Project LIFT - Promoting Healthy Behavior Through a Wearable Fitness Device and Financial Incentives

Obesity is the most common diseases in the United States - an estimated 35% of adults are
obese. Among kidney (KT) and liver transplant (LT) recipients, weight gain and obesity is
associated with poor graft function. Yet, within a year of transplantation, habituation to a
sedentary lifestyle, changes in metabolism, and immunosuppression drugs contribute to an
average 4-10 kg weight gain for recipients. Recent innovations in wearable device technology
can passively monitor an individual's physical activity. Additionally, incentives and health
questions designed using insights from behavioral economics have been shown to motivate
device engagement and improvements in health behaviors. A remotely-monitored exercise program
could improve behavior change and potentially be durable because it takes advantage of the
high motivation for improving health in this population. The objective of this study is to
use a randomized, controlled trial to test the efficacy of a home-based exercise program
using wearable devices, health engagement questions and financial incentives. Participants in
the intervention arm will establish a baseline step count during the first two weeks,
followed by a 12-week intervention period and a 4-week follow-up period.

Inclusion Criteria:

1. Adult Kidney transplant, Liver transplant, Simultaneous liver-kidney, or
kidney-pancreas transplant recipients at the Hospital of the University of
Pennsylvania within 2-24 months of transplantation

2. Ability to read and provide informed consent in English to participate in the study

3. Possess a smartphone with a data plan and willing to receive text messages

4. Willing to walk and sync wearable daily during the 2-week run-in in order to determine
baseline [for Arms 2 & 3]

5. Willing to provide a final weight at study end.

Exclusion Criteria:

1. Inability to provide informed consent

2. Does not have daily access to a smartphone compatible with the wearable device

3. Unable or unwilling to complete the baseline measurements and survey, or perform the
exit interview and weigh-in

4. Already enrolled in a financial incentive-based exercise program using a wearable
device

5. Use of a wearable accelerometer or pedometer outside of the study protocol for
step-tracking; (e.g., Fitbit; using phone step-tracker is acceptable; using existing
wearable for cycling or swimming is acceptable)

6. Any other medical conditions that would prohibit participation in a physical activity
program

7. Severe vision, hearing, or mobility impairment precluding participation.