Journal
TRANSPLANT INTERNATIONAL
Volume 33, Issue 6, Pages 632-643Publisher
FRONTIERS MEDIA SA
DOI: 10.1111/tri.13570
Keywords
behavior change; behavioral economics; exercise; physical activity; remote monitoring; self-care
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Funding
- Translational Medicine and Therapeutics (ITMAT) at the University of Pennsylvania
- Leonard Davis Institute (LDI) Center for Health Incentives and Behavioral Economics (CHIBE) Pilot Grant at the University of Pennsylvania
- National Institute of Diabetes and Digestive and Kidney Diseases [1K23DK115897-01]
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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: (i) control, (ii) accelerometer or (iii) 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 three 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.
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