Comparison of the Effect of School-Based Game and Training Intervention on Overweight and Obese Students on Weight Loss: A Randomized Controlled Trial
Yıl 2024,
, 47 - 57, 25.03.2024
Cahide Çevik
,
Özlem Örsal
,
Salvatore Amaro
Öz
Objective: The aim of this study was to compare the effects of the Kaledo game and the nutrition training designed according to the health belief model on weight loss, nutritional self-efficacy, attitude and behaviour in overweight and obese students.
Methods: This study was a randomized controlled trial. There were three groups in the study: game (n=38), training (n=35), and control (n=53). At the beginning and end of the study, the height and weight of the participants were measured in all three groups, and body mass index values were calculated and scales were applied.
Results: The BMI z-score values were found to be lower in the training group after the training than before (P<0.05). While there was no significant difference in nutritional attitude scores between the groups, in the in-group evaluations, the students in the game group were found to display a more positive nutrition attitude after the game intervention than before (P<0.05).
Conclusion: The BMI z scores of the students decreased after the training. The students had a more positive nutrition attitude after the game. There is a need for experimental studies with a longer duration, larger sample, which can more clearly reveal the effect of the Kaledo game, and the difference between it and the nutrition training prepared according to Health Belief Model.
Destekleyen Kurum
Eskişehir Osmangazi University Scientific Research Projects Coordination Unit
Teşekkür
This research was supported by Eskişehir Osmangazi University Scientific Research Projects Coordination Unit
Kaynakça
- 1. Albataineh SR, Badran EF, Tayyem RF. Overweight and obesity in childhood: dietary, biochemical, inflammatory and lifestyle risk factors. Obesity Medicine. 2019;15:100112. https://doi.org/10.1016/j.obmed.2019.100112
- 2. Moxley E, Habtzghi D, Klinkhamer N, et al. Prevention and treatment of pediatric obesity: a strategy involving children, adolescents and the family for improved body composition. Journal of Pediatric Nursing. 2019;45:13–19. https://doi.org/10.1016/j.pedn.2018.12.010.
- 3. Güngör NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol. 2014;6(3):129-143. DOI:10.4274/jcrpe.1471
- 4. Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92(2):251-265 http://dx.doi.org/10.1016/j.mayocp.2016.09.017
- 5. Gözüm S, Çapık C. Sağlık davranışlarının geliştirilmesinde bir rehber: Sağlık İnanç Modeli. DEUHYO ED. 2014;7(3): 230-237. http://deuhyoedergi.org/index.php/DEUHYOED/article/view/103/355
- 6. Kusuma GP, Wigati EK, Utomo Y, et al. Analysis of gamification models in education using MDA framework. Procedia Computer Science. 2018;135:385-392. DOI: 10.1016/j.procs.2018.08.187
- 7. Alsaleh N, Alnanih R. Gamification-based behavioral change in children with diabetes mellitus. Procedia Computer Science. 2020;170:442-449. DOI: 10.1016/j.procs.2020.03.087.
- 8. Amaro S, Viggiano A. Costanzo AD, et al. Kalèdo, a new educational board-game, gives nutritional rudiments and encourages healthy eating in children: A pilot cluster randomized trial. Eur J Pediatr. 2006;165: 630–635.DOI10.1007/s00431-006-0153-9 https://link.springer.com/content/pdf/10.1007/s00431-006-0153-9.pdf
- 9. Viggiano A, Viggiano A, Andreozzi E, et al. Kaledo, a board game for nutrition education of children and adolescents at school: cluster randomized controlled trial of healthy lifestyle promotion. Eur J Pediatr. 2015;174: 217–228. DOI 10.1007/s00431-014-2381-8
- 10. Viggiano E, Viggiano A, Costanzo AD. et al. Healthy lifestyle promotion in primary schools through the board game Kaledo: a pilot cluster randomized trial. Eur J Pediatr. 2018;177: 1371–1375 https://doi.org/10.1007/s00431-018-3091-4.
- 11. Şen M, Uzuner A, Akman M. Examination of a board game approach to children’s involvement in family-based weight management vs. traditional family-based behavioral counseling in primary care. Eur J Pediatr. 2018;177:1231–1238.
- 12. World Health Organization: https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age Date of access: 13.01.2021.
- 13. Neyzi O, Günöz H, Furman A. et al. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri [Body weight, height, head circumference and body mass index reference values in Turkish children] Çocuk Sağlığı ve Hastalıkları Dergisi. 2008;51: 1-14. ISSN 0010-0161
- 14. Parcel GS, Edmundson E, Perry CL. Measurement of self-efficacy for diet-related behaviors among elemantary school children. Journal of School Health. 1995;65(1):23-27. doi: 10.1111/j.1746-1561.1995.tb03335.x.
