Robin R. Mellecker

Games for Health for Children - Current Status and Needed Research

Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the game design and behavior change procedures that best promote G4H effectiveness and to identify and minimize possible adverse effects. Guidelines for ideal use of different types of G4H by children and adolescents should be elucidated to enhance effectiveness and minimize adverse effects. G4H stakeholders include organizational implementers, policy makers, players and their families, researchers, designers, retailers, and publishers. All stakeholders should be involved in G4H development and have a voice in setting goals to capitalize on their insights to enhance effectiveness and use of the game. In the future, multiple targeted G4H should be available to meet a populations diverse health needs in developmentally appropriate ways. Substantial, consistent, and sophisticated research with appropriate levels of funding is needed to realize the benefits of G4H.

Active video games and physical activity recommendations: A comparison of the Gamercize Stepper, XBOX Kinect and XaviX J-Mat

OBJECTIVES The current study was designed to evaluate the intensity levels of three exergames and determine the association with physical activity recommendations that correspond to specific outcomes. The variation in cardiovascular responses between the three exergames was also examined. DESIGN We employed a cross-sectional laboratory design. METHODS We recruited 18 girls to participate in a peak VO2 test and to play Gamercize, Kinect River Rush, XaviX J-Mat at three separate exergaming sessions. Linear regression equations of heart rate and percentage of peak VO2 were calculated for each participant to determine the intensity of exergame play. Differences in intensity between the three exergames and time spent in the recommended moderate (heart rate at ≥ 55% peak VO2) and vigorous (heart rate at ≥ 75% peak VO2) intensity levels were analyzed. We calculated the coefficient of variation for the mean heart rate to determine the difference in variance in heart rate values for the three exergames. RESULTS When playing Gamercize and Kinect the girls did not play at recommended moderate or vigorous levels. Although the girls did not play at vigorous levels when playing XaviX J-Mat, our results showed that when playing XaviX J-Mat they did play at moderate intensity levels. No significant differences in the coefficient of variation between the three exergames were apparent. CONCLUSIONS If active gaming is to be used to increase physical activity levels then individual differences in levels of exertion and specific activity recommendations need to be taken into consideration.

Socioeconomic Status, Neighborhood Characteristics, and Walking Within the Neighborhood Among Older Hong Kong Chinese

Objective: We examined the associations of educational attainment and area socioeconomic status (SES) with total within-neighborhood walking patterns and percentage of walking undertaken for recreation purposes in Hong Kong elders. Environmental mediators of these associations were also examined. Method: Chinese-speaking elders (N = 484), cognitively unimpaired and able to walk unassisted, were recruited from 32 street blocks stratified by SES and walkability. Interviewer-administered surveys were conducted to collect data on walking and sociodemographics. Neighborhood environments were audited. Results: Educational attainment was positively related to walking outcomes, while area SES was only positively related to percentage of walking allocated to recreational purposes. While no mediators of area SES-walking associations were identified, several environmental attributes explained the associations of educational attainment with walking. Discussion: Educational attainment rather than area SES is a key determinant of walking in Hong Kong elders; these effects are mostly attributable to social and individual rather than environmental factors.

Active Learning: Educational Experiences Enhanced Through Technology-Driven Active Game Play

ABSTRACT Recent developments in technology have resulted in innovative learning tools that couple physical activity elements with learning objectives. We aimed to determine whether Footgaming in the classroom results in learning nutritional concepts. The experiences of student participation and teachers’ perceptions of using active gaming in the classroom were reported. A total of 57 students played computerized nutritional games utilizing their feet to control mouse functions on a Footgaming pad (Cobalt Flux, Salt Lake City, UT). Nutritional knowledge was assessed at baseline and following 10 weeks of Footgaming. These preliminary findings suggest children can learn nutritional concepts and teachers and students value the educational experience when using Footgaming in the classroom. These findings are an important step in improving the understanding of physical activity–based technologies in the classroom setting.

Measures of environmental correlates of physical activity for urban Chinese preschool-aged children: development and reliability

We adapted/developed and examined the test–retest reliability and internal consistency of eight parent-report measures of home and neighborhood environmental correlates of physical activity appropriate for Chinese preschool-aged children and their parents/primary caregivers living in densely populated urban environments. This study consisted of a qualitative (cognitive interviews) and a quantitative (test–retest reliability) component. Chinese versions of the measures were pilot-tested on 20 parents of Hong Kong preschool-aged children using cognitive interviews. Measures were then administered to 61 parents twice, 1 week apart. Test–retest reliability and internal consistency were computed. Except for two items, the test–retest reliability of items and scale summary scores ranged from moderate to excellent. The internal consistency of the measures exceeded recommended minimal values (Cronbach’s α > .70). The parent-report measures examined in this study are potentially appropriate for use in investigations of environmental correlates of the physical activity of Chinese preschool-aged children living in densely populated urban environments. However, their predictive validity with respect to Chinese preschool-aged children’s physical activity needs to be assessed in future studies.

Measurement of resting energy expenditure in healthy children.

