confirmed. The incentive will be calculated separately for each week of the 6-month incentive programme. Receives: Device: Fitbit; Behavioral: Cash Incentives; Other: Usual Care |
| Charitable Incentive Group | Experimental | This group is identical to the cash incentive group except that incentive payments will be donated directly to a tax-exempt nonprofit charity of the participant's choice. The charity will be selected at the start of the programme but will be limited to the most common tax-exempt nonprofit charities operating in Singapore. As a motivational feedback component of the programme, participants will receive a thank-you email or letter from the charity. Receives: Device: Fitbit; Behavioral: Charitable Incentives; Other: Usual Care |
What is being measured
The primary outcome is the main question the study is designed to answer.
Changes in MVPA (Moderate-to-Vigorous Physical Activity) bouts of participants from baseline to months 6 and 12
MVPA bouts are defined as the total number of minutes during each 1-week assessment period in which moderate or vigorous activity of at least 8 of 10 consecutive minutes are reached. This will be assessed via the Actigraph GT3XE-Plus Triaxial Activity Monitor.
We will measure "MVPA bouts" at baseline, 6, and 12 months. We hypothesize that participants in the Programme Only, and Incentive groups record more "MVPA bouts" at 6 months compared to baseline. Furthermore, participants in the Incentive groups will record more "MVPA bouts" at 6 months compared to the Control and Programme only groups.
We also measure "MVPA bouts" for all participants at 12 months. We do so to test if the "MVPA bouts" measured at month 6, can be sustained at month 12 when incentives are no longer being provided.
Measured: Baseline, 6 and 12 months
Secondary outcomes (1)
Change in VO2Max of participants from baseline to months 6, and 12.
VO2Max is one of the major parameters to evaluate health and fitness of the cardiovascular system and is widely used for health promotion purposes. VO2Max will also be assessed via the Non Exercise Fitness Test (NEFT); NEFT predicts VO2max based on age, gender, BMI, resting heart rate and self-reported physical activities.
Measured: Baseline, 6 and 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 May 2013 (estimated)
- Study startMay 2013
- Primary completionAug 2015
- Study completionAug 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Physical ActivityStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Enrolment
- 800 participants (actual)
Sponsor and investigators
- Lead sponsor
- Duke-NUS Graduate Medical School
- Sponsor type
- University, hospital or other
- Collaborators
- Health Promotion Board, Singapore
- Responsible party
- Principal investigator, Eric A. Finkelstein, Duke-NUS Graduate Medical School
- Investigators
- Eric Finkelstein, Ph.D., M.H.A., Principal investigator, Duke-NUS Graduate Medical School
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01855776
- Sponsor's protocol ID
- HSRG10NOV002
- Status last verified
- Jan 2016
- First submitted
- 8 Aug 2012
- Last updated
- 5 Jan 2016
- Results posted
- No
- Data monitoring committee
- No
Publications
Sloan RA, Kim Y, Sawada SS, Asakawa A, Blair SN, Finkelstein EA. Is Less Sedentary Behavior, More Physical Activity, or Higher Fitness Associated with Sleep Quality? A Cross-Sectional Study in Singapore. Int J Environ Res Public Health. 2020 Feb 19;17(4):1337. doi: 10.3390/ijerph17041337.
PubMed 32092928Sloan RA, Kim Y, Sahasranaman A, Muller-Riemenschneider F, Biddle SJH, Finkelstein EA. The influence of a consumer-wearable activity tracker on sedentary time and prolonged sedentary bouts: secondary analysis of a randomized controlled trial. BMC Res Notes. 2018 Mar 22;11(1):189. doi: 10.1186/s13104-018-3306-9.
PubMed 29566746Finkelstein EA, Haaland BA, Bilger M, Sahasranaman A, Sloan RA, Nang EEK, Evenson KR. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial. Lancet Diabetes Endocrinol. 2016 Dec;4(12):983-995. doi: 10.1016/S2213-8587(16)30284-4. Epub 2016 Oct 4.
