“Creature-101”: A Serious Game to Promote Energy Balance-Related Behaviors Among Middle School Adolescents

Abstract

Background: Considering adolescents' heavy use of media, serious videogames may provide an engaging and innovative way to achieve positive impact on adolescents' diet and physical activity. The objective of this study was to evaluate the efficacy of playing a serious game, ''Creature-101'' (developed by Teachers College, Columbia University [New York, NY] and Stottler Henke Inc. [San Mateo, CA]), at promoting energy balancerelated behaviors (EBRBs) such as increasing fruits and vegetables intake, water intake, and physical activity and decreasing processed snacks intake, sweetened beverages intake, and recreational screen time. Subjects and Methods: This pre-post intervention-control study (n = 590) was conducted in New York City lowincome public middle schools. The students (11-13 years of age, 51.6 percent male) played ''Creature-101'' online in science/health education classes (seven sessions, 30 minutes each session for 1 month). ''Creature-101'' used behavioral theories as the framework for ''creature care'' in a world ''Tween.'' Students were provided with scientific evidence that promoted energy balance through minigames, educational videos, and slideshows and were motivated with interactive dialogues with game characters. Students also assessed their own behaviors, created their own ''real life'' food and activity goals, and reported their progress. A self-reported, validated, online instrument that measured frequency and amount of targeted behaviors was administered at baseline and post-intervention. Results: Analysis of covariance compared post-test means between groups with pretest scores as covariates. Intervention students reported significant decreases in frequency and amount of consumption of sweetened beverages and processed snacks compared with the controls. No changes were observed for the other behaviors. Conclusions: ''Creature-101'' was effective at reducing consumption of sweetened beverages and processed snacks, which are related to obesity risks, indicating that the game shows promise at promoting EBRBs.

Nutrition Science and Behavioral Theories Integrated in a Serious Game for Adolescents

“…[Sweetened beverages frequency: I=1.64±1.09, C=1.97±1.19, p=0.011, Processed snack frequency: I=1.79±1.24, C=2.21±1.36, p<0.000, Range 0-5, where 0 = never eat this, 1 = about 1-2 times per week, 2 = about 3-4 times per week, 3=about 5-6 times per week, 4=about once per day, and 5=more than 2 times per day; Sweetened beverage amount: I=1.43±0.87, C=2.21±1.36, p=0.007, amount scale (each time) ranged from 0 to 4, where 0 = never drink this, 1 = less than 12 ounces, 2 = about 12 ounces, 3 = about 20 ounces, and 4 = more than 20 ounces, processed snack amount: I=1.67±0.65, C=1.89±0.69, p=0.04, amount scale (each time) ranged from 0 to 3, where 0 = never eat this, 1 = small, 2 = medium, and 3 = large]. No changes were observed for the other behaviors (Majumdar et al, 2013). In the future, we intend to add more interactive game activities to promote fruit and vegetables and physical activity.…”

Interventions to increase the consumption of water among children: A systematic review and meta‐analysis

“…After all rounds of screening, 39 articles were identified and included. Eight additional studies were identified by hand searching references of included articles and other relevant articles, resulting in 47 articles that met the inclusion criteria and were included in the systematic review . Of these 47 studies, 24 studies could be included in the meta‐analysis because they had a controlled design and measured water consumption in an amount or frequency …”

“…The overall characteristics of the studies that were included in the systematic review are shown in Table ; specific details of each study are shown in Table S2. Of the 47 studies, the majority were based in the United States (24/47) or in Europe (14/47) . All studies were published after 2000, and most (40/47) were published in or after 2010.…”

Is Participatory Design Associated with the Effectiveness of Serious Digital Games for Healthy Lifestyle Promotion? A Meta-Analysis

“…Users were recruited via purposive sampling in 12 out of 22 studies (55%) [51-54,58,59,61,65,68,69,71], via a self-selected convenience sample (eg, flyers) in 8 studies out of 22 (36%) [55-57,60,62,63,66,70], and/or via snowball sampling in 4 out of 22 studies (18%) [55,57,62,64]. For one study, no information could be obtained on sampling method [67].…”