STEP Together: An Effectiveness-Implementation Study of Social Incentives and Physical Activity

NCT04942535 | Completed DMC

• 3 other identifiers: 020221R01HL152430842677
• Study Type: interventional
• Target: 779
• Locations: 1 country
• Sites: 1

Brief Summary

Higher levels of physical activity have been demonstrated to improve health across a wide range of contexts and reduce cognitive decline as adults become older, but more than half of all adults in the United States do not meet their physical activity goals. One type of physical activity that is broadly applicable to people of all ages is walking. This study will use a Hybrid Type 1 effectiveness-implementation design to adapt and test the effectiveness of two successful social incentive-based interventions, a gamification strategy and financial incentives donated to charity on the participants behalf, to increase physical activity among low-income, mostly minority families in community settings.

Conditions

Physical Activity

Keywords

Physical Activity; Older Adults; Gamification; Social Incentives; Charity; Family

Outcome Measures

Primary Outcomes (1)

• Change in mean daily step counts during the 12 month intervention

  Change in mean daily steps from baseline to the end of the 12 month intervention period. Steps will be measured using the Fitbit Inspire 2 wearable device.

  Months 1-12

Secondary Outcomes (5)

• Change in mean daily step counts during the 12 month intervention and 6 month follow up

  Months 1-18

• Change in mean minutes of moderate-to-vigorous physical activity (MVPA) during the 12 month intervention

  Months 1-12

• Change in mean minutes of moderate-to-vigorous physical activity (MVPA) during the 12 month intervention and 6 month follow up

  Months 1-18

• Difference in proportion of weeks physical activity guidelines were achieved during the 12 month intervention

  Months 1-12

• Difference in proportion of weeks physical activity guidelines were achieved during the 12 month intervention and 6 month follow up

  Months 1-18

Study Arms (3)

Social Incentive Gamification

EXPERIMENTAL

Each participant is enrolled as part of a family team. Each participant wears a Fitbit every day and strives to achieve their daily step goal. Participants in this arm receive the Social Incentive Gamification intervention during the 12 month intervention and Daily Performance Feedback during the 6 month follow up.

Behavioral: Social Incentive Gamification; Behavioral: Daily Performance Feedback

Social Goals through Incentives to Charity

EXPERIMENTAL

Each participant is enrolled as part of a family team. Each participant wears a Fitbit every day and strives to achieve their daily step goal. Participants in this arm receive the Social Goals through Incentives to Charity intervention during the 12 month intervention and Daily Performance Feedback during the 6 month follow up.

Behavioral: Social Goals through Incentives to Charity; Behavioral: Daily Performance Feedback

Control

ACTIVE COMPARATOR

Each participant is enrolled as part of a family team. Each participant wears a Fitbit every day and strives to achieve their daily step goal. Participants in this arm receive Daily Performance Feedback during the 12 month intervention and 6 month follow up.

Behavioral: Daily Performance Feedback

Interventions

Social Incentive Gamification BEHAVIORAL

Participants enroll as a family team. They are asked to use a Fitbit activity tracker daily. Each participant sets a daily step goal based on their baseline step count. Each participant signs a pre-commitment contract. Participants are entered into a game with their family members. Each family receives 70 points weekly. Each day, a family member is selected at random to represent the family. If that person's step goal was achieved, the family keeps its points; if not, they lose 10 points. The participant is notified the following day if they were the family rep. At the end of the week, if the family has 40 points or more, they advance 1 level. If they have less than 40 points, the family drops down 1 level. Each family team starts in the middle of 5 levels. At the end of the intervention, families in the top 2 levels receive a small gift. In the 6 month follow-up, participants receive a daily text message stating whether or not they achieved their step goal on the prior day.

Social Incentive Gamification

Social Goals through Incentives to Charity BEHAVIORAL

Participants enroll as a family team. They are asked to use a Fitbit activity tracker daily. Each participant sets a daily step goal based on their baseline step count. Families select a charity at the beginning of the intervention. They are informed that $20 is available each week to be donated to a charity of their choice. Each day, a family member is selected at random to represent the family. If that person's step goal was achieved, the family gets credit for meeting their goal; if not, the entire family does not get credit. The participant is notified the following day if they were the family rep. If the family achieves their goal on at least 4 of 7 days in a week, $20 is donated to charity. In the 6 month follow-up, participants receive a daily text message stating whether or not they achieved their step goal on the prior day.

Social Goals through Incentives to Charity

Daily Performance Feedback BEHAVIORAL

Participants enroll as a family team. They are asked to use a Fitbit activity tracker daily. Each participant sets a daily step goal based on their baseline step count. Participants receive a daily text message stating whether or not they achieved their step goal on the prior day.

Control; Social Goals through Incentives to Charity; Social Incentive Gamification

Eligibility Criteria

• Age: 14 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Able to read and speak English;
• Has a smartphone or tablet;
• Lives in the Philadelphia area;
• Age 14 or older;
• Able to provide informed consent;
• Enrolled as a member of a 2 to 10 member family team with least one member 60 years or older.

You may not qualify if:

• 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);
• Do not have sufficient eyesight or dexterity to operate device;
• Average step count greater than 7,500 steps/day during the run-in period.

Sponsors & Collaborators

• Abramson Cancer Center at Penn Medicine: lead
• National Heart, Lung, and Blood Institute (NHLBI): collaborator

Study Sites (1)

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (1)

• Scheffey K, Aronson J, Goncalves Y, Greysen SR, Iwu A, Kwong PL, Nezir F, Small D, Glanz K. Design and baseline characteristics of an implementation study to increase activity with social incentives: The STEP together trial. Contemp Clin Trials. 2025 Jun;153:107909. doi: 10.1016/j.cct.2025.107909. Epub 2025 Apr 10.

  PMID: 40216076 DERIVED

MeSH Terms

Conditions

Motor Activity

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Karen Glanz, PhD, MPH

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 17, 2021
• First Posted: June 28, 2021
• Study Start: September 21, 2021
• Primary Completion: April 4, 2025
• Study Completion: October 11, 2025
• Last Updated: November 25, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)