Making a game of it: Contests help new moms increase their steps

Date:
April 20, 2022
Source:
University of Pennsylvania School of Medicine
Summary:
Fun and games could be a solution to serious problems like
preeclampsia and hypertension among pregnant people and
holds promise for significant progress, according to a new
study. Researchers found that gamification-- broadly defined as
the use of specially engineered games to stimulate learning and
behavioral change--could generate greater levels of exercise in
postpartum individuals who developed these types of conditions.



FULL STORY ==========================================================================
Fun and games could be a solution to serious problems like preeclampsia
and hypertension among pregnant people and holds promise for significant progress, according to a new study from the Perelman School of Medicine
at the University of Pennsylvania. Researchers found that gamification -- broadly defined as the use of specially engineered games to stimulate
learning and behavioral change - - could generate greater levels
of exercise in postpartum individuals who developed these types of
conditions. In turn, the increased physical activity can help lower the
risk of cardiovascular disease and death. The findings are published
today in JAMA Cardiology.


========================================================================== "Experts have long recommended that we talk to postpartum women about
adopting healthier lifestyle habits to reduce their cardiovascular
risk, but there was very little guidance on how to do that," said study
first author Jennifer Lewey, MD,a cardiologist and co-director of Penn Medicine's Pregnancy and Heart Disease Program. "The question we were
trying answer was whether we could develop a digital, remote intervention
to improve physical activity for high- risk postpartum women. It was a
digital intervention that included gamification and what we call social incentives to improve accountability." Conditions like preeclampsia and gestational hypertension occur in up to 10 percent of all U.S. pregnancies
and can heighten the risks of chronic hypertension and heart disease in
the months and years following childbirth.

The dangers posed by these and similar conditions, known together
as hypertensive disorders of pregnancy (HDP), are better understood
than ever.

Nevertheless, successful strategies for improving lifestyle factors like physical activity in this population have remained elusive. Gamification
has been successfully used in various healthcare disciplines and beyond,
but this is the first time it has been tested in women with HDPs. With
that in mind, Lewey and the study's senior author, Lisa Levine, MD, the
Michael T. Mennuti, MD, associate professor in Reproductive Health and
director of the Pregnancy and Heart Disease Program, set out to apply
it in Maternal Fetal Medicine at Penn Medicine.

In the study, 127 participants received a wearable activity tracker
to tally their daily steps. Roughly half of these individuals also
took part in a game - - designed by co-author Mitesh Patel, MD, an
associate professor of Medicine at Penn and vice president for Clinical Transformation at Ascension -- that assigned them to teams and offered
points and achievement benchmarks for those who met or exceeded their
step goals.

"Each postpartum woman was joined up with two other postpartum women virtually," Lewey explained. "Each team started the week with 70 points,
and every day a team member was chosen at random. If that person met her
step goals for that day, the team got to keep its points. But if they
didn't, the team lost points." On average, game players took 647 more
steps per day than those in the control group. With existing evidence
showing that people who take 1,000 extra steps per day can lower their
risk of developing or dying from cardiovascular disease, the finding
is significant.

Making the results potentially even more impactful, about 55 percent of
the study participants were Black, while about 42 percent were enrolled
in Medicaid -- two populations often associated with a higher likelihood
of HDPs and cardiovascular risk.

"I was excited that we were able to enroll a racially diverse population," Lewey said. "That's important because a woman who identifies as Black or
is of lower socioeconomic status has a greater burden of cardiovascular
risk factors." While further studies will need to test the intervention
over longer periods of time, the strategy could be tested now in other hospitals and health systems, Lewey said. Free or lower-cost smartphone
apps can replace wearable tech, making it a relatively simple and cost-effective solution. Since many health systems keep in touch with new
moms after hospital discharge, and with communication options expanding, eligible patients could be readily identified through existing channels.

"We used text messages to recruit our participants," Lewey said. "Any
health system that already uses follow-up after delivery could easily find patients for this kind of intervention. The whole idea is that being on
the team and having this game structure can help keep postpartum women motivated in keeping their step count goal." This study was supported by
the National Institutes of Health (K23HL153667, HD65987), the Institute
for Translational Medicine and Therapeutics, and the National Center
for Advancing Translational Science (UL1TRTOO1878).


========================================================================== Story Source: Materials provided by University_of_Pennsylvania_School_of_Medicine. Note: Content may be
edited for style and length.


========================================================================== Journal Reference:
1. Jennifer Lewey, Samantha Murphy, Dazheng Zhang, Mary E. Putt,
Michal A.

Elovitz, Valerie Riis, Mitesh S. Patel, Lisa
D. Levine. Effectiveness of a Text-Based Gamification Intervention
to Improve Physical Activity Among Postpartum Individuals With
Hypertensive Disorders of Pregnancy. JAMA Cardiology, 2022; DOI:
10.1001/jamacardio.2022.0553 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220420170455.htm

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