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Randomized Controlled-Trial

Obesity prevention in low socioeconomic status urban African-American adolescents: study design and preliminary findings of the HEALTH-KIDS Study

Jason Rutter - Mon, 09/04/2007 - 11:33
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Objectives: Obesity prevention among children and adolescents is a public health priority; however, limited school-based intervention trials targeting obesity have been conducted. This article provides an overview of the study design and baseline preliminary findings of our ongoing school-based intervention study. Design: Randomized intervention trial to test a school-based, environmental obesity prevention program in urban low socioeconomic status (SES) African-American adolescents. The intervention program was developed based on several behavioral theories and was guided by preliminary findings based on focus group discussion and baseline data. Setting: Four Chicago public schools in the US. Subjects: Over 450 5 - 7th graders and their families and schools were involved. Results: Our baseline data indicate a high prevalence of overweight (43% in boys and 41% in girls) and a number of problems in these children's physical activity and eating patterns. Only 26% reported spending >= 20 min engaged in vigorous-moderate exercise in >= 5 days over the past 7 days; 29% reported spending >= 5 h each day watching TV, playing video games, or using computer. They also consumed too many fried foods and soft drinks. On average, 55% consumed fried foods >= 2 times/day over the past 7 days; regarding soft drinks, 70% reported consuming >= 2 times/day. Conclusion: School-based obesity prevention programs are urgently needed in the target US urban, low SES, minority communities. These data can be used to inform intervention activities.

Media literacy for clinicians and parents

Jason Rutter - Mon, 09/04/2007 - 11:06
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Families and children are in the midst of a media revolution. Television, Internet access, instant messaging, cell phones, and interactive video games are delivering more information for more hours than ever in history. Exposure is occurring at younger and younger ages, often without parental oversight or interpretation. The impact on children is just beginning to be studied. Does media exposure prepare children for the world in which they live or deprive them of critical developmental opportunities? Does the steady display of violence contribute to violent behavior? This article presents a developmental context, discusses the research conducted to date, reviews the recommendations of major organizations, and tries to take a balanced perspective in the midst of a rising tide of media, technology; commercialism, and controversy.

Distraction with a hand-held video game reduces pediatric preoperative anxiety

Jason Rutter - Wed, 21/03/2007 - 17:18
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Background : Video games have received widespread application in health care for distraction and behavior modification therapy. Studies on the effect of cognitive distraction during the preoperative period are lacking. We evaluated the efficacy of an interactive distraction, a hand-held video game (VG) in reducing preoperative anxiety in children. Methods: In a randomized, prospective study of 112 children aged 4-12 years undergoing outpatient surgery, anxiety was assessed after admission and again at mask induction of anesthesia, using the modified Yale Preoperative Anxiety Scale (mYPAS). Postoperative behavior changes were assessed with the Posthospital Behavior Questionnaire (PHBQ). Patients were randomly assigned to three groups: parent presence (PP), PP + a hand-held VG, and PP + 0.5 mg.kg(-1) oral midazolam (M) given > 20 min prior to entering the operating room. Results: There was a statistically significant increase in anxiety (P < 0.01) in groups M and PP at induction of anesthesia compared with baseline, but not in VG group. VG patients demonstrated a decrease in anxiety from baseline (median change in mYPAS -3), the difference compared with PP (+11.8) was significant (P = 0.04). The change in anxiety in the M group (+7.3) was not statistically different from other groups. Sixty-three percent of patients in VG group had no change or decrease in anxiety after treatment, compared with 26% in M group and 28% in PP group (P = 0.01). There was no difference in anxiety changes between female and male patients. Conclusions: A hand-held VG can be offered to most children as a low cost, easy to implement, portable, and effective method to reduce anxiety in the preoperative area and during induction of anesthesia. Distraction in a pleasurable and familiar activity provides anxiety relief, probably through cognitive and motor absorption.

Helping parents reduce children's television viewing

Jason Rutter - Fri, 09/03/2007 - 21:11
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Parents and educators around the country are concerned about the amount of time children watch television. Part of this concern stems from the fact that a considerable amount of violence is regularly portrayed on television. In addition, those youngsters who watch an excessive amount of television have little time for developing other interests and hobbies. Using simple electronic principles and behavior modification, a research team at DePaul University has developed several procedures to wean children off television. This research involved dispensing tokens to children after they had engaged in a period of prosocial behavior. Children's television viewing decreased after being provided these interventions, and follow-up data suggested that changes were maintained over time. The interventions and devices reviewed in this article are practical ways of empowering parents to have more influence on their children's television viewing.

Video game-based exercises for balance rehabilitation: A single-subject design

Jason Rutter - Fri, 09/03/2007 - 20:21
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New entry in Digiplay games research bibliography:

Objectives: To investigate whether coupling foot center of pressure (COP)-controlled video games to standing balance exercises will improve dynamic balance control and to determine whether the motivational and challenging aspects of the video games would increase a subject's desire to perform the exercises and complete the rehabilitation process. Design: Case study, pre- and postexercise. Setting: University hospital outpatient clinic. Participants: A young adult with excised cerebellar tumor, 1 middle-aged adult with single right cerebrovascular accident, and I middle-aged adult with traumatic brain injury. Intervention: A COP-controlled, video game-based exercise system. Main Outcome Measures: The following were calculated during 12 different tasks: the number of falls, range of COP excursion, and COP path length. Results: Postexercise, subjects exhibited a lower fall count, decreased COP excursion limits for some tasks, increased practice volume, and increased attention span during training. Conclusions: The COP-controlled video game-based exercise regime motivated subjects to increase their practice volume and attention span during training. This in turn improved subjects' dynamic balance control.

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