JMIR Publications

ABSTRACT

Background:

Our interdisciplinary team developed a publicly available online game, Eat and Move as I Like (EAMAIL), for tweens based on MyPlate evidence-based representation of the Dietary Guidelines.

Objective:

To test feasibility of EAMAIL in a classroom setting to promote engagement, self-awareness, and motivate healthier diet behaviors in tweens.

Methods:

Teachers in one middle school offered EAMAIL on school Chromebooks (IRB-approved). The researcher introduced EAMAIL’s login instructions, including non-identifiable username, basic demographics, and home zip code. Children were instructed to enter EAMAIL Story Mode, with five MyPlate-food group levels, catching healthy foods in matched color buckets and avoiding sweets. Each level delivers informational and motivational messages, asking users to report liking/disliking of food groups and making dietary improvements on 7-point facial hedonic scales (Love it—It’s okay–Hate it). At game completion, children rated if the game made them want to eat better and play again. Aligned with the Design, Play, and Experience Framework, the researcher made observations to assess child engagement, feelings about the game and messages, and motivation to make dietary improvements. Children were encouraged to complete the Story Mode before advancing to Free Play Mode with greater game challenges and 15-second interruptions every 2-3 minutes, delivering physical activity and health messages. Finally, each child completed a 13-item online survey to assess game-playing experiences, desire to play again, new knowledge learning, and if the game motivated healthier behaviors.

Results:

EAMAIL was administered to 5, 30-minute classes involving 54 children (mean age=11.6 years; 75% female; 58% White), 105 users, and 1187 games played. By highest user level reached in Story Mode, 10% completed level-1 (Grains), 14% level-2 (Vegetables), 11% level-3 (Healthier Protein), 17% level-4 (Fruits), 15% level-5 (Dairy), and 31% all levels. Across users’ highest level, healthier protein averaged most liked and vegetables least. Most reported at least Like it to eating more: fruits and vegetables (82%), vegetables (73%), healthier protein (79%), fruit (84%), and dairy (80%). All users responded to end game questions: 64% reported at least Like it to “The game made me want to eat better” and “I would like to play the game again.” These responses were unchanged for most users completing Story Mode and entering Free Play Mode (n=24); 6 reported worse and 3 better. From the post-game online survey, somewhat to strongly agreed was reported by 76% of children to learning about healthy eating and by 50% that the game was fun, had positive attributes (pace, challenge, flow), and that they would share their game experiences. Researcher observations were consistent with children’s online responses.

Conclusions:

EAMAIL appears feasible for tweens in classroom settings to teach about MyPlate, encourage self-reflection, and motivate healthier eating with Story Mode maximizing health promotion messages and engagement.