An interventional study of INVENT Secure Messaging Intervention in Prediabetes, sponsored by VA Office of Research and Development. Completed at 1 site in United States. Open to participants aged Up to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-07-25.
Sponsored by VA Office of Research and Development · Not applicable, Interventional, and Prevention
This study will evaluate a VA MyHealtheVet Secure Messaging intervention that uses different intervention messaging strategies designed to increase engagement in behaviors to prevent type 2 diabetes.
The investigators will enroll 144 eligible Veterans into a 12-week MyHealtheVet Secure Messaging intervention. Eligible Veterans include those who are currently using MyHealtheVet secure messaging, meet inclusion/exclusion criteria, and have received an HbA1c test within the last 6 months that meets the ADA/CDC classification for prediabetes. Study participants will be surveyed about their engagement in behaviors to prevent TDM2 and mediators of this engagement. After completing a baseline survey, participants will be randomly assigned to receive different novel presentations of information about ways to prevent T2DM through both Secure Messaging and US Mail. The investigators will test the 5 presentations that each: (1) represent an innovative approach from behavioral economics or health psychology with great promise to increase engagement in behaviors to prevent T2DM among patients with prediabetes; and (2) have not been tested in this setting.
There is tremendous national enthusiasm for translating and disseminating efficacious strategies to prevent type 2 diabetes mellitus (T2DM). Yet, little attention has been devoted to how the investigators can better leverage the processes through which patients receive information about prevention of T2DM to better engage them in such prevention. Further, despite efforts to disseminate structured programs, many patients at high risk for developing T2DM may still be unable or unwilling to access them. In these cases, increasing patient engagement in individually directed lifestyle change or pharmacotherapy is critical. Strategies developed in the fields of behavioral economics and health psychology hold significant promise for improving Veteran engagement in each of these approaches. To date, however, these strategies have rarely been translated into real-world settings where they could benefit Veterans. This novel work will address this critical gap and could transform communication with Veterans about prevention in ways that will improve their health outcomes.
The following 5 strategies will be implemented in the weekly messages that study participants will receive: (1) tailoring to aspirations in life; (2) implementation intentions; (3) preference checklists; (4) urgency framing; (5) social norms. The investigators will implement these strategies alone and in combination in a 16-arm factorial design experiment.
Exclusion Criteria:
Self-report or have any International Classification of Diseases (ICD-9/10) codes for:
Participants will only receive the stock messages that encourage following recommended behaviors for reducing the risk for developing diabetes.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the urgency frame message strategy.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the social norm messaging strategy.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with both the urgency frame and social norm messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with both the implementation intentions and urgency frame messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with both the implementation intentions and social norm messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the implementation intentions, urgency frame, and social norm messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the implementation intentions messaging strategy.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with both the preference checklists and urgency frame messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with both the preference checklists and social norm messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the preference checklists, urgency frame, and social norm messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the preference checklists messaging strategy.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with both the tailored aspirations and urgency frame messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with both the tailored aspirations and social norm messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the tailored aspirations, urgency frame, and social norm messaging strategies.
Behavioral: INVENT Secure Messaging Intervention
Participants will receive messages that encourage following recommended behaviors for reducing the risk for developing diabetes integrated with the tailored aspirations messaging strategy.
Behavioral: INVENT Secure Messaging Intervention
We are proposing a 12 week schedule of weekly Secure Messages and monthly mailings for this intervention. Each study arm represents different combinations of messages a participant will receive.
Engagement in Recommended Behaviors to Prevent Type 2 Diabetes
The investigators will use survey and medical record data to evaluate changes in participants' engagement in recommended behaviors to prevent type 2 diabetes.
Time frame: 3 months
Motivation to Prevent Type 2 Diabetes
The investigators will use survey data to evaluate mean change in motivation level to prevent diabetes between baseline and 3-months. The Treatment Self-Regulation Questionnaire (TSRQ) was included in the survey and respondents were asked about their level of motivation from 1 (Not at all motivated) to 10 (Highly motivated).
Time frame: 3 months
Importance of Preventing Type 2 Diabetes
The investigators will use survey data to evaluate mean changes in level of importance of preventing diabetes from baseline to 3 months. The Treatment Self-Regulation Questionnaire (TSRQ) was included in the survey and respondents were asked about their level of perceived importance from 1 (Not at all important) to 10 (Extremely important).
Time frame: 3 months
Use of Medication for T2DM Prevention
The investigators will use medical record data and survey data to evaluate whether participants began the use of medication for T2DM prevention from baseline to 3 months.
