Gamification for Improving Mobility After Hospitalization

(MOVE_ON Trial)

Overseen By Ryan Greysen, MD, MHS, MA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Pennsylvania

Disqualifiers: Informed consent, Smartphone access, Low mobility, Hospice, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether a game-like approach can help older adults become more active after leaving the hospital. Participants will use a wearable device, such as a FitBit, and work with a virtual health coach to encourage more walking and reduce mobility issues. This approach, called Social Support Gamification, aims to motivate participants through interactive and engaging methods. The trial targets individuals over 50 who were recently hospitalized and can walk independently. Participants will join either the gamification group or a control group, with both groups using the wearable device to track activity. As an unphased trial, this study offers participants a unique opportunity to explore innovative methods to improve health and mobility.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this gamification intervention is safe for improving mobility after hospitalization?

Research has shown that using game-like elements with social support is generally safe for encouraging increased activity. In past studies, these game-based approaches have gained popularity, and participants became more active without major negative effects.

One study found that older adults, even those at higher risk for diseases like Alzheimer's, increased their activity levels with these game-like methods. Another study demonstrated that when combined with social support, these methods not only boosted activity but also reduced healthcare visits.

Overall, this evidence suggests that using game-like elements with social support is well-accepted and does not cause major health problems. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the gamification approach to improving mobility after hospitalization because it incorporates cutting-edge behavioral economics to motivate change. Unlike traditional rehabilitation methods that might rely solely on scheduled physical therapy sessions, this approach integrates a wearable device, like a FitBit, with a game that makes increasing physical activity both engaging and rewarding. Participants also receive support from a virtual health coach, offering personalized guidance and encouragement. This combination of technology and personalized coaching could potentially overcome common barriers to maintaining mobility, making it a promising new strategy for post-hospital recovery.

What evidence suggests that social support gamification is effective for improving mobility after hospitalization?

This trial will compare the effects of social support gamification with a control group. Research has shown that games with social rewards can yield mixed results. While not everyone experienced improved movement, some groups benefited. More socially active individuals showed less decline in their abilities. In one study, only one person in the group using the game experienced a decline, compared to five people in a similar group without the game. This suggests that games with social support might help some people remain active after leaving the hospital. ^{2 6 7 8 9}

Who Is on the Research Team?

Ryan Greysen, MD, MHS, MA

Principal Investigator

University of Pennsylvania

Are You a Good Fit for This Trial?

This trial is for adults aged 50 or older who can walk on their own and were recently in the hospital for conditions like heart failure, high blood pressure, diabetes, or mobility issues. They must be able to use a smartphone with a wearable device daily and not be part of another physical activity study.

Inclusion Criteria

Admitted to the University of Pennsylvania Health System acute care hospital (Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Pennsylvania Hospital, Lancaster General Health, Chester County Hospital, or Penn Medicine Princeton Medical Center) and discharged to home

I can walk on my own without help.

I am 50 years old or older.

Exclusion Criteria

Inability to provide informed consent

I cannot walk more than 1000 steps a day on my own.

Not willing to use the wearable device for the full duration of the study

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a wearable device and engage in a gamification intervention with a virtual health coach to increase physical activity

26 weeks

Virtual interactions with health coach

Follow-up

Participants continue passive data collection of step counts and complete assessments and surveys

26 weeks

Assessments at 6 and 12 months, surveys at 3, 6, 9, and 12 months

What Are the Treatments Tested in This Trial?

Interventions

• Social Support Gamification

Trial Overview The study tests if adding game-like elements with social rewards can help older adults stay active after leaving the hospital. The goal is to see if this approach prevents them from losing their ability to move around easily.

How Is the Trial Designed?

Group I: Social Support Gamification Experimental Treatment 1 Intervention

Intervention participants will receive a wearable device (e.g. FitBit) and will enter a game designed with behavioral economics concepts to address predictable barriers to behavior change during a 26-week intervention period. Participants will also work with a virtual health coach throughout the intervention period to increase their physical activity. At the end of the 26 week intervention period, participants will enter a 26 week follow-up period during which interventions will cease but passive data collection of step counts will continue. Participants will also complete milestones within the study, such as the Function assessment during the 6, and 12-month timepoints in the study. They will also complete a series of surveys during the 3, 6, 9, and 12-month timepoints in the study. Participants will complete an end-of-study questionnaire on their experience with the wearable device and time in the study.

Group II: Control Active Control 1 Intervention

Participants will receive a wearable device (e.g. FitBit) but no other interventions during the intervention or follow-up periods.Participants will complete milestones within the study, such as the Function assessment during the 6, and 12-month timepoints in the study. They will also complete a series of surveys during the 3, 6, 9, and 12-month timepoints in the study. Participants will complete an end-of-study questionnaire on their experience with the wearable device and time in the study.

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials

2,118

Recruited

45,270,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7991973/

Effect of Behaviorally Designed Gamification With a Social ... Gamification with social incentives did not affect mobility or functional decline in all participants but may be beneficial for patients with ...

2. withpower.com withpower.com/trial/phase-hypertension-6-2023-2bdd5

Gamification for Improving Mobility After Hospitalization ... The objective of this study is to test the feasibility of using behavioral economic interventions (gamification with social incentives) to increase physical ...

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/33760089/

Effect of Behaviorally Designed Gamification With a Social ... Gamification with social incentives did not affect mobility or functional decline in all participants, but post hoc analysis suggests positive findings for ...

4. games.jmir.org games.jmir.org/2025/1/e66262

Preliminary Efficacy of a Gamified Mobile App for Promoting ... This study explores the use of a gamified mobile app to support self-health management among nurses recovering from the COVID-19 experience.

5. ascopost.com ascopost.com/news/april-2021/effect-of-gamification-with-social-incentives-on-increased-mobility-after-hospital-discharge/

Effect of Gamification With Social Incentives on Increased ... In the subgroup with higher levels of social engagement, functional decline was observed in one patient (4%) in the intervention group vs five ( ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12445784/

Effectiveness of Gamification Interventions to Improve ... Our findings showed that the gamification interventions significantly increased moderate-to-vigorous physical activity (MVPA; standardized mean ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S1071581923002148

A field experiment on gamification of physical activity Our study sought to find evidence for the effects resulting from gamification of physical activity on the users' motivation, perceived usefulness, and the ...

8. alz-journals.onlinelibrary.wiley.com alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.14058

Effect of gamification with a support partner to increase ... A gamified intervention was effective in promoting and sustaining higher physical activity in older adults at genetic risk for AD/ADRD.

9. jmir.org jmir.org/2015/1/e14/

The Effect of Social Support Features and Gamification on ... Gamification alone or with social support increased physical activity and empowerment and decreased health care utilization. This study provides ...