title: The FIT Game III: Reducing the Operating Expenses of a Game-Based Approach to Increasing Healthy Eating in Elementary Schools.
abstract: OBJECTIVE
  Previously published versions of the healthy eating "FIT Game" were administered by teachers in all grades at elementary schools. The present study evaluated whether the game would retain its efficacy if teachers were relieved of this task; presenting instead all game materials on visual displays in the school cafeteria.
  
  
  METHODS
  Participants were 572 children attending two Title 1 elementary schools (grades K-5). Following a no-intervention baseline period in which fruit and vegetable consumption were measured from food waste, the schools played the FIT Game. In the game, the children's vegetable consumption influenced events in a good versus evil narrative presented in comic book-formatted episodes in the school cafeteria. When daily vegetable-consumption goals were met, new FIT Game episodes were displayed. Game elements included a game narrative, competition, virtual currency, and limited player autonomy. The two intervention phases were separated by a second baseline phase (within-school reversal design). Simulation Modeling Analysis (a bootstrapping technique appropriate to within-group time-series designs) was used to evaluate whether vegetable consumption increased significantly above baseline levels in the FIT Game phases (P < 0.05).
  
  
  RESULTS
  Vegetable consumption increased significantly from 21.3 g during the two baseline phases to 42.5 g during the FIT Game phases; a 99.9% increase. The Game did not significantly increase fruit consumption (which was not targeted for change), nor was there a decrease in fruit consumption.
  
  
  CONCLUSIONS
  Labor-reductions in the FIT Game did not reduce its positive impact on healthy eating.
authors.affiliation: 1 Department of Nutrition, Dietetics, and Food Sciences, Utah State University , Logan, Utah.
authors.forename: Damon
authors.initials: D
authors.lastname: Joyner
authors.affiliation: 1 Department of Nutrition, Dietetics, and Food Sciences, Utah State University , Logan, Utah.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Wengreen
authors.affiliation: 1 Department of Nutrition, Dietetics, and Food Sciences, Utah State University , Logan, Utah.
authors.forename: Sheryl S
authors.initials: SS
authors.lastname: Aguilar
authors.affiliation: 2 Department of Health Science, Brigham Young University , Provo, Utah.
authors.forename: Lori Andersen
authors.initials: LA
authors.lastname: Spruance
authors.affiliation: 3 Schell Games, Pittsburgh, Pennsylvania.
authors.forename: Brooke A
authors.initials: BA
authors.lastname: Morrill
authors.affiliation: 4 Department of Psychology, Utah State University , Logan, Utah.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Madden
mesh_terms: D002648:Child; D002675:Child, Preschool; D000072001:Diet, Healthy / Q000523:psychology / Q000706:statistics & numerical data*; D004467:Economics / Q000706:statistics & numerical data*; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D005518:Food Preferences; D005638:Fruit / Q000600:supply & distribution; D005717:Games, Experimental; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D012572:School Health Services / Q000592:standards*; D014675:Vegetables / Q000600:supply & distribution; D018910:Video Games / Q000523:psychology* / Q000706:statistics & numerical data / Q000600:supply & distribution
keywords: Children; Consumption; Fruit and vegetable; Nutrition; School-based intervention