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Game Based Teaching for Youth Health: Testing a Board Game, Monster Appetite, for Classroom Implementation

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Game Based Teaching for Your Health: Testing a Board Game, Monster Appetite, for
Classroom Implementation
Introduction
Games possess the powerful features for engaging learners and sustaining interest. In
2013, US consumers spent 21.53 billion dollars on the game industry (ESA, 2014). Games are
increasingly becoming a huge part of people’s pastime, which have led educators to consider
integrating gaming into different (in)formal learning environments (Dede, 2005). Since most
players are intrinsically motivated to play a game, the longevity and success of game integration
lie in game design and content.
The pivotal role of instructional design through games is to make sure that it promotes
learning (Collins, 1996). Games should be designed so that the content and skills sought are
clear, well structured, and executed efficiently. Furthermore, games should prepare learners to do
the kinds of complex tasks that happen in real life. With this, Collins suggested that educators
must understand the tradeoffs in the learning process of using educational technologies. For
example, games may compromise seriousness and relevance to learning, if educators cannot
clearly show their students the learning aspects embedded in the gameplay. Hence, the goals of
using game-based learning (GBL) would fail. Therefore, it is important that game designers and
educators should balance these cognitive and reflective considerations and are properly trained
and exposed to game-based curriculum (Katelhut & Schifter, 2011).
Problem Statement and Objective
Educators should first be exposed to potential classroom games before they are used with
their student body (Becker, 2007). In this way the educators will have time to consider cognitive
and reflective learning aspects that the game can afford. Unfortunately, nutrition in particular is
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not mainstream in schools and therefore not much time is dedicated for preparation, let alone
time for research in good nutrition games.
From the 70s through 90s the perceived importance of nutrition education increased
tremendously because healthy eating patterns from early on promote growth and intellectual
development (Stang et al., 1998; CDC, 2014). Now nutrition education is considered a necessary
component for health promotion and establishing a healthier lifestyle. Research shows that
teachers are more likely to integrate nutrition in their courses if they have received nutrition
training (Olson & Moats, 2013). Many policy makers are advocating for a full integration of
nutrition education into… schools (IES, 2011; Jukes et al., 2007). Such full integration calls for
appropriate training and preparation if a program were to be implemented in an educational
setting. Currently, most public schools integrate three to six hours of nutrition education per year
(Henderson, 2004) and teachers express the lack of training and curriculum resources as a huge
barrier to integrating nutrition into curricula (Woodson et al., 1995).
Monster Appetite (MA) intends to address the above concerns by empowering the
teachers as the main conveyor and advocate for healthy eating behaviors through a GBL
environment. For this pilot, the researcher tests the self-created board game MA with 16
educators to see the potential of such a game for nutrition education. The pilot explores four
main aspects in an exploratory fashion: fun and engagement for individuals and groups; social
interactions; knowledge gain; and re-playability in classrooms (Xu et al., 2011).
Theoretical Framework
The most unique aspect of MA is its subversive approach for gameplay, which
encourages players to make the conventionally “wrong” or unhealthy choices. This subversive
approach of showing the negative consequences of a choice is based on the behavioral
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inoculation theory in which the dangers and disadvantages of a specific undesired behavior is
shown and experienced in order to confirm the behavior’s ill-conceived preconception
(Etheridge, 2012; McGuire, 1961). As MA employs monster avatars that show the results of
high-caloric intake, the consequences of careless eating and energy intake are visual and
realistic. The inoculation theory fits well with MA because it provides the player with the
experience that normally is highly discouraged in real life. One of the best affordances of games
is that this type of experimentation can be done freely without real world negative consequences
(Gee, 2007; McGonigal, 2011). MA affords players to explore, experiment, play, and fail as
many times as they wish while simultaneously viewing the consequences of high caloric intake
via the avatars. The inoculation theory frames MA and this pilot captured the critical reception of
the game concept and design as a potential tool to be used in different learning environments in
the future.
Methods and Data Sources
The study was designed to explore how educators interact and learn from one another
while playing MA and record the participants’ player experience. In other words, the study
investigated whether learning can occur through gameplay in various forms (e.g., collaboration,
strategic planning, reflection, engagement, inquiry) and whether the specific nutrition game
content of MA is intriguing for educators to consider implementing into their learning
environments.
