Pediatric Obesity & Health Behavior
A Pennington Biomedical Research Center Laboratory
A Pennington Biomedical Research Center Laboratory
GamerFit is a series of studies stemming from the original GameSquad study, which indicated a 6-month at-home exercise program involving exergaming, Fitbit step monitoring, and telehealth coaching over video chats elicited high adherence and improved BMI z-score, cardiometabolic health, and physical activity levels among 10-12 year old children with overweight and obesity. GameSquad was then adapted to deliver to youth with autism spectrum disorder and other psychiatric diagnoses. Our team is collaborating with Dr. April Bowling of Merrimack College, Drs. Aviva Must and Dan Hatfield of Tufts University, and Drs. Linda Bandini and Carol Curtin of UMass Chan Medical School, on a pilot feasibility study "GamerFit-ASD: Engaging Children with Mental Health and Developmental Disabilities and their Parents to Adopt a Healthy Lifestyle: Piloting the Game Squad Home Exergaming and Virtual Health Coaching Intervention" funded by the Noonan Foundation. We are also partnered with Dr. April Bowling on an NICHD R21 "GamerFit: A Digital Interventon to Improve Physical Activity and Sleep Behaviors in Youth with Psychiatric Diagnoses" that began in March 2022 that will create an app to house the intervention components of GamerFit and test the app intervention in an RCT launching fall 2022.
Staiano AE, Beyl RA, Guan W, Hendrick CA, Hsia DS, Newton RL. Home-based exergaming among children with overweight and obesity: A randomized clinical trial. Pediatric Obesity 2018;13(11):724-733. Link to Paper
Bowling AB, Slavet J, Hendrick C, Beyl RA, Nauta P, Augustyn M, Mbamalu M, Curtin C, Bandini L, Must A, Staiano AE. The adaptive GameSquad Xbox-based physical activity and health coaching intervention for youth with neurodevelopmental and psychiatric diagnoses: Pilot feasibility study. JMIR Formative Research. 2021;5(5):e24566. Link to Paper
Bowling AB, Frazier JA, Staiano AE, Brodert-Fingert S, Curtin C. Presenting a new framework to improve engagement in physical activity programs for children and adolescents with social, emotional and behavioral disabilities. Frontiers in Psychiatry 2022;13:875181. Link to Paper
Title: A Pragmatic Family-Centered Approach to Childhood Obesity Treatment
Sponsor: PCORI PCS-2017C2-7542
Dual Principal Investigators: Denise Wilfley, Ph.D., and Stephen Cook, M.D.
Site Principal Investigator: Amanda Staiano, Ph.D.
Summary: To conduct a randomized comparative effectiveness trial to test the effectiveness of a 12-month, family-centered, scalable obesity treatment program delivered in primary care to underserved populations.
TEAM UP is no longer enrolling families in designated prmary care clinics in Louisiana.
Kennedy BM, Davison G, Fowler LA, Rodriguez-Guzman E, Collins ML, Baker A, Cook S, Lindros J, Wilfley DE, Zebrick A, Staiano AE. Perceptions of a pragmatic family-centered approach to childhood obesity and treatment. The Ochsner Journal. 2021, 21 (1) 30-40. Journal Link.
SUNRISE is an international study bringing together researchers from low, middle, and high income countries around the globe to measure physical activity, sedentary behavior, and sleep for children under the age of 5 years. The SUNRISE Coordinating Center is based at University of Wollongong, Australia. Dr. Staiano and Dr. Kip Webster of University of Tennessee lead the SUNRISE USA Site and are actively enrolling families of 3 and 4 year old children across the US to participate. Learn more here: https://sunrise-study.com/
Past Projects
Title: An Intervention to Improve Motor Skills in Young Children
Sponsor: NICHD R21HD095035
multiple Principal Investigators: Amanda E. Staiano, Ph.D. and E. Kip Webster, Ph.D.
Co-Investigators: Robert Newton Jr., Ph.D., Robbie Beyl, Ph.D.
