TY - JOUR AU - Payne, E. Hannah AU - Moxley, BA Victor AU - MacDonald, Elizabeth PY - 2015/07/13 TI - Health Behavior Theory in Physical Activity Game Apps: A Content Analysis JO - JMIR Serious Games SP - e4 VL - 3 IS - 2 KW - health and fitness apps KW - mobile phone KW - behavioral health KW - theory KW - content analysis KW - physical activity N2 - Background: Physical activity games developed for a mobile phone platform are becoming increasingly popular, yet little is known about their content or inclusion of health behavior theory (HBT). Objective: The objective of our study was to quantify elements of HBT in physical activity games developed for mobile phones and to assess the relationship between theoretical constructs and various app features. Methods: We conducted an analysis of exercise and physical activity game apps in the Apple App Store in the fall of 2014. A total of 52 apps were identified and rated for inclusion of health behavior theoretical constructs using an established theory-based rubric. Each app was coded for 100 theoretical items, containing 5 questions for 20 different constructs. Possible total theory scores ranged from 0 to 100. Descriptive statistics and Spearman correlations were used to describe the HBT score and association with selected app features, respectively. Results: The average HBT score in the sample was 14.98 out of 100. One outlier, SuperBetter, scored higher than the other apps with a score of 76. Goal setting, self-monitoring, and self-reward were the most-reported constructs found in the sample. There was no association between either app price and theory score (P=.5074), or number of gamification elements and theory score (P=.5010). However, Superbetter, with the highest HBT score, was also the most expensive app. Conclusions: There are few content analyses of serious games for health, but a comparison between these findings and previous content analyses of non-game health apps indicates that physical activity mobile phone games demonstrate higher levels of behavior theory. The most common theoretical constructs found in this sample are known to be efficacious elements in physical activity interventions. It is unclear, however, whether app designers consciously design physical activity mobile phone games with specific constructs in mind; it may be that games lend themselves well to inclusion of theory and any constructs found in significant levels are coincidental. Health games developed for mobile phones could be potentially used in health interventions, but collaboration between app designers and behavioral specialists is crucial. Additionally, further research is needed to better characterize mobile phone health games and the relative importance of educational elements versus gamification elements in long-term behavior change. UR - http://games.jmir.org/2015/2/e4/ UR - http://dx.doi.org/10.2196/games.4187 UR - http://www.ncbi.nlm.nih.gov/pubmed/26168926 ID - info:doi/10.2196/games.4187 ER - TY - JOUR AU - Aebersold, Michelle AU - Villarruel, Antonia AU - Tschannen, Dana AU - Valladares, Angel AU - Yaksich, Joseph AU - Yeagley, Emily AU - Hawes, Armani PY - 2015/07/21 TI - Using a Virtual Environment to Deliver Evidence-Based Interventions: The Facilitator's Experience JO - JMIR Serious Games SP - e5 VL - 3 IS - 2 KW - Second Life KW - multi-user virtual environments KW - evidence-based interventions KW - community-based organizations N2 - Background: Evidence-based interventions (EBIs) have the potential to maximize positive impact on communities. However, despite the quantity and quality of EBIs for prevention, the need for formalized training and associated training-related expenses, such as travel costs, program materials, and input of personnel hours, pose implementation challenges for many community-based organizations. In this study, the community of inquiry (CoI) framework was used to develop the virtual learning environment to support the adaptation of the ¡Cuídate! (Take Care of Yourself!) Training of Facilitators curriculum (an EBI) to train facilitators from community-based organizations. Objective: The purpose of this study was to examine the feasibility of adapting a traditional face-to-face facilitator training program for ¡Cuídate!, a sexual risk reduction EBI for Latino youth, for use in a multi-user virtual environment (MUVE). Additionally, two aims of the study were explored: the acceptability of the facilitator training and the level of the facilitators? knowledge and self-efficacy to implement the training. Methods: A total of 35 facilitators were trained in the virtual environment. We evaluated the facilitators' experience in the virtual training environment and determined if the learning environment was acceptable and supported the acquisition