Sixteen (N=16) K-16 educators (12 females and 4 males) from two East Coast cities
participated in the study. Four dependent variables were studied: self-reported fun and
engagement of the participant and of the entire group playing the game; social interactions
among participants; knowledge gain; and re-playability in classrooms. In addition, qualitative
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feedback through questionnaires and interviews was collected. There were no treatment or
control groups and purposeful sampling was used. There were a total of six separate 1-1.5 hour-
long sessions with a total of three to five participants at any given time. All sessions were
video/audio recorded for data analysis and capturing of social interactions. Semi-structured
interviews were transcribed for analysis. All other data were retrieved via Qualtrics and analyzed
via SPSS.
Results
Participants gave high mean scores for their fun and engagement while playing MA
(Mf=8.19, Meg=8.94) as well as their perception of the group’s fun and engagement (Mf=8.19,
Meg=8.94).
[Insert Table 1]
Majority of the participants rated fun and engagement equally for themselves and the group.
The social interaction category included chores, reflection on gameplay, strategies, out-
of-game and game itself (Xu et al., 2011).
[Insert Table 2]
The video data were analyzed to tally the frequency of different aspects of each social interaction
expressed during gameplay.
Knowledge gain was measured with a Pre- and Post-Test. The test only asked if a food
had higher calories per serving than another similar item with an option to choose ‘The Same’ or
I Don’t Know.’ A t-test and between paired samples test were conducted.
[Insert Table 3 and 4]
The participants’ correct answers increased from Pre- (M=7.88, SD=4.36) to Post-test (M=12.50,
SD=2.19) with statistical significance; t(15)=-4.45, p<0.001.
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Fourteen participants stated they would play MA again if the opportunity were given.
Two participants chose ‘maybe’ on re-playability and elaborated that if certain game mechanics
and language(s) were adjusted to tailor to their students there was potential for the game to be
used in a learning environment.
The most unexpected, yet frequent evaluation drawn from interviews was about the game
length. The majority of the players commented how the length of the game was ideal for
classroom implementation as it took approximately 30 minutes with a clear ending, leaving room
for discussion and reflection for one class period.
Discussion and Significance
The current study was designed to learn and capture participants’ player experience
including fun, engagement, and social interactions; knowledge gain in identifying high versus
low caloric foods; and re-playability in other learning environments that can encourage
discussions on nutrition topics.
Fun and Engagement
Self-reported fun and engagement for each participant as well as the entire group
evaluated by each individual was fairly high. An interesting trend was that the majority of the
participants reported the level of fun and engagement for themselves the same as what they
thought the entire group experienced. Since these questions were asked one after another the
researcher suspects question order biases could have been in effect. The Post-Questionnaire
revealed that some causes for such high scores as appropriate game duration, rules that brought
about humor and excitement, and unconventional design and content that encouraged people to
pay attention to specific aspects of food consumption.
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Social Interaction
‘Collaborative Learning’ behavior under ‘Chores’ was relatively low. Though the
researcher expected to see some of these behaviors occur naturally, most sessions showed low
frequencies (see Table 3). The fast-paced nature of the game is one possible reason: because
there was not a set time to share all selected food items and their calories, many utterances of
food topics were left without a follow-up conversation. If there were an allotted time for sharing
caloric information, more natural collaborative learning behavior could have been expected.
Therefore, this pilot’s results have implications for game designers of thinking of a time where
the individually acquired knowledge is brought together as a group within the game structure.
Because of the fast-paced nature of the game, there was not a prominence of ‘Reflection
of Gameplay’ except the behavior ‘Making one’s move and laughing about it.’ This was a
consistent observation with all players in all gameplay sessions. This trend is not surprising as
the subversive approach was implicating socially undesired behavior as “good.” Participants did
not hesitate to share their ‘Strategies’ when asked during the semi-structured interviews. This
shows how post-discussions after gameplay could benefit all players in learning each other’s
strategies. Participants who had the opportunity to listen to other people’s strategies expressed
how informative it was and how it could help them strategize better in the future if they were to
replay the game. In addition, by sharing strategies the participants had another opportunity to
learn about what indicators could help them identify high versus low caloric foods.
