Preprint / Working Paper | Long-term Effects of Text Messages with Financial Incentives for Men with Obesity: Two-year Follow-up of the Game of Stones trial

Preprint / Working Paper

Long-term Effects of Text Messages with Financial Incentives for Men with Obesity: Two-year Follow-up of the Game of Stones trial

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Citation

Dombrowski SU, Hoddinott P, Swingler J, Macaulay L, O’Dolan C, Cotton S, Avenell A, Getaneh AM, Gray CM, Hunt K, Kee F, MacLean A, McKinley MC, Torrens C, Turner K, van der Pol M & MacLennan G (2024) Long-term Effects of Text Messages with Financial Incentives for Men with Obesity: Two-year Follow-up of the Game of Stones trial. https://www.medrxiv.org/. https://www.medrxiv.org/; https://doi.org/10.1101/2024.12.12.24318921

Abstract
Objectives: To compare the difference in percentage weight change at 24 months following a 12-month text messaging with financial incentive intervention compared to a waiting list control group, and to compare the text messaging alone group to the control group. Design: Assessor-blinded three-arm randomised clinical trial. Setting: Three disadvantaged communities from the UK. Participants: 585 men with body mass index (BMI) of ≥30kg/m2 enrolled between July 2021 and May 2022, of which 377 participants (64%) completed 24 months’ follow-up. Interventions: 12 months of daily behavioural text messages combined with financial incentives; 12 months of the same text messages alone; or waiting for 12 months followed by receipt of the first 3 months (months 12-15) of text messages (control). Main outcome measures: Within-participant change from baseline weight. Results: At 24 months, the mean percent weight change (standard deviation) was ?3.9% (6.9%) for the text messaging with financial incentives group, ?2.6% (6.8%) for the text messaging alone group, and ?2.2% (6.8%) for the control group. Compared with the control group, the mean percent weight change was not significantly greater in the text messaging with financial incentives group (mean difference, ?1.0%; 97.5% CI, ?2.6 to 0.6; P = .22) or the text messaging alone group (mean difference, ?0.0%; 97.5% CI, ?1.6 to 1.5; P = .95).At least 5% weight loss at 24 months was achieved by 52 (40%) participants in the text messaging with financial incentives group; 32 (28%) in the text messaging alone group and 43 (32%) in the control group. Conclusions: A scalable, low-cost text message with financial incentives intervention supported clinically relevant maintenance of weight loss 12 months after the intervention ceased, including those from disadvantaged backgrounds.

Keywords
Obesity, Health behaviour, Public Health, Financial Incentives