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Web-based rewards help kids get more exercise

A motivational game-based website can boost kids' activity levels by nearly 60%, according to findings presented at the Obesity Society's Annual Meeting in San Antonio.

Tweens who used the Zamzee, a pocket-sized activity meter linked to the site, engaged in about 45 more minutes of moderate-to-vigorous physical activity per week than their peers who used the activity meter only, researchers said.

"This is the first big study that we've done to actually prove that it works in the real world," said Dr Steve Cole, the vice president of research and development at HopeLab, the non-profit company that developed Zamzee. "There's lots of stuff that works in a lab, there's lots of ways that you can buy fancy equipment and kind of kidnap kids from reality that's not scalable, that's not going to be enough to reverse the obesity epidemic."

HopeLab researchers developed the Zamzee with funding from the Robert Wood Johnson Foundation. It retails for $29.95, and access to the Web site is free. There are currently about 5 000 registered Zamzee users, according to Richard Tate, VP of communications and marketing at HopeLab. Young Zamzee users can play a free version of the game, with virtual rewards only, or parents can load in cash rewards for specific goals.

In the study, the researchers randomly assigned 448 middle-schoolers, about a quarter of whom were overweight or obese, to use the activity meter only or to use the activity meter and the Web site for six months. Kids uploaded data from the activity meter to the Zamzee site, which let them monitor their activity levels, earn points, achieve goals and win rewards, which included cash prizes of $5 or $20, as well as the virtual rewards, like badges or special computer wallpaper.

Significant increase

Throughout the study, the researchers found, children in the Zamzee group engaged in significantly more moderate-to-vigorous physical activity than the control group. On average, they spent 59% more time being active.

Also, after six months, low-density lipoprotein levels were the same as they were at baseline for the Zamzee group, while the meter-only group saw their LDL creep up by five points (p=0.034).

Hemoglobin A1C levels also decreased slightly from baseline in the Zamzee group, but increased slightly in the control group (p=0.012).

Subgroup analyses showed both girls' and boys' saw a significant increase in physical activity, as did normal-weight and obese and overweight kids.

"The findings are outstanding. This is such a huge improvement in moderate to vigorous physical activity, and the improvement is occurring across demographic groups," Dr Debra Lieberman, a media researcher at the University of California, Santa Barbara, and director of the Health Games Research national program. Lieberman was not involved in the study, and did not participate in Zamzee's development.

Given that even the most popular video games have a shelf life of three months, Lieberman added, the fact that kids kept using the Zamzee and maintaining their increased activity level across a six-month period was "remarkable."

"What's nice is HopeLab looked at two kinds of gratifications or rewards for a young person," she added. While "extrinsic" rewards, like cash prizes, are obviously important, Lieberman explained, "intrinsic" rewards-intangibles like increased feelings of competence and autonomy, as well as mastery, purpose and relatedness-are essential too. "That is really when you're going to deeply motivate people, when the rewards of an activity enable those kinds of feelings and experiences," she said.

(Reuters Health, September 2012)

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