Video Games for Obesity and Diabetes Prevention-Diab & Nano
Condition: Obesity; Type 2 Diabetes
MeSH terms: Diabetes Mellitus; Obesity
Study type: Interventional

Summary: 
      With the increasing rates of child obesity and diabetes, innovative programs are needed that
      capture children's attention and permit behavior change messages to get through. Serious
      video games with their immersive stories offer one such promising alternative due to their
      low cost approach to intervention since the games have already been developed, and can be
      broadly disseminated by simply reproducing and distributing their DVDs. While using video
      games for health promotion is controversial, this study will establish whether video games
      can effectively change diabetes and obesity risks (especially fasting insulin, diet and
      physical activity) among children.

      "Escape from Diab" and "Nanoswarm: Invasion from Inner Space" are two video games that
      targeted children to increase fruit, vegetable and water intakes, reduce sedentary behaviors
      (SB), and increase physical activity in a pilot study with a relatively low risk children. In
      light of this, it is important to test whether these games can help decrease diabetes (i.e.
      fasting insulin) and obesity risks with high risk (85%tile < BMI < 99%tile) 10 to 12 year old
      children.

      Children will be randomly assigned to treatment or control groups. The treatment group will
      play "Diab" and "Nano" over a 3-month time period. A wait-list control group will receive the
      "Diab" and "Nano" games at the end of their second post assessment (5-months post baseline
      assessment).
    

Detailed description: 
      This project is to conduct an efficacy trial of Diab and Nanoswarm to assess their potential
      for minimizing T2D and obesity risks. The proposed research will be conducted in two phases,
      covering a 3-year period: implementation and evaluation phase of 2.5 years and an analysis
      phase of 0.5 years.

      Specific Aim 1: Conduct an efficacy outcome evaluation of Diab and Nano using a randomized
      clinical trial.

      Hypothesis 1: Children will decrease fasting insulin by, at least, 2μU/dl, increase FV intake
      by at least 1.0 servings/day, and increase MVPA by at least 10 min/day from baseline to up to
      3 months post baseline.

      Hypothesis 2: Diet, MVPA and fasting insulin changes will not be moderated by demographic
      characteristics (e.g. gender, age, ethnic group).

      Hypothesis 3: Fasting insulin change will be mediated by changes in diet, PA and SB.

      Hypothesis 4: Diet and PA change outcomes will be mediated by changes in child's preferences
      and intrinsic motivation for FV and PA.

      Control Intervention will be a wait list group and receive the intervention at the end of the
      5-month post assessment.

      Intervention: Children will play the games at home. Each game session should take about 45 to
      60 minutes to complete with an ability to go back and replay the non-behavior mini-games.

      Child Measures include:

        -  Fasting insulin and glucose

        -  Height, weight and waist circumference

        -  Body mass index (BMI; kg/m2) BMI %

        -  Fruit, vegetable and beverage intake by food frequency, and preferences, self efficacy,
           and intrinsic motivation

        -  Physical activity (PA) by Actigraph GT3X accelerometer and PA preferences/enjoyment,
           self efficacy, intrinsic motivation and home equipment availability

        -  Transportation/immersion/liking of video games played

        -  Social desirability to reflect giving answers that are socially acceptable or expected

      Parent Measures includes:

        -  Family demographics

        -  Food and physical activity equipment availability at home

        -  Report of if their child liked and played the video games
    

Intervention name(s): G4H-Diab-Nano
Intervention type(s): Behavioral
Intervention description(s): The Diab and Nanoswarm games present fun, challenging: knowledge mini-games enabling children to learn desired behavior changes; goal-setting tailored to child's current behaviors and preferences to make lifestyle changes; problem solving to enable children to find strategies to overcome behavior change barriers; motivational statements tailored to child's values to enhance their desire to make the goal related lifestyle changes; and energy balance games to enable them to balance food portions with physical activities. Each game has 9 sessions each with approximately 45-60 min of game-play. At the end of each session, goals are set. The child is allowed to re-play non-behavior change mini-games, and view video segments, but not redo their goal setting or behavior change mini-games.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: video game; diet; physical activity; sedentary behavior; obesity; diabetes