{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:51Z","timestamp":1785545091803,"version":"3.56.0"},"reference-count":46,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The administration of incentives to promote physical activity, such as the amount or timing, can vary depending on target health behaviors, research settings, intervention delivery channels, and participants\u2019 preferences. Interventions implemented at scale necessitate the consideration of potential fiscal constraints for public health promotion. Since limited funding is a barrier to implementing community-based interventions, examining both immediate and sustained effects of temporary incentive increases on physical activity is important.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the effect of a 1-week double-point event on increasing physical activity among low-engaged individuals in the context of a community-based mobile intervention.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using retrospective data from a Seoul Metropolitan Government mobile health (mHealth) intervention, we evaluated the effects of a 1-week double-point incentive on participants\u2019 physical activity. During 3 registration phases from November to December 2021, a total of 50,145 individuals enrolled. Our analysis focused on the low-engaged group (n=27,833, 55.5%), who averaged fewer than 3 days per week of meeting the daily step challenge (at least 7000 steps) before the intervention. We performed a segmented regression analysis to assess changes in physical activity before and after the event. Multivariable logistic regression and Cox proportional hazards models were used to identify factors associated with improving and maintaining physical activity after starting the intervention.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 27,833 low-engaged participants, only 13.7% (n=3835) improved their physical activity. Daily challenge engagements per week increased by 2.53 times, and average daily steps increased by 1924.97 (standardized mean difference 0.55, 95% CI 0.51\u20100.58). In multivariable logistic regression, older age was significantly associated with improved physical activity immediately after starting the intervention. However, 50% (1918\/3835) of the improved group was likely to return to low engagement 3 weeks after the intervention ended. Older age and use of certain wearable devices were associated with maintaining physical activity after the intervention.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Double-point incentives in the short term may serve as a cue-to-action to motivate low-engagement targets; however, they do not seem to guarantee long-term maintenance in the context of community-based mHealth interventions. Further research is needed to identify additional strategies beyond monetary incentives to sustain long-term healthy behavior.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/66227","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T02:15:10Z","timestamp":1747361710000},"page":"e66227-e66227","source":"Crossref","is-referenced-by-count":2,"title":["Boosting Physical Activity Among Individuals With Low Engagement Through Double-Point Incentives in a Community-Based mHealth Intervention: Retrospective Observational Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9320-031X","authenticated-orcid":false,"given":"Jungin","family":"Joo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-5978","authenticated-orcid":false,"given":"Mangyeong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1228-7435","authenticated-orcid":false,"given":"Junghee","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7652-2732","authenticated-orcid":false,"given":"Hyeonjin","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6625-448X","authenticated-orcid":false,"given":"Govind","family":"Warrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8929-9579","authenticated-orcid":false,"given":"Johannes","family":"Thrul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-0266","authenticated-orcid":false,"given":"Juhee","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"issue":"9838","key":"R1","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/S0140-6736(12)60898-8","article-title":"The pandemic of physical inactivity: global action for public health","volume":"380","author":"Kohl","journal-title":"Lancet"},{"issue":"8","key":"R2","doi-asserted-by":"publisher","first-page":"e153","DOI":"10.1161\/CIR.0000000000001052","article-title":"Heart Disease and Stroke Statistics-2022 update: a report from the American Heart Association","volume":"145","author":"Tsao","journal-title":"Circulation"},{"issue":"10051","key":"R3","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1016\/S0140-6736(16)30383-X","article-title":"The economic burden of physical inactivity: a global analysis of major non-communicable diseases","volume":"388","author":"Ding","journal-title":"Lancet"},{"issue":"443","key":"R4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15620\/cdc:120213","article-title":"Physical activity among adults aged 18 and over: United States, 2020","author":"Elgaddal","journal-title":"NCHS Data Brief"},{"issue":"12","key":"R5","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1016\/S2213-8587(16)30284-4","article-title":"Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial","volume":"4","author":"Finkelstein","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"21","key":"R6","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1136\/bjsports-2019-100633","article-title":"Financial incentives for physical activity in adults: systematic review and meta-analysis","volume":"54","author":"Mitchell","journal-title":"Br J Sports