Exergames played with a photorealistic avatar may enhance motivation to play, in addition to frequency, duration, and intensity of game-play. This article reports the feasibility and preliminary efficacy of an exergame played with a photorealistic avatar on physical activity (PA) intensity in a laboratory-based study.
Materials and Methods:
Teens (12–14 years old) were recruited from a large, metropolitan area of the southwestern United States. Parents provided written informed consent. Teens completed online data collection, played an exergame with a photorealistic avatar in an observed laboratory setting, and then participated in postassessment data collection that included online questionnaires and a telephone interview.
Results:
The program was feasible: 42 out of 48 teens recruited (87.5%) completed all data collection activities; game enjoyment was 21.9 ± 8.4 out of possible score of 32; immersion, 49.7 ± 15.6 out of a possible score of 88; avatar identification, 43.9 ± 16.5 out of a possible score of 68; and program satisfaction, 15.6 ± 3.6 out of possible score of 20. Objectively assessed PA indicated that 15.88 minutes of the laboratory-based gameplay session (74.9% of total time) was in vigorous PA; small effect sizes were observed in autonomy (ES = 0.45; P = 0.01) and competence (ES = 0.36; P = 0.03). Little change was observed in relatedness (ES = 0.04; P = 0.82) Qualitative data confirmed participants enjoyed playing the game with a photorealistic avatar and provided suggestions to enhance the gameplay experience.
Conclusion:
Playing an exergame with a photorealistic avatar holds promise as a method for increasing PA among youth. Additional research is needed to further explore its effects on gameplay frequency, intensity, and duration in nonlaboratory setting.
Get full access to this article
View all access options for this article.
References
1.
US Department of Health and Human Services - Physical Activity Guidelines Advisory Committee. 2008 Physical Activity Guidelines for Americans. [Report] Washington, DC: U.S. Department of Agriculture: Department of Health and Human Services [updated April11, 2017] www.health.gov/paguidelines/guidelines/default.aspx (accessed April11, 2017).
2.
SalbeAD, WeyerC, HarperI, et al.Assessing risk factors for obesity between childhood and adolescence: II. Energy metabolism and physical activity. Pediatrics, 2002; 110:307–314.
CeschiM, GutzwillerF, MochH, et al.Epidemiology and pathophysiology of obesity as a cause of cancer. Swiss Med Wkly, 2007; 137:50–56.
5.
FreedmanDS, DietzWH, SrinivasanSR, et al.The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics, 1999; 103:1175–1182.
6.
HussainA, ClaussenB, RamachandranA, et al.Prevention of type 2 diabetes: A review. Diabetes Res Clin Pract, 2007; 76:317–326.
TelamaR, YangX, ViikariJ, et al.Physical activity from childhood to adulthood: A 21-year tracking study. Am J Prev Med, 2005; 28:267–273.
9.
MetcalfB, HenleyW, WilkinT. Effectiveness of intervention on physical activity of children: Systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54). BMJ, 2012; 345:e5888.
10.
DumithSC, GiganteDP, DominguesMR, et al.Physical activity change during adolescence: A systematic review and a pooled analysis. Int J Epidemiol, 2011; 40:685–698.
11.
KellyS, MartinS, KuhnI, et al.Barriers and facilitators to the uptake and maintenance of healthy behaviours by people at mid-life: A rapid systematic review. PLoS ONE, 2016; 11:e0145074.
12.
PagulayanRJ, KeekerK, FullerT, et al.User-centered design in games. In: JackoJA, editor. The Human-Computer Interaction Handbook: Fundamentals, Evolving Technologies and Emerging Applications. 3rd ed. Boca Raton, FL: CRC Press - Taylor & Francis Group; 2012, pp. 795–824.
13.
ThompsonD, CantuD, RajendranM, et al.Development of a teen-focused exergame. Games Health J, 2016; 5:342–356.
14.
LyonsEJ, TateDF, WardDS, et al.Energy expenditure and enjoyment during video game play: Differences by game type. Med Sci Sports Exerc, 2011; 43:1987–1993.
15.
BiddissE, IrwinJ. Active video games to promote physical activity in children and youth: A systematic review. Arch Pediatr Adolesc Med, 2010; 164:664–672.
16.
GaoZ, ChenS. Are field-based exergames useful in preventing childhood obesity? A systematic review. Obes Rev, 2014; 15:676–691.
JinSA, ParkN. Parasocial interaction with my avatar: Effects of interdependent self-construal and the mediating role of self-presence in an avatar-based console game, Wii. Cyberpsychol Behav, 2009; 12:723–727.
