Background

Self-monitoring of obesogenic behaviors paired with social support is key to successful weight loss. However, it is challenging to motivate self-monitoring. Gamification approaches may help motivate self-monitoring and behavior change. We aimed to determine if gamification plus self-monitoring could increase steps per day among obese parent-child dyads.

Methods

Children ages 10-16 years and their parent, both with obesity, were randomized to a self-monitoring (SM, N=17) or a self-monitoring plus gamification (SM+G, N=21) intervention for 8-weeks (1-week run; 7-week intervention). We used Fitbit Flex 2 devices to self-monitor steps per day. The step per day goal started at 7,000, increasing by 250 steps per day for each subsequent intervention week. The SM+G arm accumulated points if daily step goals were achieved, which could earn participants weekly medals. Additionally, participants were asked to report their daily sugar sweetened beverage (SSB) intake each day through text messaging (# 12oz servings). Linear mixed models were used to test for between-group differences over the intervention period (arm x week interactions).

Results

We enrolled 38 parent-child dyads (90% black, 5% white and 5% other). Parents were 42 (SD=7.1) years old with a BMI of 38.3 (SD=7.5) kg/m2; all were mothers. Children were 12.8 (SD = 2.1) years old with a BMI Z-score of 2.2 (SD=0.35); 61% were girls. There were no differences in steps per day or SSB intake per day between the study arms for either the children or their parents over the 7-week study intervention (P-interactions>0.05). However, regardless of study arm, parents reduced their average SSB intake by 0.05 servings per day per week (P=0.01; i.e. 0.35 reduction per serving at week 7).

Conclusions

Self-monitoring and a points/medal gamification approach did not help parents or children with obesity to increase their steps per day. However, self-monitoring of SSB intake led to a reduction in SSB among obese parents.