Effects of game-based childhood obesity prevention framework among preschool children

This research was carried out to validate a framework of game-based childhoodobesity prevention. A mobile game titled Fight Obesity 2.0 was produced through afive-step gamification approach as an instance of the prevention framework. Thegame incorporated constructive alignment of intended prevention...

Full description

Saved in:
Bibliographic Details
Main Author: Yanzhen, Wang
Format: thesis
Language:eng
Published: 2018
Subjects:
Online Access:https://ir.upsi.edu.my/detailsg.php?det=6314
Tags: Add Tag
No Tags, Be the first to tag this record!
id oai:ir.upsi.edu.my:6314
record_format uketd_dc
institution Universiti Pendidikan Sultan Idris
collection UPSI Digital Repository
language eng
topic RA Public aspects of medicine
spellingShingle RA Public aspects of medicine
Yanzhen, Wang
Effects of game-based childhood obesity prevention framework among preschool children
description This research was carried out to validate a framework of game-based childhoodobesity prevention. A mobile game titled Fight Obesity 2.0 was produced through afive-step gamification approach as an instance of the prevention framework. Thegame incorporated constructive alignment of intended prevention outcomes andstructural game elements. The lean production strategy was deployed to produce aviable serious game with its paratextual materials. The design of the game wasvalidated by 38 game designers through a playtesting session, while the contentknowledge was validated by two pediatricians, one from China and another inMalaysia. The game also passed the age rating test under the International Age RatingCoalition. The effects of Fight Obesity 2.0 in actual prevention context wasinvestigated through a non-equivalent control group pre-test / post-test quasiexperiment.Edumetric tests were conducted with 60 children at the kindergarten inthe National Child Development Research Centre. After having a month of exposureto game playing, the experimental group performed significantly better in the post-testas compared to their performance in the pre-test and the performance of the controlgroup in the post-test. In terms of gender difference, female children performedsignificantly better than the male. Twenty-one null hypotheses were tested to examinethe effects of the game upon childrens food preferences, conception on therelationship between obesity and physical exercise, and the danger of obesity amongchildren. In conclusion, the game was found to be effective in changing the childrensfood preference, from liking unhealthy food to disliking unhealthy food. These resultswere verified by findings revealed through a one-week non-participant observation inthe kindergarten and semi-structured interviews conducted with the kindergartensupervisor. The implication of this research suggest that a serious game (designed anddeveloped based on the framework game-based childhood obesity prevention) canmake significant positive effects in changing the food preferences among preschoolchildren. However, further studies would be needed to examine how the frameworkcan afford preschool children to comprehend the relationship between physicalactivities and obesity, and the danger of childhood obesity.
format thesis
qualification_name
qualification_level Doctorate
author Yanzhen, Wang
author_facet Yanzhen, Wang
author_sort Yanzhen, Wang
title Effects of game-based childhood obesity prevention framework among preschool children
title_short Effects of game-based childhood obesity prevention framework among preschool children
title_full Effects of game-based childhood obesity prevention framework among preschool children
title_fullStr Effects of game-based childhood obesity prevention framework among preschool children
title_full_unstemmed Effects of game-based childhood obesity prevention framework among preschool children