Knowledge Gain
Knowledge gain showed significant increases from Pre- to Post-Test. Some comments
during gameplay indicated instances of learning. A participant shared with his group that he
realized anything liquid or liquid like (e.g., salad dressings, jams, condiments) has low calories
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because the serving size was always small. The group reacted to this comment and all avoided
choosing anything regarded as a liquid item. Another participant simply stated that she felt like
she was learning something and did not expect that from playing a game. These were all positive
qualitative comments illustrating instances of learning. Some participants showed regret that the
learning was limited to calories and not other nutrition information such as fat, protein, or fiber
content, while others appreciated that the learning was specific and focused.
Re-Playability in Classrooms
The majority of the participants showed desire to replay MA in some learning context in
the future. There were suggestions from participants how the game could be modified to cater to
the specific students that would be playing the game in their classes. For example, two
kindergarten teachers expressed that the high numbers for the calories might be difficult for their
students to understand. Therefore, if the game were to be utilized in their classrooms they would
implement a simpler scale to express high and low calories. In addition, some participants
mentioned how this could be useful in a math class as addition/subtraction are involved. If
students had to calculate the calories of the entire package of a food, multiplication and
proportion could be introduced. A future study could involve knowledge gain in
math/computation concepts using this game.
The main reason why most participants saw this game being employed in a classroom
setting was due to the relatively short game length. Many commented how the length of the
game was ideal to be played in one class period with a clear conclusion. With an average of half-
an-hour gameplay it leaves room to discuss the game’s message and nutrition concepts to be
covered. The fast-pace, subversive approach, competition, chance cards, and monster avatars
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were also mentioned as useful mechanics and features that could draw attention to students in a
learning environment in a fun and engaging way.
There is potential for this game to be recycled for different audiences and contents. With
technology incorporation there are various ways that the game can become more engaging and
informative for learning. Four dependent variables (fun and engagement; social interactions;
knowledge gain; and re-playability in classrooms) were explored and observed during gameplay
as predicted. Overall, the pilot was successful and informative for the researcher and this can be
a stepping-stone for a more improved future study.
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References
Becker, K. (2007). Digital gamebased learning once removed: Teaching teachers. British
Journal of Educational Technology, 38(3), 478-488.
Centers for Disease Control and Prevention (CDC, 2014). Adolescent and school health:
Nutrition and health for young people. Retrieved from
http://www.cdc.gov/healthyyouth/nutrition/facts.htm
Collins, A. (1996). Design issues for learning environments. International Perspectives on the
Psychological Foundations of Technology-Based Learning Environments, 347-361.
Dede, C. (2005). Planning for neomillenial learning styles. Educause Quarterly, 1, 7–12.
Etheridge, J. (2012). Inoculation theory. Surround Health. Retrieved from
http://surroundhealth.net/Topics/Education-and-Learning-approaches/Behavior-change-
strategies/Articles/Inoculation-Theory.aspx (accessed April. 2014)
Entertainment Software Association (ESA). (2014). Essential Facts about the Computer and
Video Game Industry: 2014 Sales, Demographics, and Usage Data. Available at
http://www.theesa.com/facts/pdfs/ESA_EF_2014.pdf (accessed Oct. 2014)
Gee, J. P. (2007). What video games have to teach us about learning and literacy. New York
NY: Palgrave MacMillan.
Henderson, C. C. (2004). The state of nutrition and physical activity in our schools. North
Haven, CT: Environment & Human Health, Inc. Retrieved from
http://www.ehhi.org/reports/obesity/obesity_report04.pdf
Institute of Education Sciences (IES): National Center for Education Evaluation and Regional
Assistance. (2011). Nutrition and physical education policy and practice in Pacific
Region secondary schools. Retrieved from
http://ies.ed.gov/ncee/edlabs/regions/pacific/pdf/REL_2012117.pdf
Jukes, M. (2007). Impact of early childhood health and nutrition on access to education in
developing countries. Paediatrics and Child Health, 17(12), 485-491.
Katelhut, D. J., & Schifter, C. C. (2011). Teachers and game-based learning: Improving
understanding of how to increase efficacy of adoption. Computer & Education, 56, 539-
546.
McGonigal, J. (2011). Reality is broken: Why games make us better and how they can change
the world. Penguin Group.
McGuire, W. J. (1961). The effectiveness of supportive and refutational defenses in immunizing
and restoring beliefs against persuasion. Sociometry, 24, 184-197.
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Olson, S., & Moats, S. (Eds.). (2013). Lessons learned from state and local experiences. In
Nutrition education in the K-12 curriculum: The role of national standards: workshop
summary. Washington, DC: The National Academies Press.
