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Effect of an Active Video Gaming Classroom Curriculum on Health-Related Fitness, School Day Step Counts, and Motivation in Sixth Graders. J Phys Act Health 2018; 15:644-650. [PMID: 29741441 DOI: 10.1123/jpah.2017-0481] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to explore the effect of an active video gaming (AVG) classroom curriculum on health-related fitness, school day steps, and motivation in sixth graders. METHODS A convenience sample of 65 sixth graders were recruited from 2 classrooms from a school located in the Western United States. One classroom served as the comparison group (n = 32) that participated in active free play, and one classroom served as the intervention group (n = 33) that participated in an AVG curriculum for 30 minutes per day, 3 days per week, for 18 weeks. Cardiorespiratory endurance was assessed using Progressive Aerobic Cardiovascular Endurance Run laps. School day steps were recorded, and motivational variables were collected using questionnaires. Measures were collected at baseline and an 18-week posttest time point. RESULTS There was a significant group × time interaction for Progressive Aerobic Cardiovascular Endurance Run laps (b = 20.7 laps; 95% confidence interval, 14.6 to 26.8; P < .001). No statistically significant interactions were found for step counts or any of the motivational variables. CONCLUSIONS An 18-week AVG classroom curriculum improved cardiorespiratory endurance relative to the comparison group in sixth graders. This study supports the use of low-cost AVG curricula to improve the health-related fitness of youth.
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Myers ND, Dietz S, Prilleltensky I, Prilleltensky O, McMahon A, Rubenstein CL, Lee S. Efficacy of the Fun For Wellness Online Intervention to Promote Well-Being Actions: A Secondary Data Analysis. Games Health J 2018; 7:225-239. [PMID: 29708773 DOI: 10.1089/g4h.2017.0132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Fun For Wellness (FFW) is a new online intervention designed to promote growth in well-being by providing capability-enhancing learning opportunities (e.g., play an interactive game) to participants. The purpose of this study was to provide an initial evaluation of the efficacy of the FFW intervention to increase well-being actions. MATERIALS AND METHODS The study design was a secondary data analysis of a large-scale prospective, double-blind, parallel-group randomized controlled trial. Data were collected at baseline and 30 and 60 days postbaseline. A total of 479 adult employees at a major university in the southeast of the United States of America were enrolled. Participants who were randomly assigned to the FFW group were provided with 30 days of 24-hour access to the intervention. A two-class linear regression model with complier average causal effect estimation was fitted to well-being actions scores at 30 and 60 days. RESULTS Intent-to-treat analysis provided evidence that the effect of being assigned to the FFW intervention, without considering actual participation in the FFW intervention, had a null effect on each dimension of well-being actions at 30 and 60 days. Participants who complied with the FFW intervention, however, had significantly higher well-being actions scores, compared to potential compliers in the Usual Care group, in the interpersonal dimension at 60 days, and the physical dimension at 30 days. CONCLUSIONS Results from this secondary data analysis provide some supportive evidence for both the efficacy of and possible revisions to the FFW intervention in regard to promoting well-being actions.
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Affiliation(s)
- Nicholas D Myers
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
| | - Samantha Dietz
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Isaac Prilleltensky
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Ora Prilleltensky
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Adam McMahon
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Carolyn L Rubenstein
- 3 Department of Educational and Psychological Studies, University of Miami , Coral Gables, Florida
| | - Seungmin Lee
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
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Wickham CA, Carbone ET. What's technology cooking up? A systematic review of the use of technology in adolescent food literacy programs. Appetite 2018; 125:333-344. [PMID: 29471069 DOI: 10.1016/j.appet.2018.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 11/18/2017] [Accepted: 02/02/2018] [Indexed: 12/31/2022]
Abstract
Over one-third of adolescents are overweight or obese. Food literacy (FL), the ability to plan and manage, select, prepare, and eat healthy foods, is a contemporary concept that provides a mechanism to understand the relationship between food-related knowledge and skills and dietary intake. Innovative interventions which focus on the core concepts of FL and include generationally appropriate technology have the potential to provide positive impact on the dietary habits of adolescents. This systematic review followed PRISMA guidelines and employed the Downs and Black criteria for rating studies. Titles and abstracts of 545 articles were collected and reviewed from 13 electronic databases. Studies were selected if they were peer-reviewed, included adolescents 12-19 years-old, incorporated concepts related to FL, and employed technology as part of the intervention. Eight studies, six randomized controlled trials (RCT) and two interventions without controls were included. Seven of the interventions used Internet or web-based platforms to access program components and all RCTs incorporated game elements. Studies included between two and four constructs of FL. All reported positive changes in food intake with five reporting significant positive pre- and post-intervention changes. Few technology-driven FL-related studies exist within the literature. Although all studies reported improvements in dietary intake, due to variation in program design, delivery, and evaluation it is difficult to tease out the effect of the technology component. Continued research is needed to: 1) determine the degree to which FL should be included in interventions to effect a positive change on dietary intake; 2) develop adolescent-specific FL measures to more appropriately evaluate changes in knowledge, food-related skills, and dietary intake; and 3) design technology-driven interventions so that technology components can be analyzed separately from other program elements.
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Affiliation(s)
- Catherine A Wickham
- University of Massachusetts Amherst, School of Public Health and Health Sciences, Department of Nutrition, Amherst, MA, United States.
| | - Elena T Carbone
- University of Massachusetts Amherst, School of Public Health and Health Sciences, Department of Nutrition, Amherst, MA, United States
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Cates JR, Fuemmeler BF, Diehl SJ, Stockton LL, Porter J, Ihekweazu C, Gurbani AS, Coyne-Beasley T. Developing a Serious Videogame for Preteens to Motivate HPV Vaccination Decision Making: Land of Secret Gardens. Games Health J 2018; 7:51-66. [PMID: 29161529 PMCID: PMC5797321 DOI: 10.1089/g4h.2017.0002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Vaccination against human papillomavirus (HPV) is routinely recommended for ages 11-12, yet in 2016 only 49.5% of women and 37.5% of men had completed the three-dose series in the United States. Offering information and cues to action through a serious videogame for preteens may foster HPV vaccination awareness, information seeking, and communication. MATERIALS AND METHODS An iterative process was used to develop an interactive videogame, Land of Secret Gardens. Three focus groups were conducted with 16 boys and girls, ages 11-12, for input on game design, acceptability, and functioning. Two parallel focus groups explored parents' (n = 9) perspectives on the game concept. Three researchers identified key themes. RESULTS Preteens wanted a game that is both entertaining and instructional. Some parents were skeptical that games could be motivational. A back-story about a secret garden was developed as a metaphor for a preteen's body and keeping it healthy. The goal is to plant a lush secret garden and protect the seedlings by treating them with a potion when they sprout to keep them healthy as they mature. Points to buy seeds and create the potion are earned by playing mini-games. Throughout play, players are exposed to messaging about HPV and the benefits of the vaccine. Both boys and girls liked the garden concept and getting facts about HPV. Parents were encouraged to discuss the game with their preteens. CONCLUSION Within a larger communication strategy, serious games could be useful for engaging preteens in health decision making about HPV vaccination.
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Affiliation(s)
- Joan R. Cates
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Sandra J. Diehl
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laurie L. Stockton
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jeannette Porter
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Chioma Ihekweazu
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Arshya S. Gurbani
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tamera Coyne-Beasley
- NC Child Health Research Network, Division of General Pediatrics and Adolescent Medicine, University of North Carolina, Chapel Hill, North Carolina
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Abstract
As the field of games for health continues to gain momentum, it is crucial to document the field's scale of growth, identify design patterns, and to address potential design issues for future health game development. Few studies have explored the attributes and usability features of games for health as a whole over time. We offer the first comprehensive systematic content analysis of digital games for health by examining 1743 health games released between 1983 and 2016 in 23 countries extracted from nine international English health game databases and directories. The majority of these games were developed in the United States (67.18%) and France (18.59%). The most popular platforms included web browsers (72.38%) and Windows (14.41%). Approximately four out of five (79.12%) of the games were available at no cost. We coded 1553 accessible games for an in-depth analysis and further assessed 1303 for usability. Popular health topics represented included: cognitive training (37.41%), indirect health education (13.33%), and medical care provision (9.98%). Most games (75.66%) could be completed within 60 minutes. The main game usability problems identified included a lack of customization, nonskippable contents, and a lack of feedback and instruction to the players. While most of the usability problems have improved as did the software and hardware technology, the players' ability to skip nonplayable contents has become slightly more restricted overtime. Comparison with game efficacy publications suggested that a further understanding of the scope for games for health is needed on a global level.
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Affiliation(s)
- Amy Shirong Lu
- Health Technology Laboratory, Department of Communication Studies, College of Arts, Media & Design, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Hadi Kharrazi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Koo HC, Poh BK, Abd Talib R. The GReat-Child™ Trial: A Quasi-Experimental Intervention on Whole Grains with Healthy Balanced Diet to Manage Childhood Obesity in Kuala Lumpur, Malaysia. Nutrients 2018; 10:E156. [PMID: 29385769 PMCID: PMC5852732 DOI: 10.3390/nu10020156] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 01/16/2018] [Accepted: 01/18/2018] [Indexed: 11/19/2022] Open
Abstract
Background: The GReat-Child Trial was a quasi-experimental intervention that has emphasized whole grain as a strategy to manage childhood obesity. Methods: Two schools in Kuala Lumpur with similar demographic characteristics were assigned as intervention (IG) and control (CG). Eligibility criteria were overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming wholegrain foods in their 3-day diet-recall during screening were excluded. A total of 63 children (31 IG; 32 CG) completed the entire intervention program. The IG children underwent six 30-min nutrition education lessons and had school delivery of wholegrain food on a daily basis over a 12-week period. Parents of IG children attended 1-h individual diet counseling. Anthropometric outcomes including BMI-for-age z-score (BAZ), body fat percentage and waist circumference were measured at baseline [T0], post-intervention [T1] (3rd month) and follow-up [T2] (9th month). Results: IG showed significantly lower BAZ (weighted difference: -0.12; 95% CI: -0.21, -0.03; p = 0.009), body fat percentage (weighted difference: -2.6%; 95% CI: -3.7, -1.5; p < 0.001) and waist circumference (weighted difference: -2.4 cm; 95% CI: -3.8, -1.0; p = 0.001) compared to CG. IG reported significantly lower body fat percentage (weighted difference: -3.4%; 95% CI: 1.8, 5.0; p < 0.001) and waist circumference (weighted difference: -2.1 cm; 95% CI: -3.7, -0.5; p = 0.014) at T1 compared to T0. Conclusions: The GReat-Child Trial made a positive impact in managing childhood obesity. It can be incorporated into childhood obesity intervention programs that are being implemented by the policy makers.
