Trading pounds for points: Engagement and weight loss in a mobile health intervention

OBJECTIVE: The objective of this study was to describe participant engagement and examine predictors of weight loss and points earned through the point-based incentive system of the Social Pounds Off Digitally (POD) app. MATERIALS AND METHODS: Overweight and obese adults with Android smartphones/tablets (body mass index 25–49.9 kg/m(2); N = 24) were recruited for a 3-month weight loss intervention. Participants completed a survey assessing demographics and personality and had their weight measured. Participants received the content of the intervention via podcasts and used the Social POD app to self-monitor diet, physical activity, and weight. The Social POD app contained: tracking features; in-app notifications to track; pre-set goals for tracking; newsfeed for updates on others’ goal attainment; ability to earn and track points for usage (exchanged for study-provided prizes); and a message screen. Analyses examined relationships between percent weight loss, personality characteristics, and total points earned. RESULTS: A total of 4843 points were earned (mean = 202 ± 105 points/participant). Most participants earned all three prizes (62.5%), followed by two prizes (21%), no prizes (12.5%), and one prize (4%). Total points earned significantly predicted percent weight loss (B = −0.02, p = .01), and higher conscientiousness significantly predicted greater total points earned (B = 10.27, p = .01), but other personality characteristics assessed did not. CONCLUSION: A mobile app yielded moderately high participant engagement, as demonstrated by points earned. Earning points was significantly associated with percent weight loss, and conscientiousness was significantly associated with total points earned. Future research should examine whether point systems impact health behavior and weight loss when rewards are discontinued. CLINICAL TRIAL REGISTRATION NUMBER: NCT02344836