Are activity-promoting video games an effective way for prevention of overweight in a family setting?

Playing traditional video games has been associated with an increased risk of
being overweight.
Thus, reduction of time spent playing traditional video games may be an
important strategy in weight
gain prevention. Further, playing activity-promoting video games have been
shown to have important
metabolic and physiological effects. Various studies have been conducted on the
energy expenditure of
activity-promoting video games. These studies have shown that playing novel
activity-promoting
video games indeed substantially increased energy expenditure. Substituting
sedentary game time with passive game time might be an innovative strategy in
weight gain prevention among adolescents, but randomized controlled trials on
the effects of activity-promoting video games are lacking. The potential of
activity-promoting video games as a
means of reducing the time spent in sedentary behaviors in order to prevent
weight gain remains
unknown. In this RCT the aims are to evaluate the positive and negative effects
of providing families with an activity-promoting video game (Dance Dance
Revolution) on sedentary
(video game) behavior, physical activity, consumption of snacks and
sugar-sweetened beverages, BMI, hip and waist circumference, and skinfold
thickness.

To evaluate the effects of providing families with an activity-promoting video
game on time spent playing
video games, physical and sedentary activities, consumption of snacks and
sugar-sweetened beverages
and objectively measured BMI, hip and waist circumference and skinfold
thickness a RCT will be
conducted. It is important to note that our aim is to substitute time spent in
traditional video games with
time spent in activity-promoting video games in order to prevent weight gain,
and not to introduce
activity-promoting video games in non-gaming families.

Eligible families who are willing to participate will be contacted by phone for
registering background
characteristics (family size, age, gender and education of family members). The
study will be explained
and an appointment for the baseline measurement will be made. After the
registration phone call,
randomization will take place at the family level stratified according to SES.
A total of 142 families in the
experimental group will receive an activity-promoting video game, and 142
families in the control group
will receive a traditional video game. These games will be delivered in a home
visit, during which also
baseline measurements of weight, height, hip and waist circumference, skinfold
thickness and
behavioral measures will be taken (T0). Post-tests will take place one (T1),
six (T2) and twelve (T3)
months after receiving the video game during home visits. Including a six and
twelve month follow-up
allows for examining the development of the motivation to play the game over
time.

Families who are assigned to the experimental group will receive the software
for the Dance Dance
Revolution (DDR) game and two DDR dance pads. DDR is available for a range of
consoles, e.g. Xbox
360 and Sony Playstation, and is relatively inexpensive. Families who are
assigned to the control group may choose a
game from a selection of traditional (sedentary) video games. The games will be
provided for free,
because it would be unethical to test the effect of an intervention in an RCT
for which the participants
have to pay. Both the intervention and control group families will receive the
game during the first home visit.

There is no additional risk for participants of this study and the potential
burden is minimal. Data will be collected four times during one year by means
of questionnaires and anthropometric measures.