Background: Childhood obesity is one of the most important public health problems. Active video games (AVGs) have been proposed as an attractive alternative to increase energy expenditure and are being investigated to determine their effectiveness against childhood obesity. Objective: The aim of this study is to summarize the existing research and draw conclusions about the effects of AVGs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. Methods: The search strategy was applied to PubMed, MEDLINE, Web of Science, and SPORTDiscus, including randomized and nonrandomized controlled trials investigating the effects of AVG programs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. To measure the risk of bias in randomized and nonrandomized controlled trials, 2 different quality assessment tools were used. In total, 15 articles met the inclusion criteria, and the variables of interest were BMI, body fat percentage, cardiorespiratory fitness (CRF), waist circumference, fat-free mass, muscular fitness, and motor competence. A meta-analysis was performed. Results: Positive effects were found for BMI and body fat percentage, favoring the AVG group compared with a control group with no intervention (mean difference −0.209; 95% CI −0.388 to −0.031 vs mean difference −0.879; 95% CI −1.138 to −0.602). Positive effects seem to be observed for CRF. The effects of AVG interventions on muscular fitness, fat-free mass, waist circumference, and motor competence are unclear. Conclusions: AVG programs showed positive effects on BMI, body fat percentage, and CRF. AVG could be a good strategy to combat childhood obesity.

This is the abstract only. Read the full text free (open access) on the JMIR Serious Games website. JMIR is the leading ehealth publisher: fast peer-review - open access - high impact.

Background: Childhood obesity is one of the most important public health problems. Active video games (AVGs) have been proposed as an attractive alternative to increase energy expenditure and are being investigated to determine their effectiveness against childhood obesity. Objective: The aim of this study is to summarize the existing research and draw conclusions about the effects of AVGs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. Methods: The search strategy was applied to PubMed, MEDLINE, Web of Science, and SPORTDiscus, including randomized and nonrandomized controlled trials investigating the effects of AVG programs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. To measure the risk of bias in randomized and nonrandomized controlled trials, 2 different quality assessment tools were used. In total, 15 articles met the inclusion criteria, and the variables of interest were BMI, body fat percentage, cardiorespiratory fitness (CRF), waist circumference, fat-free mass, muscular fitness, and motor competence. A meta-analysis was performed. Results: Positive effects were found for BMI and body fat percentage, favoring the AVG group compared with a control group with no intervention (mean difference −0.209; 95% CI −0.388 to −0.031 vs mean difference −0.879; 95% CI −1.138 to −0.602). Positive effects seem to be observed for CRF. The effects of AVG interventions on muscular fitness, fat-free mass, waist circumference, and motor competence are unclear. Conclusions: AVG programs showed positive effects on BMI, body fat percentage, and CRF. AVG could be a good strategy to combat childhood obesity.

This is the abstract only. Read the full text free (open access) on the JMIR Serious Games website. JMIR is the leading ehealth publisher: fast peer-review - open access - high impact.

Background: In recent years, augmented reality (AR), especially markerless augmented reality (MAR), has been used more prevalently to create training games in an attempt to improve humans' cognitive functions. This has been driven by studies claiming that MAR provides users with more immersive experiences that are situated in the real world. Currently, no studies have scientifically investigated the immersion experience of users in a MAR cognitive training game. Moreover, there is an observed lack of instruments on measuring immersion in MAR cognitive training games. Objective: This study, using two existing immersion questionnaires, investigates students’ immersion experiences in a novel MAR n-back game. Methods: The n-back task is a continuous performance task that taps working memory (WM) capacity. We compared two versions of n-back training. One was presented in a traditional 2D format, while the second version used MAR. There were 2 experiments conducted in this study that coordinated with 2 types of immersion questionnaires: the modified Immersive Experiences Questionnaire (IEQ) and the Augmented Reality Immersion (ARI) questionnaire. Two groups of students from two universities in China joined the study, with 60 participants for the first experiment (a randomized controlled experiment) and 51 participants for the second. Results: Both groups of students experienced immersion in the MAR n-back game. However, the MAR n-back training group did not experience stronger immersion than the traditional (2D) n-back control group in the first experiment. The results of the second experiment showed that males felt deeply involved with the AR environment, which resulted in obtaining higher levels of immersion than females in the MAR n-back game. Conclusions: Both groups of students experienced immersion in the MAR n-back game. Moreover, both the modified IEQ and ARI have the potential to be used as instruments to measure immersion in MAR game settings. Trial Registration: UMIN Clinical Trials Registry UMIN000045314; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000051725

This is the abstract only. Read the full text free (open access) on the JMIR Serious Games website. JMIR is the leading ehealth publisher: fast peer-review - open access - high impact.

Background: In recent years, augmented reality (AR), especially markerless augmented reality (MAR), has been used more prevalently to create training games in an attempt to improve humans' cognitive functions. This has been driven by studies claiming that MAR provides users with more immersive experiences that are situated in the real world. Currently, no studies have scientifically investigated the immersion experience of users in a MAR cognitive training game. Moreover, there is an observed lack of instruments on measuring immersion in MAR cognitive training games. Objective: This study, using two existing immersion questionnaires, investigates students’ immersion experiences in a novel MAR n-back game. Methods: The n-back task is a continuous performance task that taps working memory (WM) capacity. We compared two versions of n-back training. One was presented in a traditional 2D format, while the second version used MAR. There were 2 experiments conducted in this study that coordinated with 2 types of immersion questionnaires: the modified Immersive Experiences Questionnaire (IEQ) and the Augmented Reality Immersion (ARI) questionnaire. Two groups of students from two universities in China joined the study, with 60 participants for the first experiment (a randomized controlled experiment) and 51 participants for the second. Results: Both groups of students experienced immersion in the MAR n-back game. However, the MAR n-back training group did not experience stronger immersion than the traditional (2D) n-back control group in the first experiment. The results of the second experiment showed that males felt deeply involved with the AR environment, which resulted in obtaining higher levels of immersion than females in the MAR n-back game. Conclusions: Both groups of students experienced immersion in the MAR n-back game. Moreover, both the modified IEQ and ARI have the potential to be used as instruments to measure immersion in MAR game settings. Trial Registration: UMIN Clinical Trials Registry UMIN000045314; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000051725

This is the abstract only. Read the full text free (open access) on the JMIR Serious Games website. JMIR is the leading ehealth publisher: fast peer-review - open access - high impact.

Background: Sexual education has become increasingly important as unhealthy sexual practices and subsequent health risks become more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital natives exposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generation may be a useful approach for teaching sex education. Objective: The aim of this study was to improve sexual health knowledge and understanding of the problems associated with unhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-tech setting. Methods: A participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondary school students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches: (1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-like learning); and (3) traditional teaching (TT) methods. Results: The SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically, the average scores across groups demonstrated an increase of mean scores from the pre- to posttest (25.10 [SD 5.50] versus 75.86 [SD 13.16]; t119=41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretest scores (F2,117=1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG and GM groups had higher average scores than the TT group (F2,117=83.98; P<.001). Students reported increased learning motivation, attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches. Conclusions: Digital health technologies (particularly teaching and learning through gamified instruction and other novel approaches) may improve sexual health education. These findings may also be applied by practitioners in health care settings and by researchers wishing to further the development of sex education.

This is the abstract only. Read the full text free (open access) on the JMIR Serious Games website. JMIR is the leading ehealth publisher: fast peer-review - open access - high impact.