Physical activity promotion in children using a novel smartphone game: a pilot randomized controlled trial




Lapusniak, Sam

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Background: Regular physical activity (PA) is critical for children’s health and wellbeing. Despite the numerous health benefits, most Canadian children do not meet the Canadian PA guidelines. The emergence of the COVID-19 pandemic and social restrictions added new challenges to meeting the PA guidelines. Mobile health (mHealth) technology can be leveraged to promote PA among children. Combining gamification with mHealth interventions has the potential to further improve program effectiveness. Thus, “Draco” was developed as a virtual pet smartphone app to increase PA in children using self-determination theory as a framework to promote intrinsic motivation for PA. Objective: The primary objective is to evaluate the satisfaction and acceptability of the Draco app after four weeks. Secondary objectives include evaluating the preliminary effectiveness of the Draco app to improve average daily steps, average daily MVPA, perceived autonomy for PA, perceived competence for PA, and perceived relatedness to the app. Methods: 43 Canadian children, aged 8-14 years old, not meeting the Canadian PA guidelines of 60min of MVPA per day were randomly allocated to an intervention or control group. Participants in the control group used a step-tracking app for four weeks. Intervention participants were instructed to use the Draco app. Participants completed a baseline and follow-up questionnaire. PA outcomes were tracked using a Fitbit provided to each participant. Intrinsic PA motivation was assessed using an adapted version of the Intrinsic Motivation Inventory (IMI). Intrinsic motivation was assessed using the satisfaction subscale. Exit interviews were completed to determine app acceptability. Results: Participants demonstrated high levels of satisfaction and acceptability with the Draco app 2.83 (1.29). Intervention participants increased their average daily steps by 909 (1701). The control group increased their steps by 46 (1507). The Draco app had a small effect on promoting steps, MVPA, relatedness and small effects at increasing autonomy and competence. Conclusion: Participants demonstrated high levels of satisfaction and acceptability with the app. Participants in the intervention group showed greater increases in PA with small effect sizes. Preliminary evidence highlights the importance of tailoring game design to the users. Technical limitations impacted recruitment and user experiences. Additional development time should be taken to stabilize the app and add new game features for a definitive RCT.



mHealth, mobile health, digital health, gamification, randomized controlled trial, RCT, pilot study, physical activity, SDT, self determination theory, smartphone, video game, health promotion, behaviour change, game design, MVPA, moderate-to-vigorous physical activity, steps, exercise