How Long do Children Play Wii Active Video Games: An Experiment Presented at 2011 Games for Health Conference by Tom Baranowski, PhD Professor of Pediatrics (Behavioral Nutrition & PA) USDA/ARS Children’s Nutrition Research Center Baylor College of Medicine Houston, Texas, 77030, USA

1. How Long do Children
Games
for
Health
Wednesday,
May
18,
2011
5:30-­‐6:00
PM
Play Wii Active Video
Games:
An Experiment
Tom Baranowski, PhD
Professor of Pediatrics (Behavioral Nutrition & PA)
USDA/ARS Children’s 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-­‐6:00
PM

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

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

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

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

10. Measures
• Child accelerometers
-­‐ 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-­‐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-­‐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-­‐6:00
PM

13. Frequency Distribution of “Not Safe”
Neighborhood
Pediatrics
Games
for
Health
Wednesday,
May
18,
2011
5:30-­‐6:00
PM

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

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

17. Challenges in Matching Wii Record w/Game Log
Wii
LOG
Matched
Games
we
Offered
Games
we
Did
TOTAL
Y/N
#
of
Cases
Not
Offer
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-­‐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-­‐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-­‐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-­‐6:00
PM

21. Wii
Pediatrics
Games
for
Health
Wednesday,
May
18,
2011
5:30-­‐6:00
PM

22. Collaborators (in alphabetical order)
• Dina Abdelsamad • Ester Cerin, PhD
• Janice Baranowski, • Ann Chen, PhD
MPH, RD
• Teresia O’Connor, MD,
• Tony Barnett, PhD MPH
• Felica Bradford, BIT • Debbe Thompson, PhD
Pediatrics
Games
for
Health
Wednesday,
May
18,
2011
5:30-­‐6:00
PM

23. Dêkuji! (Czeck)
DANKE! (German)
MUITO
OBRIGADO!
(Portuguese)
M
G̀ÒI!
(Chinese,
Cantonese)
ARIGATŌ!
(Japanese)
MERCI BEAUCOUP!(French)
MUCHAS GRACIAS! (Spanish)
SERDECZNIE DZIĘKUJĘ!
(Polish)
SHUKRAN! (Arabic, Middle East)
TACK SÅMYCKET! (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-­‐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-­‐6:00
PM

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

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

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

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