BACKGROUND: Physical activity (PA) is important for children with a chronic disease. Serious games may be useful to promote PA levels among these children.OBJECTIVE: The primary purpose of this systematic review was to evaluate the effectiveness of serious games on PA levels in children with a chronic disease.METHODS: PubMed, EMBASE, PsycINFO, ERIC, Cochrane Library, and CINAHL were systematically searched for articles published from January 1990 to May 2018. Both randomized controlled trials and controlled clinical trials were included to examine the effects of serious games on PA levels in children with a chronic disease. Two investigators independently assessed the intervention, methods, and methodological quality in all articles using the Cochrane risk of bias tool. Both qualitative and quantitative analyses were performed.RESULTS: This systematic review included 9 randomized controlled trials (886 participants). In 2 of the studies, significant between-group differences in PA levels in favor of the intervention group were reported. The meta-analysis on PA levels showed a nonsignificant effect on moderate to vigorous PA (measured in minutes per day) between the intervention and control groups (standardized mean difference 0.30, 95% CI -0.15 to 0.75, P=.19). The analysis of body composition resulted in significantly greater reductions in BMI in the intervention group (standardized mean difference -0.24, 95% CI -0.45 to 0.04, P=.02).CONCLUSIONS: This review does not support the hypothesis that serious games improve PA levels in children with a chronic disease. The meta-analysis on body composition showed positive intervention effects with significantly greater reductions in BMI in favor of the intervention group. A high percentage of nonuse was identified in the study of serious games, and little attention was paid to behavior change theories and specific theoretical approaches to enhance PA in serious games. Small sample sizes, large variability between intervention designs, and limited details about the interventions were the main limitations. Future research should determine which strategies enhance the effectiveness of serious games, possibly by incorporating behavior change techniques.
CHI PLAY '20, November 2–4, 2020, Virtual Event, Canada We have built and implemented a set of metaphors for breathing games by involving children and experts. These games are made to facilitate prevention of asthma exacerbation via regular monitoring of children with asthma through spirometry at home. To instruct and trigger children to execute the (unsupervised) spirometry correctly, we have created interactive metaphors that respond in real-time to the child’s inhalation and exhalation. Eleven metaphors have been developed in detail. Three metaphors have been fully implemented based on current guidelines for spirometry and were tested with 30 asthmatic children. Each includes multi-target incentives, responding to three different target values (inhalation, peak expiration, and complete exhalation). We postulate that the metaphors should use separate goals for these targets, have independent responses, and allow to also go beyond expected values for each of these targets. From the selected metaphors, most children preferred a dragon breathing fire and a soccer player kicking a ball into a goal as a metaphor; least liked were blowing seeds of a dandelion and applying lotion to a dog to grow its hair. Based on this project we discuss the potential and benefits of a suite-of-games approach: multiple games that each can be selected and adapted depending on personal capabilities and interests.
MULTIFILE