Summary: To adapt and test a behavioral intervention delivered on a smartphone application (“app”) to parents of preschoolers, with the goal of using videos and instructional content to teach fundamental motor skill proficiency to their preschool-aged children. The overall goal was to examine if using an app to help parents develop their children’s fundamental motor skills is an acceptable and feasible approach to improve children’s motor skills. As exploratory outcomes, we examined if the children improve their confidence, physical activity levels, and self-regulation skills, which will contribute to the children’s physical health and academic readiness.
Staiano AE, Newton RL Jr, Beyl RA, Kracht CL, Hendrick CA, Viverito M, Webster EK. mHealth Intervention for motor skills: A randomized controlled trial. Pediatrics. 2022;149(5): e2021053362. PubMed Link.
Webster EK, Kracht CL, Newton RL Jr., Beyl RA, Staiano AE. Intervention to improve preschoolers’ fundamental motor skills: Protocol of a parent-focused, mobile app-based comparative effectiveness trial. JMIR Research Protocols. 2020 Oct 20;9(10):e19943. PubMed Link.
Title: Translational Investigation of Growth and Everyday Routine in Kids (TIGER Kids)
Sponsor: USDA
Principal Investigator: Amanda E. Staiano, Ph.D.
Co-Investigators: Robert Newton Jr., Ph.D., Peter Katzmarzyk, Ph.D., Stephanie Broyles, Ph.D., Catherine Champagne, Ph.D., RD, LDN
Medical Investigator: Daniel Hsia, M.D.
Summary: TIGER Kids enrolled 342 boys and girls ages 10 to 16 years from every weight category (normal weight, overweight, and obese). Researchers at Pennington Biomedical are using state-of-the-art technology, including activity trackers and global positioning system (GPS) information, to track physical activity, imaging to measure body fat, and messages sent through a mobile phone app (called ecological momentary assessment) to identify what motivates or prevents kids from being physically active. Participants attended an orientation session at Pennington Biomedical to learn about the study, sign consent and receive their activity tracking tools. These tools were returned at clinic visit approximately 1 week later. Assessments include body measurements, blood pressure, surveys, blood draw, dietary recall and body composition. Participants will repeat the activity monitor tracking and a second clinic visit 2 years later.
Data collection has ended. Some of our initial findings are reported below:
Kracht, CL, Beyl, R., Maher, J.P., Katzmarzyk, P.T. & Staiano, A.E. Adolescents’ sedentary behavior, affect, and contextual factors: An ecological momentary assessment study. International Journal of Behavioral Nutrition and Physical Activity. 2021;18(1):53. PubMed Link.
Kepper MM, Staiano AE, Katzmarzyk PT, Reis RS, Eyler AA, Griffith DM, Kendall ML, ElBanna B, Denstel KD, Broyles ST. Using mixed methods to understand women’s parenting practices related to their child’s outdoor play and physical activity among families living in diverse neighborhood environments. Health and Place. 2020;62:102292. PubMed Link.
Kracht CL, Katzmarzyk PT, Staiano AE. Comparison of Visceral Adipose Tissue Measurements in Adolescents using DXA and MRI. Int J Obes. 2020 Jun 4. doi: 10.1038/s41366-020-0621-8. PubMed Link.
Kracht CL, Champagne CM, Hsia DS, Martin CK, Newton RL, Katzmarzyk PT, Staiano AE. Association between meeting physical activity, sleep, and dietary guidelines and cardiometabolic risk factors and adiposity in adolescents. Journal of Adolescent Health. 2020 Jun;66(6):733-739. PubMed Link.
Kepper MM, Staiano AE, Katzmarzyk PT, Reis R, Eyler A, Griffith DM, Kendall M, ElBanna B, Denstel KD, Broyles ST. Neighborhood influences on women’s parenting practices for adolescents’ outdoor play: A qualitative study. International Journal of Environmental Research and Public Health. 2019;16(20):3853. PubMed Link.
