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Rewarding Healthy Food Choices: a Mobile Serious Game Intervention in Adolescents (REWARD)

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ClinicalTrials.gov Identifier: NCT02622165
Recruitment Status : Completed
First Posted : December 4, 2015
Last Update Posted : May 26, 2016
Sponsor:
Collaborators:
Agentschap voor Innovatie door Wetenschap en Technologie
KU Leuven
Information provided by (Responsible Party):
University Ghent

Brief Summary:
The aim of this study is to conduct an outcome and process evaluation of the REWARD intervention, a serious game intervention using reward-based strategies as a main method to trigger healthy snacking in Flemish adolescents.

Condition or disease Intervention/treatment Phase
Nutrition Intervention Behavioral: The REWARD serious game intervention Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1463 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Rewarding Healthy Food Choices: a Mobile Serious Game Intervention Targeting Snacking Behaviours in Adolescents
Study Start Date : January 2016
Actual Primary Completion Date : April 2016
Actual Study Completion Date : May 2016

Arm Intervention/treatment
Experimental: The REWARD serious game intervention
A mobile 4-week serious game intervention will be administered.
Behavioral: The REWARD serious game intervention
The REWARD intervention is based on the dual process model incorporating strategies to influence both the automatic pathway (i.e., operant learning theory) and the conscious pathway (i.e., a focus on certain determinants). The central idea of the intervention will be that participants will earn credits in the game when scanning healthy (rather than unhealthy) snacks which will influence the advancement of the players in the game. This credit system will be related to the dietary quality index of the consumed snacks.
Other Name: REWARD

No Intervention: Control group
School curriculum as usual



Primary Outcome Measures :
  1. Change in the Healthy Snacking Index [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end) ]
    A healthy snacking index will be calculated based on a Food Frequency Questionnaire (FFQ). Snacks are in this study defined as all food items consumed outside (>30 min) of breakfast, lunch and dinner. The daily intake of each FFQ category will be obtained by multiplying the frequency of consumption with the quantity of consumption per week (g) divided by 7. These daily intakes will then be summed to obtain the daily intake of healthy snacks (g), and unhealthy snacks (g). The classification of snacks and drinks into healthy and unhealthy is based on the nutrient profiling model as developed by the UK NP Ofcom model (Lobstein et al. 2009). Finally a health index for snacks will be calculated: (gram healthy snacks / (gram healthy snacks + gram unhealthy snacks))*100.


Secondary Outcome Measures :
  1. Change in Body mass index [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end) ]
    Two trained research assistants will measure body height and weight according to a standardized protocol. Adolescents will be measured without shoes and will be allowed to wear light clothing, such as a t-shirt and shorts/short pants. Body height will be measured with a Seca Leicester Portable stadiometer with an accuracy of 0.1 cm. Weight will be measured with a calibrated electronic scale SECA 861 with an accuracy of 0.1 kg. Two readings of each measurement (weight and height) will be obtained to assure accuracy. If the two readings differed more than 1%, a third measurement will be taken. These three measurements will be recorded and the outlier will be excluded during the data cleaning process. Age- and gender-adjusted Body mass indexes will be calculated based on the mean of the two measurements.

  2. Change in awareness about healthy snacking [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end) ]
    Awareness about the healthiness of the adolescent's snacking behaviour will be assessed via one question with a five-point answer format.

  3. Change in attitude about healthy snacking [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end), ]
    Attitude will be measured with five items in which adolescents' opinion will be asked on statements linking healthy snacks to taste and health.

  4. Change in self-efficacy concerning healthy snacking [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end) ]
    Self-efficacy will be assessed via three items asking adolescents how hard it is to eat healthy snacks in general and in two more specific situations (at home, and at school).

  5. Change in knowledge about snacks [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end) ]
    Knowledge about the healthiness of specific snacks will be measured by means of a visual analog scale (VAS) of 10 cm. Zero and 10 cm extremes on the VAS will be defined as "very unhealthy" and "very healthy", respectively. The adolescents will need to rate all 28 snack items included in the newly developed FFQ on the VAS. Afterward the results will be compared with the actual score of the 28 snack items calculated by means of the UK NP Ofcom model (see above) and converted to 100.

  6. Change in habits concerning snacking [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end) ]
    Habit will be assessed by a four-item automaticity subscale (the 'Self-Report Behavioral Automaticity Index'; 'SRBAI' (based on the twelve-item Self-Report Habit Index (SRHI). This subscale was found to be reliable and sensitive to detect the habit-behavior association and moderation of the intention-behavior relationship in energy balance-related behavior domains. The twelve-item Self-Report Habit Index (SRHI) is the most popular habit measure of energy-balance related behaviors. This measure characterises habit by automatic activation, behavioral frequency, and relevance to self-identity. However, earlier empirical research suggested that the SRHI could be abbreviated with no losses in reliability or predictive utility as 'automaticity' has been suggested to be the 'active ingredient' of habit . In the SRBAI, four items are included to measure automaticity.

  7. Change in social influence of peers [ Time Frame: The outcome will be measured at the baseline (before start intervention), posttest (1-7 days after the intervention end) ]
    Items measuring perceived peers' snacking behavior, peers' social support, social pressure, and subjective norm regarding healthy snacks will be added. These items are based on valid and reliable items from the HELENA and ENERGY study.



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Ages Eligible for Study:   14 Years to 16 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion criteria:

  • Adolescents attending 3th and 4th grade of secondary school in Belgium (14- to 16- year olds)
  • Adolescents understanding Dutch.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02622165


Locations
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Belgium
Ghent University-Public Health Department
Ghent, East-Flanders, Belgium, 9000
Sponsors and Collaborators
University Ghent
Agentschap voor Innovatie door Wetenschap en Technologie
KU Leuven
Investigators
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Principal Investigator: Benedicte Deforche, PhD Ghent University - Department of Public Health
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: University Ghent
ClinicalTrials.gov Identifier: NCT02622165    
Other Study ID Numbers: SBO-120054
First Posted: December 4, 2015    Key Record Dates
Last Update Posted: May 26, 2016
Last Verified: May 2016
Keywords provided by University Ghent:
health promotion
nutrition
intervention
adolescents
serious game