Time frame: 3 months
Perception for Risk for T2DM
The investigators will use survey data to evaluate mean changes in perception of risk for T2DM from baseline to 3 months. The Adriaanse T2DM Risk Perception Scale, which was included in the survey, measured self-assessed risk perception from 0 denoting no choice of developing T2DM to 100 denoting absolute confidence in developing T2DM
Time frame: 3 months
Knowledge of Strategies to Prevent T2DM
The investigators will use survey data to evaluate changes in knowledge of strategies to prevent Type 2 Diabetes between baseline and 3-month assessment. Respondents were given 3 open-ended questions to report things they could do to prevent diabetes. Each respective response to the 3 questions were coded and scored according to whether they indicated engagement in the following activities: weight loss, physical activity, use of metformin, or enrollment into a diabetes prevention program. Each question denoted with a positive response were coded with 1 whereas those that did not were coded as a 0. The three questions were summed into a final score ranging from 0 (no report of engagement in the aforementioned healthy activities) with the worst outcome to 3 (a report of 3 of the 4 aforementioned healthy activities) with the best outcome. The final scores were generated based on the mean difference between baseline and 3-month scores.
Time frame: 3 months
Participation in Weight-related Wellness Programs
The investigators will use survey data to evaluate how many participants enrolled in weight-related wellness programs from baseline to 3 months.
Time frame: 3 months
Weight Loss Behaviors
The investigators will use survey data to evaluate changes in weight loss behaviors at the 3-month post intervention assessment.
Time frame: 3 months
Physical Activity
The investigators will use survey data to evaluate changes in physical activity after the 3-month post intervention assessment. The International Physical Activity Questionnaire - Short Form (IPAQ-SF) was used to measure physical activity change. Respondents were asked to report how many hours and minutes within the past week they completed of vigorous physical activity, moderate physical activity, and brisk walking. The total sum of minutes for these three questions were subsequently coded into a yes/no binary variable for whether respondents met a recommended 150 minutes of overall physical activity within 7 days of being assessed. The values provided reflect a proportion of respondents that met or exceeded the 150 minute threshold of overall physical activity based on the newly generated variable that combined total minutes of vigorous physical activity, moderate physical activity, and brisk walking.
Time frame: 3 months
Veterans that met preliminary study eligibility criteria were mailed a letter about the study and were contacted by a Research Assistant 7-10 days later by phone to gauge their participation interest.
| Milestone | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Started | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 |
| Completed | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 |
| Not completed | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
The investigators will use survey and medical record data to evaluate changes in participants' engagement in recommended behaviors to prevent type 2 diabetes.
| Participants | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Engaged in recommended behaviors | 2 | 5 | 5 | 2 | 2 | 3 | 2 | 2 | 6 | 4 | 2 | 4 | 2 | 2 | 4 | 0 |
| Did not engage in recommended behaviors | 6 | 4 | 4 | 7 | 6 | 5 | 7 | 5 | 3 | 5 | 7 | 5 | 5 | 6 | 5 | 7 |
| Unknown | 1 | 0 | 0 | 0 | 1 | 1 | 0 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 2 |
The investigators will use survey data to evaluate mean change in motivation level to prevent diabetes between baseline and 3-months. The Treatment Self-Regulation Questionnaire (TSRQ) was included in the survey and respondents were asked about their level of motivation from 1 (Not at all motivated) to 10 (Highly motivated).
| Score on a scale | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Motivation to Prevent Type 2 Diabetes | .375 ± 2.326 | -1.222 ± 2.438 | -0.444 ± 1.333 | -0.222 ± 1.394 | 0.429 ± 2.225 | 0.000 ± 0.7071 | 0.333 ± 1.500 | -1.143 ± 2.673 | -2.000 ± 3.122 | -0.666 ± 1.323 | -0.333 ± 2.540 | -0.222 ± 1.986 | -1.166 ± 1.472 | -0.286 ± 0.9512 | -0.555 ± 1.333 | 0.857 ± 2.116 |
The investigators will use survey data to evaluate mean changes in level of importance of preventing diabetes from baseline to 3 months. The Treatment Self-Regulation Questionnaire (TSRQ) was included in the survey and respondents were asked about their level of perceived importance from 1 (Not at all important) to 10 (Extremely important).
| Score on a scale | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Importance of Preventing Type 2 Diabetes | -0.625 ± 1.847 | -0.889 ± 2.028 | -0.444 ± 1.740 | -0.222 ± 1.563 | 0.714 ± 2.430 | 0.000 ± 0.500 | -0.500 ± 2.000 | -1.571 ± 2.070 | -1.111 ± 2.934 | -0.333 ± 1.118 | -0.667 ± 2.000 | 0.667 ± 1.936 | -0.333 ± 2.582 | 0.429 ± 0.976 | -2.333 ± 2.236 | 0.286 ± 1.254 |
The investigators will use medical record data and survey data to evaluate whether participants began the use of medication for T2DM prevention from baseline to 3 months.
