JMIR Publications

ABSTRACT

Background:

Children demand advice on and assistance for maintaining healthy lifestyle behaviors (physical activity, healthy eating, and social-emotional wellness) to grow appropriately. Encouraging these behaviors as early as possible is essential since behaviors embraced during this period are probable to be sustained into adulthood. Serious games could be an effective educational tool to teach healthy lifestyle behaviors during childhood.

Objective:

This study describes the design and development of the serious game HelperFriend and presents a pilot study to evaluate its feasibility, acceptability, and preliminary effects. HelperFriend is a vicarious experiential video game designed with the aim to promote, in an integral way, physical activity, healthy eating, and social-emotional wellness among young children (8-11 years old). The game integrates educational, cognitive, and behaviors theories to support children increase their health knowledge and improve their lifestyle behaviors.

Methods:

HelperFriend was developed by a multidisciplinary team following an iterative methodology. A 4-week parallel two-arm randomized controlled pilot trial was conducted at an elementary school in Mexico. Participants, 8-11 years old, were randomized to the experimental group (EG) or a control group (CG). The EG participants used HelperFriend for six 30-minute play sessions, and the CG participants received a 45-minute healthy lifestyle behaviors educational talk. All participants completed three questionnaires before and after gameplay: a healthy behaviors knowledge questionnaire, a healthy lifestyle behaviors intention questionnaire, and a food frequency questionnaire. In addition, the EG participants answered a player satisfaction questionnaire after the gameplay.

Results:

Of the 40 children eligible for inclusion, 27 agreed to participate: (mean age 9.9 years, SD 0.9; 59% girls) and were randomized to the EG (n=15) or to the CG (n=12). The results confirm that HelperFriend is well received by players and generates high satisfaction. HelperFriend players showed significantly increased knowledge of physical activity, healthy eating, and social-emotional wellness. Players also reported significantly greater intention to perform these healthy lifestyle behaviors and self-reported reductions in consumption of 13 unhealthy foods. There was a significant difference between EG and CG in healthy lifestyle behaviors, knowledge, and intention to perform these behaviors.

Conclusions:

The results of this pilot study suggest that vicarious experiential health games, such as HelperFriend, are well received and produce high satisfaction in young children. In addition, this type of game is a feasible tool for teaching and promoting healthy lifestyle behaviors to young children. The findings also stated that it is possible to promote social-emotional wellness with health games. In addition, health games can promote, in an integral way, physical activity, healthy eating, and social-emotional wellness in children. We plan to assess medium- and long-term HelperFriend outcomes in a study with a larger sample for future research.