Mobile games and design requirements to increase teenagers’ physical activity

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Abstract

Participating in regular physical activity (PA) can help people maintain a healthy weight, and it reduces their risks of developing cardiovascular diseases and diabetes. Unfortunately, PA declines during early adolescence, particularly in minority populations. This paper explores design requirements for mobile PA-based games to motivate Hispanic teenagers to exercise. We found that some personality traits are significantly correlated to preference for specific motivational phrases and that personality affects game preference. Our qualitative analysis shows that different body weights affect beliefs about PA and games. Design requirements identified from this study include multi-player capabilities, socializing, appropriate challenge level, and variety.

Introduction

The United States Center for Disease Control recommends 60 min a day of physical activity (PA) for teenagers and adolescents to maintain healthy PA levels [1]. Increasing PA in inactive or primarily sedentary teenagers can contribute to maintaining healthy weight, which can reduce the prevalence of obesity in this population. Growing obesity rates cause a bigger strain on healthcare systems’ expenses and on an individual’s health. Countries such as Mexico have declared the Metabolic Syndrome (a condition that includes obesity) among the top diseases of interest in the country [2], [3]. One study reports that the combined prevalence of overweight and obese Mexican male adolescents is 35.7%, and it is 25.5% in female adolescents [4]. Obesity prevalence among adolescents is also steadily increasing in the United States [5]. Current estimates say that 18.1% of adolescents aged 12–19 are obese and 34% are overweight [1]. The percentage of US Hispanic children who are overweight or obese is 38.2% [6].

Regardless of the many benefits of participating in regular PA, participation declines precipitously during early adolescence [7], particularly in minority populations [8]. This decline in PA is not well understood [9]. Interventions to increase PA have generally been ineffective, with only a handful of reportedly successful systems for African–American and Hispanic youth [10]. Novel approaches to maintain and increase physical activity are therefore needed.

Using technology to address health issues can be cost effective for healthcare systems by minimizing face-to-face interactions and thus reducing labor costs [11]. Furthermore, it is argued that using technology can reduce barriers to healthcare and can “increase the sense of privacy, comfort, and acceptance of intervention” [12]. As Consolvo et al. [13] found, if we can take advantage of technology that people use (or wish to use) in their daily lives, we may be able to persuade them to be more physically active through embedded motivational strategies into this technology.

Motivating teenagers through games have been shown promising in increasing PA. For instance, using a pedometer and recorded step count for a game-based application where teenage girls compete against each other showed good level of success [14]. Some mainstream examples of successful systems include Nintendo Wii [15] or Microsoft Kinect [16]. However, a better understanding of what makes physical movement games fun, usable, and engaging for teenagers is needed to understand and develop design principles for successful PA game applications.

Portable devices, such as media players, personal game consoles and smart phones with increased capabilities and sensors have become more affordable and prevalent. For example, the iPhone and iPod Touch are now equipped with cameras, location-based sensors (Wi-Fi or GPS), an accelerometer, and a gyroscope. Cellular phones are also pervasive among teenagers, even those belonging to minority groups [17]. Large cellular phone penetration coupled with near universal coverage creates new opportunities to use cellular phone and mobile technology to improve prevention and treatment efforts in youth populations. Furthermore, mobile devices do not require complex setups in indoor locations as is often required with gaming consoles such as the Wii and Kinect (which also need to be tethered to an electrical plug). The fact that a mobile device can be used anywhere and is small enough to take anywhere makes it a more versatile candidate than gaming consoles that are attached to a television and usually played indoors.

In this work, we focus on mobile applications running on Apple’s iPod Touch, and initial design requirements to encourage PA in teenagers, especially for those with unhealthy weight and less active lifestyles. We ran a study with Hispanic teenagers in Mexico to explore various iPod games that require movements as input. We gained insights into the potential of such devices and the design requirements that can improve usability and interest in activity-based game applications.

Data was analyzed in a comparative manner between healthy weight and non-healthy weight teenagers. We chose to compare these two groups because studies have shown significant emotional differences and attitudes between overweight and obese children with their healthier weight counterparts [18]. Furthermore, studies have shown that overweight adolescents do not perceive themselves at risk and do not take part in healthy diets or physical activity [19]. This suggests that design requirements across weight may be different and should be assessed. Prior studies on preferences and values given to PA have shown that differences exist with gender [20]. Therefore, we need to consider gender differences in preference for certain physical activities that may translate into PA game preferences.

