The impact of narratives and active video games on long-term moderate-to-vigorous physical activity: A randomized controlled trial protocol

Authors: ALON, DAR - Northeastern University; SOUSA, CAIO - Northeastern University; CABRERA-PEREZ, ROMINA - Northeastern University; FERNANDEZ, AUSTIN - Northeastern University; LEE, KELLY - Northeastern University; MISAWA, AIKA - Northeastern University; SUN, KYUNG - Northeastern University; BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC); BARREIRA, TIAGO - Syracuse University; CHIU, KELLY - Harvard Medical School; FLEISCHMAN, AMY - Harvard Medical School; HUANG, SHIRLEY - Tufts Medical Center; HWANG, JUNGYUN - Stanford University School Of Medicine; GREEN, MELANIE - University At Buffalo; LEE, I - Brigham & Women'S Hospital; LESSARD, SARAH - Brigham & Women'S Hospital; LEVITSKY, LYNNE - Massachusetts General Hospital; NOUBARY, FARZAD - Northeastern University; SAMUELS, RONALD - Boston Children'S Hospital; Thompson, Deborah - Debbe; LU, AMY - Northeastern University

Submitted to: Contemporary Clinical Trials
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/13/2020
Publication Date: 7/16/2020
Citation: Alon, D., Sousa, C., Cabrera-Perez, R., Fernandez, A., Lee, K., Misawa, A., Sun, K.J., Baranowski, T., Barreira, T.V., Chiu, K., Fleischman, A., Huang, S., Hwang, J., Green, M.C., Lee, I.M., Lessard, S., Levitsky, L.L., Noubary, F., Samuels, R., Thompson, D.J., Lu, A.S. 2020. The impact of narratives and active video games on long-term moderate-to-vigorous physical activity: A randomized controlled trial protocol. Contemporary Clinical Trials. https://doi.org/10.1016/j.cct.2020.106087.
DOI: https://doi.org/10.1016/j.cct.2020.106087

Interpretive Summary: Children, especially obese children, are not getting enough physical activity (PA). Innovative programs are needed to attract, engage, and maintain children in PA. Exergames offer promise in this regard, but they need additions to enhance longer term engagement and participation. Narratives, or stories, also appear promising but need further testing. This manuscript describes a protocol study for a three group randomized controlled clinical trial to test the effect of a narrative added to a video game, the video game alone, versus a no intervention control group. The sample will include overweight or obese 8 to 12 year old children. The primary outcome will be level of physical activity with body mass index as a secondary outcome. This study offers promise of identifying a way to increase PA and thereby reduce obesity among overweight or obese children.

Technical Abstract: Although physical activity (PA) has been shown in helping prevent and treat obesity, current PA interventions are still not effective in ameliorating the obesity epidemic. Additional forms of PA need to be investigated to improve PA engagement and outcomes. We hypothesize that pairing a narrative (i.e., story) with an active video game (AVG), a less traditional form of PA, will increase participant engagement in PA. This paper presents the rationale, implementation, and pilot results of a study assessing the effect of narrative's impact on PA and a series of other health outcomes. The Active Video Game Study is a six-month randomized controlled single-blind trial projected to include 210 participants. The intervention strategy will pair a narrative to an active video game (AVG). Participants will be randomized into 3 groups: condition A [Narrative+AVG], condition B [AVG Only], and condition C [Control]. Participants will undergo three in-person data collection visits over the course of six months. Inclusion criteria are that children are between the ages of 8-12 and have a BMI>=85%. The primary outcome is change in moderate to vigorous physical activity (MVPA). Secondary outcome measures include change in BMI percentile, fasting insulin and glucose, lipid panel, C-reactive protein, and cognitive function. A pilot trial of n=6 was conducted to help develop procedures and address problems that could arise in the main trial. Successful completion of this study will provide the empirical basis for novel intervention and design strategies to enhance the impact of AVGs on long-term MVPA.