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Open Access Highly Accessed Study protocol

Active video games as a tool to prevent excessive weight gain in adolescents: rationale, design and methods of a randomized controlled trial

Monique Simons123*, Mai JM Chinapaw24, Maaike van de Bovenkamp1, Michiel R de Boer1, Jacob C Seidell1, Johannes Brug5 and Emely de Vet6

Author Affiliations

1 Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

2 Body@Work, Research Center Physical Activity, Work and Health, TNO- VU/VUmc, VU University Medical Center, Amsterdam, The Netherlands

3 TNO, Expertise Centre Life Style, Leiden, The Netherlands

4 Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

5 Department of Epidemiology & Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

6 Chairgroup Strategic Communication, Sub-department Communication, Philosophy and Technology: Centre for Integrative Development, Wageningen University and Research Centre, Wageningen, The Netherlands

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BMC Public Health 2014, 14:275  doi:10.1186/1471-2458-14-275

Published: 24 March 2014



Excessive body weight, low physical activity and excessive sedentary time in youth are major public health concerns. A new generation of video games, the ones that require physical activity to play the games –i.e. active games- may be a promising alternative to traditional non-active games to promote physical activity and reduce sedentary behaviors in youth. The aim of this manuscript is to describe the design of a study evaluating the effects of a family oriented active game intervention, incorporating several motivational elements, on anthropometrics and health behaviors in adolescents.


The study is a randomized controlled trial (RCT), with non-active gaming adolescents aged 12 – 16 years old randomly allocated to a ten month intervention (receiving active games, as well as an encouragement to play) or a waiting-list control group (receiving active games after the intervention period). Primary outcomes are adolescents’ measured BMI-SDS (SDS = adjusted for mean standard deviation score), waist circumference-SDS, hip circumference and sum of skinfolds. Secondary outcomes are adolescents’ self-reported time spent playing active and non-active games, other sedentary activities and consumption of sugar-sweetened beverages. In addition, a process evaluation is conducted, assessing the sustainability of the active games, enjoyment, perceived competence, perceived barriers for active game play, game context, injuries from active game play, activity replacement and intention to continue playing the active games.


This is the first adequately powered RCT including normal weight adolescents, evaluating a reasonably long period of provision of and exposure to active games. Next, strong elements are the incorporating motivational elements for active game play and a comprehensive process evaluation. This trial will provide evidence regarding the potential contribution of active games in prevention of excessive weight gain in adolescents.

Trial registration

Dutch Trial register NTR3228.

Video games; Active games; Exergames; Physical activity; Sedentary lifestyle; Adolescent; Prevention; Excessive body weight; Overweight; Randomized controlled trial