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Zz research slideshow

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Zz research slideshow

  1. 1. The Zamzee Research | | | I | Motivating Behavior Change and The Clinical Benefits of Zamzee A Project of HopeLa l{‘; )’. ’°
  2. 2. WHAT IS ZAMZEE? Zamzee helps motivate children to become more physically active. Zamzee users get a meter to track their physical activity and access to a motivational website where they view their activity levels and earn recognition for their achievements. Zamzee is designed to integrate into pediatric treatment programs, and to empower healthcare providers to better understand their patients through accurate data. Here’s a closer look at the initial Zamzee design research and our study of the impacts of Zamzee for children (C| inica| Tria| s.gov NCT01433679).
  3. 3. WHAT IS ZAMZEE? Kick-starting Behavior Change and Cultivating Intrinsic Motivation Zamzee offers children small, extrinsic rewards to help kick-start behavior change, and to foster intrinsic motivation that will sustain change over time. Extrinsic rewards include small prizes that help initiate physical activity. Intrinsic motivation develops out of positive experiences and sustains change over time by creating a sense of: 0 Competence — feeling capable and effective. 0 Autonomy - having freedom and a sense of control. 0 Mastery - growing and improving. - Purpose - pursuing goals and aspirations. 0 Relatedness - belonging and connecting with others. (DGCI & Ryan, 2000,’ Pink, 2009)
  4. 4. .‘» 1.! Jil'll1‘. r.a , H:'5?il¢. ‘|i‘l ~‘“ll! "» l"ll One of the preliminary Zamzee Design Studies investigated the efficacy of small rewards to initiate behavior change. We studied 100 middle school—aged children across diverse US sites. Children in the rewards conditions were given extrinsic rewards via the Zamzee website. These included virtual goods and gift cards ($5 and $20). The website also provided children with positive experiences designed to foster intrinsic motivation to sustain their behaviors. Our findings The Zamzee system motivated children to become more active. On average, children who were rewarded were more physically active than the control group. (The control group wore meters, but did not have access to the website or rewards. ) MVPA % time Control l I firtual only firtual + $5 Virtual + $20
  5. 5. THE ZAMZEE IMPACT STUDY Following our initial design testing and development of the Zamzee program, we conducted a randomized controlled Impact Study of Zamzee’s efficacy. We found significant clinical benefits for children using Zamzee, including increased physical activity levels and positive impacts on biomarkers related to type 2 diabetes and heart disease. Our questions 0 Does Zamzee motivate children to become more active? 0 Does Zamzee have a positive effect on biomarkers for chronic disease risk? We studied A diverse group of 448 children between the ages of 11-14, over the course of 6 months.
  6. 6. THE ZAMZEE IMPACT STUDY Zamzee increased physical activity by 59% We used accelerometers to measure moderate to vigorous physical activity (MVPA), like dancing, climbing 120 stairs, or jogging. And we gave kids access to the Zamzee website, where they could see charts of their '00 activity levels and earn prizes. 80 Children who had Zamzee meters and access to the Zamzee website moved 59% more, on average, than kids in the control group. (The control group wore meters, but did not have access to the website or rewards. ) 60 40 That difference is like: 2° 0 Doing push-ups non-stop for 45 minutes per week. 0 Scrubbing floors for 3 hours per month. CONTROL ZAMZEE 9 Chasing Wild pigs f0l' 6 minutes per day (really). AVERAGE MINUTES or MVPA PER WEEK (Source: Compendium of Physical Activities) ZENTTZEG APmi¢¢t0fHOpeLB. k'