Kracht CL, Chaput JP, Martin CK, Champagne CM, Katzmarzyk PT, Staiano AE. Associations of sleep with food cravings, diet, and obesity in adolescence. Nutrients. 2019 Nov 30;11(12):2899. PubMed Link.
Title: Painted Playgrounds: A scalable approach to increasing physical activity and motor skills in Louisiana preschool aged children
Sponsor: Blue Cross Blue Shield Foundation, American Council on Exercise
Investigators: Maura Kepper, Ph.D. (Lead Investigator), Amanda Staiano, Ph.D., Stephanie Broyles, Ph.D., Elizabeth ("Kip") Webster, Ph.D.
Summary: Preschool is a critical period during which children develop fundamental motor skills, build confidence in their movement, and start a physical activity trajectory that follows through adolescence and beyond. Unfortunately, few sustainable interventions have succeeded in increasing preschool children’s physical activity, and subsequently children are developing obesity at alarming rates. A simple, low-cost strategy is the addition of colorful markings (i.e. hopscotch, foursquare, fun trails) to existing playgrounds or open spaces. These “painted playgrounds” have been shown to be effective to increase physical activity in older school-aged children but remain understudied in preschool children. The proposed project will implement and test the effectiveness of a scalable playground stenciling intervention to increase physical activity and fundamental motor skills and decrease sedentary behaviors among preschool aged children attending childcare centers.
Four childcare centers participated in this study in spring 2019. Data collection is now closed.
Our Lifestyles, Our Lives
Title: Our Lifestyles, Our Lives: Obesity Treatment and Physical Activity Promotion for Underserved Children and Adolescents
Sponsor: American Council on Exercise and Franciscan Missionaries of Our Lady Foundation
Principal Investigator: Amanda E. Staiano, Ph.D.
Co-Investigators: Daniel Hsia, M.D., Peter Katzmarzyk, Ph.D., Robert Newton, Ph.D., Patrice Tyson, M.D., Savarra Mantzor, M.D.
Summary: The project aims to evaluate and adapt a 10-week pediatric obesity program delivered in a primary care provider clinical setting to increase the efficacy of achieving clinically significant weight loss in overweight and obese children. Main study outcomes are change in weight and body mass index (BMI) z-score. Secondary outcome variables include improvements in pedometer-assessed physical activity, quality of life, and physical activity enjoyment.
The research portion of this project has ended. Results are available here:
Staiano AE, Beyl RA, Hsia DS, Katzmarzyk PT, Mantzor S, Newton RL, Jarrell A, & Tyson P. Step tracking with goals increases children’s weight loss in a behavioral intervention. Childhood Obesity 2017;13(4):283-290. PubMed Link
Title: American Diabetes Association’s Project Power
Sponsor: American Council on Exercise, American Diabetes Association
Principal Investigator: Amanda E. Staiano, Ph.D.
Co-Investigator: Kathryn Lynn McKey, M.S.
Medical Investigator: Daniel Hsia, M.D.
Summary: The objective of this study is to evaluate the effects of a one week healthy lifestyle summer camp on children’s weight, self-reported health behaviors, quality of life, mood and feelings, self-esteem, weight management efficacy, enjoyment of physical activity, and body image, among children who are at risk for obesity and type 2 diabetes.
Data are being prepared to submit for publication. Preliminary results are available here:
Staiano AE, Dominique N, McKey K, Hebert C, Hendrick C, Hsia DS, Davis K, Martin M, Woolley R, Mueller K. Healthy lifestyle summer camp for children at risk for type 2 diabetes: Reductions in weight and screen-time usage. Poster presented at the Society of Behavioral Medicine, Washington, DC, March 8th, 2019.
Title: Gaming Technology to Encourage Healthy Weight and Activity in Youth
Sponsor: American Heart Association (Grant-in-Aid – Southeast Affiliate)
Principal Investigator: Amanda E. Staiano, Ph.D.
Co-Investigators: Robert Newton Jr., Ph.D.
Medical Investigator: Daniel Hsia, M.D.
