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How Long do Children
   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM	
 


                                       Play Wii Active Video
                                             Games:
                                          An Experiment
                                                                    Tom Baranowski, PhD
                                        Professor of Pediatrics (Behavioral Nutrition & PA)
                                         USDA/ARS Childrens Nutrition Research Center
                                                                Baylor College of Medicine
                                                              Houston, Texas, 77030, USA
                                                  www.bcm.edu/cnrc/faculty/?PMID=9519
                                                                                Pediatrics
Substantial interest in Exergames -
      Active Video Games
     ≒ Almost more reviews than there are original
        articles

     ≒ Can they increase PA?
     ≒ Do they increase PA at home under naturalistic
        circumstances? For how long?
     ≒ Do they increase PA in unsafe neighborhoods?

                                                      Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Can they increase PA? (Exercise
      Physiology)
     ≒ The motivated right person under the right
        circumstances for a sufficient duration can get:
        -足 A moderate work out:
             ≒ DDR
             ≒ Wii
        -足 A vigorous work out:
             ≒ DDR
             ≒ Wii
                                                           Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Do they increase PA at home under
   naturalistic circumstances?
   For how long?
     ≒ Controversy on this point
     ≒ Most studies
         -足 Not experimental
         -足 Did not use objective monitors




                                               Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Do they increase PA in unsafe
      neighborhoods under naturalistic
      circumstances?
      (when children are not allowed outside to play)




                                                        Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Hypotheses
     ≒ Children receiving their first active Wii games will have more of
        an increase in minutes of moderate to vigorous physical activity
        per day after playing each game and the increase will be
        cumulative over time (more after one game, and even more
        after two games)

     ≒ During the time playing the games (active games by the active
        group, inactive games by the inactive group), the group
        assigned the active games will get more PA during game play
        than the group playing inactive games

     ≒ The effects of these games will be moderated by the perceived
        safety of neighborhood (unsafe neighborhoods getting more PA)
                                                                   Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Research Design
                                                          Wk 1          Wk 6                   Wk 7         Wk 12
                                                          Accel         Accel          TRT2
                                                                                               Accel        Accel
                                            TRT1
                                                   n=41


 Baseline               Baseline                                                    Mid                               Post
                                       Randomization
 Assess                 Accel (1 wk)                                                Assess                            Asses
                                                   m=37
                                           CTL1
                                                                                        CTL2
                                                          Wk 1              Wk 6               Wk 7          Wk 12
                                                          Accel             Accel              Accel         Accel




                          2 weeks                                 6 weeks           2 weeks            6 weeks       2 weeks




                                                                                                                     Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Sample 1
     ≒ Inclusion Criteria
         -足 9 yo < child < 12 yo
         -足 50th < BMI%tile < 99th
         -足 English speaking
         -足 Parent allowed child to play video games
         -足 Have TV to which to attach Wii




                                                         Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Sample 2
     ≒ Exclusion Criteria
         -足 Medical problems could prevent playing video games
         -足 Hx of epileptic seizures
         -足 Already have a Wii console
         -足 Not wear accelerometer for 5 of 7 days at baseline
         -足 Live < 12 miles of CNRC




                                                            Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Measures
     ≒ Child accelerometers
         -足 Device that objectively measure PA
              ≒ Worn 7 days at each of 5 time intervals
     ≒ Child received Wii console if provided all
        measures




                                                           Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Sample Characteristics
                                       Ethnicity	
 
                                       African	
 American	
                      46%	
 
                                       	
 	
 	
 	
 White	
                    12%	
 
                                       	
 	
 	
 Hispanic	
                      4%	
 
                                       	
 	
 	
 Other	
                         7%	
 
                                       	
 	
 	
 MulGple	
                      31%	
 
                                               -
                                       Age	
 (x	
 +	
 sd)	
 (years)	
    11.2	
 +	
 1.2	
 
                                       Gender	
 
                                       	
 	
 	
 Male	
                         52%	
 
                                       	
 	
