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The old-fashioned trick of hiding broccoli in the casserole to get kids to eat it has been given a high-tech update. The new tactic? Slipping healthy behavior lessons into children's video games.
A study conducted at Baylor College of Medicine found that overweight children who play video games promoting good nutritional choices consumed more fruits and vegetables than their "Call of Duty"-playing counterparts.
Researchers noted that overweight children who played these health-focused video games over a 2-month period achieved a two-thirds increase in fruit and vegetable consumption. Dr. Tom Baranowski, head of the research team, explains that this improvement is significant for a demographic that does not eat nearly enough of the required servings of fruits and vegetables.
The video games were developed by a company called Archimage with a grant from the National Institute of Health (NIH). "Escape from Diab" and " Nanoswarm: Invasion from Inner Space" are designed to look like any other video game, with a plot and levels that must be achieved.
In "Escape from Diab," a boy named DJ falls through a time warp and lands in a magical land where the king won't allow his subjects to exercise or eat fruits and vegetables. As a result, the subjects don't have enough energy to defy him. DJ is a soccer player, though, and knows the advantages of exercising and eating well. His task is to empower the people of Diab by teaching them how to make healthy choices.
"These games aren't just 'Tetrus' with fruit," says Richard Buday, president of Archimage. In other words, they are more than just your classic game but with more face time given to fruits and veggies. "We want stuff that really works, that has a clinical underpinning," Buday says. And researchers at Baylor have provided just that underpinning.
"Just about everything we know about behavior change is incorporated into these games," says Dr. Tom Baranowski, professor of pediatrics and head of the research team.
Baranowski explains that a child must see how a behavioral change aligns with his or her own values in order to adopt it. This is why both games begin by asking a child questions that assess his or her reason for wanting to make healthier choices. The games then incorporate that motivator into the child's experience with the game.
"Behavior is most likely to be changed and maintained if kids do the behavior for internal reasons," Baranowski says.
Another key to behavioral change is making a habit out of the good behavior, so that the right choice becomes not a choice at all, but a reflex. "Thinking is an enemy of behavior change," says Baranowski. The games eliminate the thinking step by repeating scenarios in which a child has to choose between the healthy choice and the unhealthy one, until they begin to instinctively select the healthy option.
One activity places a child in a marketplace, faced with foods containing real fruit (like strawberries) and artificial fruit (like cherry Kool-aid.) Players must select 20 real fruits in 3 minutes, or they have to start over.
The fact that it took children an average of 7 tries to successfully complete the task shows that this is a lesson they need, says Baranowski.
It's also a lesson they won't get bored learning. In the case of a test, Baranowski explains, a child would never go over their answers 7 times until they got them all correct. "Within the context of a video game, though, kids say, 'Wow, that was challenging. I love that!' " he says.
Now the challenge for Archimage will be getting consumers to love the product as much as the children who have played it. Consumers are most likely to include schools, families and healthcare providers.
Archimage hopes that schools will make the games a part of their curriculum, and plans to develop workbooks and other educational materials to accompany them.
As for introducing these games to healthcare providers, the recent healthcare bill could make healthcare a viable market for the games. "Childhood obesity behavioral interventions are now fully reimbursed by insurance companies, and I have the product for that," Buday says.
Children in the U.S. spend an average of 1 hour per day playing video games, according to Baranowski. In his opinion, replacing some of the traditional games with ones that inspire healthy behavior would be a productive step in the fight against childhood obesity.
The study will be published in an article titled, "Video Game Play, Child Diet, and Physical Activity Behavior Change - A Randomized Clinical Trial" in the January 2011 issue of the American Journal of Preventive Medicine.
