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Video Games Change Children’s Eating and Exercise Habits
By David Yeager

Video games have been blamed for everything from antisocial behavior to violent outbursts to America’s obesity epidemic, but some researchers are proving that, with the proper methods, video games can influence children’s eating and exercise habits for the better.

Tom Baranowski, PhD, a professor of pediatrics specializing in behavioral nutrition, and Janice C. Baranowski, MPH, RD, an assistant professor of pediatrics, both at the Baylor College of Medicine in Houston, have researched how technology such as video games can be used to improve children’s health, and they’ve developed several games that encourage kids to make healthier choices. Initially, they began designing school curricula that emphasized greater fruit, vegetable, and water intake and physical activity, but with more instructional demands placed on schools, it became increasingly difficult to introduce these curricula to classrooms.

“Video games were becoming the thing for kids to do, and we decided, well, if you can’t beat ’em, let’s join ’em,” Janice Baranowski says. “So we started creating video games.”

Their first game, Squire’s Quest!, was used in a school setting in which fourth graders played it twice a week for five weeks as part of their regular classroom routine. The game led children to add one fruit or vegetable per day to their diet, a better result than the Baranowskis had received with their curricula. They realized they were on to something.

In the games that followed, the Baranowskis began venturing outside the classroom. They developed a Web-based Boy Scouts badge program that included video games and GEMS, a summer day camp program for girls with a Web component. Then, with their technology partner, Archimage, they developed Escape from Diab, which focuses on diabetes prevention, and Nanoswarm, which centers on how food and exercise choices affect the body. Each of these games produced results that were nearly as impressive as Squire’s Quest!

The key to the games’ success is that they require participants to set specific, clearly defined goals, Janice Baranowski says. “It’s not just, ‘I’m going to eat more fruit and vegetables.’ It’s ‘Tomorrow, on Friday, for lunch, I’m going to eat a banana. On Saturday, for dinner, I’m going to have a 1/2 cup of corn.’ They pick the day, the meal, the fruit or vegetable that they’re going to eat and how much,” she explains. “Once they set the goals, they’re locked out of the game. When they come back to play the game three days later, it asks them how they did. If they didn’t meet their goal, the game will problem solve with them to help figure out what happened and what they can do next time to meet the goals.”

One of the biggest challenges in using video games to educate kids is that they’re expensive. Janice Baranowski says that while many researchers are interested in using the medium to encourage healthful behaviors, game developers mainly are interested in the games’ entertainment value. Bringing the two groups together is a priority for the Baranowskis. Although progress is slow, Janice Baranowski says the process is inching forward.

To add to the existing body of evidence, the Baranowskis are embarking on a study of 400 children; they recently received institutional review board approval and are in the process of signing up participants. Although video game interventions can work for all kids, Janice Baranowski says the study will focus on overweight children, who will play Escape from Diab and Nanoswarm at home.

To measure physical activity, participants will wear accelerometers for one week at baseline, one week after they finish the game, and two months later to see if there’s any residual effect. Initially, food intake will be self-reported, but the Baranowskis are working with the University of Pittsburgh to develop an eButton that kids can wear on their shirts. It’s a camera badge that takes a picture every two seconds to monitor the kids’ physical activity and diet.

The Baranowskis believe video games will become an increasingly important tool in the fight against childhood obesity. So far, the research results suggest greater potential for video game interventions, but what’s needed is a better understanding of how games fit into a broader nutrition education strategy. Janice Baranowski says it’s time more people started looking at this question.

“We think video games are the future. I think the research and nutrition communities really need to figure out how to make video games work for us,” she says. “We’ve got to figure out how we can take the games that are out there or how we can develop fun games that encourage kids to change their behaviors to eat healthfully and be physically active, and that’s a long process. We’ve moved people’s thinking along, but there is still the contingent that says video games are the enemy, and we can’t let kids play video games. Well, you’re not going to stop kids from playing video games.”

— David Yeager is a freelance writer and editor based in Royersford, Pennsylvania.

 

Resources
Baranowski T, Abdelsamad D, Baranowski J, et al. Impact of an active video game on healthy children’s physical activity. Pediatrics. 2012;129(3):e636-e642.

Baranowski T, Buday R, Thompson D, Lyons EJ, Lu AS, Baranowski J. Developing games for health behavior change: getting started. Games Health J. 2013;2(4):183-190.

Baranowski T, Beltran A, Chen T, et al. Structure of corrective feedback for selection of ineffective vegetable parenting practices for use in a simulation videogame. Games Health J. 2013;2(1):29-33.

Baranowski T, Diep C, Baranowski J. Influences on children's dietary behavior, and innovative attempts to change it. Ann Nutr Metab. 2013;62 Suppl 3:38-46.

Beltran A, O’Connor T, Hughes S, et al. Alpha test of a videogame to increase children's vegetable consumption. Games Health J. 2012;1(3):219-222.

Lu AS, Thompson D, Baranowski J, Buday R, Baranowski T. Story immersion in a health videogame for childhood obesity prevention. Games Health J. 2012;1(1):37-44.

Games for Health Journal: www.liebertpub.com/overview/games-for-health-journal/588

Health Games Research: www.healthgamesresearch.org