Trial reportCirculation2024
Effect of Gamification, Financial Incentives, or Both to Increase Physical Activity Among Patients at High Risk of Cardiovascular Events: The BE ACTIVE Randomized Controlled Trial.
Trial report in Circulation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03911141 (Behavioral Economic Approaches to Increase Physical Activity Among Patients With Elevated Risk for Cardiovascular Disease), which is not on this map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Behavioral Economic Approaches to Increase Physical Activity Among Patients With Elevated Risk for Cardiovascular Disease
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Effectiveness of mHealth-Based Gamified Interventions on Physical Activity in Older Adults: Systematic Review.JMIR aging · 2025Pooled it
- A pilot randomized clinical trial of gamification to increase medication adherence.American heart journal · 2026 · on this mapTrial
- A Gamified Mobile Health Intervention to Promote Physical Activity, Executive Function, and Mental Health in College Students: Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- Effect of Gamification Plus Automated Coaching to Increase Physical Activity Among Patients With Peripheral Artery Disease: The GAMEPAD Randomized Controlled Trial.Journal of the American Heart Association · 2025Trial
- Cost-Effectiveness of Gamification, Financial Incentives, or Both to Increase Physical Activity Among Patients With Elevated Risk for Cardiovascular Disease.Circulation. Cardiovascular quality and outcomes · 2025Trial
- A village doctor-led mobile health intervention for cardiovascular risk reduction in rural China: cluster randomised controlled trial.BMJ (Clinical research ed.) · 2025Trial
- What motivates participants: a qualitative analysis of gamification and financial incentives to increase physical activity.BMC public health · 2025Trial
- Gamification Elements in Physical Activity Interventions: Scoping Review and Taxonomy Based on the Octalysis Framework.JMIR serious games · 2026Review
- Home-Based Multimodal Exergame Prototype for Patients With Chronic Stroke: Cross-Sectional Content Validation and Prospective Single-Arm Feasibility Study.JMIR serious games · 2026Article
- Messaging Informed by Behavioral Economics and Representativeness in Clinical Research Enrollment: Four Randomized Clinical Trials.JAMA network open · 2026Article
- Cardiac Telerehabilitation Using a Smartwatch and a Gamified Smartphone App: Single-Arm Pre-Post Feasibility Study.JMIR cardio · 2026Article
- Comparative effects of exercise modalities on ectopic fat reduction in overweight and obese children and adolescents: a narrative review.European journal of pediatrics · 2026Review
- Design, Characteristics, and Implementation of the Financial Support for Low-Income Patients with Heart Failure Trial.JACC. Advances · 2026Article
- Is Gamification the New Panacea for Health Behavioral Changes? Implications for the Health and Life Insurance Industry.JMIR serious games · 2026Article
- Gamification Boosts Physical Activity in Disparate Populations of Cancer Survivors.JACC. CardioOncology · 2026Article
- Defining the Name of the Game in Exercise Oncology: How Do We Incentivize Physical Activity?JACC. CardioOncology · 2025Article
- Behaviorally Designed Gamification and Physical Activity Among Breast and Prostate Cancer Survivors.JACC. CardioOncology · 2025Article
- Nudges in A Learning Health System: Applications to Cardiovascular-Kidney-Metabolic Care.JACC. Advances · 2025Review
- Article
- AI and Digital Health: Personalizing Physical Activity to Improve Population Health.Circulation. Cardiovascular quality and outcomes · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundPhysical activity is associated with a lower risk of major adverse cardiovascular events, but few individuals achieve guideline-recommended levels of physical activity. Strategies informed by behavioral economics increase physical activity, but their longer-term effectiveness is uncertain. We sought to determine the effect of behaviorally designed gamification, loss-framed financial incentives, or their combination on physical activity compared with attention control over 12-month intervention and 6-month postintervention follow-up periods.
methodsBetween May 2019 and January 2024, participants with clinical atherosclerotic cardiovascular disease or a 10-year risk of myocardial infarction, stroke, or cardiovascular death of ≥7.5% by the Pooled Cohort equation were enrolled in a pragmatic randomized clinical trial. Participants received a wearable device to track daily steps, established a baseline, selected a step goal increase, and were randomly assigned to control (n=151), behaviorally designed gamification (n=304), loss-framed financial incentives (n=302), or gamification+financial incentives (n=305). The primary outcome of the trial was the change in mean daily steps from baseline through the 12-month intervention period.
resultsA total of 1062 patients (mean±SD age, 67±8; 61% female; 31% non-White) were enrolled. Compared with control subjects, participants had significantly greater increases in mean daily steps from baseline during the 12-month intervention in the gamification arm (adjusted difference, 538.0 [95% CI, 186.2-889.9];
conclusionsBehaviorally designed gamification, loss-framed financial incentives, and the combination of both increased physical activity compared with control over a 12-month intervention period, with the largest effect in gamification+financial incentives. These interventions could be a useful component of strategies to reduce cardiovascular risk in high-risk patients. REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier: NCT03911141.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.