Long-term Effects of Text Messages with Financial Incentives for Men with Obesity: Two-year Follow-up of the Game of Stones trial
Bibliographic record
Abstract
Abstract Objectives To compare the difference in percentage weight change at 24 months following a 12-month text messaging with financial incentive intervention compared to a waiting list control group, and to compare the text messaging alone group to the control group. Design Assessor-blinded three-arm randomised clinical trial. Setting Three disadvantaged communities from the UK. Participants 585 men with body mass index (BMI) of ≥30kg/m 2 enrolled between July 2021 and May 2022, of which 377 participants (64%) completed 24 months’ follow-up. Interventions 12 months of daily behavioural text messages combined with financial incentives; 12 months of the same text messages alone; or waiting for 12 months followed by receipt of the first 3 months (months 12-15) of text messages (control). Main outcome measures Within-participant change from baseline weight. Results At 24 months, the mean percent weight change (standard deviation) was −3.9% (6.9%) for the text messaging with financial incentives group, −2.6% (6.8%) for the text messaging alone group, and −2.2% (6.8%) for the control group. Compared with the control group, the mean percent weight change was not significantly greater in the text messaging with financial incentives group (mean difference, −1.0%; 97.5% CI, −2.6 to 0.6; P = .22) or the text messaging alone group (mean difference, −0.0%; 97.5% CI, −1.6 to 1.5; P = .95). At least 5% weight loss at 24 months was achieved by 52 (40%) participants in the text messaging with financial incentives group; 32 (28%) in the text messaging alone group and 43 (32%) in the control group. Conclusions A scalable, low-cost text message with financial incentives intervention supported clinically relevant maintenance of weight loss 12 months after the intervention ceased, including those from disadvantaged backgrounds. What is already known on this topic Men, particularly those in lower socio-economic groups, engage less frequently in existing weight loss interventions and services, and might benefit from gender-sensitized interventions. The Game of Stones trial showed that a 12-month intervention consisting of text messaging with endowment financial incentives resulted in statistically significant weight loss in men with obesity compared with control. What this study adds At 24 months, participants receiving 12 months of behavioural text messages with financial incentives displayed continued weight loss which is likely to be clinically important for some men. This digital, scalable, low risk text messaging with financial incentives intervention, with low participant and staff burden, shows promise for longer-term weight maintenance in men, including those living in the most deprived areas.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".