Summary: The goal of this randomized controlled trial is to test the efficacy of exergaming, i.e. video gaming that involves physical activity, to reduce adiposity in overweight and obese children. The study is a 6-month, 2-arm randomized controlled trial among 46 overweight/obese children (aged 10 to 12 years) assigned to: 1) 3 hours/week of in-home exergaming or 2) a control group. An innovative aspect is the inclusion of a fitness trainer who will regularly videochat with the participant and virtually monitor gameplay. The primary aim is to test the hypothesis that after 6 months, children randomized to an exergaming-based physical activity intervention will decrease BMIz compared to a control group. Body fat and ideal health factors (i.e. blood pressure, total cholesterol, fasting glucose) and behaviors (i.e. physical activity, diet, and smoking status) will be investigated as secondary outcomes between baseline and month 6 of the intervention.
Results are available here:
Staiano AE, Beyl RA, Guan W, Hendrick CA, Newton RL. Home-based exergaming among children with overweight and obesity: A randomized clinical trial. Pediatric Obesity 2018;13(11):724-733.2018;13:724-733. Link to Paper
Pause & Play
Title: Physical Activity and Screen-Time Regulations in Child Care Centers: Influence on Young Children’s Health Behaviors
Partner Organization: Mayor's Healthy City Initiative
Sponsor: NIH National Institute on Minority Health and Health Disparities (U54MD008602), Gulf States Health Policy Center
Principal Investigator: Amanda E. Staiano, Ph.D.
Co-Principal Investigator: Andy Allen (Director of the Mayor's Healthy City Initiative; Community Outreach Coordinator for the Office of the Mayor-President)
Co-Investigator: Corby Martin, Ph.D.
Summary: Louisiana’s Department of Education (DOE) is implementing new regulations for children in childcare settings in 2015 to comply with national recommendations: 1) physical activity of at least 1 hour/day and 2) screen-time limited to 2 hours/day. The DOE is also providing extensive training and programmatic support to the centers. Together with the Office of the Mayor-President of Baton Rouge, we propose the following aims: 1) to examine the physical activity and screen-time environment of licensed childcare centers before and after the enactment of new state regulations; 2) to examine the physical activity and screen-time behaviors of children enrolled in childcare centers before and after the enactment of new state regulations; and 3) to establish community strategies to improve young children’s health behaviors.
Results are available here:
Staiano AE, Allen AT, Fowler W, Gustat J, Kepper MM, Lewis L, Martin CK, St. Romain J, Webster EK. State licensing regulations on screen-time in childcare centers: An impetus for participatory action research. Progress in Community Health Partnerships: Research, Education, and Action. 2018;12:101-109. Link to Paper
Staiano AE, Webster EK, Allen AT, Jarrell AR, Martin CK. Screen-time policies and practices in early care and education centers in relationship to child physical activity. Childhood Obesity. 2018;14(6):341-348. Link to Paper
Webster EK, Martin CK, Staiano AE. Fundamental motor skills, physical activity, and screen-time in preschoolers. Journal of Sport and Health Science. 2018. In press. Link to Paper
Kracht CL, Webster E, Staiano AE. A natural experiment of state-level physical activity and screen-time policy changes: Early childhood education (ECE) centers and child physical activity. BMC Public Health. 2020 Mar 24;20(1):387. PubMed Link.
Kracht CL, Webster EK, Staiano AE. Relationship between the 24-hour movement guidelines and fundamental motor skills in preschoolers. Journal of Science and Medicine in Sport. 2020 Dec;23(12):1185-1190. PubMed Link.
Joseph E, Kracht CL, St. Romain J, Allen AT, Barbaree C, Martin CK, Staiano AE. Young children’s screen-time and physical activity: Perspectives of parents and early care and education center providers. Global Pediatric Health. 2019 Jul 24;6:2333794X19865856. PubMed Link.
Webster EK, Martin CK, Staiano AE. Fundamental motor skills, physical activity, and screen-time in preschoolers. Journal of Sport and Health Science. 2019 Mar;8(2):114-121. PubMed Link.
