Design Rationale Behind the Serious Self-Regulation Game Intervention “Balance It”: Overweight Prevention Among Secondary Vocational Education Students in The Netherlands

Spook, Jorinde E; Paulussen, Theo; Paulissen, R.T.; Visschedijk, G.C.; Kok, Gerjo; Empelen, Pepijn van

doi:10.1089/g4h.2014.0142

Cited by 16 publications

(16 citation statements)

References 29 publications

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“…It was designed as an educational, strategic game that could be played on a daily basis for 4 continuing weeks or on a weekly basis for 6 continuing weeks. Within each game, players set their own graded tasks (eg, to eat two pieces of fruit per day), which were selected from a multiple-choice list ( Figure 1 ; [ 30 ]). They monitored and evaluated these goals on a daily or weekly basis, depending on the type of game they chose to play.…”

Section: Methodsmentioning

confidence: 99%

“…Reinforcement was given in the form of obtainable “Tetris-shaped” building blocks and the allocation of “super powers” after goal accomplishment and self-evaluation of the targeted behavior. With these building blocks, players were encouraged to build a tower and to keep the tower in balance (see Figure 1 ; for a full description of the game design and content see [ 30 ]).…”

Section: Methodsmentioning

confidence: 99%

“…Balance It was systematically developed by means of Intervention Mapping, a protocol that enables the systematic planning of theory- and evidence-based interventions [ 29 ]. Further elaboration on the design rationale of Balance It can be found elsewhere [ 30 ]. Our key research objectives in this pilot study were to (1) identify the effectiveness of Balance It on changes in (determinants of) secondary vocational education students’ dietary intake and PA, and (2) evaluate the uptake and usage of the game and the game elements.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a Serious Self-Regulation Game Intervention for Overweight-Related Behaviors (“Balance It”): A Pilot Study

Spook¹,

Paulussen²,

Kok³

et al. 2016

J Med Internet Res

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BackgroundSerious games have the potential to promote health behavior. Because overweight is still a major issue among secondary vocational education students in the Netherlands, this study piloted the effects of “Balance It,” a serious self-regulation game intervention targeting students’ overweight-related behaviors: dietary intake and physical activity (PA).ObjectiveWe aimed to pilot the effects of Balance It on secondary vocational education students’ dietary intake and PA.MethodsIn total, 501 secondary vocational education students participated at baseline (intervention: n=250; control: n=251) in this pre-post cluster randomized trial. After 4 weeks, at immediate posttest, 231 students filled in the posttest questionnaire (intervention: n=105; control: n=126). The sample had a mean age of 17.28 (SD 1.26, range 15-21) years, 62.8% (145/231) were female, and 26.8% (62/231) had a non-Dutch background. Body mass index (BMI kg/m2) ranged from 14.4 to 31.1 (mean 21.1, SD 3.3). The intervention and control groups were compared on the primary (behavioral) outcomes of dietary intake (fruit and vegetable consumption, snack consumption, and soft drink consumption) and PA (moderate and vigorous). Additionally, we explored (1) differences between the intervention and control groups in determinants of dietary intake and PA, including attitude, self-efficacy, intention, barrier identification, action planning, and action control, and (2) differences between active (intervention) users and the control group in dietary intake, PA, and associated determinants.ResultsAfter corrections for multiple testing, we did not find significant differences between the intervention group and control group in terms of dietary intake, PA, and determinants of dietary intake and PA. Exploratory research indicated that only 27.6% (29/105) of the intervention group reported actual intervention use (ie, active users). For exploratory reasons, we compared the active users (n=29) with the control group (n=124) and corrected for multiple testing. Results showed that active users’ snack consumption decreased more strongly (active users: mean change=–0.20; control group: mean change=–0.08; beta=–0.36, P=.01, R2 change=.05), and their use of active transport had a stronger increase (active users: mean change=0.92; control group=–0.12; beta=1.58, P=.02, R2 change=.03) than the control group. Results also revealed significant differences in action planning (active users: mean change=0.42; control group: mean change=0.07; beta=0.91, P=.01, R2 change=.04) and action control (active users: mean change=0.63; control group: mean change=–0.05; beta=1.25, P=.001, R2 change=.08) in terms of unhealthy eating.ConclusionsThe Balance It intervention did not show favorable effects on dietary intake and PA compared to the control condition. However, only a small number of people in the intervention condition actually used Balance It (27.6%). Exploratory analyses did suggest that, if used as planned, Balance It could contribute to changing dietary intake and PA behavi...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of a Serious Self-Regulation Game Intervention for Overweight-Related Behaviors (“Balance It”): A Pilot Study