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Affiliation(s)
- Hui Chin Koo
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, 50300 Kuala Lumpur, Malaysia.
| | - Bee Koon Poh
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
| | - Ruzita Abd Talib
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
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Rose T, Barker M, Jacob C, Morrison L, Lawrence W, Strömmer S, Vogel C, Woods-Townsend K, Farrell D, Inskip H, Baird J. A Systematic Review of Digital Interventions for Improving the Diet and Physical Activity Behaviors of Adolescents. J Adolesc Health 2017; 61:669-677. [PMID: 28822682 PMCID: PMC5702542 DOI: 10.1016/j.jadohealth.2017.05.024] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/08/2017] [Accepted: 05/18/2017] [Indexed: 02/03/2023]
Abstract
Many adolescents have poor diet and physical activity behaviors, which can lead to the development of noncommunicable diseases in later life. Digital platforms offer inexpensive means of delivering health interventions, but little is known about their effectiveness. This systematic review was conducted to synthesize evidence on the effectiveness of digital interventions to improve diet quality and increase physical activity in adolescents, to effective intervention components and to assess the cost-effectiveness of these interventions. Following a systematic search, abstracts were assessed against inclusion criteria, and data extraction and quality assessment were performed for included studies. Data were analyzed to identify key features that are associated with significant improvement in behavior. A total of 27 studies met inclusion criteria. Most (n = 15) were Web site interventions. Other delivery methods were text messages, games, multicomponent interventions, emails, and social media. Significant behavior change was often seen when interventions included education, goal setting, self-monitoring, and parental involvement. None of the publications reported cost-effectiveness. Due to heterogeneity of studies, meta-analysis was not feasible.It is possible to effect significant health behavior change in adolescents through digital interventions that incorporate education, goal setting, self-monitoring, and parental involvement. Most of the evidence relates to Web sites and further research into alternate media is needed, and longer term outcomes should be evaluated. There is a paucity of data on the cost-effectiveness of digital health interventions, and future trials should report these data.
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Affiliation(s)
- Taylor Rose
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom.
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit (University of Southampton),
Southampton General Hospital, Southampton UK SO16 6YD,NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust, University of Southampton, Southampton UK SO16
6YD
| | - Chandni Jacob
- Academic Unit of Human Development and Health, Faculty of Medicine,
University of Southampton, Southampton UK SO16 6YD
| | - Leanne Morrison
- Academic Unit of Psychology, University of Southampton, Southampton
UK SO17 1BJ
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Unit (University of Southampton),
Southampton General Hospital, Southampton UK SO16 6YD,NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust, University of Southampton, Southampton UK SO16
6YD
| | - Sofia Strömmer
- MRC Lifecourse Epidemiology Unit (University of Southampton),
Southampton General Hospital, Southampton UK SO16 6YD
| | - Christina Vogel
- MRC Lifecourse Epidemiology Unit (University of Southampton),
Southampton General Hospital, Southampton UK SO16 6YD,NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust, University of Southampton, Southampton UK SO16
6YD
| | - Kathryn Woods-Townsend
- NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust, University of Southampton, Southampton UK SO16
6YD,Southampton Education School, Faculty of Social and Human Sciences,
University of Southampton, Southampton UK SO17 1BJ
| | | | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit (University of Southampton),
Southampton General Hospital, Southampton UK SO16 6YD,NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust, University of Southampton, Southampton UK SO16
6YD
| | - Janis Baird
- MRC Lifecourse Epidemiology Unit (University of Southampton),
Southampton General Hospital, Southampton UK SO16 6YD,NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust, University of Southampton, Southampton UK SO16
6YD
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Maia EG, Mendes LL, Pimenta AM, Levy RB, Claro RM. Cluster of risk and protective factors for obesity among Brazilian adolescents. Int J Public Health 2017; 63:481-490. [PMID: 29143071 DOI: 10.1007/s00038-017-1053-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/17/2017] [Accepted: 11/06/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aims to identify and analyze clusters formed by risk and protective factors for obesity among Brazilian adolescents. METHODS Cross-sectional data collected in a national representative sample of adolescents by the Brazilian National School Health Survey of 2012 were used (n = 109,104). Cluster analysis was applied to identify clusters involving dietary intake, eating behavior, physical activity and sedentary behaviors. Logistic regression was employed to contextualize the clusters according to students' sociodemographics and schools' characteristics. RESULTS Two clusters were identified. Cluster 1 was predominantly characterized by the low frequency of both risk and protective factors for obesity; Cluster 2 was characterized by high frequency of both of these factors. None was essentially healthy or unhealthy. Adolescents from less developed regions and with mothers with lower education level were associated to Cluster 1. CONCLUSIONS The identification of two mixed clusters indicate wide spread obesity risk among scholars in the country. The association between the clusters and sociodemographic characteristics of the population allows a greater refinement of health promotion and obesity prevention and combat actions in Brazil.
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Affiliation(s)
- Emanuella Gomes Maia
- Graduate Program in Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Larissa Loures Mendes
- Nutrition Department, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Adriano Marçal Pimenta
- Department of Maternal Child Nursing and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Rafael Moreira Claro
- Nutrition Department, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Sparapani VDC, Fels S, Nascimento LC. The Value of Children's Voices for a Video Game Development in the Context of Type 1 Diabetes: Focus Group Study. JMIR Diabetes 2017; 2:e17. [PMID: 30291061 PMCID: PMC6238838 DOI: 10.2196/diabetes.7652] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Children with type 1 diabetes mellitus (T1DM) face daily challenges performing self-care tasks, controlling symptoms, and dealing with psychosocial issues. The use of video games to improve health is a successful support for persons with chronic diseases, promoting adequate self-management through simulations of real life. Involving future users in the development of games is essential to generating innovative, creative, and effective programs. OBJECTIVE Our goal is to identify what children with T1DM need to know about their disease and their self-care tasks as well as their preferences in video games. METHODS Children with T1DM provided input about their learning needs, self-care tasks, and preferences in video games. Three categories were identified through qualitative content analysis: dealing with emotions and knowledge, practical skills and awareness, and game preferences. RESULTS Children expressed concerns about the difficulties of self-care, lack of knowledge about diabetes, and lack of awareness about the consequences of behaviors related to self-care, which contribute to inappropriate behaviors and significantly impact self-management of their disease. They expressed enthusiasm for a video game for children with diabetes that considered their needs and preferences. CONCLUSIONS Findings support the potential benefits when children's input is considered in game design. Consideration of customer needs and preferences is a powerful resource in the development of video games with enhanced learning experience.
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Affiliation(s)
- Valéria de Cássia Sparapani
- Ribeirao Preto College of Nursing, World Health Organization Collaborating Centre for Nursing Research Development, Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Sidney Fels
- Electrical and Computer Engineering, Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, Canada
| | - Lucila Castanheira Nascimento
- Ribeirao Preto College of Nursing, World Health Organization Collaborating Centre for Nursing Research Development, Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
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Mead E, Brown T, Rees K, Azevedo LB, Whittaker V, Jones D, Olajide J, Mainardi GM, Corpeleijn E, O'Malley C, Beardsmore E, Al‐Khudairy L, Baur L, Metzendorf M, Demaio A, Ells LJ. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev 2017; 6:CD012651. [PMID: 28639319 PMCID: PMC6481885 DOI: 10.1002/14651858.cd012651] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Child and adolescent overweight and obesity has increased globally, and can be associated with significant short- and long-term health consequences. This is an update of a Cochrane review published first in 2003, and updated previously in 2009. However, the update has now been split into six reviews addressing different childhood obesity treatments at different ages. OBJECTIVES To assess the effects of diet, physical activity and behavioural interventions (behaviour-changing interventions) for the treatment of overweight or obese children aged 6 to 11 years. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS as well as trial registers ClinicalTrials.gov and ICTRP Search Portal. We checked references of studies and systematic reviews. We did not apply any language restrictions. The date of the last search was July 2016 for all databases. SELECTION CRITERIA We selected randomised controlled trials (RCTs) of diet, physical activity, and behavioural interventions (behaviour-changing interventions) for treating overweight or obese children aged 6 to 11 years, with a minimum of six months' follow-up. We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity. DATA COLLECTION AND ANALYSIS Two review authors independently screened references, extracted data, assessed risk of bias, and evaluated the quality of the evidence using the GRADE instrument. We contacted study authors for additional information. We carried out meta-analyses according to the statistical guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS We included 70 RCTs with a total of 8461 participants randomised to either the intervention or control groups. The number of participants per trial ranged from 16 to 686. Fifty-five trials compared a behaviour-changing intervention with no treatment/usual care control and 15 evaluated the effectiveness of adding an additional component to a behaviour-changing intervention. Sixty-four trials were parallel RCTs, and four were cluster RCTs. Sixty-four trials were multicomponent, two were diet only and four were physical activity only interventions. Ten trials had more than two arms. The overall quality of the evidence was low or very low and 62 trials had a high risk of bias for at least one criterion. Total duration of trials ranged from six months to three years. The median age of participants was 10 years old and the median BMI z score was 2.2.Primary analyses demonstrated that behaviour-changing interventions compared to no treatment/usual care control at longest follow-up reduced BMI, BMI z score and weight. Mean difference (MD) in BMI was -0.53 kg/m2 (95% confidence interval (CI) -0.82 to -0.24); P < 0.00001; 24 trials; 2785 participants; low-quality evidence. MD in BMI z score was -0.06 units (95% CI -0.10 to -0.02); P = 0.001; 37 trials; 4019 participants; low-quality evidence and MD in weight was -1.45 kg (95% CI -1.88 to -1.02); P < 0.00001; 17 trials; 1774 participants; low-quality evidence.Thirty-one trials reported on serious adverse events, with 29 trials reporting zero occurrences RR 0.57 (95% CI 0.17 to 1.93); P = 0.37; 4/2105 participants in the behaviour-changing intervention groups compared with 7/1991 participants in the comparator groups). Few trials reported health-related quality of life or behaviour change outcomes, and none of the analyses demonstrated a substantial difference in these outcomes between intervention and control. In two trials reporting on minutes per day of TV viewing, a small reduction of 6.6 minutes per day (95% CI -12.88 to -0.31), P = 0.04; 2 trials; 55 participants) was found in favour of the intervention. No trials reported on all-cause mortality, morbidity or socioeconomic effects, and few trials reported on participant views; none of which could be meta-analysed.As the meta-analyses revealed substantial heterogeneity, we conducted subgroup analyses to examine the impact of type of comparator, type of intervention, risk of attrition bias, setting, duration of post-intervention follow-up period, parental involvement and baseline BMI z score. No subgroup effects were shown for any of the subgroups on any of the outcomes. Some data indicated that a reduction in BMI immediately post-intervention was no longer evident at follow-up at less than six months, which has to be investigated in further trials. AUTHORS' CONCLUSIONS Multi-component behaviour-changing interventions that incorporate diet, physical activity and behaviour change may be beneficial in achieving small, short-term reductions in BMI, BMI z score and weight in children aged 6 to 11 years. The evidence suggests a very low occurrence of adverse events. The quality of the evidence was low or very low. The heterogeneity observed across all outcomes was not explained by subgrouping. Further research is required of behaviour-changing interventions in lower income countries and in children from different ethnic groups; also on the impact of behaviour-changing interventions on health-related quality of life and comorbidities. The sustainability of reduction in BMI/BMI z score and weight is a key consideration and there is a need for longer-term follow-up and further research on the most appropriate forms of post-intervention maintenance in order to ensure intervention benefits are sustained over the longer term.