of learning outcomes. To this end, the facilitators were surveyed using a modified community of inquiry survey, with questions specific to the Second Life environment and an open-ended questionnaire. In addition, a comparison to face-to-face training was conducted using survey methods. Results: Results of the community of inquiry survey demonstrated a subscale mean of 23.11 (SD 4.12) out of a possible 30 on social presence, a subscale mean of 8.74 (SD 1.01) out of a possible 10 on teaching presence, and a subscale mean of 16.69 (SD 1.97) out of a possible 20 on cognitive presence. The comparison to face-to-face training showed no significant differences in participants' ability to respond to challenging or sensitive questions (P=.50) or their ability to help participants recognize how Latino culture supports safer sex (P=.32). There was a significant difference in their knowledge of core elements and modules (P<.001). A total of 74% (26/35) of the Second Life participants did agree/strongly agree that they had the skills to deliver the ¡Cuídate! program. Conclusions: The results showed that participants found the Second Life environment to be acceptable to the learners and supported an experience in which learners were able to acquire the knowledge and skills needed to deliver the curriculum. UR - http://games.jmir.org/2015/2/e5/ UR - http://dx.doi.org/10.2196/games.4293 UR - http://www.ncbi.nlm.nih.gov/pubmed/26199045 ID - info:doi/10.2196/games.4293 ER - TY - JOUR AU - Brand, Leah AU - Beltran, Alicia AU - Buday, Richard AU - Hughes, Sheryl AU - O'Connor, Teresia AU - Baranowski, Janice AU - Dadabhoy, R. Hafza AU - Diep, S. Cassandra AU - Baranowski, Tom PY - 2015/07/24 TI - Training Vegetable Parenting Practices Through a Mobile Game: Iterative Qualitative Alpha Test JO - JMIR Serious Games SP - e6 VL - 3 IS - 2 KW - mobile games KW - games for health KW - serious games KW - pediatric nutrition KW - parenting N2 - Background: Vegetable consumption protects against chronic diseases, but many young children do not eat vegetables. One quest within the mobile application Mommio was developed to train mothers of preschoolers in effective vegetable parenting practices, or ways to approach getting their child to eat and enjoy vegetables. A much earlier version of the game, then called Kiddio, was alpha tested previously, but the game has since evolved in key ways. Objective: The purpose of this research was to alpha test the first quest, substantiate earlier findings and obtain feedback on new game features to develop an effective, compelling parenting game. Methods: Mothers of preschool children (n=20) played a single quest of Mommio 2 to 4 times, immediately after which a semi-structured interview about their experience was completed. Interviews were transcribed and double coded using thematic analysis methods. Results: Mothers generally liked the game, finding it realistic and engaging. Some participants had difficulties with mechanics for moving around the 3-D environment. Tips and hints were well received, and further expansion and customization were desired. Conclusions: Earlier findings were supported, though Mommio players reported more enjoyment than Kiddio players. Continued development will include more user-friendly mechanics, customization, opportunities for environment interaction, and food parenting scenarios. UR - http://games.jmir.org/2015/2/e6/ UR - http://dx.doi.org/10.2196/games.4081 UR - http://www.ncbi.nlm.nih.gov/pubmed/26208899 ID - info:doi/10.2196/games.4081 ER - TY - JOUR AU - Dagan, Noa AU - Beskin, Daniel AU - Brezis, Mayer AU - Reis, Y. Ben PY - 2015/10/05 TI - Effects of Social Network Exposure on Nutritional Learning: Development of an Online Educational Platform JO - JMIR Serious Games SP - e7 VL - 3 IS - 2 KW - nutrition requirements KW - obesity KW - public health KW - social networking sites N2 - Background: Social networking sites (SNSs) such as Facebook have the potential to enhance online public health interventions, in part, as they provide social exposure and reinforcement. Objective: The objective of the study was to evaluate whether social exposure provided by SNSs enhances the effects of online public health interventions. Methods: As a sample intervention, we developed Food Hero, an online platform for nutritional education in which players feed a virtual character according to their own nutritional needs and complete a set of virtual sport challenges. The platform was developed in 2 versions: a "private version" in which a user can see only his or her own score, and a "social version" in which a user can see other players? scores, including preexisting Facebook friends. We assessed changes in participants? nutritional knowledge using 4 quiz scores and 3 menu-assembly