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dc.contributor.authorMacaulay, Lisaen_UK
dc.contributor.authorO’Dolan, Catrionaen_UK
dc.contributor.authorAvenell, Alisonen_UK
dc.contributor.authorCarroll, Paulaen_UK
dc.contributor.authorCotton, Seonaidhen_UK
dc.contributor.authorDombrowski, Stephanen_UK
dc.contributor.authorElders, Andrewen_UK
dc.contributor.authorGoulao, Beatrizen_UK
dc.contributor.authorGray, Cindyen_UK
dc.contributor.authorHarris, Fiona Men_UK
dc.contributor.authorHunt, Kateen_UK
dc.contributor.authorKee, Franken_UK
dc.contributor.authorTorrens, Claireen_UK
dc.contributor.authorvan der Pol, Marjonen_UK
dc.contributor.authorHoddinott, Paten_UK
dc.description.abstractBackground Obesity increases the risk of type 2 diabetes, heart disease, stroke, mobility problems and some cancers, and its prevalence is rising. Men engage less than women in existing weight loss interventions. Game of Stones builds on a successful feasibility study and aims to find out if automated text messages with or without endowment incentives are effective and cost-effective for weight loss at 12 months compared to a waiting list comparator arm in men with obesity. Methods A 3-arm, parallel group, assessor-blind superiority randomised controlled trial with process evaluation will recruit 585 adult men with body mass index of 30 kg/m2 or more living in and around three UK centres (Belfast, Bristol, Glasgow), purposively targeting disadvantaged areas. Intervention groups: (i) automated, theory-informed text messages daily for 12 months plus endowment incentives linked to verified weight loss targets at 3, 6 and 12 months; (ii) the same text messages and weight loss assessment protocol; (iii) comparator group: 12 month waiting list, then text messages for 3 months. The primary outcome is percentage weight change at 12 months from baseline. Secondary outcomes at 12 months are as follows: quality of life, wellbeing, mental health, weight stigma, behaviours, satisfaction and confidence. Follow-up includes weight at 24 months. A health economic evaluation will measure cost-effectiveness over the trial and over modelled lifetime: including health service resource-use and quality-adjusted life years. The cost-utility analysis will report incremental cost per quality-adjusted life years gained. Participant and service provider perspectives will be explored via telephone interviews, and exploratory mixed methods process evaluation analyses will focus on mental health, multiple long-term conditions, health inequalities and implementation strategies. Discussion The trial will report whether text messages (with and without cash incentives) can help men to lose weight over 1 year and maintain this for another year compared to a comparator group; the costs and benefits to the health service; and men’s experiences of the interventions. Process analyses with public involvement and service commissioner input will ensure that this open-source digital self-care intervention could be sustainable and scalable by a range of NHS or public services.en_UK
dc.publisherSpringer Science and Business Media LLCen_UK
dc.relationMacaulay L, O’Dolan C, Avenell A, Carroll P, Cotton S, Dombrowski S, Elders A, Goulao B, Gray C, Harris FM, Hunt K, Kee F, Torrens C, van der Pol M & Hoddinott P (2022) Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial. Trials, 23 (1), Art. No.: 582.
dc.rightsThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.en_UK
dc.subjectRandomised controlled trialen_UK
dc.subjectMen with obesityen_UK
dc.subjectText messagesen_UK
dc.subjectFinancial incentivesen_UK
dc.subjectWeight managementen_UK
dc.subjectHealth inequalitiesen_UK
dc.subjectProcess evaluationen_UK
dc.titleEffectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trialen_UK
dc.typeJournal Articleen_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderNIHR National Institute for Health Researchen_UK
dc.description.notesAdditional co-authors: Graeme MacLennan, Matthew David McDonald, Michelle McKinley, Rebecca Skinner, Martin Tod, and Katrina Turner,en_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.contributor.affiliationWaterford Institute of Technologyen_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.contributor.affiliationUniversity of New Brunswicken_UK
dc.contributor.affiliationGlasgow Caledonian Universityen_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationUniversity of the West of Scotlanden_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationUK Clinical Research Collaboration (UKCRC)en_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.relation.funderprojectGame of Stones Full Trialen_UK
rioxxterms.typeJournal Article/Reviewen_UK
local.rioxx.authorMacaulay, Lisa|en_UK
local.rioxx.authorO’Dolan, Catriona|en_UK
local.rioxx.authorAvenell, Alison|en_UK
local.rioxx.authorCarroll, Paula|en_UK
local.rioxx.authorCotton, Seonaidh|en_UK
local.rioxx.authorDombrowski, Stephan|0000-0001-9832-2777en_UK
local.rioxx.authorElders, Andrew|en_UK
local.rioxx.authorGoulao, Beatriz|en_UK
local.rioxx.authorGray, Cindy|en_UK
local.rioxx.authorHarris, Fiona M|en_UK
local.rioxx.authorHunt, Kate|0000-0002-5873-3632en_UK
local.rioxx.authorKee, Frank|en_UK
local.rioxx.authorTorrens, Claire|0000-0002-3883-2502en_UK
local.rioxx.authorvan der Pol, Marjon|en_UK
local.rioxx.authorHoddinott, Pat|0000-0002-4372-9681en_UK
local.rioxx.projectNIHR129703|National Institute for Health Research|
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