 	
 Female	
                       48%	
 
                                       BMI%Gle	
                                77.8%	
 
                                                                                                     Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Sample Loss
                                                                    Treatment	
 	
  Control	
 
                                   Total	
 lost	
 due	
 to	
 


                                   End	
                                41	
           37	
 




                                                                                                    Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Frequency Distribution of Not Safe
      Neighborhood




                                        Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Mean Levels of In/Activities for
      trt & ctl




                                         Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
There was no significant interaction
      term with perceived neighborhood
      safety




                                         Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Mean, SD and SE on time spent in active and
     inactive video games for each group separately
     at each time interval
                                                             Ac2ve	
 Game	
          Inac2ve	
 Game	
 
     Group	
                  Week	
           n	
    Mean	
           Std	
    Mean	
          Std	
 
            Control	
  Week	
 1	
            37	
    6.47	
         24.17	
    27.21	
       33.89	
 
                               Week	
 6	
     37	
    8.16	
         24.10	
    21.23	
       29.48	
 
                               Week	
 7	
     37	
    1.93	
          8.85	
    59.73	
       87.51	
 
                               Week	
 12	
    37	
    6.17	
         18.95	
    17.38	
       35.54	
 


      Treatment	
  Week	
 1	
                41	
    28.14	
        31.49	
    3.75	
        15.57	
 
                               Week	
 6	
     41	
    12.03	
        13.26	
    5.53	
        14.92	
 
                               Week	
 7	
     41	
    21.10	
        24.25	
    4.18	
        13.42	
 
                               Week	
 12	
    41	
    7.86	
         10.23	
    2.57	
         8.42	
 
                                                                                                         Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Challenges in Matching Wii Record w/Game Log

            Wii	
                     LOG	
      Matched	
    Games	
 we	
 O鍖ered	
    Games	
 we	
 Did	
    TOTAL	
 
                                                    Y/N	
          #	
 of	
 Cases	
        Not	
 O鍖er	
 
              A	
                       A	
         Yes	
              521	
                     98	
             619	
 
               I	
                       I	
                            560	
                    159	
             749	
 
              A	
                        I	
        No	
                 3	
                      1	
               4	
 
               I	
                      A	
                              42	
                      5	
              47	
 
       Wii	
 Only	
                                 No	
              1169	
                    109	
            1278	
 
                                 LOG	
 Only	
                           416	
                     66	
             482	
 




                                                                                                                        Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Conclusions
     ≒ Children obtaining Wii console and two active Wii
        video games did not participate in increased PA
        over those receiving two inactive Wii video games

     ≒ Children receiving the active Wii games and living
        in an unsafe neighborhood did not participate in
        increased PA over those in safe neighborhoods

     ≒ What could be done with active video games to
        increase the level of PA? And maintain it?
                                                      Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Strengths of the Study
     ≒ Random assignment to condition
     ≒ Objective measure of PA for multiple days at 5
        time intervals
     ≒ High maintenance rage
     ≒ High complete data




                                                    Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Limitations/Weaknesses
     ≒ Modest sample
     ≒ Only in Houston
     ≒ Some cross-game contamination
     ≒ (but naturalistic in circumstances)
     ≒ Could not link accelerometry data with time of
        active game play
     ≒ Findings do not generalize to other ages
     ≒ Findings do not generalize to other AVG systems

                                                   Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Wii




                                       Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Collaborators (in alphabetical order)

     ≒ Dina Abdelsamad                ≒ Ester Cerin, PhD

     ≒ Janice Baranowski,             ≒ Ann Chen, PhD
        MPH, RD
                                       ≒ Teresia OConnor, MD,
     ≒ Tony Barnett, PhD                 MPH

     ≒ Felica Bradford, BIT           ≒ Debbe Thompson, PhD

                                                             Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
D棚kuji! (Czeck)
                                                    DANKE! (German)
                                        MUITO	
 OBRIGADO!	
 (Portuguese)	
 
