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. 2022 Jul 22;23(1):582.
doi: 10.1186/s13063-022-06504-5.

Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial

Lisa Macaulay  1 , Catriona O'Dolan  2 , Alison Avenell  3 , Paula Carroll  4 , Seonaidh Cotton  5 , Stephan Dombrowski  6 , Andrew Elders  7 , Beatriz Goulao  5 , Cindy Gray  8 , Fiona M Harris  9 , Kate Hunt  10 , Frank Kee  11 , Graeme MacLennan  5 , Matthew David McDonald  12 , Michelle McKinley  13 , Rebecca Skinner  14 , Claire Torrens  2 , Martin Tod  15 , Katrina Turner  16 , Marjon van der Pol  17 , Pat Hoddinott  2
Affiliations

Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial

Lisa Macaulay et al. Trials. .

Abstract

Background: Obesity increases the risk of type 2 diabetes, heart disease, stroke, mobility problems and some cancers, and its prevalence is rising. Men engage less than women in existing weight loss interventions. Game of Stones builds on a successful feasibility study and aims to find out if automated text messages with or without endowment incentives are effective and cost-effective for weight loss at 12 months compared to a waiting list comparator arm in men with obesity.

Methods: A 3-arm, parallel group, assessor-blind superiority randomised controlled trial with process evaluation will recruit 585 adult men with body mass index of 30 kg/m2 or more living in and around three UK centres (Belfast, Bristol, Glasgow), purposively targeting disadvantaged areas. Intervention groups: (i) automated, theory-informed text messages daily for 12 months plus endowment incentives linked to verified weight loss targets at 3, 6 and 12 months; (ii) the same text messages and weight loss assessment protocol; (iii) comparator group: 12 month waiting list, then text messages for 3 months. The primary outcome is percentage weight change at 12 months from baseline. Secondary outcomes at 12 months are as follows: quality of life, wellbeing, mental health, weight stigma, behaviours, satisfaction and confidence. Follow-up includes weight at 24 months. A health economic evaluation will measure cost-effectiveness over the trial and over modelled lifetime: including health service resource-use and quality-adjusted life years. The cost-utility analysis will report incremental cost per quality-adjusted life years gained. Participant and service provider perspectives will be explored via telephone interviews, and exploratory mixed methods process evaluation analyses will focus on mental health, multiple long-term conditions, health inequalities and implementation strategies.

Discussion: The trial will report whether text messages (with and without cash incentives) can help men to lose weight over 1 year and maintain this for another year compared to a comparator group; the costs and benefits to the health service; and men's experiences of the interventions. Process analyses with public involvement and service commissioner input will ensure that this open-source digital self-care intervention could be sustainable and scalable by a range of NHS or public services.

Trial registration: ISRCTN 91974895 . Registered on 14/04/2021.

Keywords: Cost-effectiveness; Financial incentives; Health inequalities; Men with obesity; Process evaluation; Randomised controlled trial; Text messages; Weight management.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trial flowchart
Fig. 2
Fig. 2
Recruitment flowchart
See this image and copyright information in PMC

References

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