Abstract
BackgroundComputer-based educational games present an opportunity for health education in school; however, their feasibility in school settings and effectiveness in changing behavior are poorly understood. ObjectiveTo evaluate the feasibility, acceptability, and effects of the Quest to Lava Mountain (QTLM) computer game on dietary behaviors, physical activity behaviors, and psychosocial factors among ethnically diverse children in Texas. DesignQuasi-experimental group-randomized controlled trial conducted during the 2012-2013 school year. Participants/settingA total of 107 children in fourth and fifth grade consented. There was an attrition rate of 8.8% with a final sample size of 44 children in three intervention schools, and a sample of 50 children in three comparison schools. Dietary intake was measured using two random 24-hour recalls, whereas child self-report surveys measured diet, physical activity, and psychosocial factors before and after the intervention. Process data on QTLM usability and back-end server data on QTLM exposure and progress achieved were collected. InterventionQTLM was implemented as part of the in-school or afterschool program. Recommended game exposure duration was 90 min/wk for 6 weeks. Statistical analysisAnalysis of covariance or logistic regression models evaluated effects of QTLM on diet, physical activity, and psychosocial factors. Post hoc exploratory analysis examined the changes before and after the intervention in outcome variables among children in the intervention group. Significance was set at P<0.05. ResultsChildren played an average of 274±110 minutes (approximately 4.6 hours) of QTLM during the 6 weeks (51% of recommended dosage). Compared with the comparison group, children in the intervention group reported decreased sugar consumption (P=0.021) and higher nutrition/physical activity attitudes (P=0.041) pre- to postintervention. There were no significant effects of QTLM on physical activity. However, post hoc analysis showed that higher QTLM exposure and gaming progress was associated with increased frequency of physical activity (P<0.05). ConclusionsQTLM has some promising acceptability and initial effects on diet and physical activity behaviors among children in elementary school.
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