title_sort effects of game-based childhood obesity prevention framework among preschool children
granting_institution Universiti Pendidikan Sultan Idris
granting_department Fakulti Seni, Komputeran dan Industri Kreatif
publishDate 2018
url https://ir.upsi.edu.my/detailsg.php?det=6314
_version_ 1747833255771504640
spelling oai:ir.upsi.edu.my:63142021-10-18 Effects of game-based childhood obesity prevention framework among preschool children 2018 Yanzhen, Wang RA Public aspects of medicine This research was carried out to validate a framework of game-based childhoodobesity prevention. A mobile game titled Fight Obesity 2.0 was produced through afive-step gamification approach as an instance of the prevention framework. Thegame incorporated constructive alignment of intended prevention outcomes andstructural game elements. The lean production strategy was deployed to produce aviable serious game with its paratextual materials. The design of the game wasvalidated by 38 game designers through a playtesting session, while the contentknowledge was validated by two pediatricians, one from China and another inMalaysia. The game also passed the age rating test under the International Age RatingCoalition. The effects of Fight Obesity 2.0 in actual prevention context wasinvestigated through a non-equivalent control group pre-test / post-test quasiexperiment.Edumetric tests were conducted with 60 children at the kindergarten inthe National Child Development Research Centre. After having a month of exposureto game playing, the experimental group performed significantly better in the post-testas compared to their performance in the pre-test and the performance of the controlgroup in the post-test. In terms of gender difference, female children performedsignificantly better than the male. Twenty-one null hypotheses were tested to examinethe effects of the game upon childrens food preferences, conception on therelationship between obesity and physical exercise, and the danger of obesity amongchildren. In conclusion, the game was found to be effective in changing the childrensfood preference, from liking unhealthy food to disliking unhealthy food. These resultswere verified by findings revealed through a one-week non-participant observation inthe kindergarten and semi-structured interviews conducted with the kindergartensupervisor. The implication of this research suggest that a serious game (designed anddeveloped based on the framework game-based childhood obesity prevention) canmake significant positive effects in changing the food preferences among preschoolchildren. However, further studies would be needed to examine how the frameworkcan afford preschool children to comprehend the relationship between physicalactivities and obesity, and the danger of childhood obesity. 2018 thesis https://ir.upsi.edu.my/detailsg.php?det=6314 https://ir.upsi.edu.my/detailsg.php?det=6314 text eng closedAccess Doctoral Universiti Pendidikan Sultan Idris Fakulti Seni, Komputeran dan Industri Kreatif Abt, C. C. (1970). Serious games. Lanham: University Press of America.Adams, E. (2013). Fundamentals of game design (3?? ed.). Berkeley: New Riders, p.20.Akilli, G. K. (2007). Games and simulations: a new approach in education? In: Gibson,D., Aldrich, C. & Prensky, M. ed. Games and simulations in online learning: research and development frameworks. Hershey: Information System Publishing , pp. 1-20.Alamri, A., Hossain, M. A., Hassan, M. M., Hossain, M. S., Alnuem, M., Ahmed, D. T., & Saddik, A.E. (2013). A cloud-based pervasive serious game framework to support obesity treatment.Computer Science and Information Systems, 10(3), 1229-1246.Amarasinghe, A., & DSouza, G. (2012). Individual, social, economic, andenvironmental model: a paradigm shift for obesity prevention. International ScholarlyResearch Network Public Health, 1-10.Aminah, A., Rohani, A., Nani, M., & Jameyah, S. (2013). Modul Pendidik / Pengasuh:Kursus Asuhan & Didikan Awal Kanak-kanak PERMATA Negara. Serdang: Penerbit UPM.Amri, Y. (2010). A conceptual framework for serious games and its validation.