title: Effects of open-loop feedback on physical activity and television viewing in overweight and obese children: a randomized, controlled trial.
abstract: OBJECTIVE
  Television viewing and physical inactivity increase the risk of obesity in youth. Thus, identifying new interventions that increase physical activity and reduce television viewing would be helpful in the prevention and treatment of pediatric obesity. This study evaluated the effects of open-loop feedback plus reinforcement versus open-loop feedback alone on physical activity, targeted sedentary behavior, body composition, and energy intake in youth.
  
  
  METHODS
  Thirty overweight or obese 8- to 12-year-old children were randomly assigned to an intervention (n = 14) or control group (n = 16). Participants wore accelerometers every day for 8 weeks and attended biweekly meetings to download the activity monitors. For children in the open-loop feedback plus reinforcement (intervention) group, accumulating 400 counts of physical activity on pedometers earned 1 hour of television/VCR/DVD time, which was controlled by a Token TV electronic device. Open-loop feedback control subjects wore activity monitors but had free access to targeted sedentary behavior.
  
  
  RESULTS
  Compared with controls, the open-loop feedback plus reinforcement group demonstrated significantly greater increases in daily physical activity counts (+65% vs +16%) and minutes per day of moderate-to-vigorous physical activity (+9.4 vs +0.3) and greater reductions in minutes per day spent in television viewing (-116.1 vs +14.3). The intervention group also showed more favorable changes in body composition, dietary fat intake, and energy intake from snacks compared with controls. Reductions in sedentary behavior were directly related to reductions in BMI, fat intake, snack intake, and snack intake while watching television.
  
  
  CONCLUSIONS
  Providing feedback of physical activity in combination with reinforcing physical activity with sedentary behavior is a simple method of modifying the home environment that may play an important role in treating and preventing child obesity.
authors.affiliation: Research Institute, Children's Hospital of Eastern Ontario, Mental Health Research, 401 Smyth Rd, Ottawa, Ontario, Canada K1H 8L1. ggoldfield@cheo.on.ca
authors.forename: Gary S
authors.initials: GS
authors.lastname: Goldfield
authors.forename: Risa
authors.initials: R
authors.lastname: Mallory
authors.forename: Torrey
authors.initials: T
authors.lastname: Parker
authors.forename: Terrell
authors.initials: T
authors.lastname: Cunningham
authors.forename: Christine
authors.initials: C
authors.lastname: Legg
authors.forename: Andrew
authors.initials: A
authors.lastname: Lumb
authors.forename: Kasey
authors.initials: K
authors.lastname: Parker
authors.forename: Denis
authors.initials: D
authors.lastname: Prud'homme
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gaboury
authors.forename: Kristi B
authors.initials: KB
authors.lastname: Adamo
mesh_terms: D001521:Behavior Therapy; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D002149:Energy Intake; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D050177:Overweight; D012056:Reinforcement, Social; D013690:Television