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Chittaro L. Improving Knowledge Retention and Perceived Control Through Serious Games: A Study About Assisted Emergency Evacuation. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2024; 30:5339-5349. [PMID: 37405887 DOI: 10.1109/tvcg.2023.3292473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Digital games for education and training, also called serious games (SGs), have shown beneficial effects on learning in several studies. In addition, some studies are suggesting that SGs could improve user's perceived control, which affects the likelihood that the learned content will be applied in the real world. However, most SG studies tend to focus on immediate effects, providing no indication on knowledge and perceived control over time, especially in contrast with nongame approaches. Moreover, SG research on perceived control has focused mainly on self-efficacy, disregarding the complementary construct of locus of control (LOC). This article advances both lines of research, assessing user's knowledge and LOC over time, with a SG as well as traditional printed materials that teach the same content. Results show that the SG was more effective than printed materials for knowledge retention over time, and a better retention outcome was found also for LOC. An additional contribution of the paper is the proposal of a novel SG that targets the inclusivity goal of safe evacuation for all, extending SG research to a domain not dealt with before, i.e., assisting persons with disabilities in emergencies.
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Pan S, Ren X, Vos S, Brombacher A. NutriColoring: designing a doodling toolkit to support daily self-reported dietary assessment among office workers. Front Psychol 2023; 14:1265218. [PMID: 38130964 PMCID: PMC10734690 DOI: 10.3389/fpsyg.2023.1265218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
This study was motivated by a desire to help working-age individuals gain a better understanding of their daily nutritional intakes with a new self-reported dietary assessment method because an unhealthy eating behavior increases the risks of developing chronic diseases. In this study, we present the design and evaluation of NutriColoring, a food diary that leverages doodling on sketches to report and reflect on everyday diet in the working context. Through a 2-week field study involving 18 participants, the usefulness of NutriColoring in facilitating dietary assessment was tested by making comparisons with the typical bullet diary method. Our quantitative results showed that NutriColoring provided users with improved dietary assessment experience and intrinsic motivations, with significantly low task frustration and high enjoyment. Because of the freedom and playfulness in reporting intakes at work, the interview findings showed a high acceptance of employing NutriColoring at work. This article is concluded with a set of implications for the design and development of a Doodling toolkit to support healthy eating behaviors among office workers.
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Affiliation(s)
- Sibo Pan
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Xipei Ren
- School of Design and Arts, Beijing Institute of Technology, Beijing, China
| | - Steven Vos
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, Netherlands
| | - Aarnout Brombacher
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
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Brady VJ, Mathew Joseph N, Ju HH. Impact of Gaming (Gamification) on Diabetes Self-Care Behaviors and Glycemic Outcomes Among Adults With Type 2 Diabetes. Sci Diabetes Self Manag Care 2023; 49:493-511. [PMID: 37927059 PMCID: PMC10666525 DOI: 10.1177/26350106231208153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
PURPOSE The purpose of this systematic review was to determine if the use of gaming (gamification) among persons with type 2 diabetes improves diabetes self-management behaviors and diabetes outcomes. METHODS A systematic review was conducted using electronic databases including MEDLINE, Embase, Web of Science, and CINAHL. Studies reporting on the impact of gaming on at least 1 of the Association of Diabetes Care and Education Specialists self-care behaviors (ADCES7) were included. RESULTS The review included 9 studies, 8 of which were of strong/high quality. Five of the self-care behaviors were addressed in at least 1 of the included studies. However, taking medications and problem solving were not reported in any of the studies. Physical activity and self-efficacy or quality of life (healthy coping) were the most frequently reported ADCES7 behaviors. Six of the studies used A1C as an outcome measure, with a reduction reported in all the studies except 1. CONCLUSION Type 2 diabetes affects a person holistically, necessitating a range of self-care behaviors to effectively manage the chronic condition. Novel gaming interventions may improve coping mechanisms, lifestyle behaviors, medication engagement, and monitoring of risks and problems, all of which are essential in facilitating optimal diabetes self-management.
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Affiliation(s)
- Veronica Joyce Brady
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Nitha Mathew Joseph
- Department of Undergraduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Hsiao-Hui Ju
- Department of Undergraduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas
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Aneni K, Fernandes CSF, Hoerner LA, Szapary C, Pendergrass Boomer TM, Fiellin LE. A Video Game Intervention to Prevent Opioid Misuse Among Older Adolescents: Development and Preimplementation Study. JMIR Serious Games 2023; 11:e46912. [PMID: 37921851 PMCID: PMC10656656 DOI: 10.2196/46912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/31/2023] [Accepted: 09/08/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Opioid misuse and mental disorders are highly comorbid conditions. The ongoing substance misuse and mental health crises among adolescents in the United States underscores the importance of widely scalable substance misuse preventive interventions that also address mental health risks. Serious video games offer an engaging, widely scalable method for delivering and implementing preventive interventions. However, there are no video game interventions that focus on preventing opioid misuse among older adolescents, and there are limited existing video game interventions that address mental health. OBJECTIVE This study aims to develop and conduct a formative evaluation of a video game intervention to prevent opioid misuse and promote mental health among adolescents aged 16-19 years (PlaySmart). We conducted formative work in preparation for a subsequent randomized controlled trial. METHODS We conducted development and formative evaluation of PlaySmart in 3 phases (development, playtesting, and preimplementation) through individual interviews and focus groups with multiple stakeholders (adolescents: n=103; school-based health care providers: n=51; and addiction treatment providers: n=6). PlaySmart content development was informed by the health belief model, the theory of planned behavior, and social cognitive theory. User-centered design principles informed the approach to development and play testing. The Exploration, Preparation, Implementation, and Sustainability framework informed preimplementation activities. Thematic analysis was used to identify themes from interviews and focus groups that informed PlaySmart game content and approaches to future implementation of PlaySmart. RESULTS We developed a novel video game PlaySmart for older adolescents that addresses the risk and protective factors for opioid misuse and mental health. Nine themes emerged from the focus groups that provided information regarding game content. Playtesting revealed areas of the game that required improvement, which were modified for the final game. Preimplementation focus groups identified potential barriers and facilitators for implementing PlaySmart in school settings. CONCLUSIONS PlaySmart offers a promising digital intervention to address the current opioid and mental health crises among adolescents in a scalable manner.
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Affiliation(s)
- Kammarauche Aneni
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Claudia-Santi F Fernandes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Lily A Hoerner
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Claire Szapary
- Yale School of Public Health, New Haven, CT, United States
| | | | - Lynn E Fiellin
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
- Yale School of Public Health, New Haven, CT, United States
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Pendergrass Boomer TM, Hoerner LA, Fernandes CSF, Maslar A, Aiudi S, Kyriakides TC, Fiellin LE. A digital health game to prevent opioid misuse and promote mental health in adolescents in school-based health settings: Protocol for the PlaySmart game randomized controlled trial. PLoS One 2023; 18:e0291298. [PMID: 37683047 PMCID: PMC10490848 DOI: 10.1371/journal.pone.0291298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/10/2023] Open
Abstract
Adolescents who engage in non-opioid substance misuse and/or experience mental health symptoms are at greater risk of misusing opioids and/or developing opioid use disorder. Adolescence is a critical developmental period to both prevent the initiation of opioid misuse and target mental health. To date, there are no digital health games targeting both conditions. We describe the protocol for a randomized controlled trial designed to assess the efficacy of an original digital health game, PlaySmart. Five hundred and thirty-two adolescents aged 16-19 years old, who are at greater risk for initiating opioid misuse are recruited from 10 Connecticut school-based health sites. Participants are randomized to PlaySmart or a set of time/attention control videogames. Randomization was stratified by sex at birth and school grade. Participants play their assigned game or games for up to six weeks (300 minutes) and complete assessment questions over a 12-month period (baseline, post-gameplay, 3, 6, and 12 months). The primary outcome is perception of risk of harm of opioid misuse at 3 months. Secondary outcome measures specific to opioid misuse include intentions, self-efficacy, attitudes, knowledge, and perceived norms. Mental health outcomes include measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), help-seeking behaviors, stigma, measures of self-regulation, self-efficacy to seek professional help for mental health, and knowledge around coping skills. PlaySmart has the potential to significantly reduce the risk of initiation of opioid misuse, improve mental health outcomes, and given its high levels of engagement and accessibility, holds the promise for extensive reach, scale, and impact for adolescents. Trial registration: ClinicalTrials.gov: NCT04941950. Registered on 23 June 2021.
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Affiliation(s)
- Tyra M. Pendergrass Boomer
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Lily A. Hoerner
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Claudia-Santi F. Fernandes
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Yale Child Study Center, New Haven, CT, United States of America
- Department of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States of America
| | - Amber Maslar
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Sherry Aiudi
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Tassos C. Kyriakides
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Lynn E. Fiellin
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Yale Child Study Center, New Haven, CT, United States of America
- Yale School of Public Health, New Haven, CT, United States of America
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Overviewing Gaming Motivation and Its Associated Psychological and Sociodemographic Variables: A PRISMA Systematic Review. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2023. [DOI: 10.1155/2023/5640258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Nowadays, video games are part of our everyday life, and the number of players is increasing each day passing by. Thus, understanding what motivations drive people to play video games is becoming a very important topic for researchers. That is why this systematic review had the objective to summarize the existing literature about gaming motivation by including papers that used a validated tool to do so while excluding those that did address just the psychopathological aspect of gaming. The systematic review was carried out through the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRSIMA). A total of 53 papers were included in this systematic review, and the findings revealed that nonaddicted players and addicted players seem both to play for social, achievement, and competition motivations. Male players appeared more oriented to play to compete with others, while female players seemed to use games for relationship and social reasons. Gaming motivation was stronger in younger people.
