FINANCIAL INCENTIVES TO PROMOTE PHYSICAL ACTIVITY IN SEDENTARY, OVERWEIGHT

University Of Vermont & St Agric College, Burlington VT

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Abstract

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Physical inactivity is estimated to have a causal link in ~300,000 deaths annually and is considered one of the primary causal factors for obesity, cardiovascular disease, type 2 diabetes, osteoporosis, some forms of cancer, and the metabolic syndrome. Specific Aim 1: To determine if an incremental financial incentive paradigm tied to physical activity goals will improve compliance with the national physical activity recommendations in sedentary, overweight UVM employees. Specific Aim 2: To determine if compliance to the national physical activity recommendations translates to improvements in weight status, cardiorespiratory fitness, mental health, and worker productivity in sedentary, overweight UVM employees. The proposed study will be performed at the University of Vermont, and will recruit subjects from the faculty/staff pool within the university community. The current study proposes to compare an incremental financial incentive model to elicit adherence to a 12-week walking program. Daily walking step counts will be the primary outcome assessed by individual pedometers worn by each participant. Pedometers have been successfully used in a myriad of populations and research settings as a way to assess daily physical activity and have a high degree of reliability and validity. The adult physical activity guidelines stipulate that individuals should attain at least 30 minutes per day of moderate-intensity daily physical activity in one continuous 30-minute or 3/10-minute bouts. Findings from previous research have indicated that this translates to a total walking step range of 8,000-10,000 steps/day, and in order to achieve these recommendations, 3,000-4,000 of those walking steps should be purposefully taken (specific time for walking with a minimum step rate) to achieve the physical activity goal of greater than 8,000 steps/day. Our participants will be recruited as sedentary (less than 5,000 steps/day), so in order for them to achieve the physical activity goal of greater than 8,000 steps/day, a minimum of 3,000 steps/day will have to be taken in order to reach the minimum target of greater than 8,000 steps/day. The following list describes the assessment protocols for each variable that will be measured. Physical Activity: volume of physical activity will be determined by stored step counts in the Omron HJ-720ITC a piezoelectric pedometer/accelerometer, which is easy to use, requires no input from the wearer, has a 40-day storage capacity, and is highly accurate. Each participant will be asked to wear the pedometer for all waking hour and to record their daily step count on paper. Each night the pedometer will automatically reset to zero. The pedometer has the ability to store 40 days worth of data and is blinded to the wearer. We will perform daily phone and e-mail inquires for daily step count reports, and 12 weekly visits to each participant to download weekly data from the pedometer. Vital Signs and Basic Anthropometry: GCRC nurses will assess vital signs, height, and weight by standard GCRC protocols. Body Composition and Fat Distribution: Total body fat mass and lean mass will be measured by dual-enegy x-ray absorptiometry (DEXA;Prodigy, GE-Lunar) in the GCRC Exercise Physiology Laboratory. Cardiorespiratory Fitness Testing: A maximal treadmill stress/exercise test will be performed in the GCRC Exercise Physiology Laboratory using standard protocol. Dietary Recall: Subjects will be instructed by a GCRC registered dietician on how to complete a 3-day dietary record, which will be analyzed using the National Center for Research Resources sponsored ProNutra nutrition software (Princeton Multimedia Technologies, Version 2.01, Princeton, NJ). Mood: Mood will be evaluated using the Profile of Mood States Brief Mood Form (POMS). It is a 30 item inventory that has been shown to have sound psychometric properties and is sensitive to changes within six sub-constructs of mood in exercising populations. Depression: Depression will be evaluated using the Beck Depression Inventory II (BDI-II). The BDI-II is a 21 item instrument that has been reported as reliable and valid, and is one of the most widely used depression instruments in the literature. Self Efficacy: Self efficacy germane to exercise and physical activity will be evaluated using the Exercise Specific Self Efficacy Scale (ESSES). Stages of Change: Behavioral stage of change will be assessed using the Stages of Exercise Behavior Change. This is a short, five item instrument that is sensitive to the evaluation of the stage of readiness for exercise behavioral change. Worker Productivity: Work productivity will be evaluated using the Work Limitations Questionnaire (WLQ). it is a 25 item questionnaire that is sensitive to on the job limitations and productivity deficits secondary to health related barriers. it is psychometrically sound and has been recently reported as such in similar protocols examining incentivized workplace wellness interventions.