Staiano AE, Webster EK, Allen AT, Jarrell AR, Martin CK. Screen-time policies and practices in early care and education centers in relationship to child physical activity. Childhood Obesity 2018 Aug/Sept;14(6):341-348. PubMed Link.
Staiano AE, Allen AT, Fowler W, Gustat J, Kepper MM, Lewis L, Martin CK, St. Romain J, Webster EK. State licensing regulations on screen-time in childcare centers: An impetus for participatory action research. Progress in Community Health Partnerships: Research, Education, and Action. 2018;12(1S):101-109. PubMed Link.
Project I-PAL
Title: An Interactive Physical Activity Lab Designed to Bring Real World Experiences to the Classroom and Support Healthy Development among Louisiana’s Children and Youth.
Sponsor: Louisiana Board of Regents (Undergraduate Enhancement Program)
Principal Investigator: Holly Kihm, Ph.D., Family & Consumer Sciences, Southeastern University
Co-Principal Investigator: Amanda E. Staiano, Ph.D.
Summary: The purpose of Project I-PAL (Interactive Physical Activity Lab) is to create a classroom space for the Family and Consumer Sciences program at Southeastern Louisiana University that will accommodate digital health technology and fitness equipment developed specifically for children and adolescents. The project serves a dual purpose of providing hands-on training experience for undergraduate students while laying a foundation for collaborative research opportunities.
Results are available here:
Staiano AE, Kihm HS, Sandoval P. The use of competition to elicit vigorous intensity physical activity during children's exergame play. Journal of Family & Consumer Sciences. 2018;110(3):39-47. Link to Paper
Sandoval P, Staiano AE, Kihm H. The influence of visual and auditory stimuli on intensity of physical activity in school-aged children. The Physical Educator. In Press.
Kihm H, Staiano AE, Sandoval P. Southeastern’s Family and Consumer Sciences launches Project IPAL to enhance the well-being of elementary school children. Journal of Family & Consumer Sciences. 2017;109(1):54-56. Link to Paper
Pediatric Obesity MiniCoIIN: Screen Time Project
Title: Pediatric Obesity Mini Collaborative Improvement and Innovation Network Project
Sponsor: Association of State Public Health Nutritionists
Project Team: Leslie Lewis, MPH, RD, Lisa Brochard, Kate Holmes, MPH, Amanda E. Staiano, Ph.D.
Summary: This project is a collaboration with the Louisiana Department of Education and the Louisiana Department of Health and Hospitals and seeks to insure that policies and practices affecting early care and education (ECE) facilities result in improved nutrition, and physical activity; and reduced screen time.
Improving Access to Pediatric Obesity Treatment
Title: Evidence-Based Childhood Obesity Treatment: Improving Access and Systems of Care
Sponsor: Agency for Healthcare Quality and Research (R13 HS022816)
Principal Investigator: Denise Wilfley, Ph.D.
Summary: The United States Preventive Services Task Force (USPSTF) recommends clinicians screen children aged 6 years and older for obesity and offer or refer them to intensive counseling and behavioral interventions to improve their weight status. However, few children are receiving the treatment they need and obesity remains a leading public health crisis. We propose a small conference to serve as an intensive meeting of thought-leaders and stakeholders with a shared investment in increasing access to effective, evidence-based childhood obesity treatment. Deliverables will be disseminated to the broader community of childhood obesity stakeholders, including researchers, clinicians, policymakers, and the public, through publication, presentation at national meetings and via targeted webinars, and use of partner organization member networks and advocacy channels. Dr. Staiano serves on the Steering Committee and Planning Committee, along with members of The Obesity Society and the American Academy of Pediatrics.
Publication:
Wilfley DE, Staiano AE, Altman M, Lindros J, Lima A, Hassink SG, Dietz WH, Cook S, & Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment Conference W. Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps. Obesity. 2017;25(1):16-29. PubMed Link
Klub Kinect: Social Exergaming for Healthy Weight in Adolescent Girls
Principal Investigator: Amanda E. Staiano, Ph.D.
Co-Investigators: Peter T. Katzmarzyk, Ph.D., Robert L. Newton Jr., Ph.D.