| Participants | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Taking medication | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
| Not taking medication | 7 | 8 | 8 | 9 | 8 | 8 | 9 | 7 | 9 | 9 | 8 | 9 | 7 | 8 | 8 | 7 |
| Unknown | 2 | 0 | 0 | 0 | 1 | 1 | 0 | 2 | 0 | 0 | 1 | 0 | 2 | 1 | 0 | 2 |
The investigators will use survey data to evaluate mean changes in perception of risk for T2DM from baseline to 3 months. The Adriaanse T2DM Risk Perception Scale, which was included in the survey, measured self-assessed risk perception from 0 denoting no choice of developing T2DM to 100 denoting absolute confidence in developing T2DM
| Score on a scale | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Perception for Risk for T2DM | -8.750 ± 8.345 | -1.111 ± 13.642 | 6.667 ± 15.000 | -4.444 ± 13.333 | 0.000 ± 17.321 | 1.111 ± 9.280 | -5.556 ± 40.035 | 10.000 ± 20.000 | 7.778 ± 24.889 | -3.333 ± 11.180 | 8.333 ± 24.238 | -2.222 ± 28.626 | 5.000 ± 25.100 | 10.000 ± 21.602 | 3.333 ± 33.166 | 10.000 ± 25.166 |
The investigators will use survey data to evaluate changes in knowledge of strategies to prevent Type 2 Diabetes between baseline and 3-month assessment. Respondents were given 3 open-ended questions to report things they could do to prevent diabetes. Each respective response to the 3 questions were coded and scored according to whether they indicated engagement in the following activities: weight loss, physical activity, use of metformin, or enrollment into a diabetes prevention program. Each question denoted with a positive response were coded with 1 whereas those that did not were coded as a 0. The three questions were summed into a final score ranging from 0 (no report of engagement in the aforementioned healthy activities) with the worst outcome to 3 (a report of 3 of the 4 aforementioned healthy activities) with the best outcome. The final scores were generated based on the mean difference between baseline and 3-month scores.
| Score on a scale | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Knowledge of Strategies to Prevent T2DM | 0 ± 1.069 | -0.222 ± 0.667 | -0.222 ± 0.833 | -0.222 ± 0.972 | 0.125 ± 0.641 | -0.444 ± 0.882 | 0.444 ± 0.726 | 0.429 ± 0.535 | 0.333 ± 0.866 | 0.333 ± 0.707 | 0.889 ± 0.928 | -0.333 ± 0.500 | 0.143 ± 0.378 | 0 ± 0.535 | 0.778 ± 0.833 | 0.286 ± 0.488 |
The investigators will use survey data to evaluate how many participants enrolled in weight-related wellness programs from baseline to 3 months.
| Participants | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Participation in weight-related wellness programs | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 0 |
| No participation in weight-related wellness programs | 8 | 9 | 9 | 9 | 7 | 8 | 9 | 7 | 9 | 9 | 9 | 8 | 7 | 8 | 8 | 7 |
| Unknown | 1 | 0 | 0 | 0 | 1 | 1 | 0 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 2 |
The investigators will use survey data to evaluate changes in weight loss behaviors at the 3-month post intervention assessment.
| Participants | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Losing weight | 2 | 5 | 5 | 2 | 3 | 4 | 2 | 3 | 4 | 4 | 2 | 5 | 1 | 4 | 1 | 0 |
| Gaining weight | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 0 |
| Stable and satisfied | 0 | 2 | 0 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 1 | 1 |
| Stable and lose | 5 | 2 | 4 | 6 | 4 | 3 | 5 | 3 | 3 | 5 | 7 | 3 | 5 | 3 | 6 | 6 |
| Stable and gain | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
| Unknown | 1 | 0 | 0 | 0 | 1 | 1 | 0 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 2 |
The investigators will use survey data to evaluate changes in physical activity after the 3-month post intervention assessment. The International Physical Activity Questionnaire - Short Form (IPAQ-SF) was used to measure physical activity change. Respondents were asked to report how many hours and minutes within the past week they completed of vigorous physical activity, moderate physical activity, and brisk walking. The total sum of minutes for these three questions were subsequently coded into a yes/no binary variable for whether respondents met a recommended 150 minutes of overall physical activity within 7 days of being assessed. The values provided reflect a proportion of respondents that met or exceeded the 150 minute threshold of overall physical activity based on the newly generated variable that combined total minutes of vigorous physical activity, moderate physical activity, and brisk walking.
