BOOSTH: promoting physical activity in primary schools in combination with serious gaming

Physical inactivity is considered to be one of the ten principal risk factors
for death worldwide. Children need to perform one hour of daily
moderate-to-vigorous intensity physical activity whereof at least twice a week
these activities are of vigorous intensity. In 2010, the percentage of 4-11
year-old normoactive Dutch children was approximately 20%.Previous
interventions that aimed to increase childhood physical activity produced small
to negligible effects. One possible explanation is that individuals were not
intrinsically motivated towards physical activity during the intervention
period. Children spend a substantial amount of their time behind a game
consule. There are a number of applications that motivate increase in physical
activity in a fun way through engaging individuals in games that mix real and
computing worlds. These games became known as serious games. In this study we
want to investigate if BOOSTH can stimulate physical activity behaviour in
primary school children (grades 5th to 7th).

The primary aim of this study is to examine prospectively the effects of BOOSTH
on moderate to vigorous PA (MVPA) in primary school children (5th to 7th
grade).

The study design will be a randomized controlled trial regarding a physical
activity intervention. A 1:1 randomization will be applied with intervention
schools and matched control schools. The intervention school will recieve the
BOOSTH intervention. The intervention duration is 6 months. Measurements will
be performed at baseline and 3, 6 and 12 months after the start.

The investigational treatment is the BOOSTH physical activity intervention.
Children in the intervention school will start with the BOOSTH intervention on
top of the regular PE lessons. The child will receive the BOOSTH activity
tracker. The child (under supervision of the teacher) needs to download the
BOOSTH sync app and the BOOSTH game app. Therefore it is important that the
child or their parents has a device with Bluetooth. We will create a login
account for each child. After installing the apps, the activity tracker
measures step counts, which are translated into activity points. These activity
points will be used to unlock levels in the BOOSTH game app. The child
synchronizes their activity points, with Bluetooth connection, in the BOOSTH
sync app and immediately the child can open the BOOSTH game app to play a level
in the game. The child needs seven green lights (corresponding to 30 minutes of
performed physical activity) to unlock a level in the game. The first four
levels are for free, to gain the interests of the child, but thereafter the
child needs to be physically active to unlock the rest of the levels in the
game.

The intervention school receives the BOOSTH intervention that involves
strategies to promote physical activity throughout the day.

There are no associated risks in this study and the intervention is
non-invasive. We expect that the intervention can have beneficial effects for
the intervention population such as meeting the norm of physical activity, an
intrinsic motivation towards physical activity and an improved health status.
Measurements will be done four times (at baseline and 3,6 and 12months after
the start). Measurements will be performed during regular school time.
Children in the intervention school are allowed to keep BOOSTH after the
intervention period. Children in the control school will receive BOOSTH as a
compensation for their participation at the end the study.