Wednesday, 2 September 2015

Can a smart phone game really make kids more active at school?

Physical inactivity is a global pandemic, the most pressing public health challenge of the 21st century[1].  A key goal of recent guidelines issued by the Chief Medical Officers of the United Kingdom is to increase the amount of regular physical activity undertaken by children[2]. Currently, the target of one hour of moderate to vigorous physical activity per day is often not achieved; for example, a recent study found that only 51% of English children aged between 7 and 8 meet this target[3]. We as educators can play a part in solving the problem by providing children with fun ways to be active at school, and reducing the time we expect them to sit still. If schools re-organised the structure of the day to include 60 minutes of fun physical activity for the children (including breaking up bouts of sitting through the day) it would reduce health inequalities, improve mental and physical health, and improve attainment[4]. This post is about a project I ran recently where we explored how technology might help.

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.


[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
[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 AssessmentArchives 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. Social Science & …, 75, 2299–2306. Retrieved from

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