Creature-101: A Virtual Reality Online Game to Promote Energy Balance Related Behaviors among Middle-Schoolers

Abstract

To evaluate the effectiveness of Creature-101 game at modifying middle-schoolers eating and physical activity behaviors. Middle school aged students. Prior games in nutrition education have focused primarily at increasing fruit and vegetables (FV) and physical activity (PA). Using social cognitive and self-determination theories as framework Creature-101 aims at increasing FV, water, PA, decreasing processed snacks (PS)(e.g. chips, candy), sweetened beverages (SB), and recreational screen time, and improving psychosocial mediators (knowledge, self-efficacy, outcome expectations, autonomous motivation). Creature-101 incorporates creature care in a virtual world “Tween”. In the game (7-sessions, 30-minutes each) students learn scientific evidence that promotes energy balance by playing mini-games, short educational videos, slideshows and interactive dialogues with game characters. Students also assess their own behaviors; create own “real life” food and activity action plans, and report their progress. Outcome evaluation used a quasi-experimental design (matched-paired schools) with 359 students in intervention; 172 students in control (delayed intervention) condition. Students (11-13yrs old, 50% males, 65% Hispanics) played Creature-101 in science/health education classes for 1-month. Two self-reported, validated, online surveys were administered at baseline and post intervention. Analysis of covariance compared post-test means between groups. Intention to treat analysis showed significant decreases in frequency of consumption of PS (scale:0-5, I=1.79±1.22, C=2.14±1.37, p<0.000) and increase in knowledge (scale:0-11, I=5.06±3.91, C=4.06± 1.43, p=0.012). Positive trends (p<0.1) were reported for consuming fewer SB (scale:0-5, I=1.72±1.12, C=1.95± 1.16, p=0.08), smaller sizes SB (scale:0-3, I=1.46±0.88, C=1.65±0.93, p=0.09) and PS (scale:0-3, I=1.46±0.88, C=1.65±0.93, p=0.09). Creature-101 may be effective in modifying eating behaviors in middle-schoolers to promote energy-balance.