Working Paper: CEPR ID: DP14420
Authors: Marina Serper; Iwan Barankay; Sakshum Chadha; Justine Shults; Lauren S. Jones; Kim Olthoff; Peter Reese
Abstract: Kidney transplant recipients (KTRs) and liver transplant recipients (LTRs) have significant post-transplant weight gain and low physical activity. We conducted a home-based, remotely-monitored intervention using wearable accelerometer devices to promote post-transplant physical activity. We randomized 61 KTRs and 66 LTRs within 24 months of transplant to: 1) control, 2) accelerometer, or 3) intervention: accelerometer paired with financial incentives and health engagement questions to increase steps by 15% from baseline every 2 weeks. The primary outcome was weight change. A co-primary outcome for the two accelerometer arms was steps. Participants were recruited at a median of 9.5 [3-17] months post-transplant. At 3 months, there were no significant differences in weight change across the 3 arms. The intervention arm was more likely to achieve ≥7000 steps compared to control with device (OR 1.99, 95% CI:1.03-3.87); effect remained significant after adjusting for demographics, allograft, time from transplant, and baseline weight. Adherence to target step goals was 74% in the intervention arm, 84% of health engagement questions were answered correctly. A pilot study with financial incentives and health engagement questions was feasible and led KTRs and LTRs to walk more, but did not affect weight. A definitive trial is warranted. (ClinicalTrials.gov number: NCT03221465).
Keywords: physical activity; behavior change; remote monitoring; self-care; behavioral economics; exercise
JEL Codes: No JEL codes provided
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| adherence to step goals (L21) | weight change (F31) |
| intervention arm (with accelerometer and financial incentives) (O31) | likelihood of achieving the target of 7000 steps (Y10) |
| increased physical activity (I12) | weight management (L21) |