Custom-designed motion-based games for older adults: a review of literature in human-computer interaction

Many older adults, particularly persons living in senior residences and care homes, lead sedentary lifestyles, which reduces their life expectancy. Motion-based video games encourage physical activity and might be an opportunity for these adults to remain active and engaged; however, research efforts in the field have frequently focused on younger audiences and little is known about the requirements and benefits of motion-based games for elderly players. In this paper, we present an overview of motion-based video games and other interactive technologies for older adults. First, we summarize existing approaches towards the definition of motion-based video games – often referred to as exergames – and suggest a categorization of motion-based applications into active video games, exergames, and augmented sports. Second, we use this scheme to classify case studies addressing design efforts particularly directed towards older adults. Third, we analyze these case studies with a focus on potential target audiences, benefits, challenges in their deployment, and future design opportunities to investigate whether motion-based video games can be applied to encourage physical activity among older adults. In this context, special attention is paid to evaluation routines and their implications regarding the deployment of such games in the daily lives of older adults. The results show that many case studies examine isolated aspects of motion-based game design for older adults, and despite the broad range of issues in motion-based interaction for older adults covered by the sum of all research projects, there appears to be a disconnect between laboratory-based research and the deployment of motion-based video games in the daily lives of senior citizens. Our literature review suggests that despite research results suggesting various benefits of motion-based play for older adults, most work in the field of game design for senior citizens has focused on the implementation of accessible user interfaces, and that little is known about the long-term deployment of video games for this audience, which is a crucial step if these games are to be implemented in activity programs of senior residences, care homes, or in therapy

Mobile exergaming in adolescents’ everyday life—contextual design of where, when, with whom, and how: the SmartLife case

Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential playing time, but need to be engaging and integrated in everyday life. The goal of the present study was to examine the context of gameplay for mobile exergaming in adolescents’ everyday life to inform game design and the integration of gameplay into everyday life. Eight focus groups were conducted with 49 Flemish adolescents (11 to 17 years of age). The focus groups were audiotaped, transcribed, and analyzed by means of thematic analysis via Nvivo 11 software (QSR International Pty Ltd., Victoria, Australia). The adolescents indicated leisure time and travel time to and from school as suitable timeframes for playing a mobile exergame. Outdoor gameplay should be restricted to the personal living environment of adolescents. Besides outdoor locations, the game should also be adaptable to at-home activities. Activities could vary from running outside to fitness exercises inside. Furthermore, the social context of the game was important, e.g., playing in teams or meeting at (virtual) meeting points. Physical activity tracking via smart clothing was identified as a motivator for gameplay. By means of this study, game developers may be better equipped to develop mobile exergames that embed gameplay in adolescents’ everyday life

Contribution of Exergaming Behaviour to Physical Activity: Toward Better Understanding the Role of Motivation

Physical activity (PA) is associated with numerous health benefits. Because PA patterns established early in life track into adulthood, it is important that children develop and sustain healthy PA habits. Current guidelines recommend that youth accumulate ≥ 60 minutes of moderate to vigorous intensity PA daily, but many youth do not attain this level. Evaluation of public health interventions that aim to promote PA provide little evidence of sustained positive effects over time. This could relate, at least in part, to interventions lacking a strong conceptual foundation and, in particular, to a lack of underpinnings that recognize the central role of motivation in PA. It is important that effective strategies to increase and sustain healthy PA levels in youth are identified. The Self-Determination Theory is used to explain why people adopt and maintain healthy PA behaviors and posits that sustained PA relates to natural or intrinsic tendencies or motivations to behave in healthy and effective ways. Positive PA experiences in school, at home and in community settings may foster an internal desire or motivation to sustain PA participation simply for its challenges or for enjoyment. Lack of sustained PA among youth could reflect a scarcity of enjoyable PA options that fit with the sophisticated technetronic expectations of youth today. PA interventions must “keep up with the times,” by acknowledging young peoples’ prevailing interests and by incorporating advancements in technology that heighten interest and motivation for PA. Exergaming, a type of non-sedentary videogame that requires players to be physically active in order to attain a series of incrementally challenging goals, is increasingly viewed as an enjoyable PA option among today’s technology-immersed youth. However, although critical to informing the design, implementation and sustainability of exergaming interventions, evidence on exergaming-related motivation, preferences, intentions and sustainability is lacking. Research in this domain is needed to ascertain whether exergaming interventions can help youth become and remain physically active, and which facets of exergaming hold the most promise in sustaining positive PA change. More specifically, using “gamified augmented reality” such as exergaming could help youth attain recommended PA levels and promote sustainable healthy behaviour, while at the same time contributing to enjoyment of PA. The three studies described in this thesis examine motivation and exergaming in-depth using SDT and its tenants as a theoretical guide and a common theme across studies. Thus, the role of motivation and intentions in exergaming behaviour and how they contribute to PA in the general population of youth is a key contribution of this dissertation. Study 1, a review of reviews on exergaming, provides background for the next two studies, each of which was conducted in population-based (as opposed to clinical or experimental) settings. Twenty-five reviews spanning 2009 to 2016 were retained, each of which incorporated between 5 and 100 articles. A positive relationship between exergaming and energy expenditure (EE) was well-documented, but whether exergaming increases PA or changes body composition was not established. There is however, evidence that exergaming (i.e., as a non-sedentary use of screens) is a healthy alternative to sedentary behaviour, that it improves cognitive function, that it is an interesting and enjoyable pastime in youth, that it shows promise as a PA option by adding variety and alternative PA forms in health and dietary interventions and finally that it is likely more health-promoting than traditional videogames because of higher EE and possibly improved physical fitness, body composition and cognitive health. However, more research and specifically, longitudinal studies are needed to assess whether exergaming can be sustained to obtain these benefits over time. Study 2 identified correlates of sustained exergaming. We reported that almost 50% of grade 9 students sustained exergaming for 2-3 years. Study results suggest that in non-clinical settings, exergaming may be a practical approach to help adolescents maintain PA during adolescence. Study 3 examined the psychometric properties of a new scale to assess reasons for exergaming (i.e., the Reasons to Exergame (RTEX) scale). This study also examined whether and how the scale relates to the timing, intensity and duration of past-month exergaming. RTEX items were developed in consultation with PA and exergaming experts and using key exergaming constructs, including PA, general interest in videogames and enjoyment of exergaming. RTEX was found to be a reliable and valid assessment of reasons to exergame. However, further studies should replicate these initial findings in larger, more diverse samples