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Weser V, Opara I, Budge M, Duncan L, Fernandes CSF, Hussett-Richardson S, Sands B, Hieftje K. Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e43666. [PMID: 36689272 PMCID: PMC9903186 DOI: 10.2196/43666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Black adolescent girls aged between 14 and 19 years are more likely than White girls to be diagnosed with a sexually transmitted infection (STI). As STI diagnosis is associated with an increase in the risk for HIV acquisition, an early intervention specifically tailored to Black adolescent girls is warranted. A web-based video game intervention has the potential to reach this demographic. Because studies of social and behavioral determinants of disease demonstrate the protective role of peer group structures on individual outcomes, a multiplayer game can facilitate opportunities to exchange and evaluate information, learn social norms, develop behavioral skills, and allow peers to influence attitudes and behavior. No prior research has examined the feasibility of a web-based multiplayer game intervention for this population. OBJECTIVE This study describes the protocol for a randomized controlled trial (RCT) pilot-testing the feasibility, acceptability, and limited efficacy of a multiplayer game-based intervention for increasing HIV and STI testing and condom use in Black adolescent girls. METHODS We enrolled 79 Black adolescent girls aged 14 to 19 years residing in the United States into a 2-arm parallel RCT. The intervention is a theory-based, community-informed, multiplayer game that can be played with peers on the web using videoconferencing software. The goal of the game is to empower Black adolescent girls to make healthy decisions regarding dating, relationships, and sex, thus reducing HIV and STI infection. Control condition participants received a list of resources after playing a time and attention control game. All study procedures were conducted via the internet. We conveniently sampled Black adolescent girls using web-based advertisements. Study assessments occurred at enrollment, 1 week, 1 month, and 4 months after enrollment. The primary outcome of this study is increased HIV and STI testing by Black adolescent girls. Secondary outcomes include increased condom use, self-efficacy to use condoms, positive attitudes toward condom use, intentions, harm perceptions, HIV and STI and pre-exposure prophylaxis knowledge, positive sexual norms, sexual communication with partners, and reduced incidence of sexual risk behaviors associated with HIV and STI transmission. Secondary outcomes also included assessment of intervention feasibility and acceptability. RESULTS From February to April 2022, a total of 79 Black adolescent girls were enrolled, with 40 (51%) having been randomized into the intervention condition and 39 (49%) into the control condition. At baseline, participant ages ranged from 14 to 19 (mean 16.4, SD 1.23) years. CONCLUSIONS Web-accessible game interventions overcome common impediments of face-to-face interventions presenting a unique opportunity to reach Black adolescent girls and improve their sexual health and self-efficacy. Trial data will provide information about the limited efficacy of the intervention and inform future web-based studies and a larger RCT aimed at improving the sexual health of Black adolescent girls. TRIAL REGISTRATION ClinicalTrials.gov NCT04108988; https://clinicaltrials.gov/ct2/show/NCT04108988. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43666.
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Affiliation(s)
| | - Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Mariana Budge
- Yale School of Medicine, New Haven, CT, United States
| | - Lindsay Duncan
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | | | | | - Brandon Sands
- Yale School of Medicine, New Haven, CT, United States
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Ouedraogo I, Some BMJ, Oyibo K, Benedikter R, Diallo G. Using serious mobile games to improve health literacy in rural Sub-Saharan Africa: A literature review. Front Public Health 2022; 10:768252. [PMID: 36466518 PMCID: PMC9717679 DOI: 10.3389/fpubh.2022.768252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/27/2022] [Indexed: 11/18/2022] Open
Abstract
The African gaming industry is beginning to flourish as a result of a rise in the availability of inexpensive phones and the number of mobile phone subscribers. It has enabled the development and implementation of mobile serious games to promote healthy behavior change in rural communities. This paper examines the use of mobile serious games in healthcare education, with a particular focus on those designed to increase health literacy in rural Africa. Identifying and addressing the design challenges and issues faced by people living in rural African communities through the use of persuasive mobile games can promote behavior change among these underserved communities. We used PubMed, Scopus, Google Scholar and manual search to identify relevant studies published from 2011 to July 2021. The literature review highlights how the identified challenges affect the implementation of persuasive strategies, suggests design solutions for overcoming them, and discusses how persuasive games can be tailored to suit the target rural African populations. Some of the identified challenges are technical in nature (e.g., access to electricity and internet connectivity), while others are not (e.g., language diversity and low literacy). As the number of serious games for healthcare education and awareness continues to increase, it is essential for the successful implementation of inclusive mobile health technologies in rural Africa to identify and address the specific challenges faced by underserved populations such as rural African communities.
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Affiliation(s)
- Ismaila Ouedraogo
- Bordeaux Population Health INSERM–U1219–Univ. Bordeaux, Bordeaux, France,*Correspondence: Ismaila Ouedraogo
| | | | - Kiemute Oyibo
- Electrical Engineering and Computer Science, York University, Toronto, ON, Canada
| | | | - Gayo Diallo
- Bordeaux Population Health INSERM–U1219–Univ. Bordeaux, Bordeaux, France
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Socially-Oriented Persuasive Game to Promote Disease Awareness and Prevention. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2022. [DOI: 10.1155/2022/9403578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Persuasive games are widely implemented in the health domain to promote desirable behaviour change. Previous research shows that using persuasive games employing various strategies results in increased motivation and awareness that led to a positive change in behaviour. This paper investigates the efficacy of a competition-based persuasive game at creating awareness and motivating people to adhere to COVID-19 precautionary measures. To achieve this goal, we developed and evaluated a competition-based persuasive game to promote the awareness and adoption of COVID-19 precautionary measures. The results of our pretest and posttest study (
) followed by a semistructured interview of 18 participants show the efficacy of the game with respect to promoting a positive change in attitude, intention, self-efficacy, knowledge, and promoting motivation and positive player experience among participants. The qualitative results provide insight into how and why persuasive games promote desirable behaviour. The paper contributes to the knowledge of how emerging technologies in the form of persuasive games can be designed and used to contribute to solving problems in our society.
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Ricci F, Bravo G. Live-Action Role Playing for Safety Training: Effectiveness Evaluation in two Italian Companies. New Solut 2022; 32:144-154. [PMID: 35686304 DOI: 10.1177/10482911221105785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Researchers, corporate decision-makers, government agencies, and international bodies want to know how to improve safety and limit the serious social and economic consequences of occupational injuries. Understanding how to deliver effective training is important to achieving this aim. Gamification is considered a new frontier in effective safety training. This study tested the use of gamification in safety training, considering two Italian companies that used a live-action role-play methodology called "PratiCARE la Sicurezza." Workers who were required by Italian law to receive safety training or retraining participated in a pre-post study. Collection of measures relating to knowledge, attitudes, behaviors, and perception of the health and safety climate took place at baseline and immediately after the intervention. Participants' average safety knowledge at the end of the training was significantly better than the initial level, indicating that the training improved workers' knowledge level.
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Affiliation(s)
- Federico Ricci
- 9306University of Modena and Reggio Emilia, Modena, Italy
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Oinas-Kukkonen H, Pohjolainen S, Agyei E. Mitigating Issues With/of/for True Personalization. Front Artif Intell 2022; 5:844817. [PMID: 35558170 PMCID: PMC9087902 DOI: 10.3389/frai.2022.844817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
A common but false perception persists about the level and type of personalization in the offerings of contemporary software, information systems, and services, known as Personalization Myopia: this involves a tendency for researchers to think that there are many more personalized services than there genuinely are, for the general audience to think that they are offered personalized services when they really are not, and for practitioners to have a mistaken idea of what makes a service personalized. And yet in an era, which mashes up large amounts of data, business analytics, deep learning, and persuasive systems, true personalization is a most promising approach for innovating and developing new types of systems and services—including support for behavior change. The potential of true personalization is elaborated in this article, especially with regards to persuasive software features and the oft-neglected fact that users change over time.
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Abstract
Over the years, there has been a significant increase in the adoption of game-based interventions for behaviour change associated with many fields such as health, education, and psychology. This is due to the significance of the players’ intrinsic motivation that is naturally generated to play games and the substantial impact they can have on players. Many review papers measure the effectiveness of the use of gaming on changing behaviours; however, these studies neglect the game features involved in the game design process, which have an impact of stimulating behaviour change. Therefore, this paper aimed to identify game design mechanics and features that are reported to commonly influence behaviour change during and/or after the interventions. This paper identified key theories of behaviour change that inform the game design process, providing insights that can be adopted by game designers for informing considerations on the use of game features for moderating behaviour in their own games.
