International Journal of Computer Science in Sport - Volume 9/Special Edition

www.iacss.org

Design of Video Games for Children’s Diet and
Physical Activity Behavior Change
Tom Baranowski
Debbe Thompson
USDA/ARS Children’s
Nutrition Research Center,
Baylor College of Medicine,
Houston, TX, USA

Richard Buday
Archimage, Inc.,
Houston, TX, USA

Amy Shirong Lu
Janice Baranowski
USDA/ARS Children’s
Nutrition Research Center,
Baylor College of Medicine,
Houston, TX, USA

Abstract
Serious video games (VG) offer new opportunities for promoting health related diet and physical activity change among children. Games can be designed to use storylines, characters, and behavior change procedures, including modeling (e.g., engaging characters make changes themselves, and face and overcome challenges related to fruit and vegetable (FV) and physical activity (PA) goal attainment and/or consumption), skill development (e.g., asking behaviors; virtual recipe preparation), self regulatory behaviors (problem solving, goal setting, goal review, decision making), rewards (e.g., points and positive statements generated by the program), immediate feedback (e.g., through characters and/or statements that appear on the computer screen at critical decision points), and personalization (e.g., tailored choices offered at critical junctures, based on responses to baselines questions related to preferences, outcome expectancies, etc). We are in the earliest stages of learning how to optimally design effective behavior change procedures for use in VG, and yet they have been demonstrated to change behavior. As we learn, VG offer more and better opportunities for obesity prevention that can adjust to individual needs and preferences.
VIDEO GAME, MEDIATING VARIABLES, HEALTH BEHAVIOR CHANGE
PROCEDURES, CHILDREN, DIET, PHYSICAL ACTIVITY
Introduction
Youth obesity has risen dramatically over the past few decades (Ogden et al., 2006).
Overweight and obesity combined reached approximately 50% in some US ethnic minority children (Baranowski et al., 2006). Obese youth are more likely to become obese adults (Serdula et al., 1993). The prevalence of obesity has been implicated in increased risk for type 2 diabetes (T2D) (Fagot-Campagna et al., 2000). Increased fruit and vegetable (FV) intakes are the only food groups that have shown some consistency in association with decreasing the risk of obesity (Dennis, Flack, & Davy, 2009; Rolls,
Drewnowski, & Ledikwe, 2005) and T2D (Kastorini & Panagiotakos, 2009).
Unfortunately youth consumed well below the recommended minimum of five FV servings (Baranowski, Smith et al., 1997; Domel et al., 1993) and were physically active
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International Journal of Computer Science in Sport - Volume 9/Special Edition

www.iacss.org

(PA) for much less than the recommended 60 min of moderate to vigorous physical activity (MVPA) per day (Troiano et al, 2008). Finding ways to help youth consume more FV and be more PA will help decrease their risk of developing adult obesity and
T2D.
Serious video game (VG) interventions have been effective at promoting dietary change among youth (Baranowski, Baranowski, Cullen, Marsh et al., 2003). Our recent review demonstrated that most health-related VG had some positive outcome (Baranowski,
Buday, Thompson, & Baranowski, 2008). Serious VG offer the promise of effective behavior change by immersing children in a story that exposes them to related behavior change procedures within the game (Baranowski et al., 2008), and have the potential for broad public health benefit because, once created, they can be made widely available at low cost. To the extent serious VG increase FV intake and PA, they can contribute to healthier lifestyle changes among children. Starting those changes early offers promise of preventing both adult and child obesity.
Model of Behavior Change
Behavior change interventions must be predicated on proven