Behavior
Evaluating Efficacy and Adherence in Sensor-Based Technologies for Enhancing Children’s Physical Activity with the Virtual Fitness Buddy Ecosystem Tzu-Chun Chu* Tzu-Chun Chu Allan Tate Catherine Ball Joshua Baldwin Kyle Johnsen Michael Schmidt Neila Grimsley Sun joo Ahn
Modern digital technologies enable personalized, socially supportive, and cost-effective health interventions for children, potentially surpassing traditional methods. This study assessed the efficacy of the tablet-based Virtual Fitness Buddy (VFB) ecosystem on enhancing physical activity (PA).
A randomized control trial at three YMCA sites assigned participating families to an intervention with a tablet featuring a virtual dog for setting and sharing PA goals, or a control group with a regular tablet for syncing Fitbits. All children received Fitbits to track PA levels and sedentary behavior (SB). Hierarchical linear mixed models with random intercepts (site, child/parent) and slopes (observation day) evaluated the VFB ecosystem’s effect on PA and SB. Treatment-on-treated analyses measured adherence across four domains: goal achievement, review intervals, Fitbit usage, and virtual pet engagement. Latent profile analysis of these domains identified two distinct participant classes of overall intervention adherence.
The study comprised 17 control and 24 treatment families (41 adults, 41 children), with 16 in high adherence. Predominantly boys with a median age of 9, treatment groups were balanced demographically. No significant changes were observed in light/moderate activity or sedentary time between groups, but the treatment group had a 9.5-minute (95% CL: -11.42, -7.28) reduction in vigorous activity. High-adherence children in the treatment group, with more goal achievements, frequent reviews, longer Fitbit wear, and engaging play, showed an 11-minute (95% CL: 4.01, 18.41) increase in moderate physical activity compared to low-adherence peers.
The study emphasizes the need for holistic adherence assessments in digital interventions like the VFB ecosystem for boosting children’s physical activity in real-world, non-lab settings. The promise of digital interventions as a scalable behavioral intervention solution relies on user adherence to ecosystem features.