Video games for Obesity & Diabetes Prevention: Efficacy Trial

描述（由申请人提供）：虽然糖尿病预防项目表明，饮食和体育活动的相对较小的变化可以大大降低高危成年人的糖尿病发病率，但很少有项目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上升，需要创新的项目来吸引儿童的注意力，并让改变行为的信息传递给他们。具有沉浸式故事的严肃电子游戏提供了这样一个有希望的选择。“逃离迪亚布”和“纳米温暖：来自内部空间的入侵”是两款电子游戏，它们的设计受到四种行为改变理论的指导，这些理论旨在增加水果、蔬菜和水的摄入量，减少久坐不动的行为，并在一项相对低风险样本的试点研究中被证明可以改变这些孩子的饮食和体育活动习惯。鉴于这一初步成功，我们有必要测试这些干预措施对糖尿病风险（如空腹胰岛素）的有效性，让高风险儿童（这应该会增加效果）和更大的样本来了解游戏如何使用中介变量分析改变行为。建议对444名10 ~ 12岁的高危儿童（85百分位<BMI<99百分位）进行研究。儿童将被随机分配到实验组和对照组。对照组将接受干预，包括知识型饮食、体育活动、肥胖和糖尿病、电子游戏和互联网网站。电子游戏是一种很有前途的低成本干预方法，因为游戏已经开发出来，并且可以通过简单地复制和分发其dvd来广泛传播。目前还没有一项研究测试了基于理论的电子游戏对饮食和身体活动的影响，这些研究足以调查中介变量。进行中介变量分析将为未来电子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在哪些方面有效地改变了儿童患糖尿病的风险（尤其是胰岛素、饮食和体育活动）。

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.