Gamification on Obese Children’s BMI-derivative Outcomes, Physical Activity, and Sugar Sweetened Beverage Consumption Pubblico
Chang, Audrey (Spring 2020)
Abstract
Childhood obesity is a growing public health problem around the world. Mitigating this epidemic, especially through behavioral interventions, would aid not only children’s health but alleviate economic burdens. Challenges to interventions in children’s adiposity assessment are growing; secondary to these challenges, it is important to consider anthropometric measures such as body mass index (BMI kg/m2) and its derivatives (e.g., BMI z-score). Here, we examine the effects of gamification on children using such measures, assess the association between BMI/change in BMI with sugar sweetened beverage (SSB) consumption/number of steps, and apply longitudinal analysis of change in steps and SSB per day by week.
We leveraged a pre-existing dataset from the Children’s Hospital of Philadelphia and studied the effects of a gamification intervention by looking at the effects on daily steps, SSB consumption, weight, BMI, BMI z-score, BMI percentile and BMI % change in 10-16 years-olds. We tested within-arm and between-arm differences (arms are self-monitored, SM, and self-monitored plus gamification, SM + G). Correlation for change in steps and SSB consumption with change in BMI and Pre-Intervention BMI was also evaluated. Lastly, we fitted longitudinal mixed effect models for change in steps and SSB. For each model, arm, week, and their interaction plus a priori variables sex and age were included.
When using t-test, gamification effect was not significant for any of the BMI derivatives or weight (e.g. BMI mean(SD) = 0.665(1.588) in SM vs -0.187(1.077) in SM+G, p= 0.115). Additionally, there was no within-arm difference. Change in steps was not significant but change in SSB consumption was significant for weeks 3 and 6 when using a mixed model (week 3: 0.424(0.247) in SM vs -0.008(0.155) in SM+G, p= 0. 031; week 6: p= 0.015).
The only significant correlation was change in steps for SM week 3 (r = -0.939, p <0.001) vs change in BMI. For the model with change in steps as the outcome, mother’s education and income were considered statistically significant with arm, week, their interaction, sex, and age. For change in SSB, the model included variables arm, week, their interaction, sex, age, and mother’s employment.
Table of Contents
1. Introduction…………………………………………………………………………….………..1
2. Methods
2.1 Introduction to Dataset……………………………………………………………...…3
2.2 Creating Variables………………………………………………….…..……………...5
2.3 Independent & Paired T-tests………………………………………….……………….5
2.4 Pearson Correlation………………………………………………..…………………..7
2.5 Longitudinal Mixed Effects Model…………………………………………………….7
3. Results
3.1 Summary Statistics……………………………………………………..……………...9
3.2 Independent & Paired T-tests…………………………………………………….…...10
3.3 Pearson Correlation…………………………………………………………………..10
3.4 Longitudinal Mixed Effects Model…………………………………………………...11
4. Discussion………………………………………………………………………….…………..12
5. Tables & Figures………………………………………………………………..………………15
6. References……………………………………………………………………………………...29
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