Spook¹,

Paulussen²,

Kok³

et al. 2016

J Med Internet Res

Self Cite

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“…Examples of their use in a game can be found in a serious game, 'Squire's Quest II 0 , to improve a healthy diet for children, where real-life goal attainment was linked to advancing in the game, by receiving enough badges to become a knight (Thompson et al, 2015). In a serious game for a healthy diet and physical activity among adolescents, 'Balance It', real-life goal evaluation and achievement were linked to receiving rewards, since these actions provided building blocks players needed to construct their 'Angry Birds'-like tower in the game (Spook et al, 2015). Certain game types, such as adventure games, role-playing games and strategy games (Prensky, 2007), may be well-suited to the use of selfregulation techniques, where the game also requires meeting goals, proactively avoiding barriers and picking the best strategies to reach these goals.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of the Friendly Attac serious digital game to promote prosocial bystander behavior in cyberbullying among young adolescents: A cluster-randomized controlled trial

DeSmet

Bastiaensens

Cleemput

et al. 2018

Computers in Human Behavior

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Cyberbullying is a social phenomenon which can bring severe harm to victims. Bystanders can show positive bystander behavior (e.g. defending) and decrease cyberbullying and its harm, or negative behavior (e.g. passive bystanding, joining) and sustain cyberbullying and its negative effects. Few interventions have currently targeted bystanders and evaluated results on their behavior or its determinants. The intervention consisted of a serious game specifically targeting cyberbullying bystander behavior. A cluster-randomized controlled trial was conducted among 8th graders (n ¼ 216) in two schools. Measurements were taken at baseline, immediately after the intervention and at 4-week followup. The serious game intervention resulted in significant improvements in self-efficacy, prosocial skills, and the intention to act as a positive bystander. These are mainly predictors of positive bystander behavior. No significant effects were found for predictors of negative bystander behavior. The intervention also increased witnessing of cyberbullying incidents, potentially a measure of awareness of cyberbullying taking place, and quality of life. No effects were found on behavior itself, bullying or cyberbullying prevalence. This brief serious game intervention affected determinants of bystander behavior and quality of life among adolescents. Further efforts are needed to address (negative) bystander behavior and cyberbullying involvement.

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“…A limitation of this development process was the limited resources available for investment in advanced features such as "gamification" [65]. Although most adolescents during the meetings would have preferred this as a feature, we were unable to integrate it into the current version of the app.…”

Section: Discussionmentioning

confidence: 99%

A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach (Preprint)

Scheerman¹,

Empelen²,

Loveren³

et al. 2017

Preprint

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Design Rationale Behind the Serious Self-Regulation Game Intervention “Balance It”: Overweight Prevention Among Secondary Vocational Education Students in The Netherlands

Cited by 16 publications

References 29 publications

Evaluation of a Serious Self-Regulation Game Intervention for Overweight-Related Behaviors (“Balance It”): A Pilot Study

Evaluation of a Serious Self-Regulation Game Intervention for Overweight-Related Behaviors (“Balance It”): A Pilot Study

The efficacy of the Friendly Attac serious digital game to promote prosocial bystander behavior in cyberbullying among young adolescents: A cluster-randomized controlled trial

A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach (Preprint)

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