Location-based Mobile Games in mHealth: A Preliminary Study of Pokémon Go in Promoting Health Exercising

Location-based mobile games such as Pokémon Go might improve players’ physical activities (e.g., walking) and social interactions. With a limited research on mobile exergaming activities, this study examined relationships among Pokémon Go players’ gaming activities, willingness to communicate, and the likelihood of engaging in exercises. Our study showed that the longer participants had been playing the game, the higher the likelihood that they would engage in exercises. Our findings revealed a positive relationship between exercise during gameplay and willingness to communicate with other players. Our study provides implications to the use of location-based mobile games to promote health campaigns and improve the general health of the population

Towards Evidence Based M-Health Application Design in Cancer Patient Healthy Lifestyle Interventions

Cancer is one of the most prevalent diseases in Europe and the world. Significant correlations between dietary habits and cancer incidence and mortality have been confirmed by the literature. Physical activity habits are also directly implicated in the incidence of cancer. Lifestyle behaviour change may be benefited by using mobile technology to deliver health behaviour interventions. M-Health offers a promising cost-efficient approach to deliver en-masse interventions. Smartphone apps with constructs such as gamification and personalized have shown potential for helping individuals lose weight and maintain healthy lifestyle habits. However, evidence-based content and theory-based strategies have not been incorporated by those apps systematically yet. The aim of the current work is to put the foundations for a methodologically rigorous exploration of wellness/health intervention literature/app landscape towards detailed design specifications for connected health m-apps. In this context, both the overall work plan is described as well as the details for the significant steps of application space and literature space review. Both strategies for research and initial outcomes of it are presented. The expected evidence based design process for patient centered health and wellness interventions is going to be the primary input in the implementation process of upcoming patient centered health/wellness m-health interventions.ENJECT COST-STSM-ECOST-STSM-TD1405-220216-07045

Learning and teaching with video games: Toward theoretical progress and educational practice

Learning with video games has been related to several beneficial educational effects, indicating that teaching with video games could also be a promising teaching approach to foster student learning. However, more theoretical guidance and more insights from educational practice are needed to better evaluate potentials of learning and teaching with video games. Therefore, this dissertation presents a reference framework that aims to support theoretical progress in the field of e-learning and the general workflow of e-learning projects (Article 1). Then, with a focus on educational practice and teaching with video games, three field studies were conducted that illustrate how video games could be integrated into two different educational contexts. The results of these studies show that teaching with video games can foster students’ dance skills (Article 2) and reflection processes (Article 3). Considering that teachers decide whether they teach with video games, pre-service teachers were surveyed to examine their intention to teach with digital games in their future school teaching (Article 4). The results indicate that teachers’ intention to teach with video games is related to a small set of key personal characteristics that could be specifically considered in teacher education. Given pandemic restrictions, it was also outlined how video games could provide educational experiences at home and foster physical and mental health (Article 5). In addition, findings from experimental studies show that mobile learning with quiz apps can benefit student learning in terms of cognitive and metacognitive outcomes (Article 6). Overall, this dissertation emphasizes the relevance of theoretical progress and illustrates how learning and teaching with video games can be effective in educational practice

Exerbraining for Schools: Combining Body and Brain Training

AbstractThe growing obesity problem has reinforced policymakers and educators to devise strategies that encourage introduction of novel and engaging physical activities in schools. At the same time, the gaming industry has introduced a game genre that requires the player to be physically involved in the game (e.g. Nintendo Wii, Kinect). In fact, exergames (physically activating games) is an emerging trend that may influence also the implementation of the physical education curriculum and classroom activities in the near future. In this paper we discuss the possibilities and limitations that exergames can provid e for schools. We review exergaming practices that have been introduced to schools and propose a new form of exergaming, exerbraining that combines both body and brain training and thus could fit well to school context. We report the results of the case study in which we tested an exerbraining game involving mathematical content. The results showed that students enjoyed playing the game a lot and exerbraining games can provide effective learning solutions for schools