Evaluation of the Novel Use of Gamification With Alternative Goal-setting Experiences

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in the
United States. While increased physical activity can reduce this risk, less than half of
adults in the United States meet the minimum recommendation guidelines for physical activity.
Gamification, or the application of game design elements to non-game settings, has
demonstrated promise in increasing physical activity when designed using insights from
behavioral economics. However, the best way to design goal-setting within these interventions
has not been well-examined. In this randomized controlled trial, the investigators will
evaluate the effectiveness of four different goal-setting strategies within a gamification
intervention to increase physical activity among adults with elevated risk for ASCVD. The
trial will include a 2-week run-in period to estimate a baseline, followed by an 8-week
introductory phase, an 8-week maintenance phase, and then after the intervention is completed
an 8-week follow-up period.

Inclusion Criteria:

- Age 18 years or older;

- ability to read and provide informed consent to participate in the study;

- diagnosis of clinical ASCVD or a 10-year ASCVD risk score ≥ 7.5% calculated according
to the 2013 ACC/AHA guidelines;

- Smartphone or tablet compatible with application for the wearable activity tracking
device.

Exclusion Criteria:

- Conditions that would make participation infeasible such as inability to provide
informed consent, illiteracy or inability to speak, read, and write English;

- conditions that would make participation unsafe such as pregnancy or being told by a
physician not to exercise;

- already enrolled in another study targeting physical activity;

- any other medical conditions or reasons he or she is unable to participate in a
physical activity study for 24 weeks;

- baseline step count of 10,000 steps or greater.