# Behavioral Economic Approaches to Increase Physical Activity among Patients with Elevated Risk for Cardiovascular Disease

> **NIH NIH R33** · UNIVERSITY OF PENNSYLVANIA · 2022 · $727,301

## Abstract

PROJECT SUMMARY/ABSTRACT
Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in the United States (US).
Regular physical activity has been demonstrated to reduce the risk of ASCVD and is associated with a number of other
health benefits. Yet, less than 50% of adults in the US achieve enough physical activity to actually obtain these benefits.
This level of inactivity in the US has been mostly unchanged for the past decade; innovative and scalable approaches that
achieve sustained increases in physical activity are needed.
Insights from behavioral economics have been shown to both better reflect the `predictable irrationality' of humans and to
be effective in designing interventions that achieve sustained improvements in health behavior. Our prior work has
demonstrated that interventions using financial incentives and gamification can leverage principles from behavioral
economics to increase physical activity during 3-month interventions and sustain effects in 3-month follow-up periods.
These findings warrant further investigation of longer-term effects.
In this study, we propose to conduct a four-arm randomized, controlled trial with a 12-month intervention and then a 6-
month follow-up period to address the following aims: Aim 1: To evaluate the effectiveness of gamification, financial
incentives, or both approaches combined on increasing physical activity relative to control during a 12-month intervention
among individuals at elevated risk for atherosclerotic cardiovascular events. Aim 2: To evaluate the sustainability of the
three interventions (gamification, financial incentives, or both combined) in increasing physical activity during a 6-month
follow-up period. Aim 3: To compare the cost-effectiveness of using each of the intervention approaches relative to
control in increasing physical activity. We will test a scalable intervention by using wearable devices to monitor physical
activity levels and an automated research technology platform to deliver interventions remotely.

## Key facts

- **NIH application ID:** 10478877
- **Project number:** 5R33HL141440-05
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Alexander Craig Fanaroff
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $727,301
- **Award type:** 5
- **Project period:** 2018-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10478877

## Citation

> US National Institutes of Health, RePORTER application 10478877, Behavioral Economic Approaches to Increase Physical Activity among Patients with Elevated Risk for Cardiovascular Disease (5R33HL141440-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10478877. Licensed CC0.

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