|Winter 2009||Return to Outlook Main page >>|
From the Obesity and Eating Disorders SIG
Videogames for Diet and Physical Activity Change
Tom Baranowksi, PhD
Debbe Thompson, PHD, RD
Janice Baranowski, MPH, RD
Computers, the Internet and related technologies are revolutionizing how people communicate and the enjoyments they get from life. Health behaviorists need to learn how to use these new technologies to promote diet and physical activity (PA) change.
Our recent literature review showed positive outcomes from 26 of 27 published evaluations of health related videogames1. We have designed videogames and web sites (Squire's Quest!2, Boy Scout Fit for Life Badge3, Boy Scout Five A Day Badge4, Fun, Food and Fitness5, 6, Escape from Diab7, Nanoswarm: Invasion from Inner Space) to promote diet and physical activity change among children. Each of these games targeted specific behaviors (eating fruit and vegetables, drinking water, being physically active, and/or watching less TV) and employed state of the art theory based behavior change procedures (goal setting tailored to usual behavioral practices and food preferences, action and coping implementation intentions, behavior temptation inoculation, motivational messages tailored to child values, skill training, and practical knowledge enhancement).
Rather than using usual questionnaires, data are collected by game characters asking questions of the player as part of the storyline, thereby minimizing the response burden. Practical knowledge enhancement (e.g. what counts as a fruit?) is achieved by making a game of the knowledge test, imposing high standards of attainment, and repeating the test until the standard is attained. Alpha testing revealed that children required seven times to play the practical knowledge game before they achieved the standard, but reported they enjoyed it because it was challenging. Games, thereby, enable children to perceive learning and tests as attractive.
The story encompassing the game also provides opportunities for promoting behavior change. Attractive characters can 1) model the desired behaviors (social learning), 2) model overcoming barriers to performing the behaviors (enhancing self efficacy); 3) morph over the course of the story from not believing the value of the health behaviors to developing a new norm for healthy behavior; and 4) struggle with personal change developing empathy in the player1. New perceptions of reality can emerge, e.g. from food vending machines being sources of tasty foods to sources of control and oppression1. (See trailers for "Escape from Diab" and "Nanoswarm" in the "screening room" at http://archimageonline.com/)
Another literature review revealed that active videogames (sometimes called exergames) can elicit physical activity at levels intense enough to induce a fitness effect, but in the average children didn't play them long enough to benefit in that way8. We are conducting research on how we can use "story" to enhance the long term playability of active videogames.
Videogames involving simulations of real world experiences have been used to train individuals to fly planes. We are exploring similar techniques to train parents in a fun way to conduct more effective fruit and vegetable parenting practices in which they can make mistakes in the game with no untoward consequences for their real child.
Interactive technology can be used to promote diet and physical activity behavior change almost as stealth learning. As we gain experience, we will learn how to do this better.