Factors Affecting Active Video Gaming in Adolescence

Despite the growing popularity of digital games as a new means of promoting physical activity, none of studies have identified important predictors of active video gaming while a number of factors have emerged as significant correlates of physical activity. Based on the ecological model of health behavior, personal, environmental, and social factors were used as three main constructs in this study, and we proposed and examined a structural model discussing the effects of personal, environmental, social factors on active video gaming and physical activity. In addition, the causal relationships between active video gaming and sedentary behavior, physical activity and sedentary behavior, as well as sedentary behavior and BMI were also examined in this study. Results indicated that only social factor was a significant predictor of active video gaming, even though personal, environmental, social factors were significantly associated with physical activity. Although both active video gaming and physical activity had significant influences on sedentary behavior, active video gaming was positively associated with sedentary behavior while physical activity was negatively associated with sedentary behavior. Finally, a positive association between sedentary behavior and BMI was found in this study. Running head: DETERMINANTS OF ACTIVE VIDEO GAMING 3 Factors Affecting Active Video Gaming in Adolescence Although regular physical activity (PA) is a well-known contributor to lifelong health, today’s young people are less likely to engage in PA. According to a recent report from the Centers for Disease Control and Prevention [CDC] (2012), only twenty-nine percent of high school students meet the national PA guideline for young people aged 6 to 17 years (i.e. at least 60 minutes of PA per day) recommended by the U.S. Department of Health and Human Services (Department of Health and Human Services, 2008). Lack of PA in childhood and adolescence is appeared to be a critical risk factor for chronic diseases (e.g., obesity, coronary heart disease, high blood pressure, stroke, type 2 diabetes, osteoporosis, and colon cancer) and even premature deaths in adulthood (Pate et al., 1995). Despite increases in the public awareness about the risk, unfortunately a sharp decrease in PA takes place during adolescence (Pate et al., 1995; Sallis, Owen, & Fisher, 2008). Thus, it may be argued that interventions to promote PA in adolescence should largely prevent the development of detrimental diseases, eventually leading to enhance public health in general. As playing video games has been growing in popularity as a culture of the digital age, the idea of using video games to motivate adolescents to be more active emerged. Active video games (AVGs) are a genre of video games that require upper, lower, or full body movements, thereby having the potential to increase PA (Biddiss & Irwin, 2010). In fact, a large number of AVG studies have reported that AVG play increases energy expenditure, heart rate, and other PA indicators (Graves, Ridgers, & Stratton, 2008; Maddison et al., 2007; Peng, Crouse, & Lin, 2012). Thus, we may argue that AVGs are expected to increase adolescents’ PA as a substitute of traditional exercise equipment. Nonetheless, relatively few studies have investigated the potential predictors of AVG play, while growing body of PA studies have identified the reinforcing values Running head: DETERMINANTS OF ACTIVE VIDEO GAMING 4 of PA in adolescence. In keeping with the findings of previous PA studies, this study aims to explore how personal, environmental, and social factors would influence AVG play in adolescence, which in turn helps develop effective game-based health interventions to promote PA behavior in adolescence. Ecological Models: Correlates of Physical Activity in Multiple Levels A useful theoretical framework for explaining why and how adolescents engage in PA is the ecological model of health behavior (Sallis et al., 2008). The model postulates that health behavior and health behavior change are influenced by multi-level factors, including intrapersonal, interpersonal, organizational, community, and policy influences. Drawing upon the core principle of ecological perspective, PA researchers have investigated the effects of personal, environmental, social factors on PA behavior, identifying the potential correlates of PA in adolescence (Ferreira et al., 2006; Sallis, Prochaska, & Taylor, 2000). Personal factors in the PA research refer to individuals’ attitudes and beliefs related to PA behavior, such as affective orientation towards PA itself, and beliefs about health outcomes in PA. In fact, various personal variables (e.g., enjoyment in PA) have been discussed in existing PA studies, and it is generally assumed that positive attitudes toward PA and strong beliefs about health outcomes make PA fun and engaging (Deflandre, Antonini, & Lorant, 2004; Sallis, Prochaska, Taylor, Hill, & Geraci, 