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Ndulue C, Oyebode O, Iyer RS, Ganesh A, Ahmed SI, Orji R. Personality-targeted persuasive gamified systems: exploring the impact of application domain on the effectiveness of behaviour change strategies. USER MODELING AND USER-ADAPTED INTERACTION 2022; 32:165-214. [PMID: 35281337 PMCID: PMC8900644 DOI: 10.1007/s11257-022-09319-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
Persuasive gamified systems for health are interventions that promote behaviour change using various persuasive strategies. While research has shown that these strategies are effective at motivating behaviour change, there is little knowledge on whether and how the effectiveness of these strategies vary across multiple domains for people of distinct personality traits. To bridge this gap, we conducted a quantitative study with 568 participants to investigate (a) whether the effectiveness of the persuasive strategies implemented vary within each domain (b) whether the effectiveness of various strategies vary across two distinct domains, (c) how people belonging to different personality traits respond to these strategies, and (d) if people high in a personality trait would be influenced by a persuasive strategy within one domain and not in the other. Our results show that there are significant differences in the effectiveness of various strategies across domains and that people's personality plays a significant role in the perceived persuasiveness of different strategies both within and across distinct domains. The Reward strategy (which involves incentivizing users for achieving specific milestones towards the desired behaviour) and the Competition strategy (which involves allowing users to compete with each other to perform the desired behaviour) were effective for promoting healthy eating but not for smoking cessation for people high in Conscientiousness. We provide design suggestions for developing persuasive gamified interventions for health targeting distinct domains and tailored to individuals depending on their personalities.
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Affiliation(s)
- Chinenye Ndulue
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
| | - Oladapo Oyebode
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
| | | | - Anirudh Ganesh
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
| | | | - Rita Orji
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
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Vepsäläinen H, Skaffari E, Wojtkowska K, Barlińska J, Kinnunen S, Makkonen R, Heikkilä M, Lehtovirta M, Ray C, Suhonen E, Nevalainen J, Sajaniemi N, Erkkola M. A Mobile App to Increase Fruit and Vegetable Acceptance Among Finnish and Polish Preschoolers: Randomized Trial. JMIR Mhealth Uhealth 2022; 10:e30352. [PMID: 34982718 PMCID: PMC8767468 DOI: 10.2196/30352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/08/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background Early childhood education and care (ECEC) centers are ideal venues for food education. As smartphones and tablets are becoming increasingly popular in ECEC centers, technology can be used to deliver such pedagogical content. Evidence suggests that video games can affect fruit and vegetable (FV) consumption among 9- to 12-year-old children, but studies among preschoolers are scarce. Objective This paper describes the development of the Mole’s Veggie Adventures app and its effectiveness in increasing FV acceptance among Finnish and Polish preschoolers aged 3 to 6 years. Methods A multiprofessional team created an app to be used in ECEC centers in groups of 3 to 10 children. The app aimed to increase vegetable acceptance, and it was built using elements that support the development of self-regulation and social skills. Altogether, 7 Finnish and 4 Polish ECEC centers participated in the study. Before randomization, parents reported background factors and their children’s willingness to taste different FVs. The ECEC professionals in the intervention arm were instructed to use the app at least once a week during the 3- to 4-week intervention period. The main outcomes in this unblinded, cluster-randomized study were FV acceptance and relative FV acceptance. The first was calculated as a sum variable describing the children’s willingness to taste 25 different FVs, the second as FV acceptance divided by the number of FVs served. We used analysis of covariance to compare the FV acceptance and relative FV acceptance scores between the intervention and control groups at follow-up. Results A total of 221 children were included in the analysis. At follow-up, the intervention group (115/221, 52%) had higher FV acceptance scores (baseline adjusted difference of mean 7.22; 95% CI 1.41-13.03) than the control group (106/221, 48%). The intervention effect was parallel for relative FV acceptance scores (baseline adjusted difference of mean 0.28; 95% CI 0.05-0.52). Conclusions The Mole’s Veggie Adventures app has the potential to increase FV acceptance among preschoolers and can be a valuable tool in supporting food education in ECEC centers. Furthermore, the app can be feasibly incorporated into preschool routines in countries with different educational environments. Trial Registration ClinicalTrials.gov NCT05173311; https://tinyurl.com/4vfbh283
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Affiliation(s)
- Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Essi Skaffari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | | | - Satu Kinnunen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Riikka Makkonen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Maria Heikkilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Mikko Lehtovirta
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Carola Ray
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eira Suhonen
- Department of Education, University of Helsinki, Helsinki, Finland
| | | | - Nina Sajaniemi
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
- Department of Education, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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15
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Abraham O, Szela L, Brasel K, Hoernke M. Engaging youth in the design of prescription opioid safety education for schools. J Am Pharm Assoc (2003) 2022; 62:441-449. [PMID: 34736864 PMCID: PMC9536462 DOI: 10.1016/j.japh.2021.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Opioid misuse continues to be a major concern in the United States, affecting both adults and adolescents. Unfortunately, even legitimate prescription opioid misuse in adolescence increases the risk for misuse later in life. Although adolescence is a critical period for learning, little is known about adolescents' preferences for opioid safety education. One potential avenue for prescription opioid education is the use of serious games. Serious games can result in better health outcomes and understanding for adolescents and allow them to safely experience real-life scenarios. However, few studies have examined the use of serious games for adolescent opioid education. OBJECTIVE This study explored adolescents' preferences for prescription opioid education and design of a serious game focused on opioid safety education. METHODS A focus group guide was adapted from 2 statewide surveys about participants' perspectives on opioids. Recruitment packets with consent documents and an introduction to the study were sent home to eligible students. Ten focus groups were conducted with 68 middle and high school students in Wisconsin. Adolescents were asked to discuss their preferences for prescription opioid safety education and to design a serious game to educate teens about opioid safety. Focus groups were audio-recorded, professionally transcribed, and underwent content and thematic analyses using NVivo 12 software. RESULTS Three preferred approaches for opioid safety education were identified, including the use of presentations, videos and websites, and serious games. Adolescents desired short presentations delivering personal stories to smaller audiences. They preferred websites and brief, engaging videos from reliable sources because of ease of access. Adolescents also preferred serious games for opioid education that were realistic and relatable. CONCLUSION When educating adolescents on prescription opioids, the use of presentations, particularly personal stories, brief and engaging websites and videos, or serious games with realistic and relatable scenarios should be incorporated.
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Affiliation(s)
- Olufunmilola Abraham
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, 777 Highland Avenue, Madison, WI 53705
| | - Lisa Szela
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, Madison, WI, USA
| | - Kelsey Brasel
- University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| | - Margaret Hoernke
- University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
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16
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Wen D, Yao W, Xu J, Wang S, Zhong Y, Chen H, Dong X, Saripan MI, Zhou Y. Electronic Science Games Used to Enhance Cognitive Ability: Opinion of Design From Personalization and Adaptation. Front Aging Neurosci 2021; 13:789547. [PMID: 34867306 PMCID: PMC8633556 DOI: 10.3389/fnagi.2021.789547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Dong Wen
- Institute of Artificial Intelligence, University of Science and Technology Beijing, Beijing, China
| | - Wang Yao
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Jian Xu
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Shaochang Wang
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Yingzhu Zhong
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Hongqian Chen
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Xianling Dong
- Department of Biomedical Engineering, Chengde Medical University, Chengde, China
| | - M Iqbal Saripan
- Faculty of Engineering, Universiti Putra Malaysia, Serdang, Malaysia
| | - Yanhong Zhou
- School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
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17
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Luo M, Allman-Farinelli M. Trends in the Number of Behavioural Theory-Based Healthy Eating Interventions Inclusive of Dietitians/Nutritionists in 2000-2020. Nutrients 2021; 13:nu13114161. [PMID: 34836417 PMCID: PMC8623843 DOI: 10.3390/nu13114161] [Citation(s) in RCA: 6] [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: 09/26/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.
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Affiliation(s)
- Man Luo
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310020, China
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Correspondence: ; Tel.: +61-2-90367045
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18
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Gamification for the Improvement of Diet, Nutritional Habits, and Body Composition in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13072478. [PMID: 34371989 PMCID: PMC8308535 DOI: 10.3390/nu13072478] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/29/2021] [Accepted: 07/18/2021] [Indexed: 12/21/2022] Open
Abstract
Currently, one of the main public health problems among children and adolescents is poor adherence to healthy habits, leading to increasingly high rates of obesity and the comorbidities that accompany obesity. Early interventions are necessary, and among them, the use of gamification can be an effective method. The objective was to analyse the effect of game-based interventions (gamification) for improving nutritional habits, knowledge, and changes in body composition. A systematic review and meta-analysis were performed in CINAHL, EMBASE, LILACS, MEDLINE, SciELO, and Scopus databases, following the PRISMA recommendations. There was no restriction by year of publication or language. Only randomized controlled trials were included. Twenty-three articles were found. After the intervention, the consumption of fruit and vegetables increased, as well as the knowledge on healthy food groups. The means difference showed a higher nutritional knowledge score in the intervention group 95% CI 0.88 (0.05–1.75). No significant effect of gamification was found for body mass index z-score. Gamification could be an effective method to improve nutritional knowledge about healthier nutritional habits. Promoting the development of effective educational tools to support learning related to nutrition is necessary in order to avoid and prevent chronic diseases.