[Unpublished PhD Thesis] Southampton: University of Southampton.Anderson, L. A., Prohaska, T. R., & Satariano, W. A. (2015). Prevention. In TheEncyclopedia of Adulthood and Aging. Haboken: John Wiley & Sons, pp. 1-5Annetta, L. (2010). The ?Is? have it: A framework for serious educational game design.Review of General Psychology, 14, 105112.Apovian, C. M., Baker, C., David, S. L., Hopping A. G., Hsu, G., Lenders, C., Pratt, J.S. A, Forse, R. A., OBrien, A., & Tarnoff, M. (2005). Best practice guidelines in pediatric /adolescent weight loss surgery. Obesity A Research Journal, 13(2), 274-282.Aris, I. M., Chen, L., Tint, M. T., Pang, W. W., Soh, S. E., Saw, S., Shek, L. P., Tan,K., Gluckman, P. D., Chong, Y., Yap, F., Godfrey, K. M., Kramer, M. S., & Lee, Y. S. (2017).Body mass index trajectories in the first two years and subsequent childhoodcardio-metabolic outcomes: a prospective multi-ethnic Asian cohort study. Scientific Reports,7(8424), 1-10.Bahagian Pembangunan Kurikulum. (2016). Kurikulum Standard Pra-SekolahKebangsaan. Putrajaya: Kementerian Pendidikan Malaysia.Baos, R. M., Cebolla, A., Oliver, E., Alcaiz, M., & Botella, C. (2013). Efficacy andacceptability of an Internet platform to improve the learning of nutritional knowledgein children: the ETIOBE Mates. Health Education Research, 28(2), 234-248. doi:10.1093/her/cys044Baranowski, T., Baranowski, J., Thompson, D., Buday, R., Jago, R., Griffith, M. J., Islam,N., Nguyen, N., & Watson, K. B. (2010). Video game play, child diet, and physicalactivity behavior change: a randomized clinical trial. American Journal of PreventiveMedicine, 40(1), 33-38.Beasley, N., Sharma, S., Shegog, R., Huber, R., Abernathy, P., Smith, C., & Hoelscher,D. (2012). The Quest to Lava Mountain: using video games for dietary change in children.Journal of the Academy of Nutrition and Dietetics, 112(9), 1334-1336.Bethke, E. (2003). Game development and production. Texas: Wordware Pub.Biggs, J., & Tang, C. (2007). Teaching for quality learning at university: what thestudent does (3?? ed.). Maidenhead: Open University Press.BrainPOP Educators. (n.d.). Oncology lesson plan: cancer identification andtreatment science game. [Online] Retrieved on November 20, 2017 fromhttp://educators.brainpop.com/lesson-plan/oncology-game-cancer-lesson-plan/Bryman, A. (2008). Social research methods (3?? ed.). Oxford: Oxford University Press.Carron, T., & Marty, J-C. (2009). User modelling in learning games. Proceedings of the 3rd EuropeanConference on Games Based Learning, pp. 86-94.Carver, R. P. (1974). Two dimensions of test: psychometric and edumetric, American Psychologist,29, 512-518.Centers for Disease Control and Prevention (2015). Child Development. [Online] Retrieved on January 18, 2016 from:www.cdc.gov/ncbddd/childdevelopment/facts.htmlChandler, H. M. (2006). The Game Production Handbook. Game Development Series, Charles:River Media.Christison, A., & Khan, H. A. (2012). Exergaming for health: a community-based pediatricweight management program using active video gaming. Clinical Pediatrics, 51(4), 382-388.doi: 10.1177/0009922811429480Cohen, L., Manion, L., & Morrison, K. (2007). Research methods in education (6??London: Routledge.Cramer, D. (1998). Fundamental statistics for social research: step-by-stepcalculations and computer techniques using SPSS for Windows. London: Routledge.Cresswell, J. (ed.) (2009). The Oxford Dictionary of Word Origins (2?? ed.). Oxford: OxfordUniversity Press.Creswell, J. W. (2007). Qualitative inquiry and research design: choosing among five approaches(2?? ed.). London: SAGE.Crotty, M. (1998). The foundations of social research: meaning and perspective in the researchprocess. London: SAGE.Daley, A. J. (2009). Can exergaming contribute to improving physical