3. Zamzee
Impact Study
PRIMARY
OUTCOMES
Zamzee increased physical
activity by almost 60%
We used accelerometers to measure moderate
to vigorous physical activity (MVPA), like
dancing, climbing stairs, or jogging.
140
MVPA (minutes / week)
Kids who got access to the Zamzee website 120
moved 59% more on average than kids in the 100
control group, who did not get access to the
website. 80
60
That difference is like: 40
• Doing push-ups non-stop for 45 min/week 20
• Scrubbing floors for 3 hrs/month
0
• Chasing wild pigs for 6 min/day (really)
Zamze
Control
e
Source: Compendium of Physical Activities
ClinicalTrials.gov Identifier: NCT01433679
hopelab.org/zamzee 3
4. Zamzee
Impact Study
PRIMARY
OUTCOMES
Zamzee’s impact persisted
for at least 6 months
Even after 24 weeks, kids with access to the Zamzee website were consistently
more active than kids in the control group.
160
MVPA (minutes / week)
140
120
Zamzee
100
80 Control
60
40
20
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Week
ClinicalTrials.gov Identifier: NCT01433679
hopelab.org/zamzee 4
5. Zamzee
Impact Study
SECONDARY
OUTCOMES
Using Zamzee slowed gain
in “bad” cholesterol
LDL, or “bad,” cholesterol is a heart disease
risk factor. Gradual increases in LDL are
Low-density lipoprotein (mg/dL)
typical in kids, as seen in the control group.
But among kids who used Zamzee, LDL 85
gains were reduced.
80 Control
75
Zamzee
70
65
Baseline 6 mo
ClinicalTrials.gov Identifier: NCT01433679
hopelab.org/zamzee 5
6. Zamzee
Impact Study
SECONDARY
OUTCOMES
Using Zamzee helped control
blood sugar levels
Glycated hemoglobin (HbA1c) is an indirect
measure of blood sugar. It is a risk factor for
Type 2 diabetes. Over 6 months, HbA1c 5.5
levels were better maintained among kids
who used Zamzee than kids in the control
HbA1c (%)
group. 5.4 Control
5.3
Zamzee
5.2
Baseline 6 mo
ClinicalTrials.gov Identifier: NCT01433679
hopelab.org/zamzee 6
7. Zamzee
Rewards
Studies
Zamzee works and here’s why
Combining extrinsic rewards to initiate behavior and intrinsic rewards to sustain
behavior change is a central principle of motivational science. We applied this
principle in designing the Zamzee website.
Extrinsic rewards include small prizes that help
initiate physical activity.
Intrinsic rewards are positive experiences which
sustain motivation over time.
(Deci & Ryan, 2000; Pink, 2009)
hopelab.org/zamzee 7
8. Zamzee
Rewards
Studies
Optimizing extrinsic rewards
Zamzee’s game mechanics provide a combination of small prizes and intrinsic
motivators that initiate and sustain behavior change.
To jumpstart physical activity, kids in the 9
rewards conditions experienced a
8
combination of intrinsic and extrinsic rewards
via the Zamzee website. The type of extrinsic 7
rewards included virtual goods (e.g., badges) 6
MVPA % time
and gift cards ($5 and $20). 5
4
On average, the kids who were rewarded
were more physically active than those in the 3
control group, who did not have access to the 2
website and only wore an accelerometer. 1
0
Control Virtual Virtual + Virtual +
only $5 $20
(Deci & Ryan, 2000; Pink, 2009)
hopelab.org/zamzee 8
9. Zamzee
Rewards
Studies
Fostering intrinsic rewards
Zamzee website features are designed to provide kids with positive experiences
related to physical activity. Engaging in these experiences fosters kids’ intrinsic
motivation by creating a sense of:
COMPETENCE: feeling capable and effective
AUTONOMY: having freedom and a sense of control
MASTERY: growing and improving
PURPOSE: pursuing goals and aspirations
RELATEDNESS: belonging and connecting with others
(Deci & Ryan, 2000; Pink, 2009)
hopelab.org/zamzee 9
10. TWO KEY QUESTIONS
ANSWERED
DOES ZAMZEE WORK? WHY DOES IT WORK?
