The Adaptive GameSquad Xbox-Based Physical Activity and Health Coaching Intervention for Youth With Neurodevelopmental and Psychiatric Diagnoses: Pilot Feasibility Study.

April B Bowling,Marilyn Augustyn,Amanda E Staiano,Phillip Nauta,Aviva Must,Linda Bandini,Mediatrix Mbamalu,Robbie Beyl,James Slavet,Carol Curtin,Chelsea Hendrick

doi:10.2196/24566

Abstract

BackgroundThe prevalence of neurodevelopmental and psychiatric diagnoses (NPDs) in youth is increasing, and unhealthy physical activity (PA), diet, screen time, and sleep habits contribute to the chronic disease disparities and behavioral challenges this population experiences.ObjectiveThis pilot study aims to adapt a proven exergaming and telehealth PA coaching intervention for typically developing youth with overweight or obesity; expand it to address diet, screen, and sleep behaviors; and then test its feasibility and acceptability, including PA engagement, among youth with NPDs.MethodsParticipants (N=23; mean age 15.1 years, SD 1.5; 17 males, 9 people of color) recruited in person from clinic and special education settings were randomized to the Adaptive GameSquad (AGS) intervention or wait-list control. The 10-week adapted intervention included 3 exergaming sessions per week and 6 real-time telehealth coaching sessions. The primary outcomes included feasibility (adherence to planned sessions), engagement (uptake and acceptability as reported on process questionnaires), and PA level (combined light, moderate, and vigorous as measured by accelerometer). Descriptive statistics summarized feasibility and engagement data, whereas paired, two-tailed t tests assessed group differences in pre-post PA.ResultsOf the 6 coaching sessions, AGS participants (n=11; mean age 15.3 years, SD 1.2; 7 males, 4 people of color) completed an average of 5 (83%), averaging 81.2 minutes per week of exergaming. Of 9 participants who completed the exit questionnaire, 6 (67%) reported intention to continue, and 8 (89%) reported feeling that the coaching sessions were helpful. PA and sleep appeared to increase during the course of the intervention over baseline, video game use appeared to decrease, and pre-post intervention PA per day significantly decreased for the control (−58.8 min; P=.04) but not for the intervention group (−5.3 min; P=.77), despite potential seasonality effects. However, beta testers and some intervention participants indicated a need for reduced complexity of technology and more choice in exergames.ConclusionsAGS shows promise in delivering a health behavior intervention remotely to youth with NPDs, but a full-scale efficacy trial with a larger sample size is needed to confirm this finding. On the basis of feedback from beta testers and intervention participants, the next steps should include reduced technology burden and increased exergame choice before efficacy testing.Trial RegistrationClinicalTrials.gov NCT03665415; https://clinicaltrials.gov/ct2/show/NCT03665415.

Highlights

BackgroundMental health and the resultant adverse chronic disease consequences among youth are growing concerns in the United States
Several studies have found that children with autism spectrum disorder (ASD); attention-deficit/hyperactivity disorder (ADHD); and bipolar, depressive, and anxiety disorders are at high risk of low physical activity (PA) levels [5,6], poor diet [7], disrupted sleep [8,9], and elevated screen time [10]
Intervention participation appeared to positively affect the exercise stage of change; no treatment participants were in the active stage of exercise before the intervention, nearly 50% were in the active stage after the intervention conclusion

Summary

Introduction

BackgroundMental health and the resultant adverse chronic disease consequences among youth are growing concerns in the United States. The health disparities faced by children and youth with heterogeneous neurodevelopmental and psychiatric diagnoses (NPDs) are considerable and include a higher risk of obesity and type 2 diabetes [3], compared with typically developing youth. These disparities are at least partially attributable to unhealthy behavioral patterns established in childhood, patterns that often persist throughout life [4]. The prevalence of neurodevelopmental and psychiatric diagnoses (NPDs) in youth is increasing, and unhealthy physical activity (PA), diet, screen time, and sleep habits contribute to the chronic disease disparities and behavioral challenges this population experiences

Methods

Results

Discussion

Conclusion