Squire's quest! Dietary outcome evaluation of a multimedia game

Background: Fruit, juice, and vegetable (FJV) consumption among children is low. Innovative programs are needed to enable children to increase FJV intake. Psychoeducational multimedia permits the delivery of interventions as designed and capitalizes on known behavior change principles. Design: Elementary school was the unit of recruitment, assignment, and analysis. Twenty-six elementary schools were pair matched on size and percentage of free or reduced-price lunch, and randomly assigned to treatment or control groups. Data were collected just before and just after the program. Sefting/Participants: All fourth-grade students in participating elementary schools were invited to participate. Data were collected on 1578 students. Main Outcome: Servings of fruit, 100% juice, and vegetables consumed. Intervention: Squire's Quest! is a ten-session, psychoeducational, multimedia game delivered over 5 weeks, with each session lasting about 25 minutes. Based on social cognitive theory, educational activities attempted to increase preferences for FJV through multiple exposures and associating fun with their consumption, increase asking behaviors for FJV at home and while eating out, and increase skills in FJV preparation through making virtual recipes. Measures: Four days of dietary intake were assessed before and after the intervention. Assessment was made by the Food Intake Recording Software System (FIRSSt), which conducts a multiple pass, 24-hour dietary intake interview directly with the children. Results: Children participating in Squire's Quest! increased their FJV consumption by 1.0 servings more than the children not receiving the program. Conclusions: Psychoeducational multimedia games have the potential to substantially change dietary behavior. More research is warranted.