                                                   M	
 GI!	
 (Chinese,	
 Cantonese)
                                                     ARIGAT!	
 (Japanese)	
 
                                           MERCI BEAUCOUP!(French)
                                         MUCHAS GRACIAS! (Spanish)
                                       SERDECZNIE DZIKUJ!	
 (Polish)
                                           SHUKRAN! (Arabic, Middle East)
                                       TACK SMYCKET! (Swedish)	
 	
 
                                                         TAKK! (Norwegian)
                                                  EFCHARISTO! (GREEK)
                                           Xie Xie! (Chinese, Mandarin)
                                                    Dank u wel (Dutch)
                                                   Khawp Khun maxh! (Thai)
                                                            Grazie! (Italian)
                                                                                      Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
The effect of group and time on
      average minutes per day
     ≒ aThere was a significant week effect for
        sedentary minutes[F=26.31, p<.0001]. The week
        effect indicates that Week 6 was significantly
        different from baseline, Week 1, Week 7 and
        Week 12. Sedentary minutes at Week 6 were
        higher than at baseline, Week 1, Week 7 and
        Week 12.



                                                   Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM
Pediatrics

   Games	
 for	
 Health	
 
Wednesday,	
 May	
 18,	
 2011	
 
    5:30-足6:00	
 PM

More Related Content

How Long do Children Play Wii Active Video Games: An Experiment

  • 1. How Long do Children Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM Play Wii Active Video Games: An Experiment Tom Baranowski, PhD Professor of Pediatrics (Behavioral Nutrition & PA) USDA/ARS Childrens Nutrition Research Center Baylor College of Medicine Houston, Texas, 77030, USA www.bcm.edu/cnrc/faculty/?PMID=9519 Pediatrics
  • 2. Substantial interest in Exergames - Active Video Games ≒ Almost more reviews than there are original articles ≒ Can they increase PA? ≒ Do they increase PA at home under naturalistic circumstances? For how long? ≒ Do they increase PA in unsafe neighborhoods? Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 3. Can they increase PA? (Exercise Physiology) ≒ The motivated right person under the right circumstances for a sufficient duration can get: -足 A moderate work out: ≒ DDR ≒ Wii -足 A vigorous work out: ≒ DDR ≒ Wii Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 4. Do they increase PA at home under naturalistic circumstances? For how long? ≒ Controversy on this point ≒ Most studies -足 Not experimental -足 Did not use objective monitors Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 5. Do they increase PA in unsafe neighborhoods under naturalistic circumstances? (when children are not allowed outside to play) Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 6. Hypotheses ≒ Children receiving their first active Wii games will have more of an increase in minutes of moderate to vigorous physical activity per day after playing each game and the increase will be cumulative over time (more after one game, and even more after two games) ≒ During the time playing the games (active games by the active group, inactive games by the inactive group), the group assigned the active games will get more PA during game play than the group playing inactive games ≒ The effects of these games will be moderated by the perceived safety of neighborhood (unsafe neighborhoods getting more PA) Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 7. Research Design Wk 1 Wk 6 Wk 7 Wk 12 Accel Accel TRT2 Accel Accel TRT1 n=41 Baseline Baseline Mid Post Randomization Assess Accel (1 wk) Assess Asses m=37 CTL1 CTL2 Wk 1 Wk 6 Wk 7 Wk 12 Accel Accel Accel Accel 2 weeks 6 weeks 2 weeks 6 weeks 2 weeks Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 8. Sample 1 ≒ Inclusion Criteria -足 9 yo < child < 12 yo -足 50th < BMI%tile < 99th -足 English speaking -足 Parent allowed child to play video games -足 Have TV to which to attach Wii Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 9. Sample 2 ≒ Exclusion Criteria -足 Medical problems could prevent playing video games -足 Hx of epileptic seizures -足 Already have a Wii console -足 Not wear accelerometer for 5 of 7 days at baseline -足 Live < 12 miles of CNRC Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 10. Measures ≒ Child accelerometers -足 Device that objectively measure PA ≒ Worn 7 days at each of 5 time intervals ≒ Child received Wii console if provided all measures Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 11. Sample Characteristics Ethnicity African American 46% White 12% Hispanic 4% Other 7% MulGple 31% - Age (x + sd) (years) 11.2 + 1.2 Gender Male 52% Female 48% BMI%Gle 77.8% Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 12. Sample Loss Treatment Control Total lost due to End 41 37 Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 13. Frequency Distribution of Not Safe Neighborhood Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 14. Mean Levels of In/Activities for trt & ctl Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 15. There was no significant interaction term with perceived neighborhood safety Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 16. Mean, SD and SE on time spent in active and inactive video games for each group separately at each time interval Ac2ve Game Inac2ve Game Group Week n Mean Std Mean Std Control Week 1 37 6.47 24.17 27.21 33.89 Week 6 37 8.16 24.10 21.23 29.48 Week 7 37 1.93 8.85 59.73 87.51 Week 12 37 6.17 18.95 17.38 35.54 Treatment Week 1 41 28.14 31.49 3.75 15.57 Week 6 41 12.03 13.26 5.53 14.92 Week 7 41 21.10 24.25 4.18 13.42 Week 12 41 7.86 10.23 2.57 8.42 Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 17. Challenges in Matching Wii Record w/Game Log Wii LOG Matched Games we O鍖ered Games we Did TOTAL Y/N # of Cases Not O鍖er A A Yes 521 98 619 I I 560 159 749 A I No 3 1 4 I A 42 5 47 Wii Only No 1169 109 1278 LOG Only 416 66 482 Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 18. Conclusions ≒ Children obtaining Wii console and two active Wii video games did not participate in increased PA over those receiving two inactive Wii video games ≒ Children receiving the active Wii games and living in an unsafe neighborhood did not participate in increased PA over those in safe neighborhoods ≒ What could be done with active video games to increase the level of PA? And maintain it? Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 19. Strengths of the Study ≒ Random assignment to condition ≒ Objective measure of PA for multiple days at 5 time intervals ≒ High maintenance rage ≒ High complete data Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 20. Limitations/Weaknesses ≒ Modest sample ≒ Only in Houston ≒ Some cross-game contamination ≒ (but naturalistic in circumstances) ≒ Could not link accelerometry data with time of active game play ≒ Findings do not generalize to other ages ≒ Findings do not generalize to other AVG systems Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 21. Wii Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 22. Collaborators (in alphabetical order) ≒ Dina Abdelsamad ≒ Ester Cerin, PhD ≒ Janice Baranowski, ≒ Ann Chen, PhD MPH, RD ≒ Teresia OConnor, MD, ≒ Tony Barnett, PhD MPH ≒ Felica Bradford, BIT ≒ Debbe Thompson, PhD Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 23. D棚kuji! (Czeck) DANKE! (German) MUITO OBRIGADO! (Portuguese) M GI! (Chinese, Cantonese) ARIGAT! (Japanese) MERCI BEAUCOUP!(French) MUCHAS GRACIAS! (Spanish) SERDECZNIE DZIKUJ! (Polish) SHUKRAN! (Arabic, Middle East) TACK SMYCKET! (Swedish) TAKK! (Norwegian) EFCHARISTO! (GREEK) Xie Xie! (Chinese, Mandarin) Dank u wel (Dutch) Khawp Khun maxh! (Thai) Grazie! (Italian) Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 24. The effect of group and time on average minutes per day ≒ aThere was a significant week effect for sedentary minutes[F=26.31, p<.0001]. The week effect indicates that Week 6 was significantly different from baseline, Week 1, Week 7 and Week 12. Sedentary minutes at Week 6 were higher than at baseline, Week 1, Week 7 and Week 12. Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 25. Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 26. Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 27. Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM
  • 28. Pediatrics Games for Health Wednesday, May 18, 2011 5:30-足6:00 PM