The Virtual Fitness Buddy Ecosystem: Using Digital Technology to Promote and Sustain Moderate-to-Vigorous Intensity Physical Activity in Children

项目概要 儿童肥胖是一个重要的公共卫生问题，肥胖儿童容易患上以下疾病： 潜在致命的慢性疾病。科学证据表明，日常体力活动 (PA) 预防肥胖的发生势在必行。努力制定有吸引力的健康干预措施以促进 在儿童 PA 中，研究人员正在将数字技术作为促进健康的平台。这些 干预措施通常侧重于外在奖励作为动机的主要来源，激励有 活跃的积分。新出现的证据表明，以技术为媒介的健康干预措施 鼓励孩子只专注于赢得外在奖励，并使年轻人脱离社会支持 因为 PA 的影响有限，当外在奖励停止时，这些影响可能会完全消失。 我们建议评估一种新颖的技术介导的健康干预措施：虚拟健身伙伴（VFB） 生态系统旨在鼓励儿童将 PA 视为一种生活方式的改变，而不是一种手段 获得积分。该生态系统利用儿童生活中现有的社会关系，主要是亲子关系 关系，利用父母为孩子提供的社会支持的力量。使用消费级 技术设备，例如手机，父母可以继续参与干预并支持他们的孩子 孩子们，即使他们不能和孩子在一起。此外，还有一种虚拟宠物，旨在模仿人类宠物 现实世界中的关系将指导孩子们设定和实现 PA 目标，并提供量身定制的支持。 利用技术来放大现有社会关系的力量，孩子们将学会接受 PA 作为一种 在父母和生态系统内的虚拟宠物的支持下，生活方式发生了改变。 与 YMCA 合作，将随机抽取 24 个课外项目中的 720 名儿童和 720 名家长 在整群随机对照试验中分配给治疗组和对照组。课后项目 治疗组将提供为期3个月的VFB生态系统干预；对照组的程序 将在没有生态系统的情况下获得标准护理。所有儿童将完成 3 个月的基线评估 测试后、6 个月随访和 PA 结果的 12 个月随访。家长和青少年也将提供 自我报告有关他们感知的关系质量、动机和 PA 自我效能的数据。我们的目的是测试 假设 1) 分配到 VFB 生态系统的年轻人将表现出更高水平的中度至剧烈 PA强度高于对照组，2）测试父母和青少年的变化机制，包括 亲子互动、儿童感知的社会支持水平以及父母对儿童 PA 的参与程度。 VFB 生态系统代表了新一代以技术为媒介的儿童健康干预措施， 它将技术融入现有的社会系统，以促进可持续的生活方式改变。因为 该生态系统是一种具有成本效益和劳动力效益的解决方案，它将消费级技术与低功耗集成在一起。 尽管存在继续使用的障碍，但它有可能迅速传播并产生广泛的公共卫生影响。

PROJECT SUMMARY Childhood obesity poses a critical public health concern, with obese children vulnerable to the development of potentially fatal chronic diseases. Scientific evidence has demonstrated that daily physical activity (PA) is imperative in preventing the onset of obesity. In an effort to develop engaging health interventions to promote PA among children, researchers are incorporating digital technology as a platform for health promotion. These interventions often focus on extrinsic rewards as the primary source of motivation, incentivizing children with points for being active. Emerging evidence indicates that technology-mediated health interventions that encourage children to focus solely on winning extrinsic rewards and isolate young people from social supports for PA have limited effects that may disappear altogether when the extrinsic rewards stop. We propose to evaluate a novel technology-mediated health intervention: the Virtual Fitness Buddy (VFB) Ecosystem was designed to encourage children to embrace PA as a lifestyle change rather than a means to gain points. The Ecosystem leverages existing social relationships in children’s lives, primarily the parent-child relationship, capitalizing on the power of social support that parents provide to children. Using consumer-grade technology devices, such as mobile phones, parents can stay involved in the intervention and support their children even when they cannot be with their children. In addition, a virtual pet, designed to mimic human-pet relationships in the physical world, will guide children to set and meet PA goals and offer tailored support. Using technology to amplify the power of existing social relationships, children will learn to embrace PA as a lifestyle change while supported by their parents and the virtual pet within the Ecosystem. In collaboration with YMCA, 720 children and 720 parents in 24 afterschool programs will randomly be assigned to treatment and control groups in a cluster-randomized controlled trial. Afterschool programs in the treatment group will offer the VFB Ecosystem intervention for a 3-month period; programs in the control group will receive standard of care without the Ecosystem. All children will complete baseline assessments, 3-month posttest, 6-month follow up, and a 12-month follow up of PA outcomes. Parents and youth will also provide self-report data on their perceived relationship quality, motivation, and PA self-efficacy. We aim to test the hypotheses that 1) youth assigned to the VFB Ecosystem will evince higher levels of moderate-to-vigorous intensity PA than those in the control group, and 2) test the parent and youth mechanisms of change, including parent-child interaction, children’s perceived level of social support, and parental involvement in children’s PA. The VFB Ecosystem represents a new generation of technology-mediated health interventions for children, which integrates technology into existing social systems, to promote sustainable lifestyle changes. Because the Ecosystem is a cost- and labor-effective solution that integrates consumer-grade technology with low barriers for continued use, it has the potential for rapid diffusion and widespread public health impact.