Med"},{"issue":"24","key":"R7","doi-asserted-by":"publisher","first-page":"31842383","DOI":"10.3390\/ijerph16245076","article-title":"Impact of a social media campaign on reach, uptake, and engagement with a free web- and app-based physical activity intervention: the 10,000 steps Australia program","volume":"16","author":"Rayward","journal-title":"Int J Environ Res Public Health"},{"issue":"12","key":"R8","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022508","article-title":"Evaluation of a population-wide mobile health physical activity program in 696 907 adults in Singapore","volume":"11","author":"Yao","journal-title":"J Am Heart Assoc"},{"issue":"145-58","key":"R9","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.ypmed.2014.12.029","article-title":"Acceptability of financial incentives for encouraging uptake of healthy behaviours: a critical review using systematic methods","volume":"73","author":"Giles","journal-title":"Prev Med"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0090347","article-title":"The effectiveness of financial incentives for health behaviour change: systematic review and meta-analysis","volume":"9","author":"Giles","journal-title":"PLoS One"},{"issue":"9","key":"R11","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.9912","article-title":"Evaluating the Carrot Rewards app, a population-level incentive-based intervention promoting step counts across two Canadian provinces: quasi-experimental study","volume":"6","author":"Mitchell","journal-title":"JMIR mHealth uHealth"},{"issue":"5","key":"R12","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1007\/s11606-014-2778-0","article-title":"Financial incentives for home-based health monitoring: a randomized controlled trial","volume":"29","author":"Sen","journal-title":"J Gen Intern Med"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/11540","article-title":"Investigating intervention components and exploring states of receptivity for a smartphone app to promote physical activity: protocol of a microrandomized trial","volume":"8","author":"Kramer","journal-title":"JMIR Res Protoc"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/50041","article-title":"Tracked physical activity levels before and after a change in incentive strategy among UK adults using a rewards app: retrospective quasi-experimental study","volume":"8","author":"McCarthy","journal-title":"JMIR Form Res"},{"issue":"8","key":"R15","doi-asserted-by":"publisher","DOI":"10.2196\/16797","article-title":"Examining responsiveness to an incentive-based mobile health app: longitudinal observational study","volume":"22","author":"Brower","journal-title":"J Med Internet Res"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-020-01043-1","article-title":"Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: a 24-week matched case control study","volume":"17","author":"Pearson","journal-title":"Int J Behav Nutr Phys Act"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031816-044327","article-title":"Natural experiments: an overview of methods, approaches, and contributions to public health intervention research","volume":"38","author":"Craig","journal-title":"Annu Rev Public Health"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-021-01177-w","article-title":"Barriers and facilitators to implementing community-based physical activity interventions: a qualitative systematic review","volume":"18","author":"Cooper","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"9","key":"R19","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.24516","article-title":"Steps per day and all-cause mortality in middle-aged adults in the coronary artery risk development in young adults study","volume":"4","author":"Paluch","journal-title":"JAMA Netw Open"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1186\/s12877-021-02289-5","article-title":"Is achieving 7,000 steps\/day cross-sectionally and prospectively associated with older adults\u2019 lower-extremity performance?","volume":"21","author":"Hsueh","journal-title":"BMC Geriatr"},{"issue":"79","key":"R21","doi-asserted-by":"publisher","first-page":"21798015","DOI":"10.1186\/1479-5868-8-79","article-title":"How many steps\/day are enough? For adults","volume":"8","author":"Tudor-Locke","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"9","key":"R22","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1037\/\/0003-066x.57.9.705","article-title":"Building a practically useful theory of goal setting and task motivation. A 35-year odyssey","volume":"57","author":"Locke","journal-title":"Am Psychol"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/BF01172969","article-title":"Proximal goal-setting and self-regulatory processes","volume":"14","author":"Stock","journal-title":"Cogn Ther Res"},{"issue":"7663","key":"R24","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1038\/nature23018","article-title":"Large-scale physical activity data reveal worldwide activity inequality","volume":"547","author":"Althoff","journal-title":"Nature New Biol"},{"issue":"108237","key":"R25","doi-asserted-by":"publisher","first-page":"108237","DOI":"10.1016\/j.ypmed.2025.108237","article-title":"Financial incentives for physical activity in adults: systematic review and meta-analysis update","volume":"192","author":"Salmani","journal-title":"Prev Med"},{"key":"R26","unstructured":"YOUTHREX Research & Evaluation Exchange. International physical activity questionnaire - short form. 2002. URL: https:\/\/youthrex.com\/wp-content\/uploads\/2019\/10\/IPAQ-TM.pdf [Accessed 11-06-2025]"},{"key":"R27","unstructured":"Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ) \u2013 short and long forms. IPAQ Research Committee. 