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The old-fashioned trick of hiding broccoli in the casserole to get kids to eat it has been given a high-tech update. The new tactic? Slipping healthy behavior lessons into children's video games.
A study conducted at Baylor College of Medicine found that overweight children who play video games promoting good nutritional choices consumed more fruits and vegetables than their "Call of Duty"-playing counterparts.
Researchers noted that overweight children who played these health-focused video games over a 2-month period achieved a two-thirds increase in fruit and vegetable consumption. Dr. Tom Baranowski, head of the research team, explains that this improvement is significant for a demographic that does not eat nearly enough of the required servings of fruits and vegetables.
The video games were developed by a company called Archimage with a grant from the National Institute of Health (NIH). "Escape from Diab" and " Nanoswarm: Invasion from Inner Space" are designed to look like any other video game, with a plot and levels that must be achieved.
In "Escape from Diab," a boy named DJ falls through a time warp and lands in a magical land where the king won't allow his subjects to exercise or eat fruits and vegetables. As a result, the subjects don't have enough energy to defy him. DJ is a soccer player, though, and knows the advantages of exercising and eating well. His task is to empower the people of Diab by teaching them how to make healthy choices.
"These games aren't just 'Tetrus' with fruit," says Richard Buday, president of Archimage. In other words, they are more than just your classic game but with more face time given to fruits and veggies. "We want stuff that really works, that has a clinical underpinning," Buday says. And researchers at Baylor have provided just that underpinning.
"Just about everything we know about behavior change is incorporated into these games," says Dr. Tom Baranowski, professor of pediatrics and head of the research team.
Baranowski explains that a child must see how a behavioral change aligns with his or her own values in order to adopt it. This is why both games begin by asking a child questions that assess his or her reason for wanting to make healthier choices. The games then incorporate that motivator into the child's experience with the game.
"Behavior is most likely to be changed and maintained if kids do the behavior for internal reasons," Baranowski says.
Another key to behavioral change is making a habit out of the good behavior, so that the right choice becomes not a choice at all, but a reflex. "Thinking is an enemy of behavior change," says Baranowski. The games eliminate the thinking step by repeating scenarios in which a child has to choose between the healthy choice and the unhealthy one, until they begin to instinctively select the healthy option.
One activity places a child in a marketplace, faced with foods containing real fruit (like strawberries) and artificial fruit (like cherry Kool-aid.) Players must select 20 real fruits in 3 minutes, or they have to start over.
The fact that it took children an average of 7 tries to successfully complete the task shows that this is a lesson they need, says Baranowski.
It's also a lesson they won't get bored learning. In the case of a test, Baranowski explains, a child would never go over their answers 7 times until they got them all correct. "Within the context of a video game, though, kids say, 'Wow, that was challenging. I love that!' " he says.
Now the challenge for Archimage will be getting consumers to love the product as much as the children who have played it. Consumers are most likely to include schools, families and healthcare providers.
Archimage hopes that schools will make the games a part of their curriculum, and plans to develop workbooks and other educational materials to accompany them.
As for introducing these games to healthcare providers, the recent healthcare bill could make healthcare a viable market for the games. "Childhood obesity behavioral interventions are now fully reimbursed by insurance companies, and I have the product for that," Buday says.
Children in the U.S. spend an average of 1 hour per day playing video games, according to Baranowski. In his opinion, replacing some of the traditional games with ones that inspire healthy behavior would be a productive step in the fight against childhood obesity.
The study will be published in an article titled, "Video Game Play, Child Diet, and Physical Activity Behavior Change - A Randomized Clinical Trial" in the January 2011 issue of the American Journal of Preventive Medicine.
