When patients are admitted to the hospital, they spend most of their time in bed or within their designated room. Evidence has demonstrated that this experience leads to functional decline, particularly in older adults. Health systems are open to implementing new mobility protocols to reduce the harms of hospitalization and help patients regain function faster. However, the current activity levels among admitted patients and the best way to design mobility protocols upon discharge are unknown.
We ran a randomized clinical trial to test if gamification strategies and social incentives could increase patient mobility after hospital discharge. Approximately 200 patients were enrolled from general medicine and oncology units and given a wearable device to track activity during their hospitalization. Upon discharge, participants were randomly assigned to a control group or an intervention arm. Participants in the control group received feedback from their wearable device and no other intervention. Participants in the intervention group participated in a 12-week game that assigned points and levels for achieving step goals and engaged a support partner to receive updates on progress.
Gamification with social incentives did not increase post-discharge mobility (steps per day) during the 12-week pilot. However, the subgroup of 76 patients with higher social engagement at baseline had an increase in mobility and a decrease in functional decline.
Leonard Davis Institute of Health Economics, Center for Health Incentives and Behavioral Economics, National Center for Advancing Translational Science, Institute for Translational Medicine and Therapeutics