參考譯文：
將花椰菜“藏匿”在餐盤中然后哄騙孩子們去吃的過時做法如今已被賦予了與時俱進的高科技手段。是什么呢？那就是將“健康行為”的課程教育整合到孩子們愛玩的視頻游戲中去。
由貝勒醫學院進行的一項研究發現，相比于“使命的召喚”之類的角色游戲，那些整合有營養知識的視頻游戲可幫助超重的孩子們去食用更多的水果和蔬菜。
研究者發現，那些超重的孩子在玩以“健康”為主題的視頻游戲2個月后，其水果和蔬菜的食用量將增加2/3。研究小組負責人湯姆.巴拉諾斯基博士（Dr. Tom Baranowski）解釋說，這個增加量在日常果蔬食用嚴重不足的人群中將更加明顯。
該視頻游戲是由國家衛生研究所（NIH）資助，Archimage公司開發研制的。“逃離迪亞布”和“Nanowarm：來自內心世界的入侵”這兩款游戲的情節設計及一些必須的技術水平跟其他任何視頻游戲相類似。
在“逃離迪亞布”這款游戲中，名叫DJ的男孩落入時空隧道并到了一個很神奇的地方，這里的國王不允許他的臣民運動或是吃水果蔬菜，如此就不會有足夠的力量推翻他了。DJ是個足球運動員，他深知運動和合理膳食的重要性。因此，他的任務就是教迪亞布的人們如何做出有利身體健康的選擇。
Archimage公司總裁理查德.巴德（Richard Buday）說，“它不只是跟水果有關的單純‘方塊游戲’（Tetrus）。”也就是說，與那些傳統游戲相比，它有著更多水果和蔬菜的畫面。
巴德說，“我們希望這些東西都有臨床依據并確實有效。”布勒醫學院的研究者們即給出了其所需的支撐依據。
該研究的負責人、兒科教授湯姆.巴拉諾斯基博士說，“我們幾乎將了解的有關行為改變的所有情況都加入到了游戲中。”
巴拉諾斯基表示，每個孩子都要明白他們的行為變化是如何與其自己的價值觀趨于一致的并接受之。這也是為何這兩款游戲在一開始都會問孩子們這個問題——估計一下己做出健康選擇的原因。因此，將這一激勵因子整合進了游戲體驗過程中。
巴拉諾斯基說，“發自內心的行為更容易改變并持久。”
行為改變的另一個關鍵是，讓那些良好行為變成一種習慣，從而正確選擇從根本上說也就不再是選擇，而是本能反映。巴拉諾斯基說，“思考是行為改變的敵人。”因此，游戲省去了思考的環節，而代之以不斷重復‘一個孩子要在健康和不健康的選擇項下做出自己決定’的情節，直到他們會本能的去選那些健康的選項。
有一項活動是讓孩子們置身擺有真實水果（像草莓）和人造水果（像櫻桃飲料）的超市環境中，然后必須在3分鐘內選出20種真實的水果，否則再重新開始。
巴拉諾斯基說，每個孩子平均需要嘗試7次才能成功完成任務的事實說明，他們需要這樣的課程教育。
同時，這也是一個不會讓他們感到厭煩的學習過程。巴拉諾斯基說，像平常的考試，一個孩子是決不會重7次直到答案全部正確的。
現在，Archimage公司的挑戰是獲得更多像玩過該游戲的孩子們那樣喜歡這個產品的消費者，最可能的消費群就是學校、家庭和健康保健機構等。
Archimage希望學校能把該游戲設為課程的一部分，并編制手冊及其他教學資料以輔助之。
至于要在健康保健機構中推廣該游戲，首先，現行的健康保健法要給予該游戲可行的市場。巴德說，“目前，孩童肥胖所致各種問題的行為干預全部由保險公司買單，而現在我希望這個產品能對此有所幫助。”
據巴拉諾斯基所述，美國孩子每天平均要花費1小時時間用來玩視頻游戲。在他看來，以整合有健康行為的游戲來取代一些傳統游戲將是抵制孩童肥胖極富成效的一步。
該研究將于2011年1月份在《美國預防醫學雜志》以 “視頻游戲玩法、兒童飲食及物理活動行為改變——隨機臨床試驗”的題目刊出。