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19
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20
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Abraham O, Rosenberger CA, LeMay SM, Bittner SJ. Adolescents' Perceptions About Cancer and Preferences for Cancer Education. Cancer Control 2021; 28:10732748211036057. [PMID: 34403277 PMCID: PMC8375333 DOI: 10.1177/10732748211036057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cancer is one of the leading causes of death within the United States. Adolescence remains a critical stage of development in which new cognitive skills and lifestyle factors related to cancer are acquired. It is critical to understand adolescents' knowledge of cancer and preferences for receiving clear and easy-to-comprehend information about cancer and cancer prevention. The purpose of this study was to explore adolescents' perceptions of cancer and cancer risk factors and identify their preferences for receiving cancer prevention education. METHODS The survey used in this study was based on the Health Belief Model framework, the Youth Risk Behavior Survey, and the Cancer, Clear & Simple (CC&S) Curriculum. The survey evaluated adolescents' knowledge, attitudes, and health-related behaviors regarding cancer and cancer prevention among adolescents. Three Midwestern middle and high schools were recruited, and 235 students completed the survey. Survey responses were analyzed using descriptive statistics. RESULTS Study participants had some basic knowledge of cancer; however, only 66% recognized that individuals have control over their risk of developing cancer. Participants (95%) reported that cancer prevention was important, yet only 37.3% stated they knew how to lower their risk of getting cancer and 50% indicated that they currently try to make decisions that lower their chances of getting cancer. About 82% stated that an educational game would be a useful tool to learn about cancer and prevention. CONCLUSION Study findings indicate the need for an increase in adolescent knowledge of cancer, specifically how they can control their cancer risk, and prevention strategies through development of game-based education to teach adolescents about cancer-related topics.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
- Olufunmilola Abraham, PhD, MS, BPharm, Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, Madison, WI 53705-2222, USA.
| | - Claire A. Rosenberger
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| | - Sarah M. LeMay
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| | - Sarah J. Bittner
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
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21
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Hahn L, Schmidt MD, Rathbun SL, Johnsen K, Annesi JJ, Ahn SJG. Using virtual agents to increase physical activity in young children with the virtual fitness buddy ecosystem: Study protocol for a cluster randomized trial. Contemp Clin Trials 2020; 99:106181. [PMID: 33096225 DOI: 10.1016/j.cct.2020.106181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/17/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Designing and implementing a truly self-determined physical activity (PA) intervention has required excessive amounts of labor and expenses that, until recently, have made it prohibitively costly to implement in the field at scale. METHODS Guided by self-determination theory, and harnessing the power of consumer-grade interactive technologies, we developed the Virtual Fitness Buddy (VFB) Ecosystem. Designed to foster intrinsic motivation toward adopting PA as a lifestyle change in 6-10-year-old children, the Ecosystem features a mixed-reality kiosk which houses a personalized virtual pet for each user. Each time a child visits the kiosk, the pet (a mid-sized dog) automatically detects its owner based on the data from a child's Fitbit, assists the child in setting daily PA goals and provides tailored feedback on the child's PA progress. The pet alerts parents in real-time by sending text messages and relaying the parents' response to the child, so that parents and children can remain connected about the child's PA progress even when they are physically apart. We aim to implement the kiosk in 12 after-school sites, plus use 12 additional sites as controls, where children can still set and view progress toward their PA goals without access to a virtual pet. CONCLUSION The VFB Ecosystem represents a new generation of technology-mediated health interventions for children to promote sustainable PA lifestyle changes. Because the VFB Ecosystem is a cost- and labor-effective solution that integrates consumer-grade technology with low barriers for continued use, it has the potential for rapid diffusion and widespread public health impact.
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Affiliation(s)
- Lindsay Hahn
- Department of Communication, University at Buffalo, State University of New York, United States.
| | | | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, University of Georgia, United States
| | - Kyle Johnsen
- College of Engineering, University of Georgia, United States
| | - James J Annesi
- YMCA of Metro Atlanta, United States; School of Health Professions, University of Alabama at Birmingham, United States
| | - Sun Joo Grace Ahn
- Grady College of Journalism & Mass Communication, University of Georgia, United States
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22
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Holzmann SL, Schäfer H, Plecher DA, Stecher L, Klinker GJ, Groh G, Hauner H, Holzapfel C. Serious Games for Nutritional Education: Online Survey on Preferences, Motives, and Behaviors Among Young Adults at University. JMIR Serious Games 2020; 8:e16216. [PMID: 32490847 PMCID: PMC7301263 DOI: 10.2196/16216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/26/2019] [Accepted: 04/23/2020] [Indexed: 01/27/2023] Open
Abstract
Background Data on nutritional information and digital gameplay are limited among young adults in Germany. Objective This survey aimed to gather data on nutritional information sources and digital games for nutritional education (preferences, motives, and behaviors) among young adults at both Munich universities in Germany. Methods An online survey was developed by an multidisciplinary research group using EvaSys, an in-house survey software. The questionnaire (47 items) covered questions about baseline characteristics (eg, housing situation and weight), nutrition (eg, nutritional information sources), and digital (nutritional) gameplay (eg, preferences, motives, and behaviors). A feedback field was also provided. This publication is based on a selection of 20 questions (7 baseline characteristics, 2 nutrition, 11 gameplay). Young adults, primarily Munich university students aged from 18 to 24 years, were invited to participate by digital and nondigital communication channels between 2016 and 2017. Statistical analyses were performed using Excel 2013 (Microsoft Corp) and R version 3.1.3 (R Foundation for Statistical Computing). Results In total, 468 young adults (342/468, 73.1% women; 379/468, 81.0% university students) participated. Most of the participants (269/468, 57.5%) were aged 18 to 24 years with a BMI in the normal weight range (346/447, 77.4%). Mean body weight was 65.5 [SD 14.0] kg. Most participants reported getting nutritional information from the internet (372/467, 79.7%) and printed media (298/467, 63.8%), less than 1.0% (2/467, 0.4%) named digital games. Apps (100/461, 21.7%) and university/workplace (146/461, 31.7%) were the most desired sources for additional information about nutrition, while 10.0% (46/461, 10.0%) of participants stated wanting digital games. Almost two-thirds (293/468, 62.6%) of participants played digital games, while one-fifth (97/456, 21.3%) played digital games daily using smartphones or tablets. Finally, most respondents (343/468, 73.3%), mainly women, expressed interest in obtaining nutritional information during digital gameplay. However, significant gender differences were shown for nutritional acquisition behaviors and digital gameplay preferences, motives, and behaviors. Conclusions Our survey population reported playing digital games (especially men) and wanting nutritional information during digital gameplay (especially women). Furthermore, university or workplace are named as preferred settings for nutritional information. Therefore, a digital game app might have the potential to be a tool for nutritional education among young adults within the university or workplace environment.
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Affiliation(s)
- Sophie Laura Holzmann
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hanna Schäfer
- Research Group Social Computing, Department of Informatics, Technical University of Munich, Garching, Germany
| | - David Alexander Plecher
- Chair for Computer Aided Medical Procedures & Augmented Reality, Department of Informatics, Technical University of Munich, Garching, Germany
| | - Lynne Stecher
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gudrun Johanna Klinker
- Chair for Computer Aided Medical Procedures & Augmented Reality, Department of Informatics, Technical University of Munich, Garching, Germany
| | - Georg Groh
- Research Group Social Computing, Department of Informatics, Technical University of Munich, Garching, Germany
| | - Hans Hauner
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
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23
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Zhou C, Occa A, Kim S, Morgan S. A Meta-analysis of Narrative Game-based Interventions for Promoting Healthy Behaviors. JOURNAL OF HEALTH COMMUNICATION 2019; 25:54-65. [PMID: 31829829 DOI: 10.1080/10810730.2019.1701586] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Health interventions that use serious games have become increasingly popular. However, many of these games have been designed with few immersive game features which would improve users' engagement with the persuasive messages. To address this issue, researchers have incorporated narrative elements in games to facilitate message processing and enhance behavioral change. There have been theoretical debates about whether narratives benefit these interventions; empirical evidences for their effects are slightly mixed. This meta-analysis provides a deeper understanding of the overall impact of narrative game-based interventions on health-related behaviors and their psychological determinants. Combining the results from 22 studies, this meta-analysis found that narrative game-based interventions were effective in changing behaviors, knowledge, self-efficacy, and enjoyment. These effects were moderated by factors such as the genre of the game, the genre of the story, group play, and participant age. Implications of the findings and suggestions for future design of narrative game-based interventions were discussed.
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Affiliation(s)
- Chun Zhou
- Department of Communication, College of Communication, Architecture + The Arts, Florida International University, Miami, Florida, USA
| | - Aurora Occa
- Department of Communication, College of Communication and Information, University of Kentucky, Lexington, Kentucky, USA
| | - Soyoon Kim
- Department of Communication Studies, School of Communication, University of Miami, Coral Gables, Florida, USA
| | - Susan Morgan
- Department of Communication Studies, School of Communication, University of Miami, Coral Gables, Florida, USA
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Huang KT. Exergaming Executive Functions: An Immersive Virtual Reality-Based Cognitive Training for Adults Aged 50 and Older. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2019; 23:143-149. [PMID: 31794673 DOI: 10.1089/cyber.2019.0269] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prior research suggests that both exergaming and virtual reality (VR)-based training programs could improve executive functions in older adults. However, few studies investigated whether combining exergaming with VR would be more effective. This study seeks to (a) investigate whether playing exergames in an immersive virtual environment (IVE) would yield differential outcomes in selected executive functions, including inhibition, task switching, and working, and (b) examine the role of feeling of presence as a potential mediator between immersive exergaming and cognitive improvement in specific domains. Thirty-three participants over 50 years of age (mean age = 62) participated in a 4-week training program and were randomly assigned into an IVE and non-IVE to play an exergame (Fruit Ninja) for eight sessions within 4 weeks. The results revealed a significant effect of the IVE on the Stroop Test and Trail Making Test after the 4-week training. Furthermore, the impacts of the IVE exergaming on these two tasks were mediated by the feeling of presence. These findings suggested that the immersive experience of exergaming would elicit the feeling of presence, which later contributes to improved cognitive performances in inhibition and task switching. For the theoretical implications, this study extends previous research by showing that (a) feeling of presence could contribute to older adults' cognitive improvement, and (b) the impacts of immersive exergame training on executive functions vary across individual domains. Additionally, this study provides practical implications such that the design of exergames could emphasize the game features requiring mental simulation, which can serve as a novel strategy for preventing cognitive decline in midlife and old age.