BACKGROUND The role that the components of energy expenditure play in the etiology of childhood obesity has highlighted the need for greater accuracy and standardized protocols for the measurement of resting energy expenditure (REE). However, protocols used to assess REE in children are varied, and consensus on a suitable method for measuring REE in children has not been reached. This study was undertaken to determine the effect of measurement time and measurement device (mask or mouthpiece) on REE in healthy children. DESIGN Following a 12-hour fast and abstinence from exercise, 23 children (age, 7-12 years) completed two 35-minute protocols: one with a face mask and the other with a mouthpiece/noseclip. Energy expenditure was measured continuously via indirect calorimetry, while device acceptability was assessed using a 6-point comfort rating scale. RESULTS Repeated measures ANOVA indicated that there was no significant difference in REE when measured after 10, 15, 20, or 25 minutes of rest compared to 30 minutes for either the mask or mouthpiece/noseclip (REE range, 1371-1460 kcal/d). Examination of the percentage coefficient of varia tion (CV) in energy expenditure for each time period by device showed that the least variation existed after 20 minutes of measurement using the mask (CV 6%). Paired t test analysis indicated significantly less discomfort when wearing the mask compared to the mouthpiece/noseclip. CONCLUSION It would appear that a 20-minute protocol using a mask may increase compliance and prove to be a more practical protocol for measuring REE in children.

Does playing a sports active video game improve young children's ball skill competence?

OBJECTIVES Actual and perceived object control (commonly ball) skill proficiency is associated with higher physical activity in children and adolescents. Active video games (AVGs) encourage whole body movement to control/play the electronic gaming system and therefore provide an opportunity for screen time to become more active. The purpose of this study was to determine whether playing sports AVGs has a positive influence on young childrens actual and perceived object control skills. DESIGN Two group pre/post experimental design study. METHODS Thirty-six children aged 6-10 years old from one school were randomly allocated to a control or intervention condition. The Test of Gross Motor Development-3 assessed object control skill. The Pictorial Scale of Perceived Competence for Young Children assessed perceived object control skill. The intervention consisted of 6×50min lunchtime AVG sessions on the Xbox Kinect. Two to three sport games were chosen for participants to play each session. General linear models with either perceived object control or actual object control skill as the outcome variables were conducted. Each base model adjusted for intervention status and pre-score of the respective outcome variable. Additional models adjusted for potential confounding variables (sex of child and game at home). RESULTS No significant differences between the control and intervention groups were observed for both outcomes. CONCLUSIONS This study found that playing the Xbox Kinect does not significantly influence childrens perceived or actual object control skills, suggesting that the utility of the Xbox Kinect for developing perceived and actual object control skill competence is questionable.

Children's movement skills when playing active video games

Active video games (AVGs) may be useful for movement skill practice. This study examined childrens skill execution while playing Xbox Kinect™ and during movement skill assessment. Nineteen children (10 boys, 9 girls; M age = 7.9yr., SD = 1.4) had their skills assessed before AVG play and then were observed once a week for 6 wk. while playing AVGs for 50min. While AVG play showed evidence of correct skill performance (at least 30–50% of the time when playing table tennis, tennis, and baseball), nearly all skills were more correctly performed during skill assessment (generally more than 50% of the time). This study may help researchers to better understand the role AVGs could play in enhancing real life movement skills.

Making Smart Choices: A Serious Game for Sex Education for Young Adolescents

Current educational resources for sex education in Hong Kong are mainly designed to be used in classroom. They are mostly text-based and are unattractive to the most vulnerable adolescent group. As discussion on sex is still taboo in Chinese society, self-learning resources can supplement classroom teaching. This paper describes an interactive game playable on Facebook, iPad and the web to educate young adolescents with reliable knowledge and positive attitudes towards relationship and sex and life skills necessary for making wise decisions regarding love and sex in a fun way. The effectiveness and acceptance of the game were evaluated by more than 1000 grades 7-9 students from six schools. The results showed that after playing the game, students’ sex knowledge improved with a medium effect size. The students were mostly receptive to the game, finding it fun to play with and describing the content as “interesting”, “interactive”, “informative”, “close to reality” and “applicable”. Making Smart Choices: A Serious Game for Sex Education for Young Adolescents

Comparison of Musculoskeletal Strength and Body Composition of Hong Kong Chinese Rugby Players, Dragon Boat Paddlers and Controls

Objective: This study used a cross-sectional experimental design to assess musculoskeletal strength, body composition and physical activity levels in Hong Kong Chinese dragon boat paddlers, rugby team players and controls. Methods: Sixty undergraduate male students (rugby players, n=20, dragon boat, n=20 and controls, n=20) were recruited from a local university. A One-way ANCOVA model was designed with bone strength, muscle strength, flexibility and body composition scores as the independent variables and the three groups as dependent variables. Results: Significant between-group differences in handgrip strength, flexibility, fat free mass and percentage of body fat were noted. There was a concomitant higher fat free mass in the rugby and dragon boat players when compared to the controls, whist the percentage of body fat was significantly lower for these two groups. Flexibility was also higher in the rugby and dragon boat players when compared to the control group participants. The percentage of time spent in MVPA between rugby, dragon boat and controls was analyzed using one-way ANOVA. Conclusion: These preliminary findings provide evidence into the benefits of university sports participation and much needed evidence in the role sports such as dragon boat and rugby play in musculoskeletal strength, flexibility and the possible effect on body composition.