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Kiddio-Food Fight™ A Vegetable Parenting Video Game
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Kiddio-Food Fight™ A Vegetable Parenting Video Game

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  • Lots of interest in increasing vegetable intake in U.S.Dietary guidelines emphasizes FV intakePart of the Healthy People 2020 recommendationsAnd our new My Plate logo – ½ meal from FV (not including dairy)Reason for all this interest…related to V decreasing the risk for all these diseases
  • Research from Leann Birch (70’s-80’s) showed:What you eat is what you preferKids eat what they likePreferences are formed early in lifeParents are huge influences with all things related to their young child, including foodCommon parent complaint…can’t get child to eat FVmore for V not F, since F is sweet
  • Our group at CNRC doing extensive research on parenting practices in relationship to dietary, PA and screen media behaviors.We are capitalizing on that research to develop KiddioParenting Style (authoritarian, authoritative, permissive, neglectful) is not amenable to changeIt is the attitude the parent brings to parentingParenting practices are specific behaviors that parents use to influence their child’s behavior – Practices appear amenable to changeWe also know from our research that there are effective and ineffective parenting practicesOur goal – to help parents use the effective pp to get their child to eat V
  • So, how do we train parents in using effective parenting practices?PP are skilled behaviors and simulation methods have been used in the training of skilled behaviorsEx: airplane, surgery, patientsVideo games can and many do include simulations as part of the game experienceSo we created a prototype of a fun game using simulations to help parents learn VPPWe also know that the literature on adult learning suggests that adults learn best if they select the behaviors they work on and then give them feedback
  • In our initial planning for the game, we found there wasn’t much literature on what are effective and ineffective pp to include in a game such as oursWe know that children differ in temperaments and parents likely need to take this into account to be effectiveSince temperament is a key child variable - we wanted child in game to respond like theirsBut the shortest child temp Q is 36-items - too long for a short casual gameWe wanted to include motivational variables to motivate parents to do the behaviorsSelf Determination Theory indicates that people do behaviors consistent with their valuesSo need identify values related to VPP and identify reasons statement that link behaviors to values and test to make sure they make sense to parents
  • In our first formative study, we took pp from nominal group research done by Hughes, et al and asked Pediatricians and other health practitioners and educators to rate these practicesQ we asked….Information from this survey identified the effective and ineffective pp we used in the Kiddio game
  • In our 2nd formative study we tackled the 36-item Child Temperament Q and distilled the key points in each of the 3 child temperament scalesNarrowed down characteristics into 3 simple statements. Tested our 3 short statements against the 36-item to validate.Got good patterns of correlation, so 3 short statements will work in game to identify the child temperament
  • Our 3rd formative study, we took value statements from those most commonly used with research done with teenagers.And took our related reason statements we tested and adapted from DIAB & NANO game with kidsAsked parents to evaluate themBased on parents comments, we adapted them to VPP
  • Based on parents comments, we narrowed it down to these 4 values adapted to VPP
  • And from our research with the parents we adapted these reasonsThis is an example of the reason statements for the value “Raising a healthy child”
  • Taking all of our formative research we developed a pilot VPP game with the following features:
  • And this is what our initial VPP game looked like
  • Here’s an example of one of our shortened child temperament statements that we tested with parents
  • Tested 3 storylines with parents and they liked the “Friend Dottie” best to give them help with getting their 3- 5 year old child to eat vegetables
  • Parents were able to scroll through a number of options to choose to say to try to get Kiddio to taste the vegetable on their plate
  • Kiddio immediately reacted to the selected statements according to the child temperament the parent selected during the game set-up
  • In addition, other things they could do in the game to influence the outcome…
  • Our formative study 5 had parents play Kiddio and give us feedback
  • Based on FS#5 we want to develop better feedback for the parents Research suggests that negative feedback works best when “sandwiched” between positive feedback.And since goal setting appears to be important behavior change procedure with adultsWe want to enhance this part of the gameSince GS allows parents to use what they learned in game to practice in real world with their childMajor part of “gamification” is competition, so if parents want they can subscribe to leader board to compete against themselves or others.
  • Based on our pilot research and hopefully feedback from the iTune store purchasers…
  • Some of the things currently in the works for refining the game’s interface include…
  • Once we have all 25 episodes developed we want to do a randomized clinical trial to test Kiddio’s effectiveness
  • ThanksAny questions?