PubMed 27717766
Study at a glance
From the registry record, last updated by the sponsor on 5 Jan 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Trial of Economic Incentives to Promote Walking Among Full Time Employees
- ClinicalTrials.gov ID
- NCT01855776
- Acronym / sponsor ID
- HSRG10NOV002
- Conditions
- Physical Activity
- Keywords
- Physical Activity/Walking, Full-time employees, RCT, Incentives, Wireless pedometer
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 800 participants (actual)
- Lead sponsor
- Duke-NUS Graduate Medical SchoolUniversity, hospital or other
- Collaborators
- Health Promotion Board, Singapore
- Study start
- May 2013
- Primary completion
- Aug 2015 (actual)
- Study completion
- Aug 2015 (actual)
- First posted
- 16 May 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to assess the uptake, effectiveness, and cost-effectiveness of a scalable walking programme for full-time employees both with and without incentives.
Detailed description
The first part of this study comprises an in-home face-to-face survey with 950 full-time employees in Singapore. The survey aims to identify what an optimal programme might look like and to quantify the potential uptake of the programme, if offered. Stated preference conjoint analysis, which assesses individual preferences for attributes of specific programmes, will be used.
The second part of this study is a Randomised Controlled Trial (RCT) of a 12-month walking programme. Up to 800 full-time employees will be recruited and allocated to one of four research arms: Control Group, Programme Only Group, Cash Incentive Group and Charitable Incentive Group. Participants in the intervention arms will be asked to track their physical activities using Fitbit Zip, a wireless pedometer, which automatically uploads the data to a custom website. Those in the incentive arms will earn money or raise money for charities if they meet weekly exercise targets. Those in the control and Programme Only groups with receive a weekly payment for participation. Incentives and participation payment will be provided from months 1 - 6, after which they will be withdrawn.
The key outcome variable of the RCT is defined as bouts (in minutes) of moderate to vigorous physical activity ("MVPA bouts") as measured via accelerometry. Data will be collected at baseline and month 6 and 12 assessments.
Findings from the RCT will also be used to determine the cost to employers of implementing each programme and the incremental cost-effectiveness of the incentive programmes compared to the basic programme without incentives. The primary hypotheses are that the basic programme will have lower costs per person than the cash or charity programmes, but that the incentive programmes will be more cost-effective relative to the less expensive and less effective basic programme.
Study design
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Control Group | Other | Other: Usual CareThe control group will receive a "usual care" educational programme at baseline created by the Singapore Health Promotion Board. This guide describes the importance of physical activity and illustrates one possible physical activity programme. It also discusses strategies for adopting a healthy lifestyle. They will not receive the Fitbit Zip wireless pedometer from the study team. However, they will receive $4 per week, regardless of physical activity levels. |
| Programme Only Group | Experimental | Device: Fitbit, Other: Usual CareThis group receives the Fitbit Zip, and access to the Fitbit website. Fitbit Zip counts the number of steps walked, calories burned, and distance travelled. Participants can set goals for their physical activity levels, and will have access to personalised feedback from Fitbit. This group will also receive $4 per week, regardless of physical activity levels. |
| Cash Incentive Group | Experimental | Device: Fitbit, Behavioral: Cash Incentives, Other: Usual CareThis group receives the Fitbit Zip and the opportunity to earn money each week based on the number of steps logged on the pedometer during that week. We will offer the following incentive schedule: * $0 SGD for less than 50,000 steps during the week * $15 SGD for 50,000 - 69,999 steps during the week (max of 20,000 steps per day) * $30 SGD for 70,000 or more steps during the week (max of 20,000 steps per day) Participants will receive monthly payments in cash after their physical activity is confirmed. The incentive will be calculated separately for each week of the 6-month incentive programme. |
| Charitable Incentive Group | Experimental | Device: Fitbit, Behavioral: Charitable Incentives, Other: Usual CareThis group is identical to the cash incentive group except that incentive payments will be donated directly to a tax-exempt nonprofit charity of the participant's choice. The charity will be selected at the start of the programme but will be limited to the most common tax-exempt nonprofit charities operating in Singapore. As a motivational feedback component of the programme, participants will receive a thank-you email or letter from the charity. |
Who may qualify
- Ages
- 21 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Full-time employees living in Singapore