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Affiliation(s)
- Emma Mead
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Tamara Brown
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
- Durham University Queen's CampusSchool of Medicine, Pharmacy and HealthDurhamUKTS17 6BH
| | - Karen Rees
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Liane B Azevedo
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Victoria Whittaker
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Dan Jones
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Joan Olajide
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Giulia M Mainardi
- School of Medicine, University of São PauloDepartment of Preventive MedicineSão PauloBrazilCEP 01246 903
| | - Eva Corpeleijn
- University Medical Centre GroningenDepartment of EpidemiologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Claire O'Malley
- Durham University Queen's CampusSchool of Medicine, Pharmacy and HealthDurhamUKTS17 6BH
| | | | - Lena Al‐Khudairy
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Louise Baur
- The University of SydneyDepartment of Paediatrics and Child HealthLocked Bag 4001WestmeadAustraliaNSW 2145
| | - Maria‐Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupMoorenstr. 5DüsseldorfGermany40225
| | | | - Louisa J Ells
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
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Mack I, Bayer C, Schäffeler N, Reiband N, Brölz E, Zurstiege G, Fernandez-Aranda F, Gawrilow C, Zipfel S. Chances and Limitations of Video Games in the Fight against Childhood Obesity-A Systematic Review. EUROPEAN EATING DISORDERS REVIEW 2017; 25:237-267. [PMID: 28467004 DOI: 10.1002/erv.2514] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/18/2016] [Accepted: 02/27/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE AND METHOD A systematic literature search was conducted to assess the chances and limitations of video games to combat and prevent childhood obesity. This search included studies with video or computer games targeting nutrition, physical activity and obesity for children between 7 and 15 years of age. RESULTS The study distinguished between games that aimed to (i) improve knowledge about nutrition, eating habits and exercise; (ii) increase physical activity; or (iii) combine both approaches. Overall, the games were well accepted. On a qualitative level, most studies reported positive effects on obesity-related outcomes (improvement of weight-related parameters, physical activity or dietary behaviour/knowledge). However, the observed effects were small. The games did not address psychosocial aspects. CONCLUSIONS Using video games for weight management exclusively does not deliver satisfying results. Video games as an additional guided component of prevention and treatment programs have the potential to increase compliance and thus enhance treatment outcome. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Carolin Bayer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Norbert Schäffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Nadine Reiband
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Ellen Brölz
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Guido Zurstiege
- Department of Media Studies, University of Tübingen, Tübingen, Germany
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN, ISCIII), Barcelona, Spain
| | - Caterina Gawrilow
- Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Joyner D, Wengreen HJ, Aguilar SS, Spruance LA, Morrill BA, Madden GJ. The FIT Game III: Reducing the Operating Expenses of a Game-Based Approach to Increasing Healthy Eating in Elementary Schools. Games Health J 2017; 6:111-118. [PMID: 28375645 DOI: 10.1089/g4h.2016.0096] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Previously published versions of the healthy eating "FIT Game" were administered by teachers in all grades at elementary schools. The present study evaluated whether the game would retain its efficacy if teachers were relieved of this task; presenting instead all game materials on visual displays in the school cafeteria. MATERIALS AND METHODS Participants were 572 children attending two Title 1 elementary schools (grades K-5). Following a no-intervention baseline period in which fruit and vegetable consumption were measured from food waste, the schools played the FIT Game. In the game, the children's vegetable consumption influenced events in a good versus evil narrative presented in comic book-formatted episodes in the school cafeteria. When daily vegetable-consumption goals were met, new FIT Game episodes were displayed. Game elements included a game narrative, competition, virtual currency, and limited player autonomy. The two intervention phases were separated by a second baseline phase (within-school reversal design). Simulation Modeling Analysis (a bootstrapping technique appropriate to within-group time-series designs) was used to evaluate whether vegetable consumption increased significantly above baseline levels in the FIT Game phases (P < 0.05). RESULTS Vegetable consumption increased significantly from 21.3 g during the two baseline phases to 42.5 g during the FIT Game phases; a 99.9% increase. The Game did not significantly increase fruit consumption (which was not targeted for change), nor was there a decrease in fruit consumption. CONCLUSION Labor-reductions in the FIT Game did not reduce its positive impact on healthy eating.
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Affiliation(s)
- Damon Joyner
- 1 Department of Nutrition, Dietetics, and Food Sciences, Utah State University , Logan, Utah
| | - Heidi J Wengreen
- 1 Department of Nutrition, Dietetics, and Food Sciences, Utah State University , Logan, Utah
| | - Sheryl S Aguilar
- 1 Department of Nutrition, Dietetics, and Food Sciences, Utah State University , Logan, Utah
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Wang JJ, Baranowski T, Lau PWC, Buday R, Gao Y. Story Immersion May Be Effective in Promoting Diet and Physical Activity in Chinese Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:321-329.e1. [PMID: 28391798 DOI: 10.1016/j.jneb.2017.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/22/2016] [Accepted: 01/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the effect of playing a health video game embedded with story immersion, Escape from Diab (Diab), on children's diet and physical activity (PA) and to explore whether children immersed in Diab had greater positive outcomes. DESIGN Two groups, nonrandomized; 3 outcome assessments: at baseline, immediately after the game (post 1), and 8-10 weeks after the game (post 2). PARTICIPANTS A total of 179 Chinese children aged 8-12 years. INTERVENTION The treatment group played Diab; the control group received no intervention. MAIN OUTCOME MEASURES Motivation; self-efficacy; preference for fruit, vegetables, water, and PA; as well as PA behavior. ANALYSIS Adjusted changes to post 1 and post 2 by ANCOVA controlling for demographic and baseline variables. RESULTS Children who played Diab had increased intrinsic motivation for fruit and water, self-efficacy for PA, and self-reported PA scores at post 1 (all P < .05). Children with higher immersion scores (above the median) had increased intrinsic motivation for fruit and water, and autonomous and controlled motivation for PA at post 1 (all P < .05). However, these were not significant at post 2. CONCLUSIONS AND IMPLICATIONS Diab provides a promising innovative medium for promoting Chinese children's psychological correlates of diet and PA and PA behavior. However, its maintenance of effectiveness needs to be enhanced and mechanisms of change need to be investigated more thoroughly.
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Affiliation(s)
- Jing Jing Wang
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China
| | - Tom Baranowski
- Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Patrick W C Lau
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China.
| | | | - Yang Gao
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China
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Garde A, Umedaly A, Abulnaga SM, Robertson L, Junker A, Chanoine JP, Ansermino JM, Dumont GA. Assessment of a Mobile Game ("MobileKids Monster Manor") to Promote Physical Activity Among Children. Games Health J 2017; 4:149-58. [PMID: 26181809 DOI: 10.1089/g4h.2014.0095] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The majority of children in North America are not meeting current physical activity guidelines. The purpose of this study was to evaluate the impact of a mobile phone game ("MobileKids Monster Manor") as a tool to promote voluntary physical activity among children. MATERIALS AND METHODS The game integrates data from an accelerometer-based activity monitor (Tractivity(®); Kineteks Corp., Vancouver, BC, Canada) wirelessly connected to a phone and was developed with the involvement of a team of young advisors (KidsCan Initiative: Involving Youth as Ambassadors for Research). Fifty-four children 8-13 years old completed a week of baseline data collection by wearing an accelerometer but receiving no feedback about their activity levels. The 54 children were then sequentially assigned to two groups: One group played "MobileKids Monster Manor," and the other received daily activity feedback (steps and active minutes) via an online program. The physical activity (baseline and intervention weeks) was measured using the activity monitor and compared using two-way repeated-measures analysis of variance (intervention×time). RESULTS Forty-seven children with a body mass index (BMI) z-score of 0.35±1.18 successfully completed the study. Significant (P=0.01) increases in physical activity were observed during the intervention week in both the game and feedback groups (1191 and 796 steps/day, respectively). In the game group, greater physical activity was demonstrated in children with higher BMI z-score, showing 964 steps/day more per BMI z-score unit (P=0.03; 95 percent confidence interval of 98 to 1829). CONCLUSIONS Further investigation is required to confirm that our game design promotes physical activity.
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Affiliation(s)
- Ainara Garde
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Aryannah Umedaly
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - S Mazdak Abulnaga
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Leah Robertson
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Anne Junker
- 2 Clinical and Population Studies at the Child & Family Research Institute , Vancouver, British Columbia, Canada
| | - Jean Pierre Chanoine
- 3 Endocrinology and Diabetes Unit, Department of Pediatrics, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - J Mark Ansermino
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada .,4 Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Guy A Dumont
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
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Beck AL, Lakkaraju K, Rai V. Small Is Big: Interactive Trumps Passive Information in Breaking Information Barriers and Impacting Behavioral Antecedents. PLoS One 2017; 12:e0169326. [PMID: 28099478 PMCID: PMC5242502 DOI: 10.1371/journal.pone.0169326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 12/15/2016] [Indexed: 11/18/2022] Open
Abstract
The wealth of information available on seemingly every topic creates a considerable challenge both for information providers trying to rise above the noise and discerning individuals trying to find relevant, trustworthy information. We approach this information problem by investigating how passive versus interactive information interventions can impact the antecedents of behavior change using the context of solar energy adoption, where persistent information gaps are known to reduce market potential. We use two experiments to investigate the impact of both passive and interactive approaches to information delivery on the antecedents (attitudes, subjective norms, and perceived behavioral control in the Theory of Planned Behavior) of intentions and behavior, as well as their effect on intentions and behavior directly. The passive information randomized control trial delivered via Amazon Mechanical Turk tests the effectiveness of delivering the same content in a single message versus multiple shorter messages. The interactive information delivery uses an online (mobile and PC) trivia-style gamification platform. Both experiments use the same content and are carried out over a two-week time period. Our findings suggest that interactive, gamified information has greater impact than passive information, and that shorter multiple messages of passive information are more effective than a single passive message.
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Affiliation(s)
- Ariane L. Beck
- LBJ School of Public Affairs, The University of Texas at Austin, Austin, TX, United States of America
- * E-mail:
| | | | - Varun Rai
- LBJ School of Public Affairs, The University of Texas at Austin, Austin, TX, United States of America
- Mechanical Engineering Department, The University of Texas at Austin, Austin, TX, United States of America
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Dias JD, Tibes CMDS, Fonseca LMM, Zem-Mascarenhas SH. USE OF SERIOUS GAMES FOR COPING WITH CHILDHOOD OBESITY: INTEGRATIVE LITERATURE REVIEW. TEXTO & CONTEXTO ENFERMAGEM 2017. [DOI: 10.1590/0104-07072017003010015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Objective: was to identify studies in the scientific literature in which the serious game is used as a strategy to prevent and/or treat childhood obesity. Method: an integrative review. The search in the databases resulted in 466 studies, 17 of which were elected for analysis. Results: the use of serious games for health promotion could positively influence children's health and promote behavior changes, as well as encourage healthier habits. Conclusion: the use of serious games can be a powerful strategy for child health education. Considering the use of technology by children, we believe in the potential of these resources to change this population's behavior, particularly with regard to childhood obesity.