- 15. Edmundson E, Parcel GS, Perry CL. et al. The effect of the child and adolescent trial for cardiovascular health intervention on psychosocial determinants of cardiovascular disease risk behavior among third- grade students. American Journal of Health Promotion.1996; 10 (3): 217-225. doi: 10.1006/pmed.1996.0076
- 16. Öztürk Haney M, Erdoğan S. Factors related to dietary habits and body mass index among Turkish school children: a cox's ınteraction model-based study. Journal of Advanced Nursing. 2013;69(6):1346-56. doi:10.1111/j.1365-2648.2012.06126.x
- 17. Arvidson C. Children’s cardiovascular health promotion attitude scale: an ınstrument development. Unpublished Doctoral Dissertation, Texas Woman’s University, Denton, TX, USA.1990.
- 18. Öztürk Haney M, Bahar Z. Childrens’ cardiovascular health promotion attitude scale’s validity and reliability. E-Journal of Dokuz Eylul University Nursing Faculty. 2014;7(2): 92-97. e-ISSN: 2149-0333.
- 19. Huang B, Hew KF. Implementing a theory-driven gamification model in higher education flipped courses: effects on out-of-class activity completion and quality of Artifacts. Computers & Education. 2018;125:254-272. https://doi.org/10.1016/j.compedu.2018.06.018
- 20. Moore-Burley J, Pawloski-Renee L, Goldberg P, et al. Childhood obesity study: A pilot study of the effect of the nutrition education program color my pyramid. J Sch Nurs. 2009;25(3):230-9. https://doi.org/10.1177/1059840509333325
- 21. Karataş E. Eğitimde oyunlaştırma: araştırma eğilimleri. KEFAD. 2014;15(2): 315-333.
- 22. Kansu AF, Hızlı Sayar G. Öz yeterlik, yaşam anlamı ve yaşam bağlılığı kavramları üzerine bir inceleme. Etkileşim. 2018; 1(1): 78-89.
- 23. Sharma SV, Shegog R, Chow J, et al. Effects of the quest to lava mountain computer game on dietary and physical activity behaviors of elementary school children: A pilot group-randomized controlled trial. Journal of the Academy of Nutrition and Dietetics. 2015; 115(8):1261-1271. http://dx.doi.org/10.1016/j.jand. 2015.02.022.
- 24. Schneider KL, Ferrara J, Lance B. Acceptability of an online health videogame to improve diet and physical activity in elementary school students: ‘‘fitter critters’’ games. For Health Journal: Research, Development, and Clinical Applications. 2012;1(4): 262-268. DOI: 10.1089/g4h.2012.0009
- 25. Scott CL, Haycraft E, Plateau CR. Teammate influences on the eating attitudes and behaviours of athletes: A systematic review. Psychology of Sport & Exercise.2019;43: 183–194. https://doi.org/10.1016/j.psychsport.2019.02.006.
- 26. Rucker DD. Attitudes and attitude strength as precursors to object attachment. Current Opinion in Psychology, 2021;39:38–42. https://doi.org/10.1016/j.copsyc. 2020.07.009.
- 27. Kaplan Laço S, Aytekin Özdemir A. Çocuklarda bilgisayar destekli eğitimin kalp sağlığını geliştirme tutumlarına etkisi. JICAH 2023; 3(3) 176-187. DOI: 10.5281/zenodo.10431278
- 28. Yien JM, Hung CM, Hwang GJ, et al. A Game-based learning approach to ımproving students’ learning achievements ın a nutrition course. TOJET. 2011;10:2. https://files.eric.ed.gov/fulltext/EJ932220.pdf.
- 29. Chow CY, Riantiningtyas RR, Kanstrup MB, et al. Can games change children’s eating behaviour? A review of gamification and serious games. Food Quality and Preference. 2020;80: 103823. https://doi.org /10.1016/j.foodqual.2019.103823
- 30. Orji R, Vassileva J, Mandryk RL. LunchTime: a slow-casual game for long-term dietary behavior change. Pers Ubiquit Comput. 2013;17:1211–1221. DOI 10.1007/s00779-012-0590-6
Fazla Kilolu ve Obez Öğencilere Okul Temelli Oyun ve Eğitim Müdahalesinin Kilo Vermeye Etkisinin Karşılaştırılması: Randomize Kontrollü Deneysel Bir Çalışma
Yıl 2024,
, 47 - 57, 25.03.2024
Cahide Çevik
,
Özlem Örsal
,
Salvatore Amaro
Öz
Amaç: Fazla kilolu ve obez çocuklarda Kaledo oyununun ve sağlık inanç modeline göre hazırlanmış beslenme eğitiminin kilo vermeye beslenme özyeterliğine, tutumuna ve davranışına etkisini karşılaştırmaktır.
