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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #340594
Title: Story immersion may be effective in promoting diet and physical activity in Chinese children

Author
item WANG, JING - Hong Kong Baptist University
item BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC)
item LAU, PATRICK - Hong Kong Baptist University
item BUDAY, RICHARD - Archimage, Inc
item GAO, YANG - Hong Kong Baptist University

Submitted to: Journal of Nutrition Education and Behavior
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/2/2017
Publication Date: 4/11/2017
Citation: Wang, J.J., Baranowski, T., Lau, P.W., Buday, R., Gao, Y. 2017. Story immersion may be effective in promoting diet and physical activity in Chinese children. Journal of Nutrition Education and Behavior. 49(4):321-329.

Interpretive Summary: Escape from Diab (hereinafter referred to as Diab), a videogame for diet and physical activity (PA) change for obesity and diabetes prevention, has previously been shown to influence diet and PA among 10-12 year old children in the US. Preliminary qualitative data indicated that Diab was attractive and acceptable to Hong Kong children. An interesting issue is the cross-cultural generalizability of Diab (without any cultural modifications), especially whether the story was also immersive among Hong Kong Chinese children and whether the immersion had similar effects. Hong Kong children who played the game demonstrated increased intrinsic motivation for fruit and water, self efficacy for PA and self reported PA at immediate post, but not later. Children with higher immersion scores (from the treatment group alone) also had higher intrinsic motivation for fruit and water and autonomous and controlled motivation for physical activity at immediate post, but not later. The effects in the US were significant for dietary change and less so for PA, with the reverse in Hong Kong. A videogame developed for US child audiences appears to also affect behavior among Hong Kong children without cultural adaptation, and the effects may be mediated by story immersion. Research on cross cultural effectiveness and mechanisms of effect is needed with larger samples.

Technical Abstract: This study evaluated the effect of playing a health video game embedded with story immersion, Escape from Diab (Diab), on children's diet and physical activity (PA), and also explored whether children immersed in Diab had greater positive outcomes. The study design employed two groups, nonrandomized; 3 outcome assessments: at baseline, immediately after the game (post 1), and 8–10 weeks after the game (post 2). A total of 179 Chinese children aged 8–12 years participated in the study. The treatment group played Diab; the control group received no intervention. The main outcome measures were motivation; self-efficacy; preference for fruit, vegetables, water, and PA; as well as PA behavior. Analysis was conducted using adjusted changes to post 1 and post 2 by ANCOVA, controlling for demographic and baseline variables. We found that children who played Diab had increased intrinsic motivation for fruit and water, self-efficacy for PA, and self-reported PA scores at post 1 (all P<.05). Children with higher immersion scores (above the median) had increased intrinsic motivation for fruit and water, and autonomous and controlled motivation for PA at post 1 (all P<.05). However, these were not significant at post 2. Diab provides a promising innovative medium for promoting Chinese children's psychological correlates of diet and PA and PA behavior. However, its maintenance of effectiveness needs to be enhanced and mechanisms of change need to be investigated more thoroughly.