Video games for Obesity & Diabetes Prevention: Efficacy Trial

描述（由申请人提供）：虽然糖尿病预防计划表明，饮食和体力活动的相对较小的变化可以大大降低高风险成人的糖尿病发病率，但很少有计划影响儿童的肥胖或糖尿病风险。随着儿童肥胖和糖尿病发病率的增加，需要创新的项目来吸引儿童的注意力，并允许行为改变的信息传播。严肃的视频游戏及其身临其境的故事提供了这样一个有前途的选择。《逃离迪亚伯》和《纳米暖：从内部空间入侵》是两款视频游戏，它们的设计以四种行为改变理论为指导，旨在增加水果、蔬菜和水的摄入量，减少久坐行为，并在一项风险相对较低的试点研究中显示，它们可以改变这些儿童的饮食和身体活动习惯。鉴于这一初步的成功，重要的是要测试这些干预措施对糖尿病风险（即空腹胰岛素）的有效性与高风险儿童（这应该会增加效果），并与更大的样本，以了解游戏如何改变行为使用中介变量分析。对444名10 ~ 12岁高危（85百分位数<BMI<99百分位数）儿童进行了研究。儿童将被随机分配到治疗组或对照组。对照组将接受干预，包括基于知识的饮食，体育活动，肥胖和糖尿病视频游戏和互联网上的网站。视频游戏是一种有希望的低成本干预方法，因为游戏已经开发出来，只需复制和分发DVD就可以广泛传播。目前还没有研究表明，基于理论的视频游戏对饮食和身体活动的影响足以调查中介变量。进行中介变量分析将为未来视频游戏的设计提供信息，并增强其促进健康行为改变的能力。虽然使用电子游戏促进健康是有争议的，但这项研究将确定电子游戏有效地改变儿童糖尿病风险（特别是胰岛素，饮食和体力活动）的地方。

DESCRIPTION (provided by applicant): While the Diabetes Prevention Program demonstrated that relatively small changes in diet and physical activity could substantially reduce the incidence of diabetes among high risk adults, few programs have influenced obesity or diabetes risks among children. 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. "Escape from Diab" and "Nanoswarm: Invasion from Inner Space" are two video games guided in their design by four behavior change theories that were targeted at increasing fruit, vegetable and water intakes, and lowering sedentary behaviors, and have been shown to change these children's diet and physical activity practices in a pilot study with a relatively low risk sample. In light of this preliminary success, it is important to test the efficacy of these interventions on diabetes risks (i.e. fasting insulin) with higher risk children (which should increase the effect) and with a larger sample to learn how the games change behaviors using mediating variable analyses. A study with 444 high risk (85 percentile<BMI<99 percentile) 10 to 12 year old children is proposed. Children will be randomly assigned to treatment or control groups. The control group will receive an intervention involving knowledge based diet, physical activity, obesity and diabetes video games and web sites on the internet. Video games are a promising low cost approach to intervention since the games have already been developed, and can be broadly disseminated by simply reproducing and distributing their DVDs. No study has appeared that tested the effects of theory based video games on diet and physical activity that was adequately powered to investigate mediating variables. Conducting the mediating variable analyses will inform the design of future video games and enhance their ability to promote health behavior change. While using video games for health promotion is controversial, this study will establish where video games efficaciously change diabetes risks (especially insulin, diet and physical activity) among children.