GamerFit-ASD beta test: adapting an evidence-based exergaming and telehealth coaching intervention for autistic youth

Daniel P Hatfield; Aviva Must; Winston Kennedy; Amanda E Staiano; James Slavet; Rachael A Sabelli; Carol Curtin; Linda G Bandini; Phillip Nauta; Christopher Stuetzle; April B Bowling

doi:10.3389/fped.2023.1198000

GamerFit-ASD beta test: adapting an evidence-based exergaming and telehealth coaching intervention for autistic youth

Front Pediatr. 2023 Sep 5:11:1198000. doi: 10.3389/fped.2023.1198000. eCollection 2023.

Authors

Daniel P Hatfield¹, Aviva Must², Winston Kennedy^{3

4}, Amanda E Staiano⁵, James Slavet⁶, Rachael A Sabelli², Carol Curtin⁴, Linda G Bandini⁴, Phillip Nauta⁵, Christopher Stuetzle⁷, April B Bowling^{3

8}

Affiliations

¹ Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States.
² Department of Public Health and Community Medicine, Tufts University, Boston, MA, United States.
³ Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College, North Andover, MA, United States.
⁴ Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States.
⁵ Pennington Biomedical Research Center, Baton Rouge, LA, United States.
⁶ Marblehead Family Therapy and Wellness, Marblehead, MA, United States.
⁷ Department of Computer and Data Sciences, School of Science and Engineering, Merrimack College, North Andover, MA, United States.
⁸ Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States.

Abstract

Background: Health disparities faced by autistic youth are exacerbated by inadequate physical activity (PA) and sleep, whereas healthy PA and sleep may improve mood and function. Adaptive Game Squad (AGS) is an evidence-based telehealth coaching and exergaming intervention to improve PA and sleep for adolescents with diverse neurodevelopmental and psychiatric conditions. This study aimed to adapt AGS for autistic youth ages 10-15 years; beta-test the modified intervention for feasibility, accessibility, and engagement; and further refine the intervention for a larger planned demonstration pilot.

Methods: Interdisciplinary experts adapted AGS to create GamerFit-ASD, a 12-week intervention that included a progressive exergame schedule, Fitbit step-tracking, weekly health coaching, and health tip/exercise videos. For beta testing, the intervention was shortened to a 4-week trial with 5 parent/child dyads. Children completed exit surveys and parents and children were interviewed about intervention feasibility, accessibility, and engagement. Exit survey data were summarized with descriptive statistics. Qualitative data were analyzed using a modified grounded-theory approach.

Results: All participants (n = 5; ages 10-14 years) attended all 4 planned coaching sessions and completed an average of 9 of 12 planned exergame challenges for a weekly average of 50 min. All participants reported enjoying coaching sessions, 4 of 5 reported enjoying exergames, and 3 of 5 reported enjoying on-demand exercise videos. In interviews, children generally reported finding participation feasible, exergaming challenges active and fun, and coaches friendly and helpful. Parents reported high feasibility of supporting their children's involvement and valued child goal-setting and intervention flexibility; however, some found telehealth sessions overly scripted. Several adaptations to coaching scripts, coach training, and parent materials were made for the larger demonstration pilot, including changes to reduce scriptedness of coaching sessions, to provide parents with more information specific to autism, and to make video content more appropriate to children's needs/preferences.

Discussion: A telehealth coaching and exergaming intervention appears feasible, accessible, and engaging for autistic youth aged 10-15. Future studies with larger, more diverse samples, longer study durations and/or follow-up periods, and more rigorous study designs are needed to advance understanding of the appropriateness and effectiveness of this type of intervention for this population.

Keywords: autism spectrum disorder; exercise; exergaming; health promotion; physical activity; telehealth.

Grants and funding

This research was funded by a grant from the Deborah Munroe Noonan Memorial Research Fund and the Healthy Weight Research Network, Health Resources and Services Administration, and Maternal and Child Health Bureau, grant number UT4MC41898.