  • So what are our future plans?Look for Kiddio-Lite in the iTunes app store in the next month
  • Transcript

    • 1. Kiddio-Food Fight™ A Vegetable Parenting Video GameNICHDNATIONAL INSTITUTEOF HEALTHEunice Kennedy Shriver Tom Baranowski, PhD Professor of Pediatrics (Behavioral Nutrition & PA) USDA/ARS Children’s Nutrition Research Center Baylor College of Medicine Houston, Texas, 77030, USA www.bcm.edu/cnrc/faculty/?PMID=9519 Pediatrics
    • 2. Games for HealthJune 13, 2012 High vegetable intake  Related to lower…  CVD  Several cancers  Type II Diabetes  Maybe Obesity
    • 3. Games for HealthJune 13, 2012 Child Food Preferences  A primary determinant of intake  Kids tend to eat what they like  Formed early in life  Parents are primary influences on children’s food preferences and intake  Common parent complaint – “I can’t get my child to eat vegetables”
    • 4. Games for HealthJune 13, 2012 Parenting Practices  Behaviors that influence child’s behavior  Recent research identifies parenting practices as either:  Effective  Ineffective  Our Goal - Train parents of preschool children to enable their child to eat more vegetables
    • 5. Games for HealthJune 13, 2012 Skilled Behaviors can be learned  Simulations have been used to teach how to…  Fly an airplane  Do surgery  Interact with patients  Video games can employ simulations  Adult learning requires  Self-selected practice  Feedback
    • 6. Games for HealthJune 13, 2012 Issues for Casual Game  What are important parenting practices  36-item child temperament measure too long for game  Not clear how to word Value/Reasons statements
    • 7. Games for HealthJune 13, 2012 Formative Research (1)  International Survey of Pediatricians, Health Care Providers and Educators for food parenting  36 food parenting statements  Cause short or long term harm?  Short term effectiveness?  Long term effectiveness?  Basis for food parenting selections
    • 8. Games for HealthJune 13, 2012 Formative Research (2)  Child Temperaments – Created three short statements:  He/She likes to listen to rhymes and songs. When working on a project he/she concentrates deeply and carefully follows rules and instructions. When something changes, he/she quickly notices.  He/She often shows his/her frustration or discomfort and easily becomes sad when not able to finish a project. He/She is often afraid of the dark and when upset may be difficult to calm down.  He/She has lots of energy, is easily excited and often goes fast on the playground. He/She enjoys meeting new people and going to new places.  Validated against 36-item questionnaire
    • 9. Games for HealthJune 13, 2012 Formative Research (3)  Self Determination Theory  Values / Reasons Intrinsically Motivated Behavior  Relatedness  People make decisions consistent with values  Reasons tie values to behaviors
    • 10. Games for Health Cognitive testing of Values forJune 13, 2012 Vegetable Parenting  Most commonly selected Values:  “Raising a wholesome child”  “Raising a healthy child”  “Being a role model”  “Being respected by others”
    • 11. Games for Health Reasons linking “Raising a healthyJune 13, 2012 child” Value to VPP  “Encouraging my child to eat vegetables helps my child to be healthy because it helps…”  Keep them from getting sick, so they don’t miss school  Keep them from getting… cancer (… heart disease, …obese, …diabetes)  Them be in good shape  My child learn healthy eating habits
    • 12. Games for HealthJune 13, 2012 Kiddio – Game Mechanics  7 stage game  Enter at neutral with Kiddio refusing veggie offered  Select effective parenting - move 1 step towards winning  Select ineffective parenting – move 1 step towards losing  Turn off TV, remove toys, close door to outside – move 1 step towards winning  Time out option  Works only at Level 7  Otherwise lose points
    • 13. Games for HealthJune 13, 2012 Kiddio-Food Fight™  Casual video game (5-15 minutes per session or episode)  Played anywhere, any time  G4 iPhone app  Audience – Parents of pre- schoolers (3-5 year olds) who have difficulty getting their child to eat vegetables
    • 14. Games for HealthJune 13, 2012  Tailored to child’s temperament
    • 15. Games for HealthJune 13, 2012 Game Storyline  Dottie (best friend) has a child just a little older that yours  She has faced all these problems with her child and “knows” what works
    • 16. Games for HealthJune 13, 2012  Simulate parent-child interactions  Select from alternative parenting statements
    • 17. Games for HealthJune 13, 2012 Feedback to parents is immediate  Kiddio’s facial expressions and reactions to parent statement selections
    • 18. Games for HealthJune 13, 2012 Additional Game Activities  Change environment (TV, door, toys, timeout)  Choose vegetable to serve Kiddio  Talk to Dottie for help
    • 19. Games for HealthJune 13, 2012 Formative Research (4)  Alpha testing (qualitative)  16 parents of 3 to 5 year olds, 3 ethnic groups  Most parents enjoyed  Need tutorial or directions woven into game  Improve feedback  More Kiddio facial gestures  End of episode feedback  No website feedback  Abbreviate number and wording of Values & Reasons
    • 20. Games for HealthJune 13, 2012 Behavior Change components  Feedback on parenting selections  “Oreo” – positive comment, what was wrong, positive comment  Goal Setting to do effective parenting with own child  Select parenting practice, day, meal  Identify likely problems  Identify likely problem specific solution  Tailored motivational statement  Values, reasons  Earn points with optional leader board
    • 21. Games for HealthJune 13, 2012 Future (1)  Create 24 more episodes  5 levels of difficulty  Use same game design / engine
    • 22. Games for HealthJune 13, 2012 New Kiddio Menu (2)  Based on qualitative research, made changes to make more user friendly
    • 23. Games for HealthJune 13, 2012 Future (3)  Conduct outcome evaluation RCT  Primary outcome:  Child vegetable intake  Secondary outcomes:  Child BMI  Vegetable parenting practices  Home vegetable availability  Moderating variables:  Parent BMI  Parent vegetable intake  Parenting style
    • 24. Games for HealthJune 13, 2012 Dêkuji! (Czeck) DANKE! (German) MUITO OBRIGADO! (Portuguese) M G I! (Chinese, Cantonese) ARIGATŌ! (Japanese) MERCI BEAUCOUP! (French) MUCHAS GRACIAS! (Spanish) SERDECZNIE DZIĘKUJĘ! (Polish) SHUKRAN! (Arabic, Middle East) TACK SÅMYCKET! (Swedish) TAKK! (Norwegian) EFcHARISTo! (Greek) Xie Xie! (Chinese, Mandarin) Dank u wel (Dutch) Khawp Khun maxh! (Thai) Grazie! (Italian)
    • 25. Games for HealthJune 13, 2012 Formative Research  Model of Goal Directed Behavior Attitudes toward VPP Positive anticipated Desire (motivation) Intentions to use emotions regarding VPP to use VPP VPP Negative anticipated emotions regarding VPP Subjective norms Perceived behavioral related to VPP control regarding VPP
    • 26. Games for HealthJune 13, 2012 Future (1)  Offer as an app in the iTunes App store to get consumer feedback