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Affiliation(s)
- Kuo-Ting Huang
- Department of Journalism, Center for Emerging Media Design and Development, Ball State University, Muncie, Indiana
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25
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Radomski AD, Wozney L, McGrath P, Huguet A, Hartling L, Dyson MP, Bennett KJ, Newton AS. Potential Reduction of Symptoms With the Use of Persuasive Systems Design Features in Internet-Based Cognitive Behavioral Therapy Programs for Children and Adolescents With Anxiety: A Realist Synthesis. JMIR Ment Health 2019; 6:e13807. [PMID: 31647474 PMCID: PMC7017649 DOI: 10.2196/13807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/03/2019] [Accepted: 08/04/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Internet-based cognitive behavioral therapy (iCBT) for children and adolescents is a persuasive system that combines 3 major components to therapy-therapeutic content, technological features, and interactions between the user and program-intended to reduce users' anxiety symptoms. Several reviews report the effectiveness of iCBT; however, iCBT design and delivery components differ widely across programs, which raise important questions about how iCBT effects are produced and can be optimized. OBJECTIVE The objective of this study was to review and synthesize the iCBT literature using a realist approach with a persuasive systems perspective to (1) document the design and delivery components of iCBT and (2) generate hypotheses as to how these components may explain changes in anxiety symptoms after completing iCBT. METHODS A multi-strategy search identified published and gray literature on iCBT for child and adolescent anxiety up until June 2019. Documents that met our prespecified inclusion criteria were appraised for relevance and methodological rigor. Data extraction was guided by the persuasive systems design (PSD) model. The model describes 28 technological design features, organized into 4 categories that help users meet their health goals: primary task support, dialogue support, system credibility support, and social support. We generated initial hypotheses for how PSD (mechanisms) and program delivery (context of use) features were linked to symptom changes (outcomes) across iCBT programs using realist and meta-ethnographic techniques. These hypothesized context-mechanism-outcome configurations were refined during analysis using evidence from the literature to improve their explanatory value. RESULTS A total of 63 documents detailing 15 iCBT programs were included. A total of six iCBT programs were rated high for relevance, and most studies were of moderate-to-high methodological rigor. A total of 11 context-mechanism-outcome configurations (final hypotheses) were generated. Configurations primarily comprised PSD features from the primary task and dialogue support categories. Several key PSD features (eg, self-monitoring, simulation, social role, similarity, social learning, and rehearsal) were consistently reported in programs shown to reduce anxiety; many features were employed simultaneously, suggesting synergy when grouped. We also hypothesized the function of PSD features in generating iCBT impacts. Adjunct support was identified as an important aspect of context that may have complemented certain PSD features in reducing users' anxiety. CONCLUSIONS This synthesis generated context-mechanism-outcome configurations (hypotheses) about the potential function, combination, and impact of iCBT program components thought to support desired program effects. We suggest that, when delivered with adjunct support, PSD features may contribute to reduced anxiety for child and adolescent users. Formal testing of the 11 configurations is required to confirm their impact on anxiety-based outcomes. From this we encourage a systematic and deliberate approach to iCBT design and evaluation to increase the pool of evidence-based interventions available to prevent and treat children and adolescents with anxiety.
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Affiliation(s)
- Ashley D Radomski
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Lori Wozney
- Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada
| | - Patrick McGrath
- Department of Psychology, Dalhousie University, Halifax, NS, Canada.,Department of Pediatrics, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Anna Huguet
- Department of Community of Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Lisa Hartling
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Michele P Dyson
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Kathryn J Bennett
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Amanda S Newton
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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26
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Hieftje K, Duncan L, Florsheim O, Sawyer B, Fiellin LE. One Night Stan: Feasibility Study of an HIV Prevention and Sexual Risk Reduction Social Card Game for Young Black Women. Games Health J 2019; 8:112-120. [PMID: 30964717 DOI: 10.1089/g4h.2017.0106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To develop and test the feasibility and preliminary impact of the social card game prototype, One Night Stan, a theory-driven and evidence-based human immunodeficiency virus (HIV) prevention intervention for young black women. MATERIALS AND METHODS The study included the enrollment of 21 young, heterosexual black women (mean age 19) to test the feasibility and preliminary impact of the card game, using a pre/postdesign. Participant satisfaction and gameplay experience were assessed using quantitative and qualitative measures. Knowledge, self-efficacy, and intentions regarding condom use and HIV/sexually transmitted infection partner testing were assessed using standardized assessments. Effect sizes for the change in these outcome variables were calculated to determine the preliminary efficacy of the game. RESULTS One hundred percent of participants reported that that they would play the game again, 95% liked the way the game looked, 100% enjoyed playing the game, and 100% reported that they would tell their friends to play. Effect sizes were large (ranged from 0.21 to 0.51) for all variables except perceived susceptibility (0.07) and suggest that playing the game can lead to increased self-efficacy and intentions to use condoms and insist that their partners get tested for HIV across time. CONCLUSIONS One Night Stan is a feasible intervention approach and may be efficacious in helping players develop a pattern of cognitions and motivation that can protect them against the risk of HIV.
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Affiliation(s)
- Kimberly Hieftje
- 1 Department of General Medicine, Yale Center for Health and Learning Games, New Haven, Connecticut.,2 play2PREVENT Lab at Yale, New Haven, Connecticut
| | - Lindsay Duncan
- 1 Department of General Medicine, Yale Center for Health and Learning Games, New Haven, Connecticut.,2 play2PREVENT Lab at Yale, New Haven, Connecticut.,3 McGill University, Montreal, Quebec
| | - Orli Florsheim
- 4 Department of Kinesiology and Physical Education, Irvine School of Medicine, University of California, Irvine, California
| | - Ben Sawyer
- 1 Department of General Medicine, Yale Center for Health and Learning Games, New Haven, Connecticut.,2 play2PREVENT Lab at Yale, New Haven, Connecticut.,5 Digitalmill, Inc., Freeport, Maine
| | - Lynn E Fiellin
- 1 Department of General Medicine, Yale Center for Health and Learning Games, New Haven, Connecticut.,2 play2PREVENT Lab at Yale, New Haven, Connecticut.,6 Yale Child Study Center, New Haven, Connecticut
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27
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Baranowski T, Ryan C, Hoyos-Cespedes A, Lu AS. Nutrition Education and Dietary Behavior Change Games: A Scoping Review. Games Health J 2019; 8:153-176. [PMID: 30339086 PMCID: PMC6909754 DOI: 10.1089/g4h.2018.0070] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Games provide an attractive venue for engaging participants and increasing nutrition-related knowledge and dietary behavior change, but no review has appeared devoted to this literature. A scoping review of nutrition education and dietary behavior change videogames or interactive games was conducted. A systematic search was made of PubMed, Agricola, and Google Scholar. Information was abstracted from 22 publications. To be included, the publication had to include a videogame or interactive experience involving games (a videogame alone, minigames inserted into a larger multimedia experience, or game as part of a human-delivered intervention); game's design objective was to influence dietary behavior, a psychosocial determinant of a dietary behavior, or nutrition knowledge (hereinafter referred to as diet-related); must have been reported in English and must have appeared in a professional publication, including some report of outcomes or results (thereby passing some peer review). This review was restricted to the diet-related information in the selected games. Diversity in targeted dietary knowledge and intake behaviors, targeted populations/audiences, game mechanics, behavioral theories, research designs, and findings was revealed. The diversity and quality of the research in general was poor, precluding a meta-analysis or systematic review. All but one of the studies reported some positive outcome from playing the game(s). One reported that a web-based education program resulted in more change than the game-based intervention. Studies of games may have been missed; a number of dietary/nutrition games are known for which no evaluation is known; and the data presented on the games and research were limited and inconsistent. Conclusions and Implications: A firmer research base is needed to establish the efficacy and effectiveness of nutrition education and dietary behavior change games.
