Promoting Physical Activity in Japanese Older Adults Using a Social Pervasive Game: Randomized Controlled Trial

Abstract

Background Pervasive games aim to create more fun and engaging experiences by mixing elements from the real world into the game world. Because they intermingle with players’ lives and naturally promote more casual gameplay, they could be a powerful strategy to stimulate physical activity among older adults. However, to use these games more effectively, it is necessary to understand how design elements of the game affect player behavior. Objective The aim of this study was to evaluate how the presence of a specific design element, namely social interaction, would affect levels of physical activity. Methods Participants were recruited offline and randomly assigned to control and intervention groups in a single-blind design. Over 4 weeks, two variations of the same pervasive game were compared: with social interaction (intervention group) and with no social interaction (control group). In both versions, players had to walk to physical locations and collect virtual cards, but the social interaction version allowed people to collaborate to obtain more cards. Changes in the weekly step counts were used to evaluate the effect on each group, and the number of places visited was used as an indicator of play activity. Results A total of 20 participants were recruited (no social interaction group, n=10; social interaction group, n=10); 18 participants remained active until the end of the study (no social interaction group, n=9; social interaction group, n=9). Step counts during the first week were used as the baseline level of physical activity (no social interaction group: mean 46,697.2, SE 7905.4; social interaction group: mean 45,967.3, SE 8260.7). For the subsequent weeks, changes to individual baseline values (absolute/proportional) for the no social interaction group were as follows: 1583.3 (SE 3108.3)/4.6% (SE 7.2%) (week 2), 591.5 (SE 2414.5)/2.4% (SE 4.7%) (week 3), and −1041.8 (SE 1992.7)/0.6% (SE 4.4%) (week 4). For the social interaction group, changes to individual baseline values were as follows: 11520.0 (SE 3941.5)/28.0% (SE 8.7%) (week 2), 9567.3 (SE 2631.5)/23.0% (SE 5.1%) (week 3), and 7648.7 (SE 3900.9)/13.9% (SE 8.0%) (week 4). The result of the analysis of the group effect was significant (absolute change: η2=0.31, P=.04; proportional change: η2=0.30, P=.03). Correlations between both absolute and proportional change and the play activity were significant (absolute change: r=0.59, 95% CI 0.32 to 0.77; proportional change: r=0.39, 95% CI 0.08 to 0.64). Conclusions The presence of social interaction design elements in pervasive games appears to have a positive effect on levels of physical activity. Trial Registration Japan Medical Association Clinical Trial Registration Number JMA-IIA00314; https://tinyurl.com/y5nh6ylr (Archived by WebCite at http://www.webcitation.org/761a6MVAy)

Dimensions of Interactive Pervasive Game Design: Systematic Review

“…The experiment found that the social interaction design element of the popularity game may have had some positive effects on promoting physical activity. Subsequently, in 2021, Santos et al [ 18 ] continued with the same study, comparing 2 variations of the same pervasive game over 4 weeks with the same purpose and type of experiment: the test group received social interaction whereas the control group did not. In this test, 20 participants were recruited for this experiment (no social interaction group, n=10; social interaction group, n=10), 18 of whom remained active until the end of the study (no social interaction group, n=9).…”

“…Subsequently, there are pervasive games designed for adults, teachers, and students to learn [ 32 , 44 ]. At the same time, there are pervasive games for older adults, indicating some positive effects on promoting physical activity [ 18 ]. From the literature, it can see some hints of the research tendencies of scholars: in the early days, they studied the pervasive game design experiences of children users, followed by the pervasive game design experiences of adult users, and in recent years, they focused on the pervasive game design experiences of older adult users.…”