Higher vegetable intake has been related to lower risks of diabetes, cardiovascular disease, several cancers, and obesity/adiposity later in life. Yet, children are eating vegetables well below recommended amounts. Parents are important influencers on the dietary intake of young children but they commonly report difficulty getting their child to eat vegetables. Food "parenting practices" identify procedures parents implement to maximize the likelihood their child will consume a healthy diet. Some parents require training to use effective food parenting practices, and training through behavioral interventions has been shown effective. Video games are a pervasive and persuasive form of mass communication. Providing engaging experiences that capture and focus a player's attention, video games enable theory-based behavior change to be delivered for maximal effect. Simulations of real world experiences in low risk environments with feedback have proven an effective behavior training procedure. Video games, therefore, offer a compelling intervention mechanism for delivering parenting skill training. Games appear most engaging when they involve a storyline (also called a "narrative"). Narrative is a primary form of human communication and has had significant impact on cognition, affect, and health behavior. Feedback with goal setting is a critical component of adult learning and can be woven into video game play and narrative. Storied video games for parents that simulate interactions with a child, are tailored to child personality, provide feedback on performance, offer goal setting for changing practices in the real world, and address common vegetable feeding problems should produce improved food parenting skills. A single episode prototype video game, Kiddio: Food Fight, was developed to simulate parent-child feeding interactions for parents with 3-5 year-old children. Designed for Apple's iPhone, Kiddio is an interactive story about a parent having trouble getting their young child to taste a vegetable (often the first step in developing a liking to the vegetable). The playr assumes the role of the child's parent, making Kiddio a first person, role-playing training game for effective food parenting. Alpha testing of Kiddio was positive. This proposed research develops and evaluates 24 additional Kiddio episodes, extending the storyline to encompass a wide range of food parenting barriers. Each episode will include five difficulty levels of increasing challenge to enhance entertainment value. Kiddio will be evaluated through a randomized clinical trial to assess possible effects and to rule out confounding variables. Though over 300 parenting iPhone and iPad apps have been identified in the Apple iTunes App Store, none train in food parenting practices. The investigators believe national and international markets exist for mobile video games that both train and entertain. At the end of this proposed research, Kiddio will be available as an inexpensive casual video game app, providing broad access and appeal to young parents.

Public Health Relevance

Higher levels of vegetable intake have been associated with decreased risks of heart disease, diabetes, stroke, certain cancers, and possibly obesity. Unfortunately, American diets for vegetables fall far short of Government recommendations. Kiddio is a smart phone video game that trains parents how to get their child to eat more vegetables.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1-BBBP-V (10))
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Mann Koepke, Kathy M
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Archimage, Inc.
United States
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