| Participants | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 150 minutes or more physical activity per week | 5 | 4 | 6 | 7 | 4 | 5 | 6 | 6 | 6 | 7 | 6 | 8 | 3 | 6 | 4 | 2 |
| Less than 150 minutes or more of physical activity per week | 4 | 5 | 3 | 2 | 5 | 4 | 3 | 3 | 3 | 2 | 3 | 1 | 6 | 3 | 5 | 7 |
Collected over 3-months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Arm 1: Stock Messages Only | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 2: Urgency Frame Message Strategy | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 3: Social Norm Message Strategy | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 4: Urgency Frame and Social Norm Strategies | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 5: Implementation Intentions and Urgency Frame | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 6: Implementation Intentions and Social Norm | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 7: Implementation Intentions, Urgency Frame & Social Norm | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 8: Implementation Intentions | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 9: Preference Checklists and Urgency Frame | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 10: Preference Checklists and Social Norms | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 11: Preference Checklists, Urgency Frame & Social Norm | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 12: Preference Checklists | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 13: Tailored Aspirations and Urgency Frame | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 14: Tailored Aspirations and Social Norm | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | 0/9 (0%) | 0/9 (0%) | 1/9 (11.1%) |
| Arm 16: Tailored Aspirations | 0/9 (0%) | 0/9 (0%) | 0/9 (0%) |
| Event | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Diagnosis of CancerNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 0/9 | 1/9 | 0/9 |
Enrolled study participants with a diagnosis of prediabetes that were randomized to 1 of 16 study arms.
| Age, Categorical(Participants) | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 5 | 2 | 3 | 4 | 7 | 3 | 6 | 7 | 6 | 4 | 6 | 3 | 4 | 4 | 7 | 3 | 74 |
| >=65 years | 4 | 7 | 6 | 5 | 2 | 6 | 3 | 2 | 3 | 5 | 3 | 6 | 5 | 5 | 2 | 6 | 70 |
| Age, Continuous(Years) | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | 57.3 ± 13.4 | 66 ± 8.3 | 62.1 ± 13.1 | 62.1 ± 8.9 | 55.6 ± 10.2 | 64.2 ± 9.0 | 63.3 ± 5.8 | 57.4 ± 10.9 | 62.4 ± 5.5 | 60.1 ± 10.3 | 62.1 ± 6.4 | 64.7 ± 9.0 | 63.1 ± 9.9 | 61.2 ± 10.0 | 57.1 ± 7.6 | 61.6 ± 11.3 | 61.3 ± 9.4 |
| Sex/Gender, Customized(Participants) | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Male | 9 | 8 | 8 | 8 | 7 | 8 | 7 | 8 | 8 | 6 | 6 | 9 | 9 | 9 | 9 | 7 | 126 |
| Female | 0 | 0 | 1 | 1 | 2 | 1 | 2 | 1 | 1 | 3 | 3 | 0 | 0 | 0 | 0 | 2 | 17 |
| Transgender | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
| Ethnicity (NIH/OMB)(Participants) | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hispanic or Latino | 0 | 0 | 1 | 2 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 5 |
| Not Hispanic or Latino | 9 | 9 | 8 | 7 | 9 | 9 | 9 | 9 | 9 | 8 | 8 | 9 | 9 | 9 | 9 | 9 | 139 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 3 |
| Asian | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Black or African American | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 0 | 2 | 0 | 0 | 9 |
| White | 8 | 8 | 8 | 7 | 7 | 8 | 8 | 6 | 8 | 8 | 8 | 7 | 7 | 6 | 8 | 8 | 120 |
| More than one race | 1 | 0 | 0 | 0 | 2 | 0 | 0 | 2 | 0 | 0 | 0 | 1 | 2 | 1 | 0 | 0 | 9 |
| Unknown or Not Reported | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 3 |
| Region of Enrollment(participants) | Arm 1: Stock Messages Only | Arm 2: Urgency Frame Message Strategy | Arm 3: Social Norm Message Strategy | Arm 4: Urgency Frame and Social Norm Strategies | Arm 5: Implementation Intentions and Urgency Frame | Arm 6: Implementation Intentions and Social Norm | Arm 7: Implementation Intentions, Urgency Frame & Social Norm | Arm 8: Implementation Intentions | Arm 9: Preference Checklists and Urgency Frame | Arm 10: Preference Checklists and Social Norms | Arm 11: Preference Checklists, Urgency Frame & Social Norm | Arm 12: Preference Checklists | Arm 13: Tailored Aspirations and Urgency Frame | Arm 14: Tailored Aspirations and Social Norm | Arm 15: Tailored Aspirations, Urgency Frame & Social Norm | Arm 16: Tailored Aspirations | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| United States | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 144 |
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