GamerFit: A Digital Intervention to Improve Physical Activity and Sleep Behaviors in Youth with Psychiatric Diagnoses

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PROJECT SUMMARY Exergaming has been shown to be an effective way to increase physical activity among sedentary youth, including those with neurodevelopmental and mental health disorders. However, gaming technology is constantly changing, along with the types of exergames available. Games that were previously tested in interventions are routinely discontinued, and new technology platforms and games are emerging; this evolving landscape of exergaming technology critically impacts evidence-based interventions. Understanding how components of an exergame-based physical activity intervention affect engagement among youth with psychiatric disorders may lead to changes in how these interventions are integrated in various communities. Unfortunately, however, little is known about how to assess accessibility and acceptability of existing and emerging technology based on intersectional participant characteristics, especially among populations typically underrepresented in behavior change studies. Therefore, we aim to explore the impact of intersectional characteristics (disability, race/ethnicity, gender-identity) on intervention engagement within the ongoing GamerFit exergaming and telehealth coaching study (Parent R21 grant). The GamerFit Study (Parent R21) will randomize 60 participants with at least one PD, with 30 using the GamerFit app with weekly telehealth coaching sessions and 30 using a commercial healthy habits app as a comparator group. The GamerFit app will provide access to a menu of exergames, progressive PA and sleep plan, integrated self-monitoring, pre- recorded videos addressing healthy PA and sleep habits, and motivational text messages to help users meet PA and sleep guidelines over 12 weeks. This supplemental study proposes to expand the scope of the parent grant with the following specific aims: Specific Aim 1: To understand how participants’ (n=30 intervention participants) racial/ethnic and gender identity intersect with psychiatric diagnoses to affect participant perceptions of physical activity barriers and benefits, exergaming and overall intervention acceptability, and overall intervention engagement. Specific Aim 2: To explore how racial/ethnic and gender identity intersect with psychiatric diagnoses to affect participant perceptions of how specific exergame components influence their engagement outcomes (e.g., enjoyment, acceptability, accessibility, motivation to continue play). The completion of this proposed supplemental project will both yield findings to improve the effectiveness and reach of the GamerFit intervention, and also advance Dr. Kennedy’s training and career goals to become an expert in intersectionality, disability health, and health behavior intervention design and implementation.