On
the face of it, technology might look as if it is part of the problem, not the
solution. You might argue that children spend enough time slumped in front of
screens playing games. But what if the games required the player to be
physically active? A new class of serious games – exergames – are built on this
concept. The most commonly known games are for console platforms such as Kinect
or Wii Fit, but it is also possible to use smart phones to play location-based
games. Here the game uses the phone’s GPS information to update where the
player’s character is in the game world. In our game, FitQuest, kids run round
the playground collecting invisible coins, or escaping from virtual wolves.
Game objects such as wolves and coins appear only on the phone screen in the
game world. The user’s movements in real space map to the game world; if the
user moves over a game world location where a coin is stored, they get a reward.
FitQuest was originally developed as part of Andrew Macvean’s PhD research at
Heriot-Watt University.
We
have tried FitQuest in six primary schools and two secondary schools now,
usually in PE lessons. We now have a good understanding of how children respond
to it, the sorts of goals they set for themselves, the social interactions
which typically occur, and how teachers feel that the game fits with the
classroom setting.
In
terms of methodology, we have used a mixture of qualitative and quantitative
research methods. In the early stages we did some learner centred technology
design with the children so that they could give us feedback on initial design.
Andrew then ran two in-depth pilot studies which he analysed as a series of
case studies which helped us refine the next version of the software. They also
shed some light on how children with different levels of self-efficacy (their
confidence in their ability to exercise) responded to the games.
We
wanted to follow up our initial findings with a more robust study design, so we
conducted a cluster randomised controlled trial. Our hypotheses were that the
motivational factor of games, along with the goal setting features would have a
positive impact on the children’s self-efficacy (confidence to take part in
physical activity) and their physical activity habits in the playground. In the
intervention group the primary 7 class of 5 schools used FitQuest for an hour a
week for 5 weeks. By contrast, the 5 control group schools took part in their
normal PE class. In the weeks immediately before and after the intervention,
each child filled in a self-efficacy questionnaire, and wore an accelerometer
to count their steps during school time. This objective data enabled us to run
a multi-level analysis to find out whether using FitQuest would have an impact
on the outcome variables (self-efficacy and step count) once the pre-test
results were factored in. As we were using a realist approach in our trial[5], we
did not merely want to know whether
FitQuest worked or not, but why, and
for whom. We gathered this additional
contextual information from observations and interviews with children and
teachers.
It
turned out that by the objective measures, FitQuest did not have an impact on self-efficacy or step count. The contextual
data goes some way to explaining this result, which is just as well because it
is highly frustrating! For a start, the children only had an opportunity to
play the game for around 35% of the time we recommended: it’s as if they were
only given the “wee half” of an aspirin tablet instead of the full dose. Anyone
familiar with schools can guess the endless reasons why sessions were
cancelled: rain, play rehearsals, sports competitions, school trips, teacher
absence. It is hard to draw conclusions about what might have happened if they
had used it for closer to the recommended time, but based on the qualitative
work here’s my best guess. Children able to set appropriate goals to improve
their own performance probably would have benefited most, and this would be
most likely to occur in schools where the teacher played an active interest in
the children’s scores and related the game to goal setting in the PE
curriculum. The game by itself appears to have a novelty effect – if the
initial fun factor wears off and it is not replaced by a purpose such as
improving scores, the player will lose interest. Social interactions were very
important to the children, so a multi-player version of the game is on our
to-do list. For some children, competition can be off putting. Those who feel
self-conscious while running, or those who have fixed mind-sets and poor
performance relative to their peers might feel alienated by the competitive
aspect of the leader-board.
As
is often the case in research, even relatively robust methods reveal more
questions rather than definitive answers. I believe that exergames and
technology in general can play a part in promoting health behaviour change,
such as increasing physical activity. It can potentially motivate users through
intrinsic enjoyment of play, and through personalised detailed feedback. But we
need to learn how to get better at designing it first.
Of
course, you don’t need technology to
increase physical activity in your class, fun as it may be. Technology would
only ever be part of a solution. Walking is free – why not take your class
outside for a 20 minute walk today?
Judy Robertson is Professor of Digital Learning at
University of Edinburgh. She designs and evaluates children’s technology in
schools. She is particularly interested in serious games for learning or for
health.
References:
[1] Blair, S. N. (2009). Physical
inactivity: the biggest public health problem of the 21st century. British
Journal of Sports Medicine, 43(1), 1–2.
[2] Department of Health Physical
Activity and Health Improvement. (2011). Start Active , Stay Active: A
report on physical activity for health from the four home countries’ Chief
Medical Officers. London. Retrieved from
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_128209
[3] Griffiths, L. J., Cortina-Borja,
M., Sera, F., Pouliou, T., Geraci, M., Rich, C., … Dezateux, C. (2013). How
active are our children? Findings from the Millennium Cohort Study. BMJ Open,
3, e002893. doi:10.1136/bmjopen-2013-002893
[4] A. Singh, L.
Uijtdewilligen, J. W. R. Twisk, W. van Mechelen, M. J. M. Chinapaw.Physical Activity and Performance at School: A
Systematic Review of the Literature Including a Methodological Quality
Assessment. Archives of Pediatrics and
Adolescent Medicine, 2012; 166 (1): 49 DOI:10.1001/archpediatrics.2011.716
[5] Bonell,
C., Fletcher, A., & Morton, M. (2012). Realist randomised controlled
trials: a new approach to evaluating complex public health interventions.
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