Medical Investigator: Daniel Hsia, M.D.
Project Manager: Arwen Marker, B.S.
To find out more about this study, click here.
ClinicalTrials.gov Identifier: NCT02003963
Project Summary: Klub Kinect was the pediatric pilot study for the Childhood Obesity & Diabetes Research Program at Pennington Biomedical. The purpose of Klub Kinect was to evaluate the feasibility of a 12-week exergaming dance program for adolescent girls. A dance-based exergame was selected because dance physical activity interventions have demonstrated acceptability and enjoyment by adolescent girls, most notably in the Stanford Girls’ health Enrichment Multi-site Studies (GEMS), which observed improved cardiometabolic health following a 2-year dance intervention. We aimed to determine the feasibility of recruiting, enrolling, and following overweight and obese adolescent girls in a 12-week exergaming program versus self-directed care. We also assessed changes in body weight, body fat, visceral adiposity, cardiovascular risk factors, physical activity, peer support, health-related quality of life, and self-efficacy towards exercise.
Results are available here:
Staiano AE, Marker AM, Beyl RA, Hsia DS, Katzmarzyk PT, Newton RN. A randomized controlled trial of dance exergaming for exercise training in overweight and obese adolescent girls. Pediatric Obesity. 2016; 12(2):120-128. PubMed Link
Staiano AE, Beyl RA, Hsia DS, Katzmarzyk PT, Newton RL. Twelve weeks of dance exergaming in overweight and obese adolescent girls: transfer effects on physical activity, screen-time, and self-efficacy. Journal of Sport and Health Science. 2017;6(1):4-10. Link to Paper
Staiano AE, Beyl RA, Hsia DS, Katzmarzyk PT, Newton RL. A 12-week randomized controlled pilot study of dance exergaming in a group: Influence on psychosocial factors in adolescent girls. Cyberpsychology: Journal of Psychosocial Research on Cyberspace. 2018;12(2). Link to Paper
Title: Sedentary behavior, eating disturbances, and weight gain in young adults
Sponsor: NIH National Institute of General Medical Sciences (#1U54GM104940-01), Louisiana Clinical & Translational Sciences Center (LA CaTS)
Principal Investigator: Amanda Staiano
Mentors: Peter Katzmarzyk, Corby Martin, Jennifer Rood
Brief Description: The goal of this Roadmap Scholar Award is to equip the Candidate with the necessary training and pilot data to support and statistically power a competitive R01 application to manipulate sedentary behaviors in order to reduce energy intake, improve eating behaviors, increase physical activity, and reduce excessive weight gain.
Results are available here:
Staiano AE, Marker AM, Martin CK, Katzmarzyk PT. Physical activity, mental health, and weight gain in a longitudinal observational cohort of nonobese young adults. Obesity. 2016;24(9):1969-1975. PubMed Link
Staiano AE, Martin CK, Champagne CM, Rood JC, Katzmarzyk PT. Sedentary time, physical activity, and adiposity in a longitudinal cohort of non-obese young adults. American Journal of Clinical Nutrition. 2018;108(5):946-952. Link to Paper
Title: Reducing Obesity and Diabetes Risks during Childhood: Planning Grant to Develop a Model Program for Implementation in Federally-Qualified Health Centers & School-Based Health Centers
Sponsor: Baptist Community Ministries
Co-Principal Investigators: Amanda E. Staiano, Ph.D., James Comeaux (Access Health Louisiana)
Summary: The work involved designing a model program to reduce risks for obesity and diabetes in children for implementation in federally-qualified health centers (FQHCs) and associated school-based health clinics. The work was conducted in collaboration with Access Health Louisiana, a FQHC operating in the New Orleans area.
Results are available here:
Staiano AE, Marker AM, Comeaux J, Frelier JM, Hsia DS, & Broyles ST. Family-based behavioral treatment for childhood obesity: Caretaker-reported barriers and facilitators. Ochsner Journal .2017;17(1):83-92. Link to Paper