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Baranowski T, Blumberg F, Gao Z, Kato PM, Kok G, Lu AS, Lyons EJ, Morrill BA, Peng W, Prins PJ, Snyder L, Staiano AE, Thompson D. Getting Research on Games for Health Funded. Games Health J 2016; 6:1-8. [PMID: 28026985 DOI: 10.1089/g4h.2016.0106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tom Baranowski
- 1 Department of Pediatrics, USDA/ARS Children's Nutrition Research Center , Baylor College of Medicine, Houston, Texas
| | - Fran Blumberg
- 2 Division of Psychological and Educational Services, Fordham University Graduate School of Education , New York, New York
| | - Zan Gao
- 3 School of Kinesiology, University of Minnesota , Minneapolis, Minnesota
| | - Pamela M Kato
- 4 Serious Games Institute, Coventry University , Coventry, United Kingdom
| | - Gerjo Kok
- 5 Department of Work and Social Psychology, Maastricht University , Maastricht, The Netherlands
| | - Amy S Lu
- 6 Department of Communication Studies, College of Arts, Media & Design; College of Health Sciences, Northeastern University , Boston, Massachusetts
| | - Elizabeth J Lyons
- 7 Department of Nutrition and Metabolism, The University of Texas Medical Branch , Galveston, Texas
| | | | - Wei Peng
- 9 Department of Media and Information, Michigan State University , East Lansing, Michigan
| | - Pier J Prins
- 10 Department of Developmental Psychology, University of Amsterdam , Amsterdam, The Netherlands
| | - Leslie Snyder
- 11 Department of Communication, Center for Health Intervention & Prevention, University of Connecticut , Storrs, Connecticut
| | - Amanda E Staiano
- 12 Pennington Biomedical Research Center, Louisiana State University , Baton Rouge, Louisiana
| | - Debbe Thompson
- 1 Department of Pediatrics, USDA/ARS Children's Nutrition Research Center , Baylor College of Medicine, Houston, Texas
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Lu AS, Baranowski T, Hong SL, Buday R, Thompson D, Beltran A, Dadabhoy HR, Chen TA. The Narrative Impact of Active Video Games on Physical Activity Among Children: A Feasibility Study. J Med Internet Res 2016; 18:e272. [PMID: 27742605 PMCID: PMC5086024 DOI: 10.2196/jmir.6538] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 09/21/2016] [Accepted: 09/22/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Active video games (AVGs) capable of inducing physical activity offer an innovative approach to combating childhood obesity. Unfortunately, children's AVG game play decreases quickly, underscoring the need to identify novel methods for player engagement. Narratives have been demonstrated to influence behaviors. OBJECTIVE The objective of this study was to test the hypothesis that a narrative would motivate increased AVG play, though a feasibility study that investigated the motivational effect of adding a previously developed narrative cutscene to an originally nonnarrative AVG, Nintendo Wii Sports Resort: Swordplay Showdown. METHODS A total of 40 overweight and obese 8- to 11-year-olds equally divided by sex played the AVG. Half (n=20) were randomly assigned to a narrative group that watched the narrative cutscene before game play. The other half played the game without watching it. RESULTS Children in the narrative group had significantly (P<.05) more steps per 10-second period (mean 3.2, SD 0.7) and overall (mean 523, SD 203) during game play compared with the nonnarrative group (10-second period: mean 2.7, SD 0.7; overall: mean 366, SD 172). CONCLUSIONS The AVG with narrative induced increased physical activity. Additional research is needed to understand the mechanisms through which narrative increases physical activity during AVG game play.
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Affiliation(s)
- Amy Shirong Lu
- College of Arts, Media & Design, Department of Communication Studies, Northeastern University, Boston, MA, United States.
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Howie EK, Straker LM. Rates of attrition, non-compliance and missingness in randomized controlled trials of child physical activity interventions using accelerometers: A brief methodological review. J Sci Med Sport 2016; 19:830-6. [DOI: 10.1016/j.jsams.2015.12.520] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/28/2015] [Accepted: 12/30/2015] [Indexed: 11/26/2022]
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St. George SM, Van Horn ML, Lawman HG, Wilson DK. Reliability of 24-Hour Dietary Recalls as a Measure of Diet in African-American Youth. J Acad Nutr Diet 2016; 116:1551-1559. [PMID: 27394936 PMCID: PMC5039054 DOI: 10.1016/j.jand.2016.05.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although it is a common practice to estimate dietary intake using three random 24-hour dietary recalls, some studies have suggested up to nine may be necessary to reliably estimate usual intake in youth. Given the resulting increase in resources and participant burden, more research is needed to determine whether this method is reliable, particularly in African-American youth at increased risk for obesity and other chronic diseases. OBJECTIVE This study estimated the reliability with which 24-hour dietary recalls measure energy, fat, fruit, and vegetable intake in African-American youth and examined how reliability changes as a function of the number of recalls. DESIGN This study used cross-sectional data collection across three studies. PARTICIPANTS/SETTING Participants were African-American youth (n=456, mean±standard deviation age 13.28±1.86 years, 64% were girls, mean±standard deviation body mass index [calculated as kg/m(2)] 31.45±7.94) who completed random 24-hour dietary recalls (67% completed three) conducted by research assistants using the Automated Self-Administered 24-Hour recall system (n=258) or registered dietitian nutritionists using the Nutrition Data System for Research (n=198). MAIN OUTCOME MEASURES/STATISTICAL ANALYSES Estimates provided by multilevel models were used to calculate the proportion of variance accounted for between individuals and the reliability of means within individuals as a function of the number of recalls. RESULTS Reliability estimates for assessing dietary outcomes using one to three recalls ranged from 11% to 62%. To achieve 80% reliability, the following number of recalls would need to be conducted: 8 for energy intake, 13 for fat intake, 21 to 32 for fruit intake, and 21 to 25 for vegetable intake. CONCLUSIONS The common practice of assessing dietary intake with three recalls does so with low reliability in African-American youth. Until more objective methods for reliably estimating usual intake are developed, researchers who choose to use 24-hour dietary recalls are encouraged to include estimates of the measure's reliability in a priori power calculations for improved decision making regarding the number of observations and/or sample size.
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Affiliation(s)
- Sara M. St. George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14 Street, Suite 1009, Miami, FL, 33136; 305-243-0726
| | - M. Lee Van Horn
- Department of Individual, Family, and Community Education, College of Education, University of New Mexico, MSC053040, 1 University of New Mexico, Tech 274, Albuquerque, NM 87106; 505-277-4535;
| | - Hannah G. Lawman
- Chronic Disease Prevention Division, Philadelphia Department of Health, 1101 Market Street, 9th floor, Philadelphia, PA 19107;
| | - Dawn K. Wilson
- Department of Psychology at the University of South Carolina, 1233 Washington Street, Columbia, SC 292021; 803-978-7500;
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Christensen J, Valentiner LS, Petersen RJ, Langberg H. The Effect of Game-Based Interventions in Rehabilitation of Diabetics: A Systematic Review and Meta-Analysis. Telemed J E Health 2016; 22:789-797. [DOI: 10.1089/tmj.2015.0165] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jan Christensen
- CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational Therapy and Physiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Laura Staun Valentiner
- CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Juelsgaard Petersen
- CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Langberg
- CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Spook J, Paulussen T, Kok G, van Empelen P. Evaluation of a Serious Self-Regulation Game Intervention for Overweight-Related Behaviors ("Balance It"): A Pilot Study. J Med Internet Res 2016; 18:e225. [PMID: 27670222 PMCID: PMC5057062 DOI: 10.2196/jmir.4964] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/25/2015] [Accepted: 03/29/2016] [Indexed: 02/03/2023] Open
Abstract
Background Serious games have the potential to promote health behavior. Because overweight is still a major issue among secondary vocational education students in the Netherlands, this study piloted the effects of “Balance It,” a serious self-regulation game intervention targeting students’ overweight-related behaviors: dietary intake and physical activity (PA). Objective We aimed to pilot the effects of Balance It on secondary vocational education students’ dietary intake and PA. Methods In total, 501 secondary vocational education students participated at baseline (intervention: n=250; control: n=251) in this pre-post cluster randomized trial. After 4 weeks, at immediate posttest, 231 students filled in the posttest questionnaire (intervention: n=105; control: n=126). The sample had a mean age of 17.28 (SD 1.26, range 15-21) years, 62.8% (145/231) were female, and 26.8% (62/231) had a non-Dutch background. Body mass index (BMI kg/m2) ranged from 14.4 to 31.1 (mean 21.1, SD 3.3). The intervention and control groups were compared on the primary (behavioral) outcomes of dietary intake (fruit and vegetable consumption, snack consumption, and soft drink consumption) and PA (moderate and vigorous). Additionally, we explored (1) differences between the intervention and control groups in determinants of dietary intake and PA, including attitude, self-efficacy, intention, barrier identification, action planning, and action control, and (2) differences between active (intervention) users and the control group in dietary intake, PA, and associated determinants. Results After corrections for multiple testing, we did not find significant differences between the intervention group and control group in terms of dietary intake, PA, and determinants of dietary intake and PA. Exploratory research indicated that only 27.6% (29/105) of the intervention group reported actual intervention use (ie, active users). For exploratory reasons, we compared the active users (n=29) with the control group (n=124) and corrected for multiple testing. Results showed that active users’ snack consumption decreased more strongly (active users: mean change=–0.20; control group: mean change=–0.08; beta=–0.36, P=.01, R2 change=.05), and their use of active transport had a stronger increase (active users: mean change=0.92; control group=–0.12; beta=1.58, P=.02, R2 change=.03) than the control group. Results also revealed significant differences in action planning (active users: mean change=0.42; control group: mean change=0.07; beta=0.91, P=.01, R2 change=.04) and action control (active users: mean change=0.63; control group: mean change=–0.05; beta=1.25, P=.001, R2 change=.08) in terms of unhealthy eating. Conclusions The Balance It intervention did not show favorable effects on dietary intake and PA compared to the control condition. However, only a small number of people in the intervention condition actually used Balance It (27.6%). Exploratory analyses did suggest that, if used as planned, Balance It could contribute to changing dietary intake and PA behaviors, albeit it remains debatable whether this would be sufficient to prevent overweight.
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Thompson D, Ferry RJ, Cullen KW, Liu Y. Improvement in Fruit and Vegetable Consumption Associated with More Favorable Energy Density and Nutrient and Food Group Intake, but not Kilocalories. J Acad Nutr Diet 2016; 116:1443-1449. [PMID: 27316780 PMCID: PMC5003727 DOI: 10.1016/j.jand.2016.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 05/02/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Children generally do not consume adequate amounts of fruits and vegetables (F/V). Eating more F/V can improve energy density and overall diet quality. OBJECTIVE Our aim was to investigate whether improvements in F/V consumption were associated with improvements in energy density, total calories, and dietary components related to F/V. DESIGN We performed secondary analyses of dietary data from a successful four-group randomized controlled trial promoting F/V. Data were collected at baseline, immediately after gameplay, and 3 months post intervention. PARTICIPANTS/SETTING Preadolescent child-parent dyads (n=400) were recruited. Eligibility criteria were 4th- or 5th-grade child (approximately 9 to 11 years old) with Internet access and a parent willing to participate in the intervention. Complete dietary data were collected on 387 of the 400 child participants. The videogame was available online on a secure, password-protected website. MAIN OUTCOME MEASURES Dietary intake was assessed with three unannounced dietary recalls collected at each data-collection period via telephone by trained staff using Nutrition Data System for Research software. Energy density and F/V, nutrient, and food consumption were calculated. STATISTICAL ANALYSIS PERFORMED A 4×3 (group by time) repeated measures analysis of covariance with mixed-effect linear models was used. Covariates included child's sex, race/ethnicity, and total energy intake as well as parent's age and household education. Energy was excluded as a covariate in the energy density and energy models. RESULTS Significant changes occurred in energy density. A significant interaction (group by time) was observed (F6, 515=2.40; P<0.05) in energy density from food only, while a significant time effect was observed for energy density from all foods and beverages (F2, 388=13.75; P<0.0001). Desirable changes were also observed in F/V-related dietary components. CONCLUSIONS Increasing F/V consumption improved energy density and diet quality considerably in preadolescent children.