On average, kids who used On average, kids who were
our motivational website rewarded for activity moved
moved almost 60% more than more than those who were
those who only used an not. Along with a positive
accelerometer. These results mindset, providing a bit of
persisted for 6 months and reward can be an effective
were associated with way to motivate and sustain
reductions in risk factors for behavior change.
heart disease and diabetes.
hopelab.org/zamzee 10
12. Zamzee
Impact Study
PRIMARY
OUTCOMES
Zamzee increased physical
activity in at-risk groups
Zamzee was effective even in groups which are at an increased risk for sedentary
behavior. Among these groups, participants who wore our accelerometer and used our
motivational website moved more than their peers in the control group, on average.
Girls: 103% increase Overweight kids (BMI>25): 27% increase
100 130
90 120
MVPA (minutes/week)
MVPA (minutes/week)
80 110
70 100 Control
90 Zamzee
60
50 80
40 70
30 60
ClinicalTrials.gov Identifier: NCT01433679
hopelab.org/zamzee 12
13. Zamzee
Impact Study
Zamzee
METHODS &
Impact Study
PROCEDURE
Sample Characteristics
Site Suburban N=86 (19% of total sample)
Suburban N=82 (18%)
Rural N=87 (19%)
Rural N=105 (23%)
Urban N=50 (11%)
Urban N=38 (9%)
Age 11-14 Mean = 12.7, SD = 0.8
Gender
Female N=244 (54%)
Male N=204 (46%)
Ethnicity
White N=198 (45%)
Hispanic N=110 (25%)
African-American N=64 (14%)
Multiethnic N=53 (12%)
Asian N=12 (3%)
Decline N=6 (1%)
BMI 14-50 Mean = 22.2, SD = 5.2, BMI>25 = 25%
ClinicalTrials.gov Identifier: NCT01433679
hopelab.org/zamzee 13
14. Zamzee
Impact Study
METHODS &
PROCEDURE
Study Aims
Hypothesis: Zamzee will increase MVPA and health-related biomarkers in middle school-
aged kids.
Study Design
• Multi-site randomized controlled trial: ClinicalTrials.gov NCT01433679
• Study sample: 448 middle school-aged US kids recruited from 6 diverse US sites
• Study arms
1. Zamzee accelerometer & motivational website
2. Control group: Zamzee accelerometer only
• Measurement structure
1. Continuous assessment of physical activity over 6 month study participation
2. Pre- and post-study assessments of blood biomarkers
• Outcomes
1. Primary: MVPA rates over 6 month study period
2. Secondary: Biomarkers of metabolic function (HbA1c, glucose; lipid panel)
ClinicalTrials.gov Identifier: NCT01433679
hopelab.org/zamzee 14
15. Zamzee
Rewards
Studies
METHODS &
PROCEDURE
Study Aims
Hypothesis: Zamzee’s reward model will increase MVPA in middle school-aged kids.
Study Design
• Study sample: 100 middle school-aged US kids
• Study arms:
1. Zamzee accelerometer & motivational websites
a. Virtual only
b. Virtual + $5
c. Virtual + $20
2. Control group: Zamzee accelerometer only
• Measurement structure:
1. Continuous assessment of physical activity for up to 12 weeks during study
participation
• Outcomes
1. MVPA rates measured during study participation
hopelab.org/zamzee 15
16. Zamzee
Rewards
Studies
METHODS &
PROCEDURE
Sample Characteristics
Age 11-15 Mean = 13.0, SD = 0.7
Gender
Female N=53 (53%)
Male N=47 (47%)
Ethnicity
White N=44 (44%)
Hispanic N=35 (35%)
African-American N=1 (1%)
Multiethnic N=11 (11%)
Asian N=3 (3%)
Decline N=6 (6%)
BMI 15-43 Mean = 21.6, SD = 4.9, BMI>25 = 18%
hopelab.org/zamzee 16
17. Thank you!
Pam Omidyar
Robert Wood Johnson Foundation
Special thanks to the HopeLab staff and Board
of Directors, and to all of the kids and families
who participated in this research.
hopelab.org/zamzee 17
