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Background  Playing video games contributes substantially to sedentary behavior in youth. A new generation of video games—active games—seems to be a promising alternative to sedentary games to promote physical activity and reduce sedentary behavior. At this time, little is known about correlates of active and non-active gaming among adolescents.    Objective  The objective of this study was to examine potential personal, social, and game-related correlates of both active and non-active gaming in adolescents.    Methods  A survey assessing game behavior and potential personal, social, and game-related correlates was conducted among adolescents (12-16 years, N=353) recruited via schools. Multivariable, multilevel logistic regression analyses, adjusted for demographics (age, sex and educational level of adolescents), were conducted to examine personal, social, and game-related correlates of active gaming ≥1 hour per week (h/wk) and non-active gaming >7 h/wk.    Results  Active gaming ≥1 h/wk was significantly associated with a more positive attitude toward active gaming (OR 5.3, CI 2.4-11.8;  P <.001), a less positive attitude toward non-active games (OR 0.30, CI 0.1-0.6;  P =.002), a higher score on habit strength regarding gaming (OR 1.9, CI 1.2-3.2;  P =.008) and having brothers/sisters (OR 6.7, CI 2.6-17.1;  P <.001) and friends (OR 3.4, CI 1.4-8.4;  P =.009) who spend more time on active gaming and a little bit lower score on game engagement (OR 0.95, CI 0.91-0.997;  P =.04). Non-active gaming >7 h/wk was significantly associated with a more positive attitude toward non-active gaming (OR 2.6, CI 1.1-6.3;  P =.035), a stronger habit regarding gaming (OR 3.0, CI 1.7-5.3;  P <.001), having friends who spend more time on non-active gaming (OR 3.3, CI 1.46-7.53;  P =.004), and a more positive image of a non-active gamer (OR 2, CI 1.07–3.75;  P =.03).    Conclusions  Various factors were significantly associated with active gaming ≥1 h/wk and non-active gaming >7 h/wk. Active gaming is most strongly (negatively) associated with attitude with respect to non-active games, followed by observed active game behavior of brothers and sisters and attitude with respect to active gaming (positive associations). On the other hand, non-active gaming is most strongly associated with observed non-active game behavior of friends, habit strength regarding gaming and attitude toward non-active gaming (positive associations). Habit strength was a correlate of both active and non-active gaming, indicating that both types of gaming are habitual behaviors. Although these results should be interpreted with caution because of the limitations of the study, they do provide preliminary insights into potential correlates of active and non-active gaming that can be used for further research as well as preliminary direction for the development of effective intervention strategies for replacing non-active gaming by active gaming among adolescents.

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Personal, Social, and Game-Related Correlates of Active and Non-Active Gaming Among Dutch Gaming Adolescents: Survey-Based Multivariable, Multilevel Logistic Regression Analyses