- Aged between 21-65
Key exclusion criteria (6 listed)
- report difficulty doing 10 minutes of aerobic activities without stopping
- report difficulty walking up 10 stairs without stopping
- report difficulty performing basic activities of daily living
- have any medical conditions that limit their ability to walk as a means of physical activity
- self-identify medical conditions that limit ability to walk AND do not have medical consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| FitbitAlso: Fitbit Zip; Wireless pedometer; Physical activity tracker;Fitbit Zip is a wireless pedometer that tracks steps of participants, and will be offered in conjunction with a tailored website with customized information for participants, employers, and/or charities. | Device | Cash Incentive Group, Charitable Incentive Group, Programme Only Group |
| Cash IncentivesAlso: Money, Cash, Financial IncentivesIncentives will be awarded to participants for meeting specified weekly step goals as measured by a pedometer. | Behavioural | Cash Incentive Group |
| Charitable IncentivesAlso: Donations, CharityIncentives will be awarded to charities selected by participants should the latter meet specified weekly step goals measured by a pedometer. | Behavioural | Charitable Incentive Group |
| Usual CareAlso: Educational Programme; Health Promotion BoardThe "usual care" programme consists of educational materials designed by the Singapore Health Promotion Board. It includes material on how to stay active, walking programmes, and healthy eating. | Other | Cash Incentive Group, Charitable Incentive Group, Control Group, Programme Only Group |
Primary outcome
Changes in MVPA (Moderate-to-Vigorous Physical Activity) bouts of participants from baseline to months 6 and 12
Time frame: Baseline, 6 and 12 months
MVPA bouts are defined as the total number of minutes during each 1-week assessment period in which moderate or vigorous activity of at least 8 of 10 consecutive minutes are reached. This will be assessed via the Actigraph GT3XE-Plus Triaxial Activity Monitor. We will measure "MVPA bouts" at baseline, 6, and 12 months. We hypothesize that participants in the Programme Only, and Incentive groups record more "MVPA bouts" at 6 months compared to baseline. Furthermore, participants in the Incentive groups will record more "MVPA bouts" at 6 months compared to the Control and Programme only groups. We also measure "MVPA bouts" for all participants at 12 months. We do so to test if the "MVPA bouts" measured at month 6, can be sustained at month 12 when incentives are no longer being provided.
1 secondary outcome
Change in VO2Max of participants from baseline to months 6, and 12.
Time frame: Baseline, 6 and 12 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jan 2016.
- Derived from this study: PubMed 32092928Sloan RA, Kim Y, Sawada SS, Asakawa A, Blair SN, Finkelstein EA. Is Less Sedentary Behavior, More Physical Activity, or Higher Fitness Associated with Sleep Quality? A Cross-Sectional Study in Singapore. Int J Environ Res Public Health. 2020 Feb 19;17(4):1337. doi: 10.3390/ijerph17041337.
- Derived from this study: PubMed 29566746Sloan RA, Kim Y, Sahasranaman A, Muller-Riemenschneider F, Biddle SJH, Finkelstein EA. The influence of a consumer-wearable activity tracker on sedentary time and prolonged sedentary bouts: secondary analysis of a randomized controlled trial. BMC Res Notes. 2018 Mar 22;11(1):189. doi: 10.1186/s13104-018-3306-9.
- Derived from this study: PubMed 27717766Finkelstein EA, Haaland BA, Bilger M, Sahasranaman A, Sloan RA, Nang EEK, Evenson KR. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial. Lancet Diabetes Endocrinol. 2016 Dec;4(12):983-995. doi: 10.1016/S2213-8587(16)30284-4. Epub 2016 Oct 4.
Related trials for Physical Activity
Recruiting
THE EFFECTS OF GAME-BASED EXERCISE PROGRAMS
Physical Activity, Body Image
Not yet recruiting
Feasibility of a Robot-Guided Active Play Intervention for Children With Cerebral Palsy
Cerebral Palsy
Enrolling by invitation
Online Exercise Program for Transplant Patients: A Pilot Study
Kidney Transplantation, Physical Function
Recruiting
Effect of a Brief Daily Digital Meditation on Well-Being in US Young Adults (BEGIN II)
Mental Health and General Well-being
RecruitingPhase 4
The Effects of Ferric Derisomaltose in Patients With Acute Heart Failure and Iron Deficiency on Exercise Capacity and Quality of Life(COREVIVE-HFrEF)
Heart Failure With Reduced Ejection Fraction, Iron Deficiency
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Eric Finkelstein, Ph.D., M.H.A. principal investigator
Duke-NUS Graduate Medical School
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Fitbit, Cash Incentives and Charitable Incentives in people with Physical Activity, run by Duke-NUS Graduate Medical School at 1 site in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Jan 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Changes in MVPA (Moderate-to-Vigorous Physical Activity) bouts of participants from baseline to months 6 and 12 (time frame: Baseline, 6 and 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01855776, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jan 2016.