ASPO Abstracts
Gamifying Step Count to Increase Cancer Survivors' Motivation and Physical Activity: A Randomized Controlled Feasibility Study of Steps2Health
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020
Abstract Body:
Purpose
The primary objective of this study was to evaluate the feasibility and acceptability of Steps2Health, a novel
physical activity intervention for cancer survivors. Steps2Health is grounded in Self-Determination Theory (SDT)
and uses game design elements with wearable technologies to increase physical activity-related motivation.
Methods
We randomized 78 insufficiently active cancer survivors to an experimental or comparison group. All participants
received a physical activity tracker. Participants in the experimental group also received MMS messages. The
messages were triggered by real-time step count and presented information about a virtual journey. They included
photographs and vivid descriptions of the journey locations to increase intrinsic motivation associated with physical
activity. Additional messages targeted perceptions of autonomy, relatedness, and competence. We administered
surveys pre- and post-intervention and conducted 15 individual interviews to evaluate the intervention. We
conducted mixed effects linear modeling to explore changes in motivation and physical activity.
Results
There was minimal loss to follow up (4%), device wear was high (83.5% of days), and technical problems were
minimal. Messages targeting intrinsic motivation, autonomy, and competence were generally perceived as
enjoyable and compelling. Messages targeting relatedness were less highly rated, and the response rate (36%) to
these messages did not meet the feasibility criterion (75%). From pre- to post-test, participants tended to increase
their motivation for physical activity (B = 0.156, 95% CI [0.010, 0.302], P = 0.039, d = 0.50), but there was not a
statistically significant group difference. Assignment to the experimental group was associated with increases in
self-reported physical activity (B = 10.778, 95% CI [3.541, 18.015], P = 0.005, d = 0.69).
Conclusions
Evidence supports the feasibility and acceptability of Steps2Health's use of real-time game design elements to
target intrinsic motivation, however, acceptably targeting relatedness presents additional challenges. Steps2Health
may help cancer survivors increase their physical activity levels.
Keywords: Physical activity; Cancer Survivors; Self- Determination Theory; Gamification