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- All Subjects: Behavioral Sciences
- All Subjects: Rewards
- Creators: Adams, Marc
Obesity rates among adults have steadily grown in recent decades all the way up to 42.4% in 2018. This is a 12% increase from the turn of the century (Center for Disease Control and Prevention, 2021). A major reason for this rise is increased consumption of processed, high-calorie foods. People eat these foods at a young age and develop bad eating habits that can last for the rest of their lives. It is essential to intervene early and help adolescents form balanced, healthy eating habits before bad habits are already formed. Our solution to this problem is Green Gamers. Green Gamers combines adolescent’s passion for gaming with healthy eating via in-game rewards for healthy eating. People will be able to purchase healthy food items, such as a bag of carrots, and on the packaging there will be a QR code. They will then be able to scan the code on our website, and earn points which will unlock in-game items and other rewards. Video game rewards act as effective motivators for you people to eat more healthy foods. After the solution was formulated, a preliminary survey was conducted to confirm that video game related rewards would inspire children to eat more healthy foods. Based on those results, we are currently in the process of running a secondary market research campaign to learn if gift card rewards are a stronger motivator. Our end goal for Green Gamers would be to partner with large gaming studios and food producers. This would allow us access to many gaming franchises, so that rewards are available from a wide variety of games: making the platform appealing to a diverse audience of gamers. Similarly, a relationship with large food producers would give us the ability to place QR codes on a greater assortment of healthy food items. Although no relationships with large companies have been forged yet, we plan to utilize funding to test our concept on small focus groups in schools.
Purpose: The purpose of this study was to understand how implementing EIM influenced provider behaviors in a university-based healthcare system, using a process evaluation.
Methods: A multiple baseline, time series design was used. Providers were allocated to three groups. Group 1 (n=11) was exposed to an electronic medical record (EMR) systems change, EIM-related resources, and EIM training session. Group 2 (n=5) received the EMR change and resources but no training. Group 3 (n=6) was only exposed to the systems change. The study was conducted across three phases. Outcomes included asking about patient physical activity (PA) as a vital sign (PAVS), prescribing PA (ExRx), and providing PA resources or referrals. Patient surveys and EMR data were examined. Time series analysis, chi-square, and logistic regression were used.
Results: Patient survey data revealed the systems change increased patient reports of being asked about PA, χ2(4) = 95.47, p < .001 for all groups. There was a significant effect of training and resource dissemination on patients receiving PA advice, χ2(4) = 36.25, p < .001. Patients receiving PA advice was greater during phase 2 (OR = 4.7, 95% CI = 2.0-11.0) and phase 3 (OR = 2.9, 95% CI = 1.2-7.4). Increases were also observed in EMR data for PAVS, χ2(2) = 29.27, p <. 001 during implementation for all groups. Increases in PA advice χ2(2) = 140.90, p < .001 occurred among trained providers only. No statistically significant change was observed for ExRx, PA resources or PA referrals. However, visual analysis showed an upwards trend among trained providers.
Conclusions: An EMR systems change is effective for increasing the collection of the PAVS. Training and resources may influence provider behavior but training alone increased provider documentation. The low levels of documented outcomes for PA advice, ExRx, resources, or referrals may be due to the limitations of the EMR system. This approach was effective for examining the EIM Solution and scaled-up, longer trials may yield more robust results.