2005. URL: https:\/\/sites.google.com\/view\/ipaq\/home?authuser=0 [Accessed 11-06-2025]"},{"issue":"8","key":"R28","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1002\/clc.4960130809","article-title":"Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity","volume":"13","author":"Jett\u00e9","journal-title":"Clin Cardiol"},{"issue":"5","key":"R29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0176921","article-title":"Users of the main smartphone operating systems (iOS, Android) differ only little in personality","volume":"12","author":"G\u00f6tz","journal-title":"PLoS One"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1007\/s13142-016-0455-z","article-title":"A comparison of the characteristics of iOS and Android users of a smoking cessation app","volume":"7","author":"Ubhi","journal-title":"Transl Behav Med"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.5350","article-title":"Perceived user preferences and usability evaluation of mainstream wearable devices for health monitoring","volume":"6","author":"Jia","journal-title":"PeerJ"},{"issue":"11","key":"R32","doi-asserted-by":"publisher","DOI":"10.2196\/11066","article-title":"Usability study of mainstream wearable fitness devices: feature analysis and system usability scale evaluation","volume":"6","author":"Liang","journal-title":"JMIR mHealth uHealth"},{"issue":"104039","key":"R33","doi-asserted-by":"publisher","first-page":"104039","DOI":"10.1016\/j.ijmedinf.2019.104039","article-title":"Factors influencing user\u2019s adherence to physical activity applications: a scoping literature review and future directions","volume":"134","author":"Yang","journal-title":"Int J Med Inform"},{"issue":"8","key":"R34","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.9863","article-title":"Effect of different financial incentive structures on promoting physical activity among adults: a randomized clinical trial","volume":"2","author":"Bachireddy","journal-title":"JAMA Netw Open"},{"issue":"8","key":"R35","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.9859","article-title":"Using multiple financial incentive structures to promote sustainable changes in health behaviors","volume":"2","author":"Rummo","journal-title":"JAMA Netw Open"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1177\/17456916241247152","article-title":"What happens when payments end? Fostering long-term behavior change with financial incentives","author":"Winkler-Schor","journal-title":"Perspect Psychol Sci"},{"issue":"9","key":"R37","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1037\/a0032727","article-title":"When do financial incentives reduce intrinsic motivation? Comparing behaviors studied in psychological and economic literatures","volume":"32","author":"Promberger","journal-title":"Health Psychol"},{"issue":"2","key":"R38","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.psychsport.2018.11.010","article-title":"Self-determination theory and physical","volume":"6","author":"Ryan","journal-title":"Hell J Psychol"},{"issue":"3","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.6967","article-title":"Feasibility and acceptability of a wearable technology physical activity intervention with telephone counseling for mid-aged and older adults: a randomized controlled pilot trial","volume":"5","author":"Lyons","journal-title":"JMIR mHealth uHealth"},{"issue":"11","key":"R40","doi-asserted-by":"publisher","DOI":"10.2196\/14645","article-title":"User engagement and attrition in an app-based physical activity intervention: secondary analysis of a randomized controlled trial","volume":"21","author":"Edney","journal-title":"J Med Internet Res"},{"issue":"21","key":"R41","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-020-0224-8","article-title":"Indicators of retention in remote digital health studies: a cross-study evaluation of 100,000 participants","volume":"3","author":"Pratap","journal-title":"NPJ Digit Med"},{"issue":"6","key":"R42","doi-asserted-by":"publisher","DOI":"10.2196\/34191","article-title":"Electronic health record-based recruitment and retention and mobile health app usage: multisite cohort study","volume":"24","author":"Coughlin","journal-title":"J Med Internet Res"},{"issue":"8","key":"R43","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1002\/gps.3889","article-title":"Age differences in satisfaction with and perceived benefit from mental health services: results from the collaborative psychiatric epidemiology surveys","volume":"28","author":"Ford","journal-title":"Int J Geriatr Psychiatry"},{"issue":"3","key":"R44","doi-asserted-by":"publisher","first-page":"241","DOI":"10.3200\/JRLP.141.3.241-262","article-title":"Age, gender, and level of activity as moderators of personal incentives to physical activity in Israel","volume":"141","author":"Raviv","journal-title":"J Psychol"},{"issue":"8","key":"R45","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.51594\/csitrj.v5i8.1491","article-title":"Developing crossplatform software applications to enhance compatibility across devices and systems","volume":"5","journal-title":"Comput Sci IT Res J"},{"key":"R46","unstructured":"Sandle T . South Korea bound: welcome to the world\u2019s most social city. Digital Journal. Mar 21, 2025. URL: https:\/\/www.digitaljournal.com\/social-media\/south-korea-bound-welcome-to-the-worlds-most-social-city\/article [Accessed 11-06-2025]"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e66227","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:28:58Z","timestamp":1785536938000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e66227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,21]]},"references-count":46,"URL":"https:\/\/doi.org\/10.2196\/66227","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,21]]},"article-number":"v13i9838e66227"}}