  7. 7. THE ZAMZEE IMPACT STUDY Zamzee’s impact persisted for the entire 6-month trial Even after 24 weeks, children with access to the Zamzee website were consistently more active than those in the control group. 160 2.‘ :3 3 <3 100 80 60 MVPA (minutes / week) 40 20 AVERAGE MINUTES OF MVPA PER STUDY WEEK Week I I 18 I ZAMZEE ‘I i I I 24 Q CONTROL A Praise: of HopeLal; ‘;‘
  8. 8. THE ZAMZEE IMPACT STUDY Using Zamzee slowed gains in “bad” cholesterol LDL, or “bad, ” cholesterol is a heart disease risk factor. Gradual increases in LDL are typical in kids, as seen in the control group. But among kids who used Zamzee, LDL gains were reduced. Low-density lipoprotein (mg/ dL) 85 80 75 70 65 LDL CHOLESTEROL CONTROL ZAMZEE Baseline 6 mo Group x Time Interaction p = .034
  9. 9. THE ZAMZEE IMPACT STUDY Using Zamzee helped control blood sugar levels GIyCated heITIOgIObIn IS an GLyCATED HEMOGLOB/ N» indirect measure of blood sugar. Elevated levels of HbA1c indicate a risk for type 2 diabetes. Over 6 5-3 months, HbA1c levels were better maintained among kids who used 5.4 CONTROL ZAMZEE 5.2 6.0 HbA1c (%) S“ O) Zamzee than kids in the control group. 5.0 Baseline 6 mo ’ Measurement adherent: Group x Time Interaction p = .012
  10. 10. THE ZAMZEE IMPACT STUDY Zamzee increased physical activity among at-risk groups Zamzee was effective for girls and children who are overweight*, two groups at the highest risk for sedentary behavior. Both groups moved more, on average, than their peers in the control group. * We defined oveniveight as BMI 2 25. GIRLS: 103% INCREASE OVERWEIGHT KIDS: 27% INCREASE 100 130 za 5 120 80 MD 70 100 6D 90 50 SD MVPA (minutes/ week) 40 70 30 60 CONTROL ZAMZEE CONTROL ZAMZEE
  11. 11. THE ZAMZEE IMPACT STUDY DETAILS: THE POPULATION Sample Characteristics Site Suburban N = 86 (19% of total sample) Suburban N = 82 (18%) Rural N = 87 (19%) Rural N = 105 (23%) Urban N = 50 (11%) Urban N = 38 (9%) Age 11-14 Mean = 12.7, SD: 0.8 Gender Female N = 244 (54%) Male N = 204 (46%) Ethnicity White N = 198 (45%) Hispanic N = 110 (25%) African—American N = 64 (14%) Multi-ethnic N = 53 (12%) Asian N = 12 (3%) Decline N = 6 (1%) BMI 14-50 Mean = 22.2. SD = 5.2, BM|225 = 25%
  12. 12. THE ZAMZEE IMPACT STUDY DETAILS: THE DESIGN Hypothesis Zamzee will increase MVPA and have a positive impact on health-related biomarkers in middle-school aged children. Study design Multi-site randomized controlled trial: ClinicalTrials. gov NCT01433679. Study arms 1. Zamzee accelerometer and motivational website. 2. Control group: Zamzee accelerometer only. Measurement structure 1. Continuous assessment of physical activity over the 6-month study period. 2. Pre- and post—study assessments of blood biomarkers. Outcomes 1. Primary: MVPA rates over 6-month study period. 2. Secondary: Biomarkers of metabolic function (HbA1c, glucose, lipid panel).
  13. 13. ZAMZEE REWARDS STUDY DETAILS: THE POPULATION Sample Characteristics Age 11-15 Mean = 13.0, SD: 0.7 Gender Female N = 53 (53%) Male N = 47 (47%) Ethnicity White N = 44 (44%) Hispanic N = 35 (35%) African-American N = 1 (1%) Multi-ethnic N = 11 (11%) Asian N = 3 (3%) Decline N = 6 (6%) BMI 15-43 Mean = 21.6, SD = 4.9, BM|225 = 18%
  14. 14. ZAMZEE REWARDS STUDY DETAILS: THE DESIGN Hypothesis Zamzee’s reward model would increase MVPA in middle school—aged children. Study arms 1.Chi| dren use the accelerometer and the motivational website with varying reward possibilities: a. Website access with no rewards b. Website access with $5 rewards c. Website access with $20 rewards 2. Control group: Zamzee accelerometer only Measurement structure Continuous assessment of physical activity for up to 12 weeks during study participation.
  15. 15. Zamzee was researched, developed, and tested by a team of behavioral scientists at HopeLab, led by Dr. Steve Cole. HopeLab is a non-profit research organization working to harness the power and appeal of technology to improve human health and well-being. Ii / -i—rr{'f'/ '® . ‘.. A Project of i (‘*7 f}Lab Research Sponsored by Robert Wood Johnson Foundation For complete results of our studies, please visit our research abstract.