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First, only a small portion of the individuals invited enrolled into the trial, and this may limit generalizability. Second, the control arm did not receive daily messaging; therefore, we cannot disentangle the impact of the gamification interventions with daily messaging. Third, we are evaluating physical activity using step counts and do not have other measures of physical activity or exercise.
JMIR Res Protoc 2019;8(11):e14180
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