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Affiliation(s)
- Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Courtney Ryan
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | | | - Amy Shirong Lu
- Health Technology Lab, Department of Communication Studies, College of Arts, Media & Design, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
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Schwarz A, Mertens L, Simons M, Spook JE, Thompson D, Cardon G, De Bourdeaudhuij I, Chastin SF, DeSmet A. Which Game Narratives Do Adolescents of Different Gameplay and Sociodemographic Backgrounds Prefer? A Mixed-Methods Analysis. Games Health J 2019; 8:195-204. [DOI: 10.1089/g4h.2017.0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ayla Schwarz
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Lieze Mertens
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Monique Simons
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Jorinde E. Spook
- Department of Communication, Philosophy and Technology, Centre for Integrative Development, Wageningen University, Wageningen, The Netherlands
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sebastien F.M. Chastin
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Institute for Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Scotland, United Kingdom
| | - Ann DeSmet
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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Abraham O, Feathers A, Grieve L, Babichenko D. Developing and piloting a serious game to educate children about over‐the‐counter medication safety. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2019. [DOI: 10.1111/jphs.12292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Olufunmilola Abraham
- Social & Administrative Sciences University of Wisconsin‐Madison School of Pharmacy Madison Wisconsin USA
| | - Alison Feathers
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania USA
| | - Lorin Grieve
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania USA
| | - Dmitriy Babichenko
- University of Pittsburgh School of Computing and Information Pittsburgh Pennsylvania USA
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Oyibo K, Orji R, Vassileva J. Developing Culturally Relevant Design Guidelines for Encouraging Physical Activity: a Social Cognitive Theory Perspective. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2018; 2:319-352. [PMID: 35415413 PMCID: PMC8982739 DOI: 10.1007/s41666-018-0026-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 05/08/2018] [Accepted: 05/19/2018] [Indexed: 10/14/2022]
Abstract
The prevalence of physical inactivity and non-communicable diseases is on the rise worldwide. This calls for a systematic approach in addressing the problem, which is almost becoming a global epidemic. Research has shown that theory-driven interventions are more likely to be effective than uninformed interventions. However, research on the determinants of physical activity and the moderating effect of culture is scarce. To bridge this gap, we conducted a large-scale comparative study of the determinants of physical activity among 633 participants from individualist and collectivist cultures. Using the Social Cognitive Theory, a widely applied behavioral theory in health interventions, we modeled the determinants of physical activity for each culture and mapped them to implementable strategies in the application domain. Our structural equation model shows that, in the individualist culture, Self-Efficacy (βT = 0.55, p < 0.001) and Self-Regulation (βT = 0.33, p < 0.001) are the strongest determinants of Physical Activity. However, in the collectivist culture, Social Support (βT = 0.42, p < 0.001) and Outcome Expectation (βT = 0.11, p < 0.01) are the strongest determinants of Physical Activity. We discussed these findings, mapped the respective behavioral determinants to the corresponding persuasive strategies in the health domain and provided a set of general design guidelines for tailoring the strategies to the respective cultures.
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Affiliation(s)
- Kiemute Oyibo
- Multi-User Adaptive Distributed Mobile and Ubiquitous Computing Laboratory, Department of Computer Science, University of Saskatchewan, Saskatoon, S7N 5C9 Canada
| | - Rita Orji
- Faculty of Computer Science, Dalhousie University, Halifax, B3H 4R2 Canada
| | - Julita Vassileva
- Multi-User Adaptive Distributed Mobile and Ubiquitous Computing Laboratory, Department of Computer Science, University of Saskatchewan, Saskatoon, S7N 5C9 Canada
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Safdari R, Ghazisaeidi M, Goodini A. Sweet care against sugar bitterness, designing health-based electronic game. Health Informatics J 2018; 25:1825-1845. [PMID: 30295108 DOI: 10.1177/1460458218799444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Health-based electronic games present an innovative tool to deal with mental and behavioral disorders as well as physical. An appropriately designed game can optimize health care. The aim of this study was to establish a design for health-based electronic games model and to develop a sample game in diabetes. This study was carried out in two phases: first, the design of a health-based electronic game framework and second, the design and production of sweet care game. There were two intended information prerequisites: determination of effective components in models of behavior change and validation of these components on health topics and structural formation of a game. The game framework design was presented. In the second phase, a sample of the game was developed in the field of diabetes. Important components to empower people were ranked using the Friedman test in the following order: self-learning, treatment, mental empowerment, condition management, healthy eating and physical activity. The axis of self-learning received the highest rating from the perspective of the subjects with an average of 3.93 percent. Another part was the game framework with components as follows: application areas, educational content for change behavior, resources, game structure and game production. Finally, the sweet care game was designed on diabetes with educational, technological and clinical content. The health-based electronic game designed on a systematic framework could be applied as a tool to expanding the knowledge base on how to create effective health-based digital games that entertain while promoting behavior change.
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Affiliation(s)
| | | | - Azadeh Goodini
- University of Medical Sciences, Iran; Tehran University of Medical Sciences, Iran
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Nieh HP, Wu WC. Effects of a Collaborative Board Game on Bullying Intervention: A Group-Randomized Controlled Trial. THE JOURNAL OF SCHOOL HEALTH 2018; 88:725-733. [PMID: 30203481 DOI: 10.1111/josh.12675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 11/09/2017] [Accepted: 05/17/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND We examined the effects of the Galaxy Rescuers game, a collaborative board game on schoolchildren's bullying intervention. METHODS We conducted a group-randomized controlled trial. We recruited 328 fifth graders at an elementary school in northern Taiwan. The study took place in fall 2015 over a 7-week period. We used the generalized estimation equation (GEE) to evaluate the intervention effects on students' scores on the outcome measures. RESULTS At posttest, the change in bullying knowledge was statistically significant for the game-only group and the game-with-debriefing group. Students in the game-with-debriefing group also showed an increase in empathy and a decrease in bullying attitude. At the follow-up test, knowledge increase remained significant for both the game-only group and the game-with-debriefing group. Game satisfaction survey indicated that 66.8% of the players said that the game was enjoyable. CONCLUSIONS The Galaxy Rescuers game is effective in changing players' bullying knowledge, attitude, and empathy. This game is an entertaining tool for promoting awareness of bullying and encouraging defending atmosphere among children.
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Affiliation(s)
- Hsi-Ping Nieh
- Journalism and Mass Communication Program, Ming Chuan University, No. 250, Zhong Shan N. Road, Sec. 5, Taipei 111, Taiwan
| | - Wen-Chi Wu
- Department of Health Industry Management, Kainan University, No. 1 Kainan Road, Shinshing Tsuen, Luchu Shiang, Taoyuan 338, Taiwan
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Orji R, Oyibo K, Lomotey RK, Orji FA. Socially-driven persuasive health intervention design: Competition, social comparison, and cooperation. Health Informatics J 2018; 25:1451-1484. [PMID: 29801426 DOI: 10.1177/1460458218766570] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Persuasive technologies are tools for motivating behaviour change using persuasive strategies. socially-driven persuasive technologies employ three common socially-oriented persuasive strategies in many health domains: competition, social comparison, and cooperation. Research has shown the possibilities for socially-driven persuasive interventions to backfire by demotivating behaviour, but we lack knowledge about how the interventions could motivate or demotivate behaviours. To close this gap, we studied 1898 participants, specifically Socially-oriented strategies and their comparative effectiveness in socially-driven persuasive health interventions that motivate healthy behaviour change. The results of a thematic analysis of 278 pages of qualitative data reveal important strengths and weaknesses of the individual socially-oriented strategies that could facilitate or hinder their effectiveness at motivating behaviour change. These include their tendency to simplify behaviours and make them fun, challenge people and make them accountable, give a sense of accomplishment and their tendency to jeopardize user's privacy and relationships, creates unnecessary tension, and reduce self-confidence and self-esteem, and provoke a health disorder and body shaming, respectively. We contribute to the health informatics community by developing 15 design guidelines for operationalizing the strategies in persuasive health intervention to amplify their strengths and overcome their weaknesses.
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Jiang R, McKanna J, Calabrese S, Seif El-Nasr M. Iterative Design and Testing for the Development of a Game-Based Chlamydia Awareness Intervention: A Pilot Study. Games Health J 2018; 6:205-216. [PMID: 28816513 DOI: 10.1089/g4h.2016.0112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Herein we describe a methodology for developing a game-based intervention to raise awareness of Chlamydia and other sexually transmitted infections among youth in Boston's underserved communities. MATERIALS AND METHODS We engaged in three design-based experiments. These utilized mixed methods, including playtesting and assessment methods, to examine the overall effectiveness of the game. In this case, effectiveness is defined as (1) engaging the target group, (2) increasing knowledge about Chlamydia, and (3) changing attitudes toward Chlamydia testing. These three experiments were performed using participants from different communities and with slightly different versions of the game, as we iterated through the design/feedback process. RESULTS Overall, participants who played the game showed a significant increase in participants' knowledge of Chlamydia compared with those in the control group (P = 0.0002). The version of the game, including elements specifically targeting systemic thinking, showed significant improvement in participants' intent to get tested compared with the version of the game without such elements (Stage 2: P > 0.05; Stage 3: P = 0.0045). Furthermore, during both Stage 2 and Stage 3, participants showed high levels of enjoyment, mood, and participation and moderate levels of game engagement and social engagement. During Stage 3, however, participants' game engagement (P = 0.0003), social engagement (P = 0.0003), and participation (P = 0.0003) were significantly higher compared with those of Stage 2. Thus, we believe that motivation improvements from Stage 2 to 3 were also effective. Finally, participants' overall learning effectiveness was correlated with their prepositive affect (r = 0.52) and their postproblem hierarchy (r = -0.54). CONCLUSION The game improved considerably from its initial conception through three stages of iterative design and feedback. Our assessment methods for each stage targeted and integrated learning, health, and engagement outcomes. Lessons learned through this iterative design process are a great contribution to the games for health community, especially in targeting the development of health and learning goals through game design.