We also analyzed personality traits from the Big 5 model of personality [21] and its relation to preference for motivational phrases and games. The Big 5 model of personality argues that there are five traits that can be used to describe a person’s personality. Individuals with similar measured degrees of each of these traits express similar characteristics and behaviors. Prior research in the area of personality shows that personality traits are related to motivators [22], [23] and physical activity (i.e. barriers, activity preferences, and motivators) [24]. If personality plays a role in PA games and motivational phrases, then our premise is that if we personalize an application based on a user’s personality then we can create an enjoyable and intrinsically motivating experience for this user.

In the following, we present results from a study conducted in Monterrey, Mexico, where teenagers were asked to play mobile games that required physical movements as the game control mechanism, complete a set of surveys, and undergo an exit interview. Through analyzing their responses we gained insight towards the characteristics of games and motivational phrases that can potentially be successful in motivating Mexican teenagers to become more active.

Section snippets

Literature review

Several applications have been developed that encourage physical activity in individuals by using game-like approaches. Prior studies on such applications found that motivation to play video games includes emotional attachment to a game character and competitive game play [25], motivational phrases, and availability of rewards in the form of hints for Sudoku games [26]. The best kind of competitive game play was found to be against another player instead of against the computer [27], [26].

Method

This study was conducted in the city of Monterrey, México, in collaboration with researchers and students of the School of Nursing from the Universidad Autónoma de Nuevo León (UANL). Prior to conducting the study, Institutional Review Board (IRB) approval was obtained for this study from the University of California at Santa Cruz, where two of the authors are affiliated. Informed consent was also obtained from a legal guardian or parent for each of the teenagers participating in the study.

Results

A total of 51 teenagers participated in the study. The participants varied in BMI weight category (i.e. from underweight to obese), with 21.6% in the overweight or obese category. More girls than boys participated, i.e. 38 girls and 13 boys. The mean and standard deviation across the personality traits were as follows: openness (μ=0.77, σ=0.145), conscientiousness (μ=0.74,σ=0.148), extroversion (μ=0.708,σ=0.145), agreeableness (μ=0.594,σ=0.150), and neuroticism (μ=0.542,σ=0.159). Table 2 shows

Discussion

Our results show that some personality traits play a role in preference for certain motivational phrases. For example, individuals with higher degrees of agreeableness found “Form a group and play” as more motivating. People who have higher degrees of agreeableness are associated as being more helpful and as enjoying working with other people. Perhaps enjoying being helpful and working with others may explain why they found being asked to form a group as more motivating. Individuals with higher

Conclusion

To conclude, we have discussed and shown data analysis that resulted in mobile game design guidelines to motivate teenagers’ PA. From these design requirements we see that many considerations need to be taken into account when designing applications for teenagers that are meant to motivate PA. Long-term adoption design requirements are still not known, as a long-term study would be required with longer game play, but our findings can provide starting points for places of investigation into

Acknowledgments

We thank the UANL’s School of Nursing for their help in gathering biometric data and assisting during the study in Mexico and UCMEXUS for its support of this study. We also express our thanks to the Asociación Mexicana de Cultura A.C. For its support with this study.

References (36)

  • P. Gordon-Larsen et al.

    Ethnic differences in physical activity and inactivity patterns and overweight status

    Obesity Research

    (2002)
  • D. Spruijt-Metz et al.

    Behavioral aspects of physical activity in childhood and adolescence

  • C.D. Summerbell et al.

    Interventions for preventing obesity in children

    Cochrane Database System Review

    (2005)
  • R. Hurling et al.

    Using Internet and mobile technology to deliver an automated physical activity program: randomized controlled trial

    Journal of Medical Internet Research

    (2007)
  • K.E. Heron et al.

    Ecological momentary interventions: incorporating mobile technology into psychosocial behavior treatments

    British Journal of Health Psychology

    (2010)
  • S. Consolvo et al.

    Theory-driven design strategies for technologies that support behavior change in everyday life

  • T. Toscos, A. Faber, S. An, M.P. Gandhi, Chick clique: persuasive technology to motivate teenage girls to exercise, in:...
  • L.E.F. Graves et al.

    The contribution of upper limb and total body movement to adolescents’ energy expenditure whilst playing Nintendo Wii

    Journal of Applied Physiology

    (2008)
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