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

项目总结 儿童肥胖是一个严重的公共卫生问题，肥胖儿童容易患上 可能致命的慢性病。科学证据表明，日常体力活动(PA)是 预防肥胖症的发生势在必行。努力制定参与性健康干预措施，以促进 PA在儿童中，研究人员正在将数字技术作为促进健康的平台。这些 干预措施通常将外部奖励作为动力的主要来源，激励儿童 活跃的分数。新出现的证据表明，技术中介的健康干预措施 鼓励孩子只专注于赢得外在的奖励，将年轻人与社会支持隔绝 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的技术中介的健康干预：虚拟健身伙伴(VFB) 生态系统旨在鼓励孩子们将PA视为一种生活方式的改变，而不是一种手段 加分。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 利用父母为子女提供的社会支持的力量。使用消费级 技术设备，如手机，家长可以继续参与干预并支持他们的 孩子，即使他们不能和他们的孩子在一起。此外，还有一个虚拟宠物，旨在模仿人类宠物 将指导儿童设定和实现PA目标，并提供量身定做的支持。 使用技术放大现有社会关系的力量，孩子们将学习接受PA作为一种 在父母和生态系统中的虚拟宠物的支持下，改变生活方式。 在与基督教青年会的合作下，24个课外项目中的720名儿童和720名家长将随机 在整群随机对照试验中被分配到治疗组和对照组。学校的课外活动 治疗组将提供为期3个月的VFB生态系统干预；对照组的计划 将在没有生态系统的情况下得到标准的护理。所有儿童将完成基线评估，为期3个月 后测、6个月随访期和12个月随访期。家长和青少年也将提供 自我报告他们感知的关系质量、动机和PA自我效能感的数据。我们的目标是测试 假设1)被分配到VFB生态系统的年轻人将表现出更高水平的中等到剧烈的 2)检测亲代和幼代的变化机制，包括 亲子互动、儿童感受到的社会支持水平，以及父母对儿童PA的参与。 VFB生态系统代表了新一代以技术为中介的儿童健康干预措施， 它将技术整合到现有的社会系统中，以促进可持续的生活方式变化。因为 生态系统是一种经济实惠的解决方案，将消费级技术与低成本技术相结合 如果无法继续使用，它有可能迅速扩散，并对公共卫生造成广泛影响。

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.