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Preventing Childhood Obesity: Is There an App for That?

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Fitness technology has come a long way since the stationary bike. These days, you can live-stream a spin class from across the world, lift weights in your living room with a virtual trainer, track the calories you burn with a Fitbit and add drama to your morning jog with the Zombies, Run! app.

But as the fitness bands and “exergames” continue to proliferate, more than one-third of U.S. adults are obese, according to the Centers for Disease Control and Prevention. Among children and adolescents, the rate stands at 17 percent, and childhood obesity has nearly tripled since 1980.

Many believe that technology—from television and video games to the Internet and smartphones—keeps kids on the couch, out of playgrounds and off the recommended weight charts. But it’s not that simple, said Dr. Ernie Medina, a preventive care specialist who uses exergames as part of his exercise and wellness programs.

“It’s interesting that you don’t hear those same critics complaining that reading books is part of the cause of childhood obesity,” he told HealthBiz Decoded. “Why not? Because they usually are biased towards video games as the bad guy. Why not blame schooling, which requires kids to sit for long periods of time?”

“…kids get completely immersed in [technology]. It really engages them. You might as well embrace it …”

Karin Pfeiffer, an exercise physiologist and associate professor of kinesiology at Michigan State University, described games and technology as “one small piece of the puzzle” representing the array of factors behind childhood obesity.

“But,” she continued, “the fact of the matter is technology is here, it’s here to stay, and kids get completely immersed in it. It really engages them. You might as well embrace it and have it actually help you get them to be more active.”

Embracing High Tech Solutions

For Pfeiffer, Medina, and a growing community of doctors, researchers and innovators, young people could benefit from the high-tech solutions many adults are now using to get fit, lose weight and track their progress. These include exergames, websites, mobile apps, tracking devices and social media.

“We can use technology to address head-on the factors that are associated with childhood obesity,” Medina said. “Not only increasing physical activity, but nutritional needs as well, social support in making healthy behavior changes, motivating and incentivizing behavior change, and educating and training.”

Games and apps are digital, portable, easy to update and most importantly, fun, which helps kids adhere to a program over time, he said.

“[Games] are powerful learning environments… We can create content that is desirable rather than objectionable.”

Debra Lieberman, a communication researcher and professor at the University of California Santa Barbara, recognized this potential in the early 1990s, when she developed video games aimed at helping kids manage their asthma and diabetes. Over a six-month period, kids with type 1 diabetes who played the self-management game reduced their urgent care and emergency room visits by 77 percent, she said.

“One of the reasons I got into this field is because I saw that games were having such a powerful negative impact,” Lieberman explained. “I said, aha, these are powerful learning environments. I really want to turn that around. I believe that we can create content that is desirable rather than objectionable.”

Zamzee increased physical activity in kids by an average of 59 percent over a six-month period

Lieberman now serves as the director of Health Games Research, a program funded by the Robert Wood Johnson Foundation. It awards grants for research on the effectiveness of digital games and game technologies in promoting health and fitness. In 2010, a Georgetown University study found that playing Wii Fit games, such as Dance Dance Revolution, can help low-income teens get more exercise and lower their body mass index, Lieberman said.

Despite encouraging research findings, very few exergames, fitness apps and activity trackers have been designed specifically for kids and teens, Lieberman said. One noteworthy exception is Zamzee, established in 2010 by the nonprofit research organization HopeLab. Zamzee links an activity meter to a website where its 10,000-plus registered users can upload their data and track their progress. Children also take part in interactive challenges and earn points, which can be redeemed for rewards like collectibles, gadgets, gift cards and charitable donations.

Group dashboards allow medical professionals to motivate and manage their patients’ activity in real time.

“When we hear feedback from kids and parents, being incentivized to move is really important to them,” said Robin Raskob, a spokesperson for Zamzee. “It’s a goal they want to reach, and that intrinsic motivation is really important.”

According to a study sponsored by HopeLab and the Robert Wood Johnson Foundation, Zamzee increased physical activity in kids by an average of 59 percent over a six-month period, Raskob said. It also had a positive impact on risk factors associated with heart disease and diabetes.

Initially designed for kids and families, Zamzee has sparked interest within the medical community, Raskob noted. Instead of self-reporting their exercise, children in weight management programs can simply share their Zamzee data with their clinicians, she said.

This October, Zamzee will launch group dashboards that allow medical professionals to motivate and manage their patients’ activity in real time.

The idea that fitness-related hardware and software can improve patient care also resonates with pediatrician Stephen Pont, medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity and chair of the American Academy of Pediatrics Section on Obesity.

“As health professionals, we only have a limited amount of time in the clinic, so technology can be a great way to allow us to have more touch points with our patients between visits,” he said. “It would be wonderful to be able to send a congratulatory message to a patient who has had an active and healthy week, or a patient that is having success meeting health goals that we set at their last visit. And if they’re finding a goal hard to achieve, it would be wonderful to be able to help them brainstorm a creative solution to help them find success.”

The Difference Between Children and Adults

With so many fitness devices, games and apps flooding the market, why do young people need specialized tools like Zamzee? Not only does children’s play follow different patterns than adults’ workouts, but kids have shorter attention spans, experts say.

“Unless you keep things interesting or keep introducing new games, kids get bored,” Pfeiffer said. “You also have to keep in mind that kids need to think it’s cool.”

Since lifelong physical fitness requires sustained dedication, successful products have to capture kids’ interest and retain it over the long term, Pont said.

“Some of the Xbox Kinect games can really get your heart rate up, but we don’t always see kids continuing to play the game regularly, say 30 to 60 minutes a few times a week,” he said. “Once the novelty wears off, their interest starts to wane. But these are still the early days. I’m confident that we can find ways that will help kids maintain and increase their activity through technology.”

3 Responses to “Preventing Childhood Obesity: Is There an App for That?”

Steve Calhoun

Great article. Most exergames, that are designed for outdoor play, create a reward system that kids can only check once or twice a day, and its typically a final reward or accomplishments toward a reward once finished. Here at GenZPlay, we are creating interactive cartoons and stories. You pick a character, run with the device (smartphone or activity tracker) and then watch your performance on the handheld screen. This is pure intrinsic motivation as it allows the child to see what they accomplished immediately and it excites them to try again for a better or similar result. Check out genzplay.com or watch a video of kids trying our Big Cat Race exergame here. http://vimeo.com/40755334

samantha

How about we put PE back into the school system? Get the kids moving? Most adults put on weight when they get out of school and get a desk job— why are we giving our kids a desk job in grade school? My youngest son has PE only two times a week– and my high-schooler was denied PE— when I was in school there was PE every day of every year I went. We need healthier foods and PE in our schools where our children are the majority of the day!