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Ledoux T, Griffith M, Thompson D, Nguyen N, Watson K, Baranowski J, Buday R, Abdelsamad D, Baranowski T. An educational video game for nutrition of young people: Theory and design. SIMULATION & GAMING 2016; 47:490-516. [PMID: 27547019 PMCID: PMC4987000 DOI: 10.1177/1046878116633331] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Playing Escape from DIAB (DIAB) and Nanoswarm (NANO), epic video game adventures, increased fruit and vegetable consumption among a multi-ethnic sample of 10-12 year old children during pilot testing. Key elements of both games were educational mini-games embedded in the overall game that promoted knowledge acquisition regarding diet, physical activity and energy balance. 95-100% of participants demonstrated mastery of these mini-games suggesting knowledge acquisition. AIM This article describes the process of designing and developing the educational mini-games. A secondary purpose was to explore the experience of children while playing the games. METHOD The educational games were based on Social Cognitive and Mastery Learning Theories. A multidisciplinary team of behavioral nutrition, PA, and video game experts designed, developed, and tested the mini-games. RESULTS Alpha testing revealed children generally liked the mini-games and found them to be reasonably challenging. Process evaluation data from pilot testing revealed almost all participants completed nearly all educational mini-games in a reasonable amount of time suggesting feasibility of this approach. CONCLUSIONS Future research should continue to explore the use of video games in educating children to achieve healthy behavior changes.
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Affiliation(s)
| | | | | | - Nga Nguyen
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kathy Watson
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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75
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Baghaei N, Nandigam D, Casey J, Direito A, Maddison R. Diabetic Mario: Designing and Evaluating Mobile Games for Diabetes Education. Games Health J 2016; 5:270-8. [DOI: 10.1089/g4h.2015.0038] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - John Casey
- Unitec Institute of Technology, Auckland, New Zealand
| | - Artur Direito
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
| | - Ralph Maddison
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
- Institute for Physical Activity and Nutrition, Deakin University Geelong, Australia
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76
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Abstract
With the growing prevalence of diabetes in teens and frequent concomitant problems with adherence, adolescents are a frequent target for diabetes self-management support and education. Due to widespread use of technology among teens in general, the use of serious games, games used for purposes beyond entertainment with the intention to educate and support health behavior for teens with diabetes self-management, is an emerging and promising practice. This report explores games intended for teens with diabetes, how the use of games may enhance clinical practice, and provides suggestions for future research and better utilization of these technologies. Current research on the use of gaming for promoting diabetes management in teens is fairly limited, with some initial support for improvements in both behavioral and clinical outcomes among teens. More research is clearly needed in order to further determine how gaming can best be utilized to impact health outcomes in these teens, as well as potential mechanisms of change.
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Affiliation(s)
- Ellen Swartwout
- O'Neil Center/GetWellNetwork, 7700 Old Georgetown Road, 4th Floor, Bethesda, MD, 20814, USA.
| | - Ashley El-Zein
- O'Neil Center/GetWellNetwork, 7700 Old Georgetown Road, 4th Floor, Bethesda, MD, 20814, USA
| | - Patricia Deyo
- O'Neil Center/GetWellNetwork, 7700 Old Georgetown Road, 4th Floor, Bethesda, MD, 20814, USA
| | - Rachel Sweenie
- Center for Translational Science, Children's National Health System, 111 Michigan Ave., NW, Washington, DC, 20010, USA
| | - Randi Streisand
- Center for Translational Science, Children's National Health System, 111 Michigan Ave., NW, Washington, DC, 20010, USA
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77
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Nguyen S, Häcker AL, Henderson M, Barnett T, Mathieu ME, Pagani L, Bigras JL. Physical Activity Programs with Post-Intervention Follow-Up in Children: A Comprehensive Review According to Categories of Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E664. [PMID: 27376315 PMCID: PMC4962205 DOI: 10.3390/ijerph13070664] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 11/17/2022]
Abstract
Only 9% of Canadian children meet the National Guidelines of 60 min of daily moderate-to-vigorous intensity physical activity. The aim of this review is to assess the mid- and long-term effectiveness of physical activity interventions and their impact on cardiovascular risk factors in children. We assessed the success of interventions within three different categories: those using a behavioural and social approach, an informational approach or an environmental approach. The average number of children included in these studies was 860 (range of 30-5106); the age range was from 2 to 18 years; and the mean intervention duration was 1607 min (range of 12-8160 min). The length of follow-up post-intervention averaged 13 months (ranging from 0.25 to 96 months). A positive impact on physical activity was found in 74% and on any measured outcomes in 90% of the studies reviewed. However, the benefits of physical activity interventions decreased with longer follow-up. Regardless of the approaches, physical activity interventions improved cardiovascular risk factors. However, the challenge of any program is to maintain beneficial effects once the intervention is completed. These findings will inform the development of future intervention programs in order to optimize sustained cardiovascular benefits.
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Affiliation(s)
- Sally Nguyen
- Department of Pediatrics, CIRCUIT Center, University of Montreal, Montreal, QC H3T 1J4, Canada.
| | | | - Melanie Henderson
- Department of Pediatrics, CIRCUIT Center, University of Montreal, Montreal, QC H3T 1J4, Canada.
- Sainte-Justine UHC Research Center, University of Montreal, Montreal, QC H3T 1C5, Canada.
| | - Tracie Barnett
- Sainte-Justine UHC Research Center, University of Montreal, Montreal, QC H3T 1C5, Canada.
- Epidemiology and Biostatistics Unit, INRS-Institute Armand-Frappier, Laval, QC H7V 1B7, Canada.
| | - Marie-Eve Mathieu
- Sainte-Justine UHC Research Center, University of Montreal, Montreal, QC H3T 1C5, Canada.
- Department of Kinesiology, University of Montreal, Montreal, QC H3T 1J4, Canada.
| | - Linda Pagani
- Sainte-Justine UHC Research Center, University of Montreal, Montreal, QC H3T 1C5, Canada.
| | - Jean-Luc Bigras
- Department of Pediatrics, CIRCUIT Center, University of Montreal, Montreal, QC H3T 1J4, Canada.
- Sainte-Justine UHC Research Center, University of Montreal, Montreal, QC H3T 1C5, Canada.
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78
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DeSmet A, Thompson D, Baranowski T, Palmeira A, Verloigne M, De Bourdeaudhuij I. Is Participatory Design Associated with the Effectiveness of Serious Digital Games for Healthy Lifestyle Promotion? A Meta-Analysis. J Med Internet Res 2016; 18:e94. [PMID: 27129447 PMCID: PMC4867751 DOI: 10.2196/jmir.4444] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/28/2015] [Accepted: 12/14/2015] [Indexed: 01/21/2023] Open
Abstract
Background Serious digital games can be effective at changing healthy lifestyles, but large differences in their effectiveness exist. The extent of user involvement in game design may contribute to game effectiveness by creating a better fit with user preferences. Participatory design (PD), which represents active user involvement as informant (ie, users are asked for input and feedback) or codesigner (ie, users as equal partners in the design) early on and throughout the game development, may be associated with higher game effectiveness, as opposed to no user involvement or limited user involvement. Objective This paper reports the results of a meta-analysis examining the moderating role of PD in the effectiveness of serious digital games for healthy lifestyle promotion. Methods Four databases were searched for peer-reviewed papers in English that were published or in press before October 2014, using a (group-) randomized controlled trial design. Effectiveness data were derived from another meta-analysis assessing the role of behavior change techniques and game features in serious game effectiveness. Results A total of 58 games evaluated in 61 studies were included. As previously reported, serious digital games had positive effects on healthy lifestyles and their determinants. Unexpectedly, PD (g=0.075, 95% CI 0.017 to 0.133) throughout game development was related to lower game effectiveness on behavior (Q=6.74, P<.05) than when users were only involved as testers (g=0.520, 95% CI 0.150 to 0.890, P<.01). Games developed with PD (g=0.171, 95% CI 0.061 to 0.281, P<.01) were also related to lower game effectiveness on self-efficacy (Q=7.83, P<.05) than when users were not involved in game design (g=0.384, 95% CI 0.283 to 0.485, P<.001). Some differences were noted depending on age group, publication year of the study, and on the specific role in PD (ie, informant or codesigner), and depending on the game design element. Games developed with PD were more effective in changing behavioral determinants when they included users in design elements on game dynamics (beta=.215, 95% CI .075 to .356, P<.01) and, more specifically, as an informant (beta=.235, 95% CI .079 to .329, P<.01). Involving users as informants in PD to create game levels was also related to higher game effectiveness (Q=7.02, P<.01). Codesign was related to higher effectiveness when used to create the game challenge (Q=11.23, P<.01), but to lower game effectiveness when used to create characters (Q=4.36, P<.05) and the game world (Q=3.99, P<.05). Conclusions The findings do not support higher effectiveness of games developed with PD. However, significant differences existed among PD games. More support was found for informant roles than for codesign roles. When PD was applied to game dynamics, levels, and game challenge, this was associated with higher effectiveness than when it was applied to game aesthetics. Since user involvement may have an important influence on reach, adoption, and implementation of the intervention, further research and design efforts are needed to enhance effectiveness of serious games developed with PD.
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Affiliation(s)
- Ann DeSmet
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium
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79
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Perspectives on Active Video Gaming as a New Frontier in Accessible Physical Activity for Youth With Physical Disabilities. Phys Ther 2016; 96:521-32. [PMID: 26316530 PMCID: PMC4817210 DOI: 10.2522/ptj.20140258] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
Abstract
This perspective article explores the utility of active video gaming as a means of reducing sedentary behavior and increasing physical activity among youth with physical disabilities and limitations in lower extremity function who typically are excluded from mainstream exercise options. Youth with physical disabilities are disproportionately affected by health problems that result from sedentary behavior, lack of physical activity, and low fitness levels. Physical, programmatic, and attitudinal barriers have a synergistic and compounded impact on youths' ability to participate in physical activity. A recent health and wellness task force recommendation from the American Physical Therapy Association's Section on Pediatrics supports analyzing individualized health behaviors and preferences that are designed to improve fitness, physical activity, and participation in pediatric rehabilitation. This recommendation represents an opportunity to explore nontraditional options to maximize effectiveness and sustainability of pediatric rehabilitation techniques for youth with disabilities who could best benefit from customized programming. One new frontier in promoting physical activity and addressing common physical activity barriers for youth with physical disabilities is active video games (AVGs), which have received growing attention as a promising strategy for promoting health and fitness in children with and without disabilities. The purpose of this article is to discuss the potential for AVGs as an accessible option to increase physical activity participation for youth with physical disabilities and limitations in lower extremity function. A conceptual model on the use of AVGs to increase physical activity participation for youth with physical disabilities is introduced, and future research potential is discussed, including a development project for game controller adaptations within the Rehabilitation Engineering Research Center on Interactive Exercise Technologies and Exercise Physiology for People With Disabilities (RERC RecTech) at the University of Alabama at Birmingham (UAB)/Lakeshore Foundation Research Collaborative.
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80
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Francis DB, Comello MLG, Marshall LH. How Does Gameplaying Support Values and Psychological Well-Being Among Cancer Survivors? Games Health J 2016; 5:128-34. [PMID: 26959395 DOI: 10.1089/g4h.2015.0044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This qualitative study examined the extent to which playing recreational computer games and videogames is perceived by cancer survivors as supporting personal values. Values serve as behavioral guides and may thus impact health outcomes; therefore activities that have the potential to support values deserve further attention so their role in promoting health may be better understood. MATERIALS AND METHODS We asked a sample of survivors who play recreational games (n = 73) open-ended questions about the types of recreational games they play, about something they really value in life, and the extent to which playing games supports the value. Data analysis used a grounded theory approach, supported by computer-assisted qualitative analysis software. RESULTS Three major themes emerged linking gameplaying to survivors' values: the need to create and maintain social connections, the desire to help others, and the need to experience alternate realities (including escape and exploration). CONCLUSIONS The present study offers a unique perspective by focusing on the intersection of values and gameplay among survivors. The findings suggest that playing recreational computer games and videogames may be congruent with survivors' personal values and may have potential to influence positive health outcomes among survivors. The findings have implications for developing effective values-based interventions for cancer survivors.
