trips4health: a single-blinded randomised controlled trial incentivising adult public transport use for physical activity gain

• Published in: The international journal of behavioral nutrition and physical activity Vol. 20; no. 1; pp. 1 - 98
• Main Authors: Evans, Jack. T, Stanesby, Oliver, Blizzard, Leigh, Jose, Kim, Sharman, Melanie J, Ball, Kylie, Greaves, Stephen, Palmer, Andrew J, Cooper, Katie, Gall, Seana L, Cleland, Verity J
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 16.08.2023; BioMed Central; BMC
• Subjects: Adults; Australians; Behavior; Behaviour; Clinical trials; Commuting; COVID-19; Cycling; Economic incentives; Exercise; Health aspects; Health promotion; Intervention; Local transit; Medical research; Medicine, Experimental; Methods; Monetary incentives; Pandemics; Physical fitness; Public health; Public transportation; Self report; Testing; Text messaging; Translational medical research; Transportation; Walking; Australia; Tasmania Australia
• ISSN: 1479-5868; 1479-5868
• DOI: 10.1186/s12966-023-01500-7

Public transport users tend to accumulate more physical activity than non-users; however, whether physical activity is increased by financially incentivising public transport use is unknown. The trips4health study aimed to determine the impact of an incentive-based public transport intervention on physical activity. A single-blinded randomised control trial of a 16-week incentive-based intervention involved Australian adults who were infrequent bus users ([greater than or equal to] 18 years; used bus [less than or equal to] 2 times/week) split equally into intervention and control groups. The intervention group were sent weekly motivational text messages and awarded smartcard bus credit when targets were met. The intervention group and control group received physical activity guidelines. Accelerometer-measured steps/day (primary outcome), self-reported transport-related physical activity (walking and cycling for transport) and total physical activity (min/week and MET-min/week) outcomes were assessed at baseline and follow-up. Due to the COVID pandemic, the trial was abandoned prior to target sample size achievement and completion of all assessments (N = 110). Steps/day declined in both groups, but by less in the intervention group [-557.9 steps (-7.9%) vs.-1018.3 steps/week (-13.8%)]. In the intervention group, transport-related physical activity increased [80.0 min/week (133.3%); 264.0 MET-min/week (133.3%)] while total physical activity levels saw little change [35.0 min/week (5.5%); 25.5 MET-min/week (1.0%)]. Control group transport-related physical activity decreased [-20.0 min/week (-27.6%); -41.3 MET-min/week (-17.3%)], but total physical activity increased [260.0 min/week (54.5%); 734.3 MET-min/week (37.4%)]. This study found evidence that financial incentive-based intervention to increase public transport use is effective in increasing transport-related physical activity These results warrant future examination of physical activity incentives programs in a fully powered study with longer-term follow-up.