Behavioral Economic Approaches to Increase Physical Activity Among Patients With Elevated Risk for Cardiovascular Disease

  • End date
    Mar 31, 2023
  • participants needed
  • sponsor
    University of Pennsylvania
Updated on 13 May 2021
cardiovascular disease


The objective of this study is to use a randomized, controlled trial to test the effectiveness of using gamification, financial incentives, or both to increase physical activity among patients with elevated risk for atherosclerotic cardiovascular disease (ASCVD). ASCVD is the leading cause of morbidity and mortality in the United States. Regular physical activity has been shown to reduce the risk of ASCVD, but less than 50% of US adults achieve enough physical activity to obtain these benefits.


Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in the United States (US). Regular physical activity has been demonstrated to reduce the risk of ASCVD and is associated with a number of other health benefits. Yet, less than 50% of adults in the US achieve enough physical activity to actually obtain these benefits. Insights from behavioral economics have been shown to both better reflect the 'predictable irrationality' of humans and to be effective in designing interventions that achieve sustained improvements in health behavior. Our prior work has demonstrated that interventions using financial incentives and gamification can leverage principles from behavioral economics to increase physical activity during 3-month interventions and sustain effects in 3-month follow-up periods. These findings warrant further investigation of longer-term effects. In this study, we conduct a four-arm randomized, controlled trial to evaluate the effectiveness of using behavioral economic approaches including gamification, financial incentives, or both to increase physical activity among patients with elevated risk for atherosclerotic cardiovascular disease during a 12-month intervention with a 6-month follow-up.

Condition Atherosclerotic Cardiovascular Disease
Treatment gamification, Financial, Financial
Clinical Study IdentifierNCT03911141
SponsorUniversity of Pennsylvania
Last Modified on13 May 2021


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Inclusion Criteria

Age 18 years or older
Have a 10-year ASCVD risk score of 7.5% or greater (including those with existing ASCVD)
Are able to provide informed consent

Exclusion Criteria

Are already participating in another physical activity study
An 18-month physical activity program is infeasible (e.g. metastatic cancer; unable to ambulate or provide informed consent) or unsafe (currently pregnant or told by a physician not to exercise)
They do not have a device (e.g. smartphone, tablet, or computer) to transmit data from the wearable activity tracker
Baseline step count is 7,500 or greater
They do not have a primary care physician in the University of Pennsylvania Health System
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