1999). Among a number of personal factors examined, enjoyment or fun in PA can be considered to be positive attitudes toward PA, and beliefs about health outcome in PA may include energy increases, feeling good, and feeling of success during PA. Thus, enjoyment or fun in PA as well as perceived energy increases, feeling good, and Running head: DETERMINANTS OF ACTIVE VIDEO GAMING 5 feeling of success were hypothesized to be the main personal correlates of AVG play in the present study. Enjoyment or fun in PA has been a consistent determinant of PA participation and engagement (Vallerand, 2001). Sallis and Owen (1998) and Salmon, Owen, Crawford, Bauman, & Sallis (2003) reviewed PA literature and found enjoyment in PA to be positively related to PA behavior, with higher levels of enjoyment in PA being associated with higher levels of PA. Similar findings were also found in other PA studies (Danaei et al., 2009; Ferreira et al., 2006). Since playing AVGs can be a substitute of PA, personal factors may affect active video gaming. In line with the findings of previous PA studies, we hypothesized that personal factors would positively influence active video gaming: H1a: Personal factors will be positively associated with active video gaming. H1b: Personal factors will be positively associated with physical activity. Barriers to PA have been discussed as a strong influence, and as its external barriers, environmental factors emerged as significant determinants of PA. Environmental factors refer to the underlying conditions in which individuals are situated, including familial and societal structure (King et al., 2000). Although environmental factors and those influences on PA have been reported in multiple studies, factors mainly discussed in existing PA studies are accessibility and/or availability of exercising equipment (e.g., balls, bicycles, skates) and recreational facilities (e.g., playgrounds, parks), and neighborhood safety (Brownson et al., 2001; Ferreira et al., 2006). Running head: DETERMINANTS OF ACTIVE VIDEO GAMING 6 Using exercise equipment and access to facilities have been reported to increase PA among adolescents (Bedimo-Rung, Mowen, & Cohen, 2005). Living in safe neighborhoods is also associated with greater PA behaviors (Bennett et al., 2007). A report from the Centers for Disease Control and Prevention (1999) found perceived neighborhood safety to be positively associated with PA. In contrast to the findings of previous PA studies, the direction of the relationship with active video gaming can be different because AVGs can be played in any settings including no available exercise facilities or unsafe neighborhoods. In other words, those adolescents may be encouraged to substitute traditional forms of PA with AVG play at home. For example, those who live in unsafe neighborhoods may engage in more active video gaming for the purpose of being active. Thus, it may be argued that environmental factors could be negatively associated with active video gaming. H2a: Environmental factors will be negatively associated with active video gaming. H2b: Environmental factors will be positively associated with physical activity. A number of PA studies have indicated social support as an important social factor of PA and reported a consistent positive association (Caspersen, Pereira, & Curran, 2000; Springer, Kelder, & Hoelscher, 2006). In their studies of adolescents, social factors generally refer to one’s perception of how significant others help themselves participate in PA, including PA encouragement of adults in household, PA participation of adults in household, and so on (Duncan, Duncan, & Strycker, 2005). Sallis et al. (2000) reviewed studies and found support and direct help from family were consistently associated with regular PA. Aaron, Storti, Robertson, Kriska, and LaPorte (2002) and Ogden et al. (2006) have also reported that parent participation and encouragement in PA appear to be positively influences on adolescents’ PA levels. Thus, we Running head: DETERMINANTS OF ACTIVE VIDEO GAMING 7 hypothesized that social factors would help adolescents more physically active and the adolescents may be also encouraged to use AVGs at home as a form of PA interventions. H3a: Social factors will be positively associated with active video gaming. H3b: Social factors will be positively associated with physical activity. Sedentary behavior (SB) is defined as “activities that do not increase energy expenditure substantially above the resting level” (Pate, O’Neill, & Lobelo, 2008, p.174). Likewise, physical inactivity or insufficient PA may refer to SB. As a growing number of new media (e.g., computers, Internet, SNSs, and etc.) has emerged in recent years, sedentary behavior tends to be operationalized as passive screen-based activities such as watching television or videos and playing video games (Must & Tybor, 2005). However, the advent of AVGs has made screen time more active. In fact, extant studies on AVGs have reported a positive re