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Affiliation(s)
- Diane B Francis
- School of Media and Journalism, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Maria Leonora G Comello
- School of Media and Journalism, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Laura Heisner Marshall
- School of Media and Journalism, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
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81
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Tuominen PPA, Husu P, Raitanen J, Luoto RM. Differences in sedentary time and physical activity among mothers and children using a movement-to-music video program in the home environment: a pilot study. SPRINGERPLUS 2016; 5:93. [PMID: 26848433 PMCID: PMC4729752 DOI: 10.1186/s40064-016-1701-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 01/11/2016] [Indexed: 12/03/2022]
Abstract
Measured objectively, less than a quarter of adults and under half of preschool children in Finland meet the physical activity recommendations. Moreover, higher sedentary time among parents (such as watching television) is associated with higher sedentary time of their children. The study introduces an intervention based on reducing sedentary behavior among mothers and their children. It utilizes a combination of music and exercise via a motivation-targeting movement-to-music video program in the home environment. Data were collected in summer 2014 from Finland’s Pirkanmaa region. Each mother–child pair (n = 24, child age: 4–7 years) was assigned to the intervention and control group. Both groups used an accelerometer and completed physical activity diaries for two consecutive weeks (14 days) during waking hours. In addition, the intervention group was instructed to use the movement-to-music video program during the second week. Differences between groups were expected in analysis of sedentary time and physical activity between weeks 1 and 2. The parameters assessed were sedentary time (i.e., lying down or sitting), standing still, and time spent in physical activity. Less sedentary time was revealed in week 2 than in week 1 among both intervention group mothers (56.6 vs. 53.3 %) and for intervention group children (49.5 vs. 46.0 %). The opposite was true of control group mothers (52.1 vs. 52.4 %) and children (46.7 vs. 49.8 %). Within-group differences in mothers’ sedentary time correlated moderately with the children’s sedentary time (Spearman’s r = 0.56). All groups exhibited slightly more standing in the second week than in week 1. Both sets of intervention participants also engaged in more light physical activity in week 2, with the opposite evident for the two control sets. In all groups, except the control children, the proportion of moderate to vigorous physical activity was higher in the second week than the first. The use of music and video content together may yield added benefits in efforts to reduce sedentary behavior and increase physical activity among mothers and their children in the home environment.
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Affiliation(s)
- Pipsa P A Tuominen
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, PL 30, 33501 Tampere, Finland ; Department of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauliina Husu
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, PL 30, 33501 Tampere, Finland
| | - Jani Raitanen
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, PL 30, 33501 Tampere, Finland ; School of Health Sciences, University of Tampere, Tampere, Finland
| | - Riitta M Luoto
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, PL 30, 33501 Tampere, Finland
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82
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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83
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Hall AK, Mercado R, Anderson-Lewis C, Darville G, Bernhardt JM. How to Design Tobacco Prevention and Control Games for Youth and Adolescents: A Qualitative Analysis of Expert Interviews. Games Health J 2015; 4:488-93. [PMID: 26230046 DOI: 10.1089/g4h.2015.0013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. MATERIALS AND METHODS Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. RESULTS Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. CONCLUSIONS The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents.
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84
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Baranowski T, Maddison R, Maloney A, Medina E, Simons M. Building a Better Mousetrap (Exergame) to Increase Youth Physical Activity. Games Health J 2015. [PMID: 26196047 DOI: 10.1089/g4h.2014.0018] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although exergames have been demonstrated to induce moderate levels of physical activity (PA) if played as designed, there is conflicting evidence on use of exergaming leading to increased habitual PA. Exergames have increased PA in some home and school studies, but not others. Exergames have been used in community centers to good effect, but this has not generally been validated with research. PA from exergames may be enhanced by innovative use of sensors, "fun"-enhancing procedures, tailored messaging, message framing, story or narrative, goal setting, feedback, and values-based messaging. Research is needed on PA-enhancing procedures used within exergames for youth to provide a firmer foundation for the design and use of exergames in the future.
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Affiliation(s)
- Tom Baranowski
- 1 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Ralph Maddison
- 2 National Institute for Health Innovation, University of Auckland , Auckland, New Zealand
| | - Ann Maloney
- 3 University of Massachusetts , Worcester, Massachusetts
| | - Ernie Medina
- 4 Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University , Loma Linda, California
| | - Monique Simons
- 5 Department of Health Science and EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University , Amsterdam, The Netherlands .,6 Body@Work, Research Center Physical Activity, Work and Health, TNO-VU/VUmc, VU University Medical Center , Amsterdam, The Netherlands .,7 TNO, Expertise Centre Life Style , Leiden, The Netherlands
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85
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Rahmani E, Boren SA. Videogames and Health Improvement: A Literature Review of Randomized Controlled Trials. Games Health J 2015; 1:331-41. [PMID: 26191999 DOI: 10.1089/g4h.2012.0031] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE There are potential benefits of playing videogames for health improvement such as increasing knowledge about health-related issues by playing educational games and fighting a sedentary lifestyle by playing exergames. The number of systematic review articles about "videogames" and "health improvement" is limited. Therefore, the purpose of this study is to review those randomized controlled trials (RCTs) with the topic of "videogames" and "health improvement." MATERIALS AND METHODS Several electronic databases were searched for RCTs testing videogames on health outcomes that were published in English between January 2000 and April 2012. RESULTS Forty-five articles met the eligibility criteria and were categorized into five groups: (1) videogames and patient pain and stress reduction (nine articles), (2) videogames and patient behavioral change (19 articles), (3) videogames and patient rehabilitation (eight articles), (4) videogames as diagnostic tools (three articles), and (5) videogames and cognitive ability (six articles). CONCLUSIONS Most of the articles have shown promising results in using videogames within various fields of healthcare. Although exergames are the most prominent choice regarding health improvement, videogames have the potential to be used as a pain management tool, diagnostic tool, or educational tool. They also can be used as a facilitator in physical rehabilitation or cognitive loss prevention. More RCTs are needed to fully uncover the benefits of using videogames for improving patients' health.
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Affiliation(s)
- Esmaeel Rahmani
- 1 Department of Health Management and Informatics, School of Medicine, University of Missouri , Columbia, Missouri
| | - Suzanne Austin Boren
- 1 Department of Health Management and Informatics, School of Medicine, University of Missouri , Columbia, Missouri.,2 Informatics Institute, University of Missouri , Columbia, Missouri
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86
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Gammon CS, Pfeiffer KA, Peng W, Suton D, Winn B. Contribution of Active Videogame Play to Physical Activity Among College Students. Games Health J 2015; 3:395-8. [PMID: 26192647 DOI: 10.1089/g4h.2014.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Fewer than half of college students meet physical activity (PA) recommendations. Active videogames (AVGs) may increase PA. The contribution that AVGs make to total PA is unknown. This study aimed to examine the contribution of AVG play to total PA and to compare sedentary, light, and moderate- to vigorous-intensity PA (MVPA) on game-days and non-game-days. MATERIALS AND METHODS For 1 week, the PA of 42 students (mean age, 20.4±1.3 years) was assessed by accelerometry. During this week an AVG was played one to three times, for 30 minutes each. The percentage contribution of AVG play to MVPA was calculated. To compare PA on game-days versus non-game-days, t tests were used. RESULTS Students performed an average of 47.2±32.0 minutes of MVPA/day, during the monitored weekdays. MVPA during AVG play contributed 4.8±8.1 percent to total MVPA on game-days. The percentage of time spent in moderate PA was significantly higher on game-days (4.9 percent) than on non-game-days (3.3 percent). CONCLUSIONS This is the first study to examine the contribution of AVG play to daily PA. These data support further investigation of AVGs as a means of increasing health-enhancing PA and reducing sedentary behavior among college students.
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Affiliation(s)
- Catherine S Gammon
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
| | - Karin A Pfeiffer
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
| | - Wei Peng
- 2 Department of Telecommunications, Information Studies, and Media, Michigan State University , East Lansing, Michigan
| | - Darijan Suton
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
| | - Brian Winn
- 2 Department of Telecommunications, Information Studies, and Media, Michigan State University , East Lansing, Michigan
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87
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Aggio D, Smith L, Hamer M. Effects of reallocating time in different activity intensities on health and fitness: a cross sectional study. Int J Behav Nutr Phys Act 2015; 12:83. [PMID: 26104041 PMCID: PMC4482052 DOI: 10.1186/s12966-015-0249-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effects of replacing time in specific activity categories for other categories (e.g. replacing sedentary time with light activity) on health and fitness are not well known. This study used isotemporal substitution to investigate the effects of substituting activity categories in an equal time exchange fashion on health and fitness in young people. METHODS Participants were drawn from schools in Camden, London (n = 353, mean age 9.3 ± 2.3 years). Time sedentary, in light and in moderate-to-vigorous activity (MVPA) was measured via accelerometry. The effects of substituting time in activity categories (sedentary, light and MVPA) with equivalent time in another category on health and fitness were examined using isotemporal substitution. RESULTS In single and partition models, MVPA was favourably associated with body fat %, horizontal jump distance and flexibility. Time sedentary and in light activity were not associated with health and fitness outcomes in these models. In substitution models, replacing one hour of sedentary time with MVPA was favourably associated with body fat % (B = -4.187; 95% confidence interval (CI), -7.233, -1.142), horizontal jump distance (B = 16.093; 95% CI, 7.476, 24.710) and flexibility (B = 4.783; 95% CI, 1.910, 7.656). Replacing time in light activity with MVPA induced similar benefits but there were null effects for replacing sedentary with light intensity. CONCLUSION Substituting time sedentary and in light activity with MVPA was associated with favourable health and fitness. Time in sedentary behaviour may only be detrimental to health and fitness when it replaces time in MVPA in young people.
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Affiliation(s)
- Daniel Aggio
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, WC1E 6BT, London, UK. .,Department of Epidemiology and Public Health, Physical Activity Research Group, University College London, 1-19 Torrington Place, WC1E 6BT, London, UK.
| | - Lee Smith
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, WC1E 6BT, London, UK.,Department of Epidemiology and Public Health, Physical Activity Research Group, University College London, 1-19 Torrington Place, WC1E 6BT, London, UK
| | - Mark Hamer
- Department of Epidemiology and Public Health, Physical Activity Research Group, University College London, 1-19 Torrington Place, WC1E 6BT, London, UK.,National Centre Sport & Exercise Medicine, Loughborough University, Loughborough, UK
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Boushey CJ, Harray AJ, Kerr DA, Schap TE, Paterson S, Aflague T, Bosch Ruiz M, Ahmad Z, Delp EJ. How willing are adolescents to record their dietary intake? The mobile food record. JMIR Mhealth Uhealth 2015; 3:e47. [PMID: 26024996 PMCID: PMC4464313 DOI: 10.2196/mhealth.4087] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/26/2015] [Accepted: 03/16/2015] [Indexed: 11/17/2022] Open
Abstract
Background Accurately assessing the diets of children and adolescents can be problematic. Use of technologies, such as mobile apps designed to capture food and beverages consumed at eating occasions with images taken using device-embedded cameras, may address many of the barriers to gathering accurate dietary intake data from adolescents. Objective The objectives of this study were to assess the willingness of adolescents to take images of food and beverages at their eating occasions using a novel mobile food record (mFR) and to evaluate the usability of the user confirmation component of the mFR app, referred to as the “review process.” Methods Mixed methods combining quantitative and qualitative protocols were used in this study. Adolescents (11-15-year olds) attending a summer camp were recruited to participate in the study. First, the participants were asked to take images of foods and beverages consumed as meals and snacks for 2 consecutive days using the mFR app running on an iPhone and the number of images taken was noted. This was followed by focus group sessions to evaluate usability, which was analyzed by content and themes. After using the mFR, a think-aloud method was used to evaluate the usability of the mFR method for reviewing system-identified foods (ie, the review process). A usability questionnaire was administered at the end of all activities. Results The mFR was accepted by the majority of the 24 boys and 17 girls (n=41) but varied according to gender and eating occasion. Girls were significantly more likely than boys to capture images of their eating occasions (Fisher exact test, P=.03). Participants were more likely to take images of their breakfasts (90%, 36/40) and lunches (90%, 72/80) and least likely to capture afternoon and evening snacks, 54% (43/80) and 40% (32/80), respectively. The major themes from the focus groups with regard to using the mFR were games, rewards, and the need to know more about why they were using the app. Results of the usability questionnaire indicated that including a game component would be important to increase willingness to use the mFR, and a high majority of the participants indicated a willingness to use the mFR for 7 days or more. The image review process was found to be easy to use except for some confusion with overlapping markers on the screen. Conclusions The adolescents’ experiences with and feedback about the mFR highlighted the importance of increased training, reminders, entertainment (eg, games), and training with practice in using the device to capture complete dietary intake as part of their active lifestyles.