Yöntemler: Bu araştırma randomize kontrollü deneysel çalışmadır. Araştırmada oyun (n=38), eğitim (n=35) ve kontrol (n=53) olmak üzere üç grup yer aldı. Araştırma başlangıcında, oyun ve eğitim müdahalelerin sonunda her üç grupta boy ve kilo ölçümleri yapılarak beden kitle indeksi değerleri hesaplandı ve ölçekler uygulandı.
Bulgular: Beden kitle indeksi z skoru değerlerinin eğitim grubunda eğitim sonrasında öncesine göre daha düşük olduğu tespit edildi (P<0,05). Beslenme tutum puanları gruplar arası farklılık göstermezken, grup içi değerlendirmelerde oyun grubundaki öğrencilerin oyun müdahalesi sonrası öncesine göre daha olumlu beslenme tutumu sergilediği tespit edildi (P<0,05).
Sonuç : Eğitim sonrasında öğrencilerin BKİ z puanlarında düşüş gözlendi. Oyun sonrası öğrenciler daha olumlu beslenme tutumuna sahip olmuştur. Kaledo oyununun etkisini ve Sağlık İnanç Modeli'ne göre hazırlanan beslenme eğitimi ile arasındaki farkı daha net ortaya koyabilecek daha uzun süreli, daha geniş örneklemli deneysel çalışmalara ihtiyaç
vardır.
Kaynakça
- 1. Albataineh SR, Badran EF, Tayyem RF. Overweight and obesity in childhood: dietary, biochemical, inflammatory and lifestyle risk factors. Obesity Medicine. 2019;15:100112. https://doi.org/10.1016/j.obmed.2019.100112
- 2. Moxley E, Habtzghi D, Klinkhamer N, et al. Prevention and treatment of pediatric obesity: a strategy involving children, adolescents and the family for improved body composition. Journal of Pediatric Nursing. 2019;45:13–19. https://doi.org/10.1016/j.pedn.2018.12.010.
- 3. Güngör NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol. 2014;6(3):129-143. DOI:10.4274/jcrpe.1471
- 4. Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92(2):251-265 http://dx.doi.org/10.1016/j.mayocp.2016.09.017
- 5. Gözüm S, Çapık C. Sağlık davranışlarının geliştirilmesinde bir rehber: Sağlık İnanç Modeli. DEUHYO ED. 2014;7(3): 230-237. http://deuhyoedergi.org/index.php/DEUHYOED/article/view/103/355
- 6. Kusuma GP, Wigati EK, Utomo Y, et al. Analysis of gamification models in education using MDA framework. Procedia Computer Science. 2018;135:385-392. DOI: 10.1016/j.procs.2018.08.187
- 7. Alsaleh N, Alnanih R. Gamification-based behavioral change in children with diabetes mellitus. Procedia Computer Science. 2020;170:442-449. DOI: 10.1016/j.procs.2020.03.087.
- 8. Amaro S, Viggiano A. Costanzo AD, et al. Kalèdo, a new educational board-game, gives nutritional rudiments and encourages healthy eating in children: A pilot cluster randomized trial. Eur J Pediatr. 2006;165: 630–635.DOI10.1007/s00431-006-0153-9 https://link.springer.com/content/pdf/10.1007/s00431-006-0153-9.pdf
- 9. Viggiano A, Viggiano A, Andreozzi E, et al. Kaledo, a board game for nutrition education of children and adolescents at school: cluster randomized controlled trial of healthy lifestyle promotion. Eur J Pediatr. 2015;174: 217–228. DOI 10.1007/s00431-014-2381-8
- 10. Viggiano E, Viggiano A, Costanzo AD. et al. Healthy lifestyle promotion in primary schools through the board game Kaledo: a pilot cluster randomized trial. Eur J Pediatr. 2018;177: 1371–1375 https://doi.org/10.1007/s00431-018-3091-4.
- 11. Şen M, Uzuner A, Akman M. Examination of a board game approach to children’s involvement in family-based weight management vs. traditional family-based behavioral counseling in primary care. Eur J Pediatr. 2018;177:1231–1238.
- 12. World Health Organization: https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age Date of access: 13.01.2021.
