ABC Brain Games Self-Regulation Intervention
Condition: Obesity; Self-Regulation
Study type: Interventional

Summary: 
      The goal of this project is to measure childhood self-regulation targets known to be
      associated with obesity risk and poor adherence to medical regimens and to assess whether
      intervening on these mechanisms can improve self-regulation. The investigators will do so in
      a pre-existing cohort of low-income school-age children.
    

Detailed description: 
      Poor self-regulation (i.e., inability to harness cognitive, emotional or motivational
      resources to achieve goals) contributes to a number of unhealthy behaviors across the life
      course, including overeating, a lack of physical activity, smoking, alcoholism and substance
      abuse that are linked to poor long-term health. The self-regulation processes that generate
      the desire for such substances or that make it difficult to engage in healthy habits are
      theorized to begin very early in the lifespan. Targeting early self-regulation profiles that
      signal risk for engaging in unhealthy behaviors would allow more effective intervention. The
      investigators will assess self-regulation during pre-adolescence, a critical transition when
      children gain responsibility for managing their health choices and self-regulation becomes
      increasingly associated with health outcomes. Obesity is a complex health issue with
      early-emerging biological and behavioral precursors that are related to self-regulation; as
      such it is a good model for understanding a broad range of health conditions that require
      active self-management. Childhood obesity is also an ongoing public health crisis, with
      almost 25% of children overweight by age 4 years (35% by school-age). The goal of this study
      is to measure childhood self-regulation targets known to be associated with obesity risk and
      poor adherence to medical regimens and to assess whether intervening on these mechanisms can
      improve self-regulation. The investigators will do so in a cohort of children with a high
      rate of obesity who have been extensively phenotyped for bio-behavioral self-regulation and
      obesity risk factors from early childhood.

      The aim is to, in low-income school-age children from extant cohorts, develop and field-test
      interventions designed to address self-regulation targets using a Multiphase Optimization
      Strategy (MOST) design to detect intervention effectiveness and child or family factors
      (e.g., maternal education, family stress, early childhood eating or stress regulation
      pattern) that may moderate intervention effects. The investigators hypothesize that our
      interventions will cause change in the self-regulation targets most closely related to the
      intervention components (e.g., EF-focused intervention will change EF targets).
    

Intervention name(s): 2. Executive Functioning; 3. Food Bias; 4. Emotion Regulation; 5. Future orientation
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Interventions will occur in 3 biweekly visits plus technology-based practice. The investigators will use computer-based working memory training to improve Executive Functioning (EF) and will use a working memory training game that has been used with children this age (N-back task).; The investigators will use attention-bias retraining techniques that have been tested in adults that have children practice approach and avoidance attentional strategies using a joystick and food images (healthy and unhealthy foods). Interventions will occur in 3 biweekly visits. Children in this arm will use a computer-based approach avoidance task to reduce attentional biases for food by using a joystick to push away images of nonhealthy foods and pull closer images of healthy foods.; Interventions will occur in 3 biweekly visits plus home practice. The investigators will use assisted relaxation training where children are trained to monitor and control their heart rate and skin conductance using biofeedback in a computer-game context (Journey to Wild Divine).; Interventions will occur in 3 biweekly visits. Children will participate in an interview protocol designed to enhance their capacity to visualize upcoming future events and describe them in detail, with the goal to make the "future" become "present".
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: children