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Affiliation(s)
- Carol Jo Boushey
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI, United States.
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89
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Sharma SV, Shegog R, Chow J, Finley C, Pomeroy M, Smith C, Hoelscher DM. Effects of the Quest to Lava Mountain Computer Game on Dietary and Physical Activity Behaviors of Elementary School Children: A Pilot Group-Randomized Controlled Trial. J Acad Nutr Diet 2015; 115:1260-71. [PMID: 25912520 DOI: 10.1016/j.jand.2015.02.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Computer-based educational games present an opportunity for health education in school; however, their feasibility in school settings and effectiveness in changing behavior are poorly understood. OBJECTIVE To evaluate the feasibility, acceptability, and effects of the Quest to Lava Mountain (QTLM) computer game on dietary behaviors, physical activity behaviors, and psychosocial factors among ethnically diverse children in Texas. DESIGN Quasi-experimental group-randomized controlled trial conducted during the 2012-2013 school year. PARTICIPANTS/SETTING A total of 107 children in fourth and fifth grade consented. There was an attrition rate of 8.8% with a final sample size of 44 children in three intervention schools, and a sample of 50 children in three comparison schools. Dietary intake was measured using two random 24-hour recalls, whereas child self-report surveys measured diet, physical activity, and psychosocial factors before and after the intervention. Process data on QTLM usability and back-end server data on QTLM exposure and progress achieved were collected. INTERVENTION QTLM was implemented as part of the in-school or afterschool program. Recommended game exposure duration was 90 min/wk for 6 weeks. STATISTICAL ANALYSIS Analysis of covariance or logistic regression models evaluated effects of QTLM on diet, physical activity, and psychosocial factors. Post hoc exploratory analysis examined the changes before and after the intervention in outcome variables among children in the intervention group. Significance was set at P<0.05. RESULTS Children played an average of 274±110 minutes (approximately 4.6 hours) of QTLM during the 6 weeks (51% of recommended dosage). Compared with the comparison group, children in the intervention group reported decreased sugar consumption (P=0.021) and higher nutrition/physical activity attitudes (P=0.041) pre- to postintervention. There were no significant effects of QTLM on physical activity. However, post hoc analysis showed that higher QTLM exposure and gaming progress was associated with increased frequency of physical activity (P<0.05). CONCLUSIONS QTLM has some promising acceptability and initial effects on diet and physical activity behaviors among children in elementary school.
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Brand L, Beltran A, Buday R, O'Connor T, Hughes S, Baranowski J, Diep C, Lu AS, Baranowski T. Prose Fiction as a Narrative Companion for a Vegetable Parenting Videogame. Games Health J 2015; 4:305-11. [PMID: 26182218 DOI: 10.1089/g4h.2014.0143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this research is to explore the capacity of story to connect to a health-related videogame, as well as the qualities that may increase efficacy by making the story compelling. Parents of 3-5-year-old children often report difficulty getting their children to eat vegetables, which are protective against chronic illnesses. Videogames may be vehicles for training parenting practices for successful vegetable consumption outcomes but often rely on stories to provide context and details. Unfortunately, storytelling may interrupt immersion and player agency. Delivering stories outside of gameplay may provide an understanding of game situations while maintaining immersion. MATERIALS AND METHODS Two companion storylines (one a romantic adventure and the other a suspenseful fantasy) were generated for a vegetable parenting game, "Mommio," targeting mothers of preschool children. Mothers of 3-5-year-old children (n=18) read both storylines and completed semistructured interviews. RESULTS Mothers preferred the romantic adventure, which featured strong characters, relatable issues, and an engaging plot. Most mothers were interested in playing the "Mommio" videogame after reading the stories. CONCLUSIONS Results suggest that it is possible for prose literature to both motivate gameplay and be an immersive narrative companion to, but separate from, games for health. This literature should include engaging, realistic stories and relatable strong characters.
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Affiliation(s)
- Leah Brand
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Alicia Beltran
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | | | - Teresia O'Connor
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Sheryl Hughes
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Janice Baranowski
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Cassandra Diep
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Amy Shirong Lu
- 3 Department of Communication Studies, Northeastern University , Boston, Massachusetts
| | - Tom Baranowski
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
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Thompson D, Bhatt R, Vazquez I, Cullen KW, Baranowski J, Baranowski T, Liu Y. Creating action plans in a serious video game increases and maintains child fruit-vegetable intake: a randomized controlled trial. Int J Behav Nutr Phys Act 2015; 12:39. [PMID: 25890060 PMCID: PMC4372224 DOI: 10.1186/s12966-015-0199-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 03/06/2015] [Indexed: 11/17/2022] Open
Abstract
Background Child fruit and vegetable intake is below recommended levels, increasing risk for chronic disease. Interventions to influence fruit and vegetable intake among youth have had mixed effects. Innovative, theory-driven interventions are needed. Goal setting, enhanced by implementation intentions (i.e., plans tightly connected to a behavioral goal), may offer a solution. Action plans state “how” a goal will be achieved, while coping plans identify a potential barrier and corresponding solution. The research reported here evaluated the short- and long-term effects of goal setting enhanced with implementation intentions on child fruit and vegetable intake in a 10-episode, theoretically-grounded serious videogame promoting fruit and vegetables. This is one of the first studies to test the efficacy of implementation intentions on the dietary intake of healthy children. Methods A four-group randomized design with three data collection periods (baseline, immediate post-intervention, 3 months post-intervention) was employed. Groups varied on whether children created an implementation intention (none, action, coping, both) as part of goal setting. Participants were 4th and 5th grade children (~9-11 years old) and one parent. An a priori power analysis indicated this would provide >80% power to detect a small effect (Cohen’s d = 0.17). Children played a 10-episode online videogame; parents received 10 electronic newsletters and access to a parent-only website. The primary outcome was child fruit and vegetable intake, assessed via three, dietitian-assisted telephone recalls at each data collection period. The primary analysis was conducted using a repeated measures analysis of covariance with a mixed model procedure. Secondary analyses examined intervention effects on fruit and vegetables separately. Results Four hundred parent/child dyads were recruited. A significant group-by-time interaction for fruit and vegetable intake (p < 0.001) was found in only the Action group, which had significant increases in fruit and vegetable intake at post 1 (p < 0.0001) and post 2 (p < 0.0001). No other significant interactions were observed; however, there were significant time effects for fruit (p < 0.0001). Conclusions Action intentions may be an important component of successful interventions to increase and maintain fruit and vegetable intake in pre-adolescent children. Videogames promoting healthy diets offer an effective vehicle for delivering behavior change interventions to children. Trial registration ClinicalTrials.gov NCT01004094.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA.
| | - Riddhi Bhatt
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Houston, TX, USA.
| | - Isabel Vazquez
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA.
| | - Karen W Cullen
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA.
| | - Janice Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA.
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA.
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA.
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Marchetti D, Fraticelli F, Polcini F, Lato R, Pintaudi B, Nicolucci A, Fulcheri M, Mohn A, Chiarelli F, Di Vieste G, Vitacolonna E. Preventing Adolescents' Diabesity: Design, Development, and First Evaluation of "Gustavo in Gnam's Planet". Games Health J 2015; 4:344-51. [PMID: 26287925 PMCID: PMC4545704 DOI: 10.1089/g4h.2014.0107] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The goal of this study was to design, develop, and evaluate a game for health, “Gustavo in Gnam's Planet” (“Gustavo”), aimed to improve knowledge on healthy foods and to increase consumption of healthy foods. Subjects and Methods: Eighty-three high school students were enrolled in the study. The game was designed and developed by a multidisciplinary team. Behavioral change theories were adopted to guide the design of the health messages. Participants were assessed about food frequency, healthy food knowledge, and the game's interest. Results: Forty-seven subjects (mean age, 14.9±1.0 years; 72.3 percent males) completed the study. At posttest, participants showed significant higher scores (i.e., increased knowledge) in the questionnaire on knowledge of healthy foods (70.0±9.2 versus 71.3±10.0 for pretest and posttest, respectively; P<0.05). Improvements in healthy eating habits were also detected: higher frequency of consumption during a week of white meat (1 [1–2] versus 2 [1–2]; P=0.01), eggs (1 [1–1] versus 1 [1–2]; P=0.01], and legumes (1 [0–1] versus 1 [1–2]; P=0.03) and lower frequency of consumption of sugar-containing packaged snacks (1 [0–1] versus 0 [0–1]; P=0.009). Most of the participants found the game easy to use and clear in its content. Half of the participants found the game interesting. Conclusions: Our study shows that “Gustavo” is a promising tool for health education, in schools or in other environments. Limitations of the study and future directions are discussed.
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Affiliation(s)
- Daniela Marchetti
- 1 Department of Psychological Sciences, Humanities and the Territory, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | - Federica Fraticelli
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | | | - Roberto Lato
- 3 "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | - Basilio Pintaudi
- 4 Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, S. Maria Imbaro, Chieti, Italy
| | - Antonio Nicolucci
- 4 Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, S. Maria Imbaro, Chieti, Italy
| | - Mario Fulcheri
- 1 Department of Psychological Sciences, Humanities and the Territory, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | - Angelika Mohn
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy .,5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
| | - Francesco Chiarelli
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy .,5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
| | - Giacoma Di Vieste
- 5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
| | - Ester Vitacolonna
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy .,5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
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93
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DeSmet A, Van Ryckeghem D, Compernolle S, Baranowski T, Thompson D, Crombez G, Poels K, Van Lippevelde W, Bastiaensens S, Van Cleemput K, Vandebosch H, De Bourdeaudhuij I. A meta-analysis of serious digital games for healthy lifestyle promotion. Prev Med 2014; 69:95-107. [PMID: 25172024 PMCID: PMC4403732 DOI: 10.1016/j.ypmed.2014.08.026] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 08/15/2014] [Accepted: 08/17/2014] [Indexed: 12/14/2022]
Abstract
Several systematic reviews have described health-promoting effects of serious games but so far no meta-analysis has been reported. This paper presents a meta-analysis of 54 serious digital game studies for healthy lifestyle promotion, in which we investigated the overall effectiveness of serious digital games on healthy lifestyle promotion outcomes and the role of theoretically and clinically important moderators. Findings showed that serious games have small positive effects on healthy lifestyles (g=0.260, 95% CI 0.148; 0.373) and their determinants (g=0.334, 95% CI 0.260; 0.407), especially for knowledge. Effects on clinical outcomes were significant, but much smaller (g=0.079, 95% CI 0.038; 0.120). Long-term effects were maintained for all outcomes except for behavior. Serious games are best individually tailored to both socio-demographic and change need information, and benefit from a strong focus on game theories or a dual theoretical foundation in both behavioral prediction and game theories. They can be effective either as a stand-alone or multi-component programs, and appeal to populations regardless of age and gender. Given that effects of games remain heterogeneous, further explorations of which game features create larger effects are needed.