- 13. Neyzi O, Günöz H, Furman A. et al. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri [Body weight, height, head circumference and body mass index reference values in Turkish children] Çocuk Sağlığı ve Hastalıkları Dergisi. 2008;51: 1-14. ISSN 0010-0161
- 14. Parcel GS, Edmundson E, Perry CL. Measurement of self-efficacy for diet-related behaviors among elemantary school children. Journal of School Health. 1995;65(1):23-27. doi: 10.1111/j.1746-1561.1995.tb03335.x.
- 15. Edmundson E, Parcel GS, Perry CL. et al. The effect of the child and adolescent trial for cardiovascular health intervention on psychosocial determinants of cardiovascular disease risk behavior among third- grade students. American Journal of Health Promotion.1996; 10 (3): 217-225. doi: 10.1006/pmed.1996.0076
- 16. Öztürk Haney M, Erdoğan S. Factors related to dietary habits and body mass index among Turkish school children: a cox's ınteraction model-based study. Journal of Advanced Nursing. 2013;69(6):1346-56. doi:10.1111/j.1365-2648.2012.06126.x
- 17. Arvidson C. Children’s cardiovascular health promotion attitude scale: an ınstrument development. Unpublished Doctoral Dissertation, Texas Woman’s University, Denton, TX, USA.1990.
- 18. Öztürk Haney M, Bahar Z. Childrens’ cardiovascular health promotion attitude scale’s validity and reliability. E-Journal of Dokuz Eylul University Nursing Faculty. 2014;7(2): 92-97. e-ISSN: 2149-0333.
- 19. Huang B, Hew KF. Implementing a theory-driven gamification model in higher education flipped courses: effects on out-of-class activity completion and quality of Artifacts. Computers & Education. 2018;125:254-272. https://doi.org/10.1016/j.compedu.2018.06.018
- 20. Moore-Burley J, Pawloski-Renee L, Goldberg P, et al. Childhood obesity study: A pilot study of the effect of the nutrition education program color my pyramid. J Sch Nurs. 2009;25(3):230-9. https://doi.org/10.1177/1059840509333325
- 21. Karataş E. Eğitimde oyunlaştırma: araştırma eğilimleri. KEFAD. 2014;15(2): 315-333.
- 22. Kansu AF, Hızlı Sayar G. Öz yeterlik, yaşam anlamı ve yaşam bağlılığı kavramları üzerine bir inceleme. Etkileşim. 2018; 1(1): 78-89.
- 23. Sharma SV, Shegog R, Chow J, et al. Effects of the quest to lava mountain computer game on dietary and physical activity behaviors of elementary school children: A pilot group-randomized controlled trial. Journal of the Academy of Nutrition and Dietetics. 2015; 115(8):1261-1271. http://dx.doi.org/10.1016/j.jand. 2015.02.022.
- 24. Schneider KL, Ferrara J, Lance B. Acceptability of an online health videogame to improve diet and physical activity in elementary school students: ‘‘fitter critters’’ games. For Health Journal: Research, Development, and Clinical Applications. 2012;1(4): 262-268. DOI: 10.1089/g4h.2012.0009
- 25. Scott CL, Haycraft E, Plateau CR. Teammate influences on the eating attitudes and behaviours of athletes: A systematic review. Psychology of Sport & Exercise.2019;43: 183–194. https://doi.org/10.1016/j.psychsport.2019.02.006.
- 26. Rucker DD. Attitudes and attitude strength as precursors to object attachment. Current Opinion in Psychology, 2021;39:38–42. https://doi.org/10.1016/j.copsyc. 2020.07.009.
- 27. Kaplan Laço S, Aytekin Özdemir A. Çocuklarda bilgisayar destekli eğitimin kalp sağlığını geliştirme tutumlarına etkisi. JICAH 2023; 3(3) 176-187. DOI: 10.5281/zenodo.10431278
- 28. Yien JM, Hung CM, Hwang GJ, et al. A Game-based learning approach to ımproving students’ learning achievements ın a nutrition course. TOJET. 2011;10:2. https://files.eric.ed.gov/fulltext/EJ932220.pdf.
- 29. Chow CY, Riantiningtyas RR, Kanstrup MB, et al. Can games change children’s eating behaviour? A review of gamification and serious games. Food Quality and Preference. 2020;80: 103823. https://doi.org /10.1016/j.foodqual.2019.103823
- 30. Orji R, Vassileva J, Mandryk RL. LunchTime: a slow-casual game for long-term dietary behavior change. Pers Ubiquit Comput. 2013;17:1211–1221. DOI 10.1007/s00779-012-0590-6