The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity

BackgroundHealth games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses 3 core topics of nutrition, physical activity, and stress coping. It is the first serious game that extensively targets the di...

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Main Authors: Mack, Isabelle, Reiband, Nadine, Etges, Carolin, Eichhorn, Sabrina, Schaeffeler, Norbert, Zurstiege, Guido, Gawrilow, Caterina, Weimer, Katja, Peeraully, Riyad, Teufel, Martin, Blumenstock, Gunnar, Giel, Katrin Elisabeth, Junne, Florian, Zipfel, Stephan
Format: Article
Language:English
Published: JMIR Publications 2020-04-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2020/4/e15725
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author Mack, Isabelle
Reiband, Nadine
Etges, Carolin
Eichhorn, Sabrina
Schaeffeler, Norbert
Zurstiege, Guido
Gawrilow, Caterina
Weimer, Katja
Peeraully, Riyad
Teufel, Martin
Blumenstock, Gunnar
Giel, Katrin Elisabeth
Junne, Florian
Zipfel, Stephan
author_facet Mack, Isabelle
Reiband, Nadine
Etges, Carolin
Eichhorn, Sabrina
Schaeffeler, Norbert
Zurstiege, Guido
Gawrilow, Caterina
Weimer, Katja
Peeraully, Riyad
Teufel, Martin
Blumenstock, Gunnar
Giel, Katrin Elisabeth
Junne, Florian
Zipfel, Stephan
author_sort Mack, Isabelle
collection DOAJ
description BackgroundHealth games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses 3 core topics of nutrition, physical activity, and stress coping. It is the first serious game that extensively targets the dietary energy density principle (DED-P) in relation to nutrition. The game is intended to provide an additional educational component for the prevention and treatment of obesity in children. ObjectiveThe Kids Obesity Prevention study aimed to evaluate the newly developed game and to evaluate how well children are able to understand and apply the DED-P. MethodsThis cluster randomized controlled trial collected data from 82 primary school children aged 9 to 12 years and their parents at baseline (T0), at 2 weeks after study commencement (T1), and at the 4-week follow-up (T2). The dropout rate was 3.6%. The intervention group (IG) played the game within 2 weeks (2 sessions with different game modules). One part of the game involves selection of food with the lower energy density when presented with a pair of foods. This allows assessment of whether the children have understood the DED-P and whether they can apply it to unknown foods under time pressure. The control group (CG) received a brochure about the food pyramid concept and physical activity. The primary outcome was the gain in knowledge (nutrition and stress coping) and measured with a pretested questionnaire. The secondary outcomes were the maintenance of knowledge, application of the DED-P, feelings during game play, game acceptance, and behavioral measures (physical activity, media consumption, and dietary intake). ResultsThe knowledge score ranging from 0 to 100 increased from T0 (IG: 53 [SD 10], CG: 50 [SD 11]) to T1 (IG: 69 [SD 11], CG: 52 [SD 12]) in IG versus CG (P<.001). At T2, the knowledge score of IG remained at the same level as that of T1. Game data showed that after DED-P education, the classification under time pressure of unknown versus known food pairs according to their DED category was similar (hit rate around 70%). Overall, 95% of the children liked the game very much or much. No group changes were observed at the behavioral level. ConclusionsThe Kids Obesity Prevention program sustainably increased knowledge in the areas of nutrition and stress coping, and children were able to apply the DED-P. Trial RegistrationClinicalTrials.gov NCT02551978; https://clinicaltrials.gov/ct2/show/NCT02551978
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spelling doaj.art-75e0f08fe779417692ff1907d126fa1e2022-12-21T20:12:05ZengJMIR PublicationsJournal of Medical Internet Research1438-88712020-04-01224e1572510.2196/15725The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood ObesityMack, IsabelleReiband, NadineEtges, CarolinEichhorn, SabrinaSchaeffeler, NorbertZurstiege, GuidoGawrilow, CaterinaWeimer, KatjaPeeraully, RiyadTeufel, MartinBlumenstock, GunnarGiel, Katrin ElisabethJunne, FlorianZipfel, StephanBackgroundHealth games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses 3 core topics of nutrition, physical activity, and stress coping. It is the first serious game that extensively targets the dietary energy density principle (DED-P) in relation to nutrition. The game is intended to provide an additional educational component for the prevention and treatment of obesity in children. ObjectiveThe Kids Obesity Prevention study aimed to evaluate the newly developed game and to evaluate how well children are able to understand and apply the DED-P. MethodsThis cluster randomized controlled trial collected data from 82 primary school children aged 9 to 12 years and their parents at baseline (T0), at 2 weeks after study commencement (T1), and at the 4-week follow-up (T2). The dropout rate was 3.6%. The intervention group (IG) played the game within 2 weeks (2 sessions with different game modules). One part of the game involves selection of food with the lower energy density when presented with a pair of foods. This allows assessment of whether the children have understood the DED-P and whether they can apply it to unknown foods under time pressure. The control group (CG) received a brochure about the food pyramid concept and physical activity. The primary outcome was the gain in knowledge (nutrition and stress coping) and measured with a pretested questionnaire. The secondary outcomes were the maintenance of knowledge, application of the DED-P, feelings during game play, game acceptance, and behavioral measures (physical activity, media consumption, and dietary intake). ResultsThe knowledge score ranging from 0 to 100 increased from T0 (IG: 53 [SD 10], CG: 50 [SD 11]) to T1 (IG: 69 [SD 11], CG: 52 [SD 12]) in IG versus CG (P<.001). At T2, the knowledge score of IG remained at the same level as that of T1. Game data showed that after DED-P education, the classification under time pressure of unknown versus known food pairs according to their DED category was similar (hit rate around 70%). Overall, 95% of the children liked the game very much or much. No group changes were observed at the behavioral level. ConclusionsThe Kids Obesity Prevention program sustainably increased knowledge in the areas of nutrition and stress coping, and children were able to apply the DED-P. Trial RegistrationClinicalTrials.gov NCT02551978; https://clinicaltrials.gov/ct2/show/NCT02551978https://www.jmir.org/2020/4/e15725
spellingShingle Mack, Isabelle
Reiband, Nadine
Etges, Carolin
Eichhorn, Sabrina
Schaeffeler, Norbert
Zurstiege, Guido
Gawrilow, Caterina
Weimer, Katja
Peeraully, Riyad
Teufel, Martin
Blumenstock, Gunnar
Giel, Katrin Elisabeth
Junne, Florian
Zipfel, Stephan
The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity
Journal of Medical Internet Research
title The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity
title_full The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity
title_fullStr The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity
title_full_unstemmed The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity
title_short The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity
title_sort kids obesity prevention program cluster randomized controlled trial to evaluate a serious game for the prevention and treatment of childhood obesity
url https://www.jmir.org/2020/4/e15725
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