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Affiliation(s)
- Ann DeSmet
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium.
| | - Dimitri Van Ryckeghem
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Sofie Compernolle
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium
| | - Tom Baranowski
- Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Debbe Thompson
- Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Karolien Poels
- Department of Communication Studies, Faculty of Political and Social Sciences, University of Antwerp, Belgium
| | - Wendy Van Lippevelde
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Sara Bastiaensens
- Department of Communication Studies, Faculty of Political and Social Sciences, University of Antwerp, Belgium
| | - Katrien Van Cleemput
- Department of Communication Studies, Faculty of Political and Social Sciences, University of Antwerp, Belgium
| | - Heidi Vandebosch
- Department of Communication Studies, Faculty of Political and Social Sciences, University of Antwerp, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium
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94
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Abstract
Almost 60 percent of Americans play videogames, which is a significant opportunity for health professionals to reach mass audiences. But although legions of fans spend countless hours playing entertainment games, player interest in health videogames quickly wanes. A good question to ask is, "Why?" A game developer with 20 years of experience offers his perspective on what may be limiting health games' appeal and what can be done about it.
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95
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van 't Riet J, Crutzen R, Lu AS. How Effective Are Active Videogames Among the Young and the Old? Adding Meta-analyses to Two Recent Systematic Reviews. Games Health J 2014; 3:311-8. [PMID: 26192486 DOI: 10.1089/g4h.2014.0005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Two recent systematic reviews have surveyed the existing evidence for the effectiveness of active videogames in children/adolescents and in elderly people. In the present study, effect sizes were added to these systematic reviews, and meta-analyses were performed. MATERIALS AND METHODS All reviewed studies were considered for inclusion in the meta-analyses, but only studies were included that investigated the effectiveness of active videogames, used an experimental design, and used actual health outcomes as the outcome measures (body mass index for children/adolescents [k=5] and functional balance for the elderly [k=6]). RESULTS The average effect of active videogames in children and adolescents was small and nonsignificant: Hedges' g=0.20 (95 percent confidence interval, -0.08 to 0.48). Limited heterogeneity was observed, and no moderator analyses were performed. For the effect of active videogames on functional balance in the elderly, the analyses revealed a medium-sized and significant effect of g=0.68 (95 percent confidence interval, 0.13-1.24). For the elderly studies, substantial heterogeneity was observed. Moderator analyses showed that there were no significant effects of using a no-treatment control group versus an alternative treatment control group or of using games that were especially created for health-promotion purposes versus off-the-shelf games. Also, intervention duration and frequency, sample size, study quality, and dropout did not significantly moderate the effect of active videogames. CONCLUSIONS The results of these meta-analyses provide preliminary evidence that active videogames can have positive effects on relevant outcome measures in children/adolescents and elderly individuals.
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Affiliation(s)
- Jonathan van 't Riet
- 1 Behavioural Science Institute, Radboud University Nijmegen , Nijmegen, The Netherlands
| | - Rik Crutzen
- 2 School for Public Health and Primary Care (CAPHRI), Maastricht University , The Netherlands
| | - Amy Shirong Lu
- 3 School of Communication, Northwestern University , Evanston, Illinois
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96
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Thompson D. What serious video games can offer child obesity prevention. JMIR Serious Games 2014; 2:e8. [PMID: 25654589 PMCID: PMC4307831 DOI: 10.2196/games.3480] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/11/2014] [Accepted: 06/13/2014] [Indexed: 11/13/2022] Open
Abstract
Childhood obesity is a worldwide issue, and effective methods encouraging children to adopt healthy diet and physical activity behaviors are needed. This viewpoint addresses the promise of serious video games, and why they may offer one method for helping children eat healthier and become more physically active. Lessons learned are provided, as well as examples gleaned from personal experiences.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Pediatrics, Baylor College of Medicine, Houston, TX, United States.
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97
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Nakhasi A, Shen AX, Passarella RJ, Appel LJ, Anderson CA. Online social networks that connect users to physical activity partners: a review and descriptive analysis. J Med Internet Res 2014; 16:e153. [PMID: 24936569 PMCID: PMC4090378 DOI: 10.2196/jmir.2674] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/03/2013] [Accepted: 01/20/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The US Centers for Disease Control and Prevention have identified a lack of encouragement, support, or companionship from family and friends as a major barrier to physical activity. To overcome this barrier, online social networks are now actively leveraging principles of companion social support in novel ways. OBJECTIVE The aim was to evaluate the functionality, features, and usability of existing online social networks which seek to increase physical activity and fitness among users by connecting them to physical activity partners, not just online, but also face-to-face. METHODS In September 2012, we used 3 major databases to identify the website addresses for relevant online social networks. We conducted a Google search using 8 unique keyword combinations: the common keyword "find" coupled with 1 of 4 prefix terms "health," "fitness," "workout," or "physical" coupled with 1 of 2 stem terms "activity partners" or "activity buddies." We also searched 2 prominent technology start-up news sites, TechCrunch and Y Combinator, using 2 unique keyword combinations: the common keyword "find" coupled with 1 of 2 stem terms "activity partners" and "activity buddies." Sites were defined as online social health activity networks if they had the ability to (1) actively find physical activity partners or activities for the user, (2) offer dynamic, real-time tracking or sharing of social activities, and (3) provide virtual profiles to users. We excluded from our analysis sites that were not Web-based, publicly available, in English, or free. RESULTS Of the 360 initial search results, we identified 13 websites that met our complete criteria of an online social health activity network. Features such as physical activity creation (13/13, 100%) and private messaging (12/13, 92%) appeared almost universally among these websites. However, integration with Web 2.0 technologies such as Facebook and Twitter (9/13, 69%) and the option of direct event joining (8/13, 62%) were not as universally present. Largely absent were more sophisticated features that would enable greater usability, such as interactive engagement prompts (3/13, 23%) and system-created best fit activities (3/13, 23%). CONCLUSIONS Several major online social networks that connect users to physical activity partners currently exist and use standardized features to achieve their goals. Future research is needed to better understand how users utilize these features and how helpful they truly are.
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Affiliation(s)
- Atul Nakhasi
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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98
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Leung MM, Tripicchio G, Agaronov A, Hou N. Manga comic influences snack selection in Black and Hispanic New York City youth. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:142-147. [PMID: 24433817 DOI: 10.1016/j.jneb.2013.11.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 10/25/2013] [Accepted: 11/04/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To determine whether a single exposure to a Manga comic (Japanese comic art) with multiple messages promoting fruit intake influenced snack selection in minority urban youth. METHODS Fifty-seven youth (mean age 10.8 y; 54% female; 74% black/African American) attending after-school programs in Brooklyn, NY participated in a pilot study in which they were randomly assigned to receive the comic or a non-health-related newsletter. After reading their media, participants were offered a snack and could choose from among healthy/unhealthy options. Secondary outcomes included knowledge, self-efficacy, and outcome expectations related to fruit intake and media transportation. Data were analyzed using regression and paired t test. RESULTS Comic group participants were significantly more likely to choose a healthy snack, compared to the Attention-control group (odds ratio = 3.6, 95% confidence interval: 1.1-12.1, P = .04). The Comic group reported increases in self-efficacy (P = .04) and greater transportation (immersion into media) (P = .006). CONCLUSIONS AND IMPLICATIONS Results suggest Manga comics may be a useful format to promote healthy snack selection in urban minority youth.
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Affiliation(s)
- May May Leung
- Nutrition Program, City University of New York School of Public Health, Hunter College, New York, NY.
| | - Gina Tripicchio
- Department of Nutrition, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Alen Agaronov
- Nutrition Program, City University of New York School of Public Health, Hunter College, New York, NY
| | - Ningqi Hou
- Department of Health Studies, University of Chicago, Chicago, IL
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Raaff C, Glazebrook C, Wharrad H. A systematic review of interactive multimedia interventions to promote children's communication with health professionals: implications for communicating with overweight children. BMC Med Inform Decis Mak 2014; 14:8. [PMID: 24447844 PMCID: PMC3926331 DOI: 10.1186/1472-6947-14-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 01/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interactive multimedia is an emerging technology that is being used to facilitate interactions between patients and health professionals. The purpose of this review was to identify and evaluate the impact of multimedia interventions (MIs), delivered in the context of paediatric healthcare, in order to inform the development of a MI to promote the communication of dietetic messages with overweight preadolescent children. Of particular interest were the effects of these MIs on child engagement and participation in treatment, and the subsequent effect on health-related treatment outcomes. METHODS An extensive search of 12 bibliographic databases was conducted in April 2012. Studies were included if: one or more child-participant was 7 to 11-years-of-age; a MI was used to improve health-related behaviour; child-participants were diagnosed with a health condition and were receiving treatment for that condition at the time of the study. Data describing study characteristics and intervention effects on communication, satisfaction, knowledge acquisition, changes in self-efficacy, healthcare utilisation, and health outcomes were extracted and summarised using qualitative and quantitative methods. RESULTS A total of 14 controlled trials, published between 1997 and 2006 met the selection criteria. Several MIs had the capacity to facilitate engagement between the child and a clinician, but only one sought to utilise the MI to improve communication between the child and health professional. In spite of concerns over the quality of some studies and small study populations, MIs were found useful in educating children about their health, and they demonstrated potential to improve children's health-related self-efficacy, which could make them more able partners in face-to-face communications with health professionals. CONCLUSIONS The findings of this review suggest that MIs have the capacity to support preadolescent child-clinician communication, but further research in this field is needed. Particular attention should be given to designing appropriate MIs that are clinically relevant.
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Affiliation(s)
- Carol Raaff
- School of Medicine, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham, UK
| | - Cris Glazebrook
- School of Medicine, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham, UK
| | - Heather Wharrad
- School of Health Sciences, Division of Nursing, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
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Panic K, Cauberghe V, De Pelsmacker P. Promoting dental hygiene to children: comparing traditional and interactive media following threat appeals. JOURNAL OF HEALTH COMMUNICATION 2014; 19:561-576. [PMID: 24393019 DOI: 10.1080/10810730.2013.821551] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Until now, social marketing campaigns mainly targeted children using traditional media. However, little is known about the effectiveness of computer games to communicate health-related information to children. This study compares the impact of an interactive game as a medium to provide health information and improve children's dietary habits to the impact of more traditional media. Using a 2 × 3 between-subject factorial design with 190 children (7-9 years old), this study investigates the effect of threat messages (weak vs. strong) concerning dental hygiene on behavioral outcome (snack choice), and how this effect is moderated by the type of medium used to communicate subsequent health information after the threat appeal (computer game, information brochure, narrative story). Results show a positive significant effect of perceived threat on children's adaptive behavior. However, this effect only remains significant when afterwards children are exposed to a narrative health-related story. When children play a game or read a brochure, they need to devote more attention to process this content, distracting them from the original threat message. In sum, when a threat message is followed by additional health information, the medium through which this information is presented influences the effectiveness of the preceding threat message.
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Affiliation(s)
- Katarina Panic
- a Department of Communication Sciences , Ghent University , Ghent , Belgium
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