JMIR Publications

ABSTRACT

Background:

Background:

Insufficient physical activity is common among university students, while conventional campus exercise programs frequently encounter problems of limited reach, delayed feedback, and declining adherence. Mobile health (mHealth) technologies permit continuous monitoring, timely feedback, and individualized support. Gamification may add motivational and social value, but its incremental effect beyond standard mHealth management remains uncertain. This protocol describes a randomized controlled trial of a theory-informed, team-based gamified mHealth intervention.

Objective:

Objectives (1) Primary objective To determine whether adding an 8-week team-based gamification package to otherwise identical mHealth physical activity management increases mean daily objectively measured MVPA among university students (Refs. 23). (2) Secondary objectives To estimate effects on daily steps, weekly MET-min, adherence and technology-use indicators, body composition, selected physical fitness indicators, mental health, and safety outcomes. (3) Exploratory objectives To explore changes in executive function and associations among intervention exposure, technology use, adherence, and health-related outcomes without treating these analyses as confirmatory.

Methods:

Methods and analysis: This two-arm, parallel-group randomized controlled trial will recruit 240 university students aged 18–25 years at Yantai University and allocate them 1:1 to the intervention group (IG; n = 120) or control group (CG; n = 120). Both groups will use the same Shouti Fitness app and study-issued smartwatch and will receive identical activity goals, routine reminders, and progression guidance. The IG will additionally receive six-team competition, points, team-average leaderboards, private individual performance feedback, and low-value non-academic rewards. A two-week device familiarization period and a separate seven-day baseline monitoring period will precede randomization; the formal intervention will last 8 weeks. The sole primary outcome will be mean daily moderate-to-vigorous physical activity (MVPA). Daily steps, weekly MET-min, adherence indicators, body composition, selected physical fitness indicators, and mental health will be secondary outcomes; cognitive function will be exploratory. The primary analysis will follow the intention-to-treat principle and use a partially nested mixed-effects model that accounts for team clustering in the IG.

Results:

Expected results: The trial will estimate the incremental effect of adding team-based gamification to otherwise identical mHealth physical activity management. The primary hypothesis is that the IG will have higher mean daily MVPA over the 8-week intervention than the CG. Secondary and exploratory analyses will estimate effects on adherence, steps, MET-min, selected health outcomes, and executive function without treating those outcomes as confirmatory evidence.

Conclusions:

Conclusions:

This trial will provide evidence on whether theory-informed team-based gamification adds measurable value to standard wearable-supported mHealth management for university students. The findings will inform the design, implementation, and future multisite evaluation of scalable digital physical activity interventions. Clinical Trial: Trial registration: Chinese Clinical Trial Registry, ChiCTR2600123251; https://www.chictr.org.cn/showproj.html?proj=315059