19.
FoxJ, BailensonJN. Virtual self-modeling: The effects of vicarious reinforcement and identification on exercise behaviors. Media Psychol, 2009; 12:1–25.
20.
BillinghamSA, WhiteheadAL, JuliousSA. An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database. BMC Med Res Methodol, 2013; 13:104.
WilsonPM, RogersWT, RodgersWM, et al.The Psychological Need Satisfaction in Exercise Scale. J Sport Exerc Psychol, 2006; 28:231–251.
24.
SkalskiP, TamboriniR, SheltonA, et al.Mapping the road to fun: Natural video game controllers, presence, and game enjoyment. New Media Soc, 2011; 13:224–242.
25.
LuAS, ThompsonD, BaranowskiJ, et al.Story immersion in a health videogame for childhood obesity prevention. Games Health J, 2012; 1:37–44.
26.
GreenMC, BrockTC. The role of transportation in the persuasiveness of public narratives. J Pers Soc Psychol, 2000; 79:701–721.
27.
Van LooyJ, CourtoisC, De VochtM, et al.Player identification in online games: Validation of a scale for measuring identification in MMOGs. Media Psychol, 2012; 15:197–221.
28.
BowenDJ, KreuterM, SpringB, et al.How we design feasibility studies. Am J Prev Med, 2009; 36:452–457.
29.
National Cancer Institute. SAS programs for analyzing NHANES 2003–2004 accelerometer data. 2014 [updated February3, 2016]. http://appliedresearch.cancer.gov/nhanes_pam/ (accessed April11, 2017).
30.
TrostSG, LoprinziPD, MooreR, et al.Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc, 2011; 43:1360–1368.
31.
BraunV, ClarkeV. Using thematic analysis in psychology. Qual Res Psychol, 2006; 3:77–101.
32.
LiangY, LauPWC. Effects of active videogames on physical activity and related outcomes among healthy children: A systematic review. Games Health J, 2014; 3:122–144.
33.
BaileyBW, McInnisK. Energy cost of exergaming: A comparison of the energy cost of 6 forms of exergaming. Arch Pediatr Adolesc Med, 2011; 165:597–602.
34.
ThompsonD. Incorporating behavioral techniques into a serious videogame for children. Games Health J, 2017; 6:75–86.
35.
BaranowskiT, AndersonC, CarmackC. Mediating variable framework in physical activity interventions. How are we doing? How might we do better?. Am J Prev Med, 1998; 15:266–297.
36.
RyanRM, DeciEL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well being. Am Psychol, 2000; 55:68–78.
37.
RyanR, RigbyC, PrzybylskiA. The motivational pull of videogames: A self determination theory aproach. Motiv Emotion, 2006:347–363.
38.
ThompsonD, BaranowskiT, BudayR, et al.Serious video games for health: How behavioral science guided the development of a serious video game. Simul Gaming, 2010; 41:587–606.
39.
JacobsRN. The narrative integration of personal and collective identity in social movements. In: GreenMC, StrangeJJ, BrockTC, editors. Narrative Impact: Social and Cognitive Foundations. Mahwah, NJ: Lawrence Erlbaum; 2002. pp. 205–228.
40.
SchneiderEF. Death with a story: How story impacts emotional, motivational, and physiological responses to first-person shooter video games. Hum Commun Res, 2004; 30:361–375.
41.
HefnerD, KlimmtC, VordererP. Identification with the player character as determinant of video game enjoyment. In: MaL, RauterbergM, NakatsuR, editors. Entertainment Computing–ICEC 2007 Lecture Notes in Computer Science. Berlin, Heidelberg Springer; 2007, pp. 39–48.
42.
VordererP, HartmannT, KlimmtC. Explaining the enjoyment of playing video games: The role of competition. ICEC '03 Proceedings of the second international conference on entertainment computing. Pittsburgh, PA: ACM; 2003, pp. 1–9.
43.
KlimmtC, BlakeC, HefnerD, et al.Player performance, satisfaction, and video game enjoyment. In: NatkinS, DupireJ, editors. Entertainment Computing–ICEC 2009 Lecture Notes in Computer Science. Berlin, Heidelberg Springer; 2009, pp. 1–12.
44.
LyonsEJ, TateDF, KomoskiSE, et al.Novel approaches to obesity prevention: Effects of game enjoyment and game type on energy expenditure in active video games. J Diabetes Sci Technol, 2012; 6:839–848.