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Affiliation(s)
- Rui Jiang
- 1 School of Animation and Digital Media Arts, Communication University of China , Beijing, China
| | - James McKanna
- 2 Electrical and Computer Engineering, Northeastern University , Boston, Massachusetts
| | - Samantha Calabrese
- 3 Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda, Maryland
| | - Magy Seif El-Nasr
- 4 College of Computer and Information Science, Northeastern University , Boston, Massachusetts
- 5 College of Arts, Media and Design, Northeastern University , Boston, Massachusetts
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DeSmet A, Bastiaensens S, Van Cleemput K, Poels K, Vandebosch H, Deboutte G, Herrewijn L, Malliet S, Pabian S, Van Broeckhoven F, De Troyer O, Deglorie G, Van Hoecke S, Samyn K, De Bourdeaudhuij I. The efficacy of the Friendly Attac serious digital game to promote prosocial bystander behavior in cyberbullying among young adolescents: A cluster-randomized controlled trial. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.10.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hust SJT, Adams PM, Willoughby JF, Ren C, Lei M, Ran W, Marett EG. The Entertainment-Education Strategy in Sexual Assault Prevention: A Comparison of Theoretical Foundations and a Test of Effectiveness in a College Campus Setting. JOURNAL OF HEALTH COMMUNICATION 2017; 22:721-731. [PMID: 28796574 DOI: 10.1080/10810730.2017.1343877] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Among the existing sexual assault prevention efforts on college campuses, few use mass communication strategies designed to simultaneously entertain and educate. Although many entertainment-education efforts are guided by social cognitive theory, other theories may be useful in entertainment-education design. Previous research has found that social cognitive theory and social norms theory can successfully influence participants' perceived norms and efficacy related to sexual assault reduction; however, whether such results can be replicated in a naturalistic setting and the extent to which the guiding theoretical foundation may influence outcomes remain unknown. We used a pre- and posttest field experiment with college students in residence halls to assess how different theoretical foundations may influence effects. Over the course of a semester, the participants viewed eight mini-magazines developed using (1) social cognitive theory, (2) social norms theory, (3) a combination of both theoretical frameworks, or (4) a control condition with no sexual assault prevention messaging. Participants in the combined content condition had greater levels of self-efficacy related to sexual assault prevention and more accurate norm perceptions. There were also effects for the mini-magazines developed with only one theoretical framework. Overall, we found that multiple theories can effectively guide entertainment-education message development.
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Affiliation(s)
- Stacey J T Hust
- a The Edward R. Murrow College of Communication , Washington State University , Pullman , Washington , USA
| | - Paula M Adams
- b Health & Wellness Services , Washington State University , Pullman , Washington , USA
| | - Jessica Fitts Willoughby
- a The Edward R. Murrow College of Communication , Washington State University , Pullman , Washington , USA
| | - Chunbo Ren
- c College of Communication and Fine Arts , Central Michigan University , Mount Pleasant , Michigan , USA
| | - Ming Lei
- d Department of Communication , State University of New York Geneseo , Geneseo , New York , USA
| | - Weina Ran
- e Department of Communication and Media , Rensselaer Polytechnic Institute , Troy , New York , USA
| | - Emily Garrigues Marett
- f Management and Information Systems , Mississippi State University , Mississippi State , Mississippi , USA
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Nour M, Yeung SH, Partridge S, Allman-Farinelli M. A Narrative Review of Social Media and Game-Based Nutrition Interventions Targeted at Young Adults. J Acad Nutr Diet 2017; 117:735-752.e10. [DOI: 10.1016/j.jand.2016.12.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
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Meng J, Peng W, Shin SY, Chung M. Online Self-Tracking Groups to Increase Fruit and Vegetable Intake: A Small-Scale Study on Mechanisms of Group Effect on Behavior Change. J Med Internet Res 2017; 19:e63. [PMID: 28264793 PMCID: PMC5359417 DOI: 10.2196/jmir.6537] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 01/04/2017] [Accepted: 02/08/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Web-based interventions with a self-tracking component have been found to be effective in promoting adults' fruit and vegetable consumption. However, these interventions primarily focus on individual- rather than group-based self-tracking. The rise of social media technologies enables sharing and comparing self-tracking records in a group context. Therefore, we developed an online group-based self-tracking program to promote fruit and vegetable consumption. OBJECTIVE This study aims to examine (1) the effectiveness of online group-based self-tracking on fruit and vegetable consumption and (2) characteristics of online self-tracking groups that make the group more effective in promoting fruit and vegetable consumption in early young adults. METHODS During a 4-week Web-based experiment, 111 college students self-tracked their fruit and vegetable consumption either individually (ie, the control group) or in an online group characterized by a 2 (demographic similarity: demographically similar vs demographically diverse) × 2 (social modeling: incremental change vs ideal change) experimental design. Each online group consisted of one focal participant and three confederates as group members or peers, who had their demographics and fruit and vegetable consumption manipulated to create the four intervention groups. Self-reported fruit and vegetable consumption were assessed using the Food Frequency Questionnaire at baseline and after the 4-week experiment. RESULTS Participants who self-tracked their fruit and vegetable consumption collectively with other group members consumed more fruits and vegetables than participants who self-tracked individually (P=.01). The results did not show significant main effects of demographic similarity (P=.32) or types of social modeling (P=.48) in making self-tracking groups more effective in promoting fruit and vegetable consumption. However, additional analyses revealed the main effect of performance discrepancy (ie, difference in fruit and vegetable consumption between a focal participant and his/her group members during the experiment), such that participants who had a low performance discrepancy from other group members had greater fruit and vegetable consumption than participants who had a high performance discrepancy from other group members (P=.002). A mediation test showed that low performance discrepancy led to greater downward contrast (b=-0.78, 95% CI -2.44 to -0.15), which in turn led to greater fruit and vegetable consumption. CONCLUSIONS Online self-tracking groups were more effective than self-tracking alone in promoting fruit and vegetable consumption for early young adults. Low performance discrepancy from other group members lead to downward contrast, which in turn increased participants' fruit and vegetable consumption over time. The study highlighted social comparison processes in online groups that allow for sharing personal health information. Lastly, given the small scale of this study, nonsignificant results with small effect sizes might be subject to bias.
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Affiliation(s)
- Jingbo Meng
- Michigan State University, Department of Communication, East Lansing, MI, United States
| | - Wei Peng
- Michigan State University, Department of Media and Information, East Lansing, MI, United States
| | - Soo Yun Shin
- Michigan State University, Department of Communication, East Lansing, MI, United States
| | - Minwoong Chung
- Michigan State University, Department of Communication, East Lansing, MI, United States
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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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Shiyko M, Hallinan S, Seif El-Nasr M, Subramanian S, Castaneda-Sceppa C. Effects of Playing a Serious Computer Game on Body Mass Index and Nutrition Knowledge in Women. JMIR Serious Games 2016; 4:e8. [PMID: 27255497 PMCID: PMC4911511 DOI: 10.2196/games.4977] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 12/20/2015] [Indexed: 12/01/2022] Open
Abstract
Background Obesity and weight gain is a critical public health concern. Serious digital games are gaining popularity in the context of health interventions. They use persuasive and fun design features to engage users in health-related behaviors in a non-game context. As a young field, research about effectiveness and acceptability of such games for weight loss is sparse. Objective The goal of this study was to evaluate real-world play patterns of SpaPlay and its impact on body mass index (BMI) and nutritional knowledge. SpaPlay is a computer game designed to help women adopt healthier dietary and exercise behaviors, developed based on Self-Determination theory and the Player Experience of Need Satisfaction (PENS) model. Progress in the game is tied to real-life activities (e.g., eating a healthy snack, taking a flight of stairs). Methods We recruited 47 women to partake in a within-subject 90-day longitudinal study, with assessments taken at baseline, 1-, 2-, and 3- months. Women were on average, 29.8 years old (±7.3), highly educated (80.9% had BA or higher), 39% non-White, baseline BMI 26.98 (±5.6), who reported at least contemplating making changes in their diet and exercise routine based on the Stages of Change Model. We computed 9 indices from game utilization data to evaluate game play. We used general linear models to examine inter-individual differences between levels of play, and multilevel models to assess temporal changes in BMI and nutritional knowledge. Results Patterns of game play were mixed. Participants who reported being in the preparation or action stages of behavior change exhibited more days of play and more play regularity compared to those who were in the contemplation stage. Additionally, women who reported playing video games 1-2 hours per session demonstrated more sparse game play. Brief activities, such as one-time actions related to physical activity or healthy food, were preferred over activities that require a longer commitment (e.g., taking stairs every day for a week). BMI decreased significantly (P<.001) from baseline to 3-month follow-up, yielding a large effect size of 1.28. Nutritional knowledge increased significantly (P<.001) from first to third month follow-ups, with an effect size of .86. The degree of change in both outcomes was related to game play, baseline readiness to change, and the extent of video game play in general. Conclusions This work demonstrates initial evidence of success for using a serious game as an intervention for health behavior change in real world settings. Our findings also highlight the need to understand not only game effectiveness but also inter-individual differences. Individualizing content and the intervention medium appears to be necessary for a more personalized and long-lasting impact.
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Affiliation(s)
- Mariya Shiyko
- Northeastern University, Applied Psychology, Boston, MA, United States.
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Orji R, Moffatt K. Persuasive technology for health and wellness: State-of-the-art and emerging trends. Health Informatics J 2016; 24:66-91. [PMID: 27245673 DOI: 10.1177/1460458216650979] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The evolving field of persuasive and behavior change technology is increasingly targeted at influencing behavior in the area of health and wellness. This paper provides an empirical review of 16 years (85 papers) of literature on persuasive technology for health and wellness to: (1.) answer important questions regarding the effectiveness of persuasive technology for health and wellness, (2.) summarize and highlight trends in the technology design, research methods, motivational strategies, theories, and health behaviors targeted by research to date, (3.) uncover pitfalls of existing persuasive technological interventions for health and wellness, and (4.) suggest directions for future research.
