April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: The Impact of Narratives and Active Video Games on Physical Activity and Body Composition Among Children
Background: Underrepresented children with overweight and obesity have been disproportionally affected by the COVID-19 pandemic, when disruptions to daily routines heightened concerns about sedentary screen media exposure, excessive weight gain, and lack of physical activity (PA). Narratives, coupled with home-based Active video games (AVGs), offer a promising strategy to promote PA and mitigate these concerns.
Objective: To investigate the effect of pairing narratives with home-based active video games (AVGs) on body composition and PA among underrepresented children with overweight and obesity.
Design, Setting, and Participants: This randomized controlled trial was conducted from January 2020 to May 2022 in Boston, MA. Eligible children aged 8-14-year-olds were recruited from multiple pediatric obesity and primary care clinics.
Interventions: This three-arm study aimed to evaluate whether the addition of narratives and AVGs would improve body composition and PA over six months. The [Narrative+ AVG] group received an Xbox/Kinect bundle with six AVGs, accompanied by a narrative animation Ataraxia (72 episodes/six seasons); the [AVG Only] group got the same Xbox/Kinect bundle and AVGs but without narratives; the Wait List Control group did not get game bundle or narratives until after the study ended.
Main Outcomes and Measures: The primary outcomes were between-group mean differences in PA behaviors (measured by triaxial accelerometers) and body composition, specifically fat and lean tissue percentages, as determined by dual-energy X-ray absorptiometry (DEXA) scans.
Results: 135 children (Mean Age: 10.93+1.68 years; Boys: 50 [63.3%]) were randomized to three conditions at their baseline visit [A: Narrative + AVG; 28 children] or [B: AVG Only; 25 children] or [C: Wait List Control; 26 children]. Measurements were taken at baseline, 3 months, and 6 months. The trial was severely impacted by COVID-19, but 79 participants completed all three visits. Data were analyzed using a linear mixed model to assess between-group differences in primary outcomes over time, followed by intention-to-treat analysis. Over the first three months, the [Narrative + AVGs] group showed an increase of 2.8 minutes in daily moderate PA and 6.8 minutes in daily MVPA compared to [Wait List Control] and took 199 more daily brisk-walking steps than [AVGs Only]; from 3 to 6 months, they gained 1170 grams less fat mass than [Wait List Control]. On the other hand, in the first three months, the [AVGs Only] group had 5.6 more minutes of daily moderate PA than [Wait List Control]; from 3 to 6 months, they had 3.3 more minutes in daily MVPA than [Narrative + AVGs] and experienced 1447 grams less fat mass gain than [Wait List Control].
Conclusions and Relevance: Over a six-month period during the pandemic, both AVGs paired with narratives and AVGs alone improved various physical activity and body composition outcomes among underrepresented children with overweight and obesity. Supplying children with video game consoles during the pandemic did not negatively impact their body composition or PA levels. While the evidence for the added advantage of narratives was inconclusive, several implementation challenges related to their addition explained the lesser-than-expected effects, proving invaluable insights for future studies.
Objective: To investigate the effect of pairing narratives with home-based active video games (AVGs) on body composition and PA among underrepresented children with overweight and obesity.
Design, Setting, and Participants: This randomized controlled trial was conducted from January 2020 to May 2022 in Boston, MA. Eligible children aged 8-14-year-olds were recruited from multiple pediatric obesity and primary care clinics.
Interventions: This three-arm study aimed to evaluate whether the addition of narratives and AVGs would improve body composition and PA over six months. The [Narrative+ AVG] group received an Xbox/Kinect bundle with six AVGs, accompanied by a narrative animation Ataraxia (72 episodes/six seasons); the [AVG Only] group got the same Xbox/Kinect bundle and AVGs but without narratives; the Wait List Control group did not get game bundle or narratives until after the study ended.
Main Outcomes and Measures: The primary outcomes were between-group mean differences in PA behaviors (measured by triaxial accelerometers) and body composition, specifically fat and lean tissue percentages, as determined by dual-energy X-ray absorptiometry (DEXA) scans.
Results: 135 children (Mean Age: 10.93+1.68 years; Boys: 50 [63.3%]) were randomized to three conditions at their baseline visit [A: Narrative + AVG; 28 children] or [B: AVG Only; 25 children] or [C: Wait List Control; 26 children]. Measurements were taken at baseline, 3 months, and 6 months. The trial was severely impacted by COVID-19, but 79 participants completed all three visits. Data were analyzed using a linear mixed model to assess between-group differences in primary outcomes over time, followed by intention-to-treat analysis. Over the first three months, the [Narrative + AVGs] group showed an increase of 2.8 minutes in daily moderate PA and 6.8 minutes in daily MVPA compared to [Wait List Control] and took 199 more daily brisk-walking steps than [AVGs Only]; from 3 to 6 months, they gained 1170 grams less fat mass than [Wait List Control]. On the other hand, in the first three months, the [AVGs Only] group had 5.6 more minutes of daily moderate PA than [Wait List Control]; from 3 to 6 months, they had 3.3 more minutes in daily MVPA than [Narrative + AVGs] and experienced 1447 grams less fat mass gain than [Wait List Control].
Conclusions and Relevance: Over a six-month period during the pandemic, both AVGs paired with narratives and AVGs alone improved various physical activity and body composition outcomes among underrepresented children with overweight and obesity. Supplying children with video game consoles during the pandemic did not negatively impact their body composition or PA levels. While the evidence for the added advantage of narratives was inconclusive, several implementation challenges related to their addition explained the lesser-than-expected effects, proving invaluable insights for future studies.