Stang, J., Story, M. & Kalina, B. (1998). Nutrition education in Minnesota public schools:Percep
tions and practices of teachers. Journal of Nutrition Education, 30, 396-404
Woodson, J. M., Benedict, J. A., & Hill, G. C. (1995). Nutrition education assessment of
classroom teachers in Nevada: status, resources, and preferences. Journal of Nutrition
Education, 27(1), 42-46.
Xu, Y., Barba, E., Radu, I., Gandy, M. and MacIntyre, B. (2011). Chores are fun: Understanding
social play in board games for digital tabletop game design. Proceedings of DiGRA 2011
Conference: Think Design Play.
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Tables
Table 1. Fun and Engagement Individual vs. Group
Descriptive Statistics
Minimu
m
Maximu
m
Mean
Std.
Deviation
Fun_Individ
5
10
8.19
1.328
Fun_Grp
5
10
8.19
1.377
Engage_Individ
5
10
8.94
1.289
Engage_Grp
7
10
8.94
1.124
Valid N (listwise)
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Table 2. Social Interaction Tally Sheet Count and Average of Counts
24-Jun
10-Jul
14-Jul
15-Jul
18-Aug
24-Aug
AVG
CHORES
object maneuvering
7
0
0
14
0
0
3.50
discussion while waiting
for turns
3
0
7
0
3
14
4.50
enforcing rules via social
agreement
8
7
9
14
13
7
9.67
collaborative learning
3
2
3
3
3
8
3.67
REFLECTION ON GAMEPLAY
making a move & laughing
about it
7
17
7
7
7
27
12.00
discussion referring back to
past moves
2
0
8
3
0
0
2.17
discussion on the whole
game
1
0
1
0
1
7
1.67
discussion on
improving/changing
current game mechanics
1
1
2
7
0
0
1.83
STRATEGIES
talking about the strategy
1
0
1
0
0
1
0.50
pointing at obj to discuss
the specifics of a move
2
2
2
4
1
5
2.67
negotiating & changing
strategies according to
game state
4
0
0
3
0
0
1.17
OUT-OF-GAME
talking about out-of-game
subjects
2
3
1
1
1
4
2.00
reacting to distractions
1
3
0
0
1
1
1.00
between-session/round
casual chat
0
0
0
1
0
6
1.17
GAME ITSELF
commenting on the rules
and setup of the game
3
24
33
14
17
29
20.00
joking abt (reacting to) the
game lang/mechanic/rules
14
17
13
9
14
19
14.33
talking food ingredients
7
27
13
10
17
19
15.50
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Table 3. The Mean Pre- and Post-Test Scores
Paired Samples Statistics
Mean
N
Std.
Deviation
Std. Error
Mean
Pair 1
PreTest
7.8750
16
4.36463
1.09116
PostTest
12.5000
16
2.19089
.54772
Table 4. Paired Samples Test
Paired Samples Test
Paired Differences
t
df
Sig. (2-
tailed)
Mean
Std.
Deviation
Std.
Error
Mean
95% Confidence Interval
of the Difference
Lower
Upper
PreTest
PostTest
-
4.62500
4.16133
1.04033
-6.84242
-2.40758
-4.446
15
.000
... Our hypothesis was that participants in the subversively- framed game group would (1) choose/purchase the low-caloric snack items for (2) caloric reasons more so than those in the two-sided inoculation game group would have. This hypothe- sis was based on players' high-engagement and positive feed- back with Monster Appetite's subversive mechanism from the pilot results [46]. ...
... Therefore, from the feedback alone it was difficult to see whether the framing and interface worked as it was intended to: people fully engaged in reading the framed mes- sages and observing the changes in the monster avatar's health and mood status. The pilot study [46] indicated that the subver- sive approach was fun and enticing for the majority. However, regarding framing, we also encountered some resistance that was indicated through the following participant's comments: ...
... These results indicate that in both conditions, exposure to MA increased participants' awareness of caloric content; yet this awareness had different effects in the two conditions. Our focus here was on the subversive condition, which was partic- ularly engaging and attractive during our pilots [46]. Previous research showed games that allow their users to en- gage in activities deemed unacceptable or subversive in the real world may have a particular appeal for certain popula- tions that are challenging to reach with more traditional public health interventions [23]. ...
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