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Fiellin LE, Kyriakides TC, Hieftje KD, Pendergrass TM, Duncan LR, Dziura JD, Sawyer BG, Fiellin DA. The design and implementation of a randomized controlled trial of a risk reduction and human immunodeficiency virus prevention videogame intervention in minority adolescents: PlayForward: Elm City Stories. Clin Trials 2016; 13:400-8. [PMID: 27013483 DOI: 10.1177/1740774516637871] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To address the need for risk behavior reduction and human immunodeficiency virus prevention interventions that capture adolescents "where they live," we created a tablet-based videogame to teach skills and knowledge and influence psychosocial antecedents for decreasing risk and preventing human immunodeficiency virus infection in minority youth in schools, after-school programs, and summer camps. METHODS We developed PlayForward: Elm City Stories over a 2-year period, working with researchers, commercial game designers, and staff and teens from community programs. The videogame PlayForward provides an interactive world where players, using an avatar, "travel" through time, facing challenges such as peer pressure to drink alcohol or engage in risky sexual behaviors. Players experience how their choices affect their future and then are able to go back in time and change their choices, creating different outcomes. A randomized controlled trial was designed to evaluate the efficacy of PlayForward. Participants were randomly assigned to play PlayForward or a set of attention/time control games on a tablet at their community-based program. Assessment data were collected during face-to-face study visits and entered into a web-based platform and unique real-time "in-game" PlayForward data were collected as players engaged in the game. The innovative methods of this randomized controlled trial are described. We highlight the logistical issues of conducting a large-scale trial using mobile technology such as the iPad(®), and collecting, transferring, and storing large amounts of in-game data. We outline the methods used to analyze the in-game data alone and in conjunction with standardized assessment data to establish correlations between behaviors during gameplay and those reported in real life. We also describe the use of the in-game data as a measure of fidelity to the intervention. RESULTS In total, 333 boys and girls, aged 11-14 years, were randomized over a 14-month period: 166 were assigned to play PlayForward and 167 to play the control games. To date (as of 1 March 2016), 18 have withdrawn from the study; the following have completed the protocol-defined assessments: 6 weeks: 271 (83%), 3 months: 269 (84%), 6 months: 254 (79%), 12 months: 259 (82%), and 24 months: is ongoing with 152 having completed out of the 199 participants (76%) who were eligible to date (assessment windows were still open). CONCLUSION Videogames can be developed to address complex behaviors and can be subject to empiric testing using community-based randomized controlled trials. Although mobile technologies pose challenges in their use as interventions and in the collection and storage of data they produce, they provide unique opportunities as new sources of potentially valid data and novel methods to measure the fidelity of digitally delivered behavioral interventions.
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Affiliation(s)
- Lynn E Fiellin
- play2PREVENT Lab, Yale University School of Medicine, New Haven, CT, USA
| | | | - Kimberly D Hieftje
- play2PREVENT Lab, Yale University School of Medicine, New Haven, CT, USA
| | - Tyra M Pendergrass
- play2PREVENT Lab, Yale University School of Medicine, New Haven, CT, USA
| | | | | | - Benjamin G Sawyer
- play2PREVENT Lab, Yale University School of Medicine, New Haven, CT, USA Digitalmill, Inc., Freeport, ME, USA
| | - David A Fiellin
- play2PREVENT Lab, Yale University School of Medicine, New Haven, CT, USA Yale School of Public Health, New Haven, CT, USA
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Huang LY, Yeh YC. Mediated enactive experience versus perceived mastery experience: An enhancing mechanism versus a mediator of character attachment and internal political efficacy in serious games. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2015.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Turnin MC, Buisson JC, Ahluwalia N, Cazals L, Bolzonella-Pene C, Fouquet-Martineau C, Martini P, Tauber M, Hanaire H. Effect of Nutritional Intervention on Food Choices of French Students in Middle School Cafeterias, Using an Interactive Educational Software Program (Nutri-Advice). JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:131-7.e1. [PMID: 26548405 DOI: 10.1016/j.jneb.2015.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 09/17/2015] [Accepted: 09/22/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the impact of interactive Nutri-Advice kiosks on children's nutritional skills and their ability to apply it to food choices in a middle school cafeteria menu (food choice competencies). DESIGN Quasi-experimental design; pre/post-test. SETTING Freestanding interactive computer terminals (kiosks) were installed in three middle schools in Toulouse, France. PARTICIPANTS A total of 580 children were enrolled into the study (mean age, 13 ± 1 years). INTERVENTION Each child's physiological profile was stored in a personal barcode card. During 1 school year, once a day, each child could access the kiosk with this card, trying to find the most balanced meal according to his or her profile and the food available on the cafeteria menu. MAIN OUTCOME MEASURES Children's food choice competency changes and body mass index z-score were evaluated. ANALYSIS Significance of change in food choice competencies (postintervention vs baseline) was examined using paired t test. RESULTS Across the study, children chose significantly less cheese and pastry or desserts, and significantly more starchy food and dairy, and tended to choose fruits and vegetables more often. Body mass index z-score decreased significantly during the period. CONCLUSIONS AND IMPLICATIONS Personalized nutrition counseling through an interactive device has the potential to improve the food choice competencies of children.
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Affiliation(s)
- Marie-Christine Turnin
- Department of Diabetology, Metabolic and Nutrition Disease, University Hospital of Toulouse, Toulouse, France.
| | - Jean-Christophe Buisson
- University of Toulouse, Institut National Polytechnique de Toulouse-Ecole Nationale Supérieure d'Électrotechnique, d'Électronique, d'Informatique, d'Hydraulique, et des Télécommunications, Toulouse, France
| | - Namanjeet Ahluwalia
- Department of Epidemiology and Analyses in Public Health: Risks, Chronic Diseases, Handicaps, University Hospital of Toulouse, Toulouse, France
| | - Laurent Cazals
- Department of Diabetology, Metabolic and Nutrition Disease, University Hospital of Toulouse, Toulouse, France
| | - Caroline Bolzonella-Pene
- Department of Diabetology, Metabolic and Nutrition Disease, University Hospital of Toulouse, Toulouse, France
| | - Caroline Fouquet-Martineau
- Department of Diabetology, Metabolic and Nutrition Disease, University Hospital of Toulouse, Toulouse, France
| | - Pascale Martini
- Department of Diabetology, Metabolic and Nutrition Disease, University Hospital of Toulouse, Toulouse, France
| | - Maïthé Tauber
- Department of Paediatrics, Endocrinology, Genetics, and Medical Gynaecology, University Hospital of Toulouse, Hôpital des Enfants, Toulouse, France
| | - Hélène Hanaire
- Department of Diabetology, Metabolic and Nutrition Disease, University Hospital of Toulouse, Toulouse, France
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47
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Lee YH. Does Digital Game Interactivity Always Promote Self-Efficacy? CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2015; 18:669-73. [PMID: 26378739 DOI: 10.1089/cyber.2015.0165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Interactive digital games can promote self-efficacy by engaging players in enactive and observational learning. However, interactivity does not always lead to greater self-efficacy. Important constructs in social cognitive theory, such as performance outcome and perceived similarity, are often not accounted for in studies that have tested the effect of digital game interactivity on self-efficacy. This study assessed the effects of interactive digital games compared with passive digital games based on video comparison, a common experimental design used to test the effect of digital game interactivity on self-efficacy. In addition, this study also evaluated player performance and measured perceived similarity to the observed player. Findings suggested that in general, digital game interactivity predicted higher self-efficacy compared with noninteractive passive games. However, in the noninteractive conditions, the effects of performance on self-efficacy were moderated by perceived similarity between the observer and the observed player. When the observed player was perceived to be similar to the observer, the effects of performance on self-efficacy were comparable to the interactive game, but when the observed player was perceived as dissimilar to the observer, observing the dissimilar player failed to increase observer self-efficacy. Implications for interactivity manipulations and game developers are discussed.
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Affiliation(s)
- Yu-Hao Lee
- Department of Telecommunication, University of Florida , Gainesville, Florida
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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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Lin JH, Peng W. The Contributions of Perceived Graphic and Enactive Realism to Enjoyment and Engagement in Active Video Games. INTERNATIONAL JOURNAL OF TECHNOLOGY AND HUMAN INTERACTION 2015. [DOI: 10.4018/ijthi.2015070101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
How perceived realism in a video game contributes to game enjoyment and engagement is a theoretically important and practically significant question. The conceptualization and operationalization of perceived realism in previous video game studies vary greatly, particularly regarding the dimensions of perceived graphic realism and perceived external realism. The authors argue that it is important to examine perceived enactive realism, particularly for interactive and participatory media such as video games. This study examines the contribution of two types of perceived realism—perceived graphic realism and perceived enactive realism—to enjoyment and engagement as manifested by the level of physical movement intensity in an active video game playing context. It was found that perceived enactive realism was a significant predictor of enjoyment and engagement in playing active video games. However, perceived graphic realism was not found to be a significant predictor of enjoyment or engagement. Theoretical and practical implications are discussed.
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Affiliation(s)
- Jih-Hsuan Lin
- Department of Communication and Technology, National Chiao Tung University, Zhubei City, Taiwan
| | - Wei Peng
- Department of Media and Information, Michigan State University, East Lansing, MI, 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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