参考译文：
将花椰菜“藏匿”在餐盘中然后哄骗孩子们去吃的过时做法如今已被赋予了与时俱进的高科技手段。是什么呢？那就是将“健康行为”的课程教育整合到孩子们爱玩的视频游戏中去。
由贝勒医学院进行的一项研究发现，相比于“使命的召唤”之类的角色游戏，那些整合有营养知识的视频游戏可帮助超重的孩子们去食用更多的水果和蔬菜。
研究者发现，那些超重的孩子在玩以“健康”为主题的视频游戏2个月后，其水果和蔬菜的食用量将增加2/3。研究小组负责人汤姆.巴拉诺斯基博士（Dr. Tom Baranowski）解释说，这个增加量在日常果蔬食用严重不足的人群中将更加明显。
该视频游戏是由国家卫生研究所（NIH）资助，Archimage公司开发研制的。“逃离迪亚布”和“Nanowarm：来自内心世界的入侵”这两款游戏的情节设计及一些必须的技术水平跟其他任何视频游戏相类似。
在“逃离迪亚布”这款游戏中，名叫DJ的男孩落入时空隧道并到了一个很神奇的地方，这里的国王不允许他的臣民运动或是吃水果蔬菜，如此就不会有足够的力量推翻他了。DJ是个足球运动员，他深知运动和合理膳食的重要性。因此，他的任务就是教迪亚布的人们如何做出有利身体健康的选择。
Archimage公司总裁理查德.巴德（Richard Buday）说，“它不只是跟水果有关的单纯‘方块游戏’（Tetrus）。”也就是说，与那些传统游戏相比，它有着更多水果和蔬菜的画面。
巴德说，“我们希望这些东西都有临床依据并确实有效。”布勒医学院的研究者们即给出了其所需的支撑依据。
该研究的负责人、儿科教授汤姆.巴拉诺斯基博士说，“我们几乎将了解的有关行为改变的所有情况都加入到了游戏中。”
巴拉诺斯基表示，每个孩子都要明白他们的行为变化是如何与其自己的价值观趋于一致的并接受之。这也是为何这两款游戏在一开始都会问孩子们这个问题——估计一下己做出健康选择的原因。因此，将这一激励因子整合进了游戏体验过程中。
巴拉诺斯基说，“发自内心的行为更容易改变并持久。”
行为改变的另一个关键是，让那些良好行为变成一种习惯，从而正确选择从根本上说也就不再是选择，而是本能反映。巴拉诺斯基说，“思考是行为改变的敌人。”因此，游戏省去了思考的环节，而代之以不断重复‘一个孩子要在健康和不健康的选择项下做出自己决定’的情节，直到他们会本能的去选那些健康的选项。
有一项活动是让孩子们置身摆有真实水果（像草莓）和人造水果（像樱桃饮料）的超市环境中，然后必须在3分钟内选出20种真实的水果，否则再重新开始。
巴拉诺斯基说，每个孩子平均需要尝试7次才能成功完成任务的事实说明，他们需要这样的课程教育。
同时，这也是一个不会让他们感到厌烦的学习过程。巴拉诺斯基说，像平常的考试，一个孩子是决不会重7次直到答案全部正确的。
现在，Archimage公司的挑战是获得更多像玩过该游戏的孩子们那样喜欢这个产品的消费者，最可能的消费群就是学校、家庭和健康保健机构等。
Archimage希望学校能把该游戏设为课程的一部分，并编制手册及其他教学资料以辅助之。
至于要在健康保健机构中推广该游戏，首先，现行的健康保健法要给予该游戏可行的市场。巴德说，“目前，孩童肥胖所致各种问题的行为干预全部由保险公司买单，而现在我希望这个产品能对此有所帮助。”
据巴拉诺斯基所述，美国孩子每天平均要花费1小时时间用来玩视频游戏。在他看来，以整合有健康行为的游戏来取代一些传统游戏将是抵制孩童肥胖极富成效的一步。
该研究将于2011年1月份在《美国预防医学杂志》以 “视频游戏玩法、儿童饮食及物理活动行为改变——随机临床试验”的题目刊出。
