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Behavioral economics implementation: Regret lottery improves mHealth patient study adherence

BACKGROUND: Nonadherence to study protocols reduces the generalizability, validity, and statistical power of longitudinal studies. PURPOSE: To determine whether an automated electronically-delivered regret lottery would improve adherence to an intensive mHealth self-monitoring protocol as part of a...

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Autores principales: Husain, S. Ali, Diaz, Keith M., Schwartz, Joseph E., Parsons, Faith E., Burg, Matthew M., Davidson, Karina W., Kronish, Ian M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555893/
https://www.ncbi.nlm.nih.gov/pubmed/31198881
http://dx.doi.org/10.1016/j.conctc.2019.100387
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author Husain, S. Ali
Diaz, Keith M.
Schwartz, Joseph E.
Parsons, Faith E.
Burg, Matthew M.
Davidson, Karina W.
Kronish, Ian M.
author_facet Husain, S. Ali
Diaz, Keith M.
Schwartz, Joseph E.
Parsons, Faith E.
Burg, Matthew M.
Davidson, Karina W.
Kronish, Ian M.
author_sort Husain, S. Ali
collection PubMed
description BACKGROUND: Nonadherence to study protocols reduces the generalizability, validity, and statistical power of longitudinal studies. PURPOSE: To determine whether an automated electronically-delivered regret lottery would improve adherence to an intensive mHealth self-monitoring protocol as part of a longitudinal observational study. METHODS: We enrolled 77 adults into a 52-week study requiring five daily ecologic momentary assessments (EMA) of stress and daily accelerometer use. We performed a pre/post single-arm study to evaluate the efficacy of a lottery intervention in improving adherence to this protocol. Midway through the study, participants were invited to enter a weekly regret lottery ($50 prize, expected value <$1) in which prize collection was contingent upon meeting adherence thresholds for the prior week. Study protocol adherence before and after lottery initiation were compared using mixed models repeated measures analysis of variance. RESULTS: 62 participants consented to lottery participation. In the 12 weeks prior to lottery initiation, weekly adherence was declining (slope −1.4%/week). The weekly per-participant probability of adherence was higher after lottery initiation when comparing the 4-week (32% pre-lottery vs 50% post-lottery, p < 0.001), 8-week (37% vs 49%, p < 0.001), and 12-week periods (39% vs 45%, p = 0.001) before and after lottery initiation. However, the rate of decline in adherence over time was unchanged. CONCLUSION: The implementation of an automated, electronically-delivered weekly regret lottery improved adherence with an intensive self-monitoring study protocol. Regret lotteries may represent a cost-effective tool to improve adherence and reduce bias caused by dropout or nonadherence.
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spelling pubmed-65558932019-06-13 Behavioral economics implementation: Regret lottery improves mHealth patient study adherence Husain, S. Ali Diaz, Keith M. Schwartz, Joseph E. Parsons, Faith E. Burg, Matthew M. Davidson, Karina W. Kronish, Ian M. Contemp Clin Trials Commun Article BACKGROUND: Nonadherence to study protocols reduces the generalizability, validity, and statistical power of longitudinal studies. PURPOSE: To determine whether an automated electronically-delivered regret lottery would improve adherence to an intensive mHealth self-monitoring protocol as part of a longitudinal observational study. METHODS: We enrolled 77 adults into a 52-week study requiring five daily ecologic momentary assessments (EMA) of stress and daily accelerometer use. We performed a pre/post single-arm study to evaluate the efficacy of a lottery intervention in improving adherence to this protocol. Midway through the study, participants were invited to enter a weekly regret lottery ($50 prize, expected value <$1) in which prize collection was contingent upon meeting adherence thresholds for the prior week. Study protocol adherence before and after lottery initiation were compared using mixed models repeated measures analysis of variance. RESULTS: 62 participants consented to lottery participation. In the 12 weeks prior to lottery initiation, weekly adherence was declining (slope −1.4%/week). The weekly per-participant probability of adherence was higher after lottery initiation when comparing the 4-week (32% pre-lottery vs 50% post-lottery, p < 0.001), 8-week (37% vs 49%, p < 0.001), and 12-week periods (39% vs 45%, p = 0.001) before and after lottery initiation. However, the rate of decline in adherence over time was unchanged. CONCLUSION: The implementation of an automated, electronically-delivered weekly regret lottery improved adherence with an intensive self-monitoring study protocol. Regret lotteries may represent a cost-effective tool to improve adherence and reduce bias caused by dropout or nonadherence. Elsevier 2019-05-31 /pmc/articles/PMC6555893/ /pubmed/31198881 http://dx.doi.org/10.1016/j.conctc.2019.100387 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Husain, S. Ali
Diaz, Keith M.
Schwartz, Joseph E.
Parsons, Faith E.
Burg, Matthew M.
Davidson, Karina W.
Kronish, Ian M.
Behavioral economics implementation: Regret lottery improves mHealth patient study adherence
title Behavioral economics implementation: Regret lottery improves mHealth patient study adherence
title_full Behavioral economics implementation: Regret lottery improves mHealth patient study adherence
title_fullStr Behavioral economics implementation: Regret lottery improves mHealth patient study adherence
title_full_unstemmed Behavioral economics implementation: Regret lottery improves mHealth patient study adherence
title_short Behavioral economics implementation: Regret lottery improves mHealth patient study adherence
title_sort behavioral economics implementation: regret lottery improves mhealth patient study adherence
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555893/
https://www.ncbi.nlm.nih.gov/pubmed/31198881
http://dx.doi.org/10.1016/j.conctc.2019.100387
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