The Game of Stones Trial V1.0

  • Research type

    Research Study

  • Full title

    Effectiveness and cost-effectiveness of text message and endowment incentives for weight management in men with obesity: The Game of Stones randomised controlled trial

  • IRAS ID

    290955

  • Contact name

    Pat Hoddinott

  • Contact email

    p.m.hoddinott@stir.ac.uk

  • Sponsor organisation

    University of Stirling

  • ISRCTN Number

    ISRCTN91974895

  • Duration of Study in the UK

    3 years, 6 months, 0 days

  • Research summary

    Summary of Research
    People with obesity are at greater risk of type two diabetes, some cancers, heart disease, stroke, infections like Covid-19 and mobility problems. However, men rarely take part in weight loss services. Together with men who have tried to lose weight, we designed a new weight loss service.
    GAME OF STONES AIMS: to find out if text messages (with and without cash incentives) can help men to lose weight over 1 year and keep it off for another year compared to a waiting list group. To find out the costs and benefits to the health service, and men’s experiences.
    RESEARCHERS IN GLASGOW, BELFAST AND BRISTOL will recruit 585 men who want to lose weight from varied backgrounds. GP practices will send invitation letters and researchers will recruit men at community venues. Men will be allocated by chance to one of three groups: texts with incentives; texts only; and a 12-month waiting list for texts. The full cash incentive is paid at 12 months only if all personal weight loss targets are met when men are weighed at 3, 6, and 12 months. Some money is lost for each target weight that is not met. Weight loss after 12 months is the main outcome hoped for and men are asked questions about their health, quality of life, well-being and experiences. Men are also weighed 1 year later (24 months after the start), a year after the texts stop.
    KEY QUESTIONS THIS STUDY WILL ANSWER: Does Game of Stones help men lose weight and keep it off? What are the costs and benefits for men and the NHS? Does this service help men who are less or more well-off?
    THE FINDINGS will be shared with the public, men’s health groups and health service staff through social media, blogs, reports, presentations and research papers.

    Summary of Results
    The Game of Stones study aimed to help men lose weight and keep it off for at least two years.
    585 men living with obesity across the UK were split into three groups by chance:
    1. Supportive text messages for a year and opportunity to get money for weight loss;
    2. The same text messages alone for a year; and
    3. Neither for one year, then text messages for 3 months.
    The first two groups received the same daily text messages about changing weight related behaviours. Group 1 were told at the start that £400 had been put aside for them and that money would be lost if weight targets were missed. The targets were 5% weight loss at 3 months, 10% at 6 months, and maintaining that 10% loss at 12 months. Money was then paid to the men after being weighed at 12 months. Every man was asked questions about their health, wellbeing, and experiences of being in the study. Men were followed up for two years.
    After one year, the men in group 1 lost the most weight. The men in group 2 lost some weight but not as much as the first group. The men in group 3 lost the smallest amount of weight. On average, men in group 1 received £128 for meeting weight loss targets.
    After two years, there was less weight loss difference between the groups. Men in groups 1 and 2 had gained back some weight. Men in group 3 lost a bit more weight between year one and two. Weight loss was similar whether or not men had long-term health conditions, disability, mental health issues, or lived in the most deprived areas.
    This study showed that Game of Stones was a popular, low-cost and effective way of helping men to lose weight.

  • REC name

    North of Scotland Research Ethics Committee 2

  • REC reference

    20/NS/0141

  • Date of REC Opinion

    11 Dec 2020

  • REC opinion

    Favourable Opinion