Effects of open-loop feedback on physical activity and television viewing in overweight and obese children: a randomized, controlled trial.
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.
Goldfield
Gary S
GS
Research Institute, Children's Hospital of Eastern Ontario, Mental Health Research, 401 Smyth Rd, Ottawa, Ontario, Canada K1H 8L1. ggoldfield@cheo.on.ca
Mallory
Risa
R
Parker
Torrey
T
Cunningham
Terrell
T
Legg
Christine
C
Lumb
Andrew
A
Parker
Kasey
K
Prud'homme
Denis
D
Gaboury
Isabelle
I
Adamo
Kristi B
KB
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