Clinical trial NCT02058342: Family-based Intervention for Youth With Prader-Willi Syndrome: The Active Play at Home Study
Official title: Family-based Exercise Intervention for Children and Adolescents With Prader-Willi Syndrome
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Prader Willi Syndrome
Childhood Obesity
Keywords: Prader Willi syndrome
Obesity
Childhood
Family
Interactive games
Playground games
Exercise routine
Lead sponsor: California State University, Fullerton
Sponsor class: OTHER
Collaborators: name: University of Florida
First posted: 2014-02-10
Enrollment: 115
Sex: ALL
Minimum age (years): 8
Maximum age (years): 15
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Compared to other children, those with disability have additional challenges to being physically active. Prader-Willi Syndrome (PWS) is a genetic form of childhood obesity that is characterized by hypotonia, growth hormone deficiency, behavioral, and cognitive disability. In children, the low prevalence of PWS (1 in 10,000 to 15,000 live births) makes group-based physical activity (PA) interventions impossible. In contrast, the home environment presents a natural venue to establish a PA routine for this population. The present high prevalence of non-syndromal childhood obesity (one in four) and high physical inactivity rates, make alternative approaches to increasing PA in this population an area of high interest. Therefore, we have developed a 24-week home-based physical activity that could be suitable for children and adolescents ages 8-15 with PWS as well as obese children without PWS ages 8-11 years. It is hypothesized that: 1) an age-appropriate 24-week home-based PA intervention will increase PA levels in youth with PWS and without the syndrome but with obesity; 2) motor proficiency, central sensory reception and integration, and body composition will significantly improve in youth with and without PWS following completion of the home-based PA intervention and 3) physical activity self-efficacy and quality of life will increase significantly in youth with and without PWS who complete the home-based PA intervention. The study participants are 115 youth ages 8-15 y (45 with PWS and 70 without PWS but categorized as obese). The study utilizes a parallel design with the wait-listed control group receiving the intervention after serving as control. Participants are expected to complete the PA curriculum 4 days a week for six months including playground games 2 days a week and interactive console games 2 days a week. Parents are trained at baseline and then provided with a PA curriculum (Active Play at Home) and equipment to guide their implementation of the program at home. Measurements of children and parent dyads are assessed at baseline and at the end (week 24) of the intervention or control periods. Outcome measures include PA, body composition, motor proficiency, central sensory reception and integration (subsample of children only), quality of life and physical activity self-efficacy. PA intervention compliance is monitored using mail-in daily self-report checklists.

Detailed description: Compared to other children, those with disability have additional challenges to being physically active. Prader-Willi Syndrome (PWS) is a genetic form of childhood obesity that is characterized by hypotonia, growth hormone deficiency, behavioral, and cognitive disability. In children, the low prevalence of PWS (1 in 10,000 to 15,000 live births) makes group-based physical activity (PA) interventions impossible. In contrast, the home environment presents a natural venue to establish a PA routine for this population. The present high prevalence of non-syndromal childhood obesity (one in four) and high physical inactivity rates, make alternative approaches to increasing PA in this population an area of high interest. Specifically, approaches that involve the family have been identified as possible areas where further research is needed. Therefore, we have developed a 24-week home-based physical activity that could be suitable for children and adolescents ages 8-15 with PWS as well as obese children without PWS ages 8-11 years. It is hypothesized that: 1) an age-appropriate 24-week home-based PA intervention will increase PA levels in youth with PWS and without the syndrome but with obesity; 2) motor proficiency, central sensory reception and integration, and body composition will significantly improve in youth with and without PWS following completion of the home-based PA intervention and 3) physical activity self-efficacy and quality of life will increase significantly in youth with and without PWS who complete the home-based PA intervention. The study participants are 115 youth ages 8-15 y (45 with PWS and 70 without PWS but categorized as obese). The study utilizes a parallel design with the wait-listed control group receiving the intervention after serving as control. Participants are expected to complete the PA curriculum 4 days a week for six months including playground games 2 days a week and interactive console games 2 days a week. Parents are trained at baseline and then provided with a PA curriculum (Active Play at Home) and equipment to guide their implementation of the program at home. Tips related to scheduling and coping with barriers to daily program implementation are also included. Throughout, parents are contacted by phone once a week (weeks 1-4) and then every other week to provide support in between visits. Measurements of children and parent dyads are assessed at baseline, at 12-weeks of receiving the intervention and at the end (week 24) of the intervention or control periods. PA intervention compliance is monitored using mail-in daily self-report checklists.

Eligibility criteria: Inclusion Criteria:

* Having Prader-Willi Syndrome and being between ages 8-15 years. PWS status will be documented by appropriate molecular and cytogenetic testing (i.e., chromosomes, florescence in situ hybridization \[FISH\] 15, DNA methylation, DNA polymorphism studies)
* Being obese and between ages 8-11 years. Obesity is defined as having a body fat percentage greater than the 95th percentile (McCarthy, H. D., Cole, T. J., Fry, T., Jebb, S. A., \& Prentice, A. M. (2006). Body fat reference curves for children. International Journal of Obesity (Lond), 30(4), 598-602).

Exclusion Criteria:

* Obese children without Prader-Willi Syndrome currently on lipid-lowering medication, diabetes medications, or blood pressure medications.
* Being pregnant

Primary outcomes:
measure: Physical Activity
timeFrame: Baseline to 24 weeks
Secondary outcomes:
measure: Body composition
timeFrame: Baseline to 24 weeks
measure: Motor proficiency
timeFrame: Baseline to 24 weeks
measure: Sensory reception and motor integration
timeFrame: Baseline to 24 weeks
measure: Physical activity self-efficacy
timeFrame: Baseline to 24 weeks
measure: Quality of life
timeFrame: Baseline to 24 weeks
Other outcomes:
measure: Anthropometrics
timeFrame: Baseline to 24 weeks
measure: Dietary intake
timeFrame: Baseline to 24 weeks
measure: Parent confidence
timeFrame: Baseline to 24 weeks
measure: Parent influence
timeFrame: Baseline to 24 weeks
Locations:
city: Fullerton
country: United States
facility: California State University Fullerton
state: California
city: Gainesville
country: United States
facility: University of Florida Gainesville
state: Florida
Study officials:
affiliation: California State University Fullerton, Department of Kinesiology
name: Daniela A Rubin, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Rubin DA, Wilson KS, Castner DM, Dumont-Driscoll MC. Changes in Health-Related Outcomes in Youth With Obesity in Response to a Home-Based Parent-Led Physical Activity Program. J Adolesc Health. 2019 Sep;65(3):323-330. doi: 10.1016/j.jadohealth.2018.11.014. Epub 2019 Mar 2.
citation: Rubin DA, Wilson KS, Dumont-Driscoll M, Rose DJ. Effectiveness of a Parent-led Physical Activity Intervention in Youth with Obesity. Med Sci Sports Exerc. 2019 Apr;51(4):805-813. doi: 10.1249/MSS.0000000000001835.
citation: Rubin DA, Wilson KS, Honea KE, Castner DM, McGarrah JG, Rose DJ, Dumont-Driscoll M. An evaluation of the implementation of a parent-led, games-based physical activity intervention: the Active Play at Home quasi-randomized trial. Health Educ Res. 2019 Feb 1;34(1):98-112. doi: 10.1093/her/cyy035.
citation: Rubin DA, Wilson KS, Wiersma LD, Weiss JW, Rose DJ. Rationale and design of active play @ home: a parent-led physical activity program for children with and without disability. BMC Pediatr. 2014 Feb 14;14:41. doi: 10.1186/1471-2431-14-41.