Lu Amy S, Baranowski Tom, Barreira Tiago V, Fleischman Amy, Green Melanie C, Huang Shirley Y, Lee I-Min, Levitsky Lynne L, Noubary Farzad, Thompson Debbe
Health Technology Lab, Department of Communication Studies, College of Arts, Media, and Design, Department of Public Health & Health Sciences, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA.
Department of Pediatrics, and USDA funded Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA.
Int J Behav Nutr Phys Act. 2025 May 26;22(1):60. doi: 10.1186/s12966-025-01756-1.
Overweight and obesity disproportionately affect Black and Hispanic children who also play more video games. Narratives, coupled with home-based active video games (AVGs), may enhance PA and mitigate these disparities. This study tested the effect of narrative-enhanced home-based AVGs among predominantly Black and Hispanic children with overweight and obesity.
This 6-month three-group RCT recruited 135 children aged 7-14 from pediatric clinics in Boston, MA (January 2020 - May 2022) during the COVID-19 pandemic. Participants were randomized into: [Narrative + AVG], receiving an Xbox/Kinect with six AVGs interspersed with a narrative animation Ataraxia (72 episodes over six months), which accompanied the AVGs; [AVG Only], receiving the Xbox/Kinect and AVGs without narrative animation; and [Waitlist Control], receiving the intervention post-RCT. The primary outcome was objectively assessed daily moderate-to-vigorous PA (MVPA). Secondary outcomes included body composition (fat and lean mass, total region fat), BMI%, fasting insulin, glucose, lipid panel (Cholesterol, HDL, LDL, and Triglycerides), and C-reactive protein. Assessments occurred at baseline, 3, and 6 months. It was hypothesized that [Narrative + AVG] would outperform [AVG Only], which would outperform [Waitlist Control].
79 children completed all three visits (Age = 10.9 ± 1.7; 63% Boys; 62% Black; 25% Latino; 11% Mixed; and 1% Asian). No statistically significant improvements in MVPA were observed within any condition at 3 or 6 months. A post-hoc exploratory analysis revealed that over the first three months, [Narrative + AVG] increased daily MVPA by 6.8 min compared to [Waitlist Control]. Over the same period, the [AVG Only] group exhibited 815 g less lean mass gain and 7.2 mg/dL lower HDL cholesterol levels relative to the [Waitlist Control].
While neither narrative-enhanced AVGs nor AVGs alone consistently increased daily MVPA across the 6-month RCT, participants in the narrative AVGs group demonstrated greater daily MVPA compared to the control group during the initial three months. During this same period, the AVG-only group exhibited reduced lean mass gain and lower HDL cholesterol levels compared to the waitlist control. The added advantage of narratives was inconclusive, likely due to implementation challenges encountered during the pandemic. These findings highlight the need for addressing these challenges in future research in a fully powered study.
Active Video Games on Physical Activity (Main Trial), NCT04116515. Registered December 25, 2019, https//clinicaltrials.gov/study/NCT04116515.
超重和肥胖对黑人和西班牙裔儿童的影响尤为严重，而这些儿童玩电子游戏的时间也更多。带有故事情节的家庭主动式电子游戏（AVG）可能会增加身体活动（PA）并减轻这些差异。本研究测试了带有故事情节的家庭主动式电子游戏对主要为超重和肥胖的黑人和西班牙裔儿童的影响。
在2019年冠状病毒病大流行期间（2020年1月至2022年5月），这项为期6个月的三组随机对照试验从马萨诸塞州波士顿的儿科诊所招募了135名7至14岁的儿童。参与者被随机分为：[故事情节+AVG]组，接受一台Xbox/Kinect游戏机和六个AVG游戏，游戏中穿插有一个名为《阿塔拉西亚》的故事情节动画（六个月内共72集），该动画伴随AVG游戏；[仅AVG]组，接受Xbox/Kinect游戏机和无故事情节动画的AVG游戏；以及[候补对照组]，在随机对照试验结束后接受干预。主要结局指标是通过客观测量每日中度至剧烈身体活动（MVPA）。次要结局指标包括身体成分（脂肪和瘦体重、全身脂肪）、BMI百分比、空腹胰岛素、血糖、血脂指标（胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯）以及C反应蛋白。评估在基线、3个月和6个月时进行。研究假设[故事情节+AVG]组的表现将优于[仅AVG]组，而[仅AVG]组又将优于[候补对照组]。
79名儿童完成了全部三次访视（年龄=10.9±1.7岁；63%为男孩；62%为黑人；25%为拉丁裔；11%为混血；1%为亚洲人）。在3个月或6个月时，任何一组的MVPA均未观察到统计学上的显著改善。一项事后探索性分析显示，在最初三个月中，与[候补对照组]相比，[故事情节+AVG]组的每日MVPA增加了6.8分钟。在同一时期，与[候补对照组]相比，[仅AVG]组的瘦体重增加量少815克，高密度脂蛋白胆固醇水平低7.2毫克/分升。
在为期6个月的随机对照试验中，无论是带有故事情节的AVG游戏还是单纯的AVG游戏，均未持续增加每日MVPA，但在最初三个月中，故事情节AVG游戏组的参与者与对照组相比，每日MVPA更高。在同一时期，与候补对照组相比，仅AVG游戏组的瘦体重增加量减少，高密度脂蛋白胆固醇水平降低。故事情节的额外优势尚无定论，可能是由于大流行期间遇到的实施挑战。这些发现凸显了在未来研究中通过充分有力的研究来应对这些挑战的必要性。
身体活动的主动式电子游戏（主要试验），NCT04116515。于2019年12月25日注册，https//clinicaltrials.gov/study/NCT04116515 。
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