Mission Possible: Using visual feedback to improve physical activity in children
This paper describes the deployment of a novel ubiquitous behaviour change system for social interaction and reflection amongst school children. For four weeks, a class of schoolchildren (Year 5) was monitored with Fitbit activity monitors and their daily physical activity was visualised on a custom ambient display. In addition, video segments describing mission-based activities were shown on tablet devices to the children at the start of each week. The ambient display would indicate if they performed better than the previous day. We describe how the system was designed and developed, present findings from the in-the-wild study, and provide design guidelines for future studies.
It is well established that peadiatric obesity is associated with numerous health implications in later life (Freedman 2007). Despite evidence to suggest that the prevalence of obesity has plateaued in recent years within the UK (Boddy 2010) and internationally (Rokholm 2010), there is no evidence of a decline, and a high proportion of children remain at risk of morbidity. Physical activity and sedentary behaviour are key variables implicated in childhood obesity due to their influence on energy balance (Rowland 2004). Current physical activity guidelines recommend children between 5 and 18 years of age to engage in at least 60 minutes moderate-to-vigorous physical activity every day (Department of Health 2011). Despite this, children, on average, are insufficiently active (Hills 2011) and engage in excessive sedentary behaviour. Specifically, only 41 percent of boys and 30 percent of girls in Wales meet these recommended guidelines1. Moreover, according to the Department of Health, more than 30 percent of 5 to 12 year old children in the UK are obese, with Wales leading at 36 percent2.
Many interventions have been conducted to reverse childhood overweight and obesity, employing a variety of strategies to enhance levels of habitual physical activity and reduce time spent in sedentary behaviours. Schools have been identified as a key context to implement such physical activity promoting interventions, given that children spend, on average, 40 percent of their waking time there (Fox 2004). Despite this, school-based interventions have been conducted with varied success (Summerbell 2012), which could be attributed to the different intervention strategies and variable methodological quality, such as lack of objective measurements of physical activity (Mountjoy 2011). Furthermore, interventions targeting reduced sedentary behaviour tend to discourage highly valued behaviours, such as engagement with technology. Therefore, there is a need to integrate such technological behaviours into future interventions. Some interventions have sought to do this. Specifically, ambient displays, also known as glanceable displays, which are peripheral, aesthetically pleasing displays of information that support awareness of some data, can be utilised to make information visible in an appealing and socially interactive manner. They are designed to be looked at occasionally without distracting us from our activities (Rogers 2010).Consolvoetala et al. (Consolvo 2008, Consolvo 2008a) integrated an interactive mobile fitness application with a glanceable display finding that those individuals utilising an awareness display maintained their physical activity levels better in comparison to those with no ambient display. However, such devices have inherent problems, such as monitor placement (Trost 2005), and have not been incorporated into a community-based settings, especially targeting children. Therefore, the aim of the present pilot study was to utilise ambient displays in order to provide near real-time visual feedback on physical activity levels during school time.
Since the birth of ubiquitous computing (ubicomp), monitoring health-related behaviour has become more accessible for a wider age group of people. The potentials of the emerging generation of ubicomp technologies are moving beyond step-counting and physiological monitoring to goal-sharing and information provision systems. This section of the paper reviews some prominent ubicomp technologies that have been used to promote physical activity, in particular walking.