scores. Monitoring feeding and exercising attempts assessed engagement with the platform. Results: The 2 versions of the platform were randomly assigned between a study group (30 members receiving the social version) and a control group (33 members, private version). The study group's performance on the quizzes gradually increased over time, relative to that of the control group, becoming significantly higher by the fourth quiz (P=.02). Furthermore, the study group's menu-assembly scores improved over time compared to the first score, whereas the control group's performance deteriorated. Study group members spent an average of 3:40 minutes assembling each menu compared to 2:50 minutes in the control group, and performed an average of 1.58 daily sport challenges, compared to 1.21 in the control group (P=.03). Conclusions: This work focused on isolating the SNSs' social effects in order to help guide future online interventions. Our results indicate that the social exposure provided by SNSs is associated with increased engagement and learning in an online nutritional educational platform. UR - http://games.jmir.org/2015/2/e7/ UR - http://dx.doi.org/10.2196/games.4002 UR - http://www.ncbi.nlm.nih.gov/pubmed/26441466 ID - info:doi/10.2196/games.4002 ER - TY - JOUR AU - Bird, Marie-Louise AU - Clark, Brodie AU - Millar, Johanna AU - Whetton, Sue AU - Smith, Stuart PY - 2015/11/27 TI - Exposure to ?Exergames? Increases Older Adults? Perception of the Usefulness of Technology for Improving Health and Physical Activity: A Pilot Study JO - JMIR Serious Games SP - e8 VL - 3 IS - 2 KW - health care reform KW - postural balance KW - pleasure KW - exercise KW - perception N2 - Background: High rates of sedentary behaviors in older adults can lead to poor health outcomes. However, new technologies, namely exercise-based videogames (?exergames?), may provide ways of stimulating uptake and ongoing participation in physical activities. Older adults? perceptions of the use of technology to improve health are not known. Objective: The study aimed to determine use and perceptions of technology before and after using a 5-week exergame. Methods: Focus groups determined habitual use of technology and the participant?s perceptions of technology to assist with health and physical activity. Surveys were developed to quantitatively measure these perceptions and were administered before and after a 5-week intervention. The intervention was an exergame that focused on postural balance (?Your Shape Fitness Evolved 2012?). Games scores, rates of game participation, and enjoyment were also recorded. Results: A total of 24 healthy participants aged between 55 and 82 years (mean 70, SD 6 years) indicated that after the intervention there was an increased awareness that technology (in the form of exergames) can assist with maintaining physical activity (P<.001). High levels of enjoyment (Physical Activity Enjoyment Scale [PACES-8] score mean 53.0, SE 0.7) and participation rates over the whole study (83%-100%) were recorded. Conclusions: Older adults? have low perception of the use of technology for improving health outcomes until after exposure to exergames. Technology, in the form of enjoyable exergames, may be useful for improving participation in physical activity that is relevant for older adults. UR - http://games.jmir.org/2015/2/e8/ UR - http://dx.doi.org/10.2196/games.4275 UR - http://www.ncbi.nlm.nih.gov/pubmed/26614263 ID - info:doi/10.2196/games.4275 ER - TY - JOUR AU - de Vette, Frederiek AU - Tabak, Monique AU - Dekker - van Weering, Marit AU - Vollenbroek-Hutten, Miriam PY - 2015/12/18 TI - Engaging Elderly People in Telemedicine Through Gamification JO - JMIR Serious Games SP - e9 VL - 3 IS - 2 KW - gamification KW - framework KW - elderly KW - older adults KW - eHealth KW - telemedicine KW - adherence KW - engagement KW - classification KW - player type KW - personality N2 - Background: Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. Objective: This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. Methods: We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Results: Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great connectivity between these taxonomies. Conclusions: Gamification frameworks have been developed from different backgrounds?business and academia?but rarely target the elderly user. The effectiveness of user classifications for tailored game content in this context is not yet known. As a next step, we propose the development of a framework based on the hypothesized existence of a relation between preference for game content and personality. UR - http://games.jmir.org/2015/2/e9/ UR - http://dx.doi.org/10.2196/games.4561 UR - http://www.ncbi.nlm.nih.gov/pubmed/26685287 ID - info:doi/10.2196/games.4561 ER -