activity levels and healthoutcomes in children? Pediatrics, 124(2), 763-771.Deckelbaum, R. J., & Williams, C. L. (2001). Childhood obesity: the health issues,Obesity Reviews, 9, 239-243De Freitas, S., & Oliver, M. (2006). How can exploratory learning with games and simulationswithin the curriculum be most effectively evaluated? Computer & Education, 46, 249-264.DeMaria, E. J., Murr, M, Byrne, T. K., Blackstone, R., Grant, J. P., Budak, A. &Wolfe, L. (2007). Validation of the obesity surgery mortality risk score in a multicenter studyproves it stratifies mortality risk in patients undergoing gastric bypass for morbidobesity. Annals of Surgery, 246(4), 578-582.Dias, J. D., Tibes, C. M. S., Fonseca, L. M. M, Zem-Mascarenhas, S. H. (2017).Use of seriousgames for coping with childhood obesity: integrative literature review. Texto ContextoEnferm, 26(1), 1-10.Dietz, W. H., & Gortmaker, S. L. (1985). Preventing obesity in children and adolescent.Annual Review of Public Health, 22, 337-353.Dillon, R. (2013). Serious games and fun: an analysis. International Journal ofInnovative Research and Development, 2(5), 1046-1063.Doane, D. P., & Seward, L. E. (2011). Measuring skewness: A forgotten statistic?Journal of Statistics Education, 19(2), 1-18.Elsevier Health Sciences. (2010, December 13). Improving children's diets using behaviorchange video games shows promise. Science Daily. Retrieved on January 25, 2017 fromwww.sciencedaily.com/releases/2010/12/101206201238.htmFogel, V. A., Miltenberger, R. G., Graves, R., & Koehler, S. (2010). The effects of physical activity among inactive children in a physical education classroom. Journal of Applied Behavior Analysis, 43(4), 591-600.doi: 10.1901/jaba.2010.43-591Forslund, A., Staaf, J., Kullberg, J., Ciba, I., Dahlbom, M, & Bergsten, P. (2014).Uppsala Longitudinal Study of Childhood Obesity: Protocol description. Pediatrics, 133(2),386-393.Frankfort-Nachmias, C., Nachmias, D., & DeWaard, J. (2014). Research Methods in the Social Sciences(8?? ed.). Gordonsville: Worth Publishers.Frenn, M., Malin, S., Brown, R. L., Greer, Y., Fox, J., Greer, J., & Smyczek, S.(2005). Changing the tide: An internet/video exercise and low-fat diet obesity prevention withmiddle school students. Applied Nursing Research, 18(1),13 21.Gao, Z., Hannan, P., Stodden, D. F., & Valdez, V. E. (2013). Video game-basedexercise, Latino children's physical health, and academic achievement. American Journal of Preventive Medicine, 44(3), 240-246. doi:10.1016/j.amepre.2012.11.023.Gibson, J. (2014). Introduction to game design, prototyping, and development: from concept toplayable game with Unity and C#. Upper Saddle River: Addision- Wesley, p.144.Gbel, S., & Wiemeyer, J. (Eds.)(2014). Games for training, education, health andsports. Proceedings of the 4?? International Conference on Serious Games. Cham: SpringerInternational Publishing.Goldfield, G. S., Moore, C., Henderson, K., Buchholz, A., Obeid, N., & Flament, M.F. (2010). Body dissatisfaction, dietary restraint, depression, and weight status in adolescents.The Journal of School Health, 80(4), 186-192.Google Play Developer Console. (2016). Google Play Developer DistributionAgreement. [Online] Retrieve on August 29, 2016 fromhttps://play.google.com/about/developer-distribution-agreement.htmlGoran M. I. (2001). Metabolic precursors and effects of obesity in children: A decade of progress,19901999. The American Journal of Clinical Nutrition, 73(2), 158 71.Gortmaker, S. L., Peterson, K, Wiecha, J., Sobol, A. M., Dixit, S., Fox, M. K., &Laird, N. (1999). Reducing obesity via a school-based interdisciplinary obesity prevention amongyouth. Archives of Pediatrics & Adolescent Medicine , 153(4), 40918.Graf, L. D., Pratt, L. V., Hester, C. N., & Short, K. R. (2009). Playing active videogames increases energy expenditure in children. Pediatrics, 124(2), 534-540.Graves, L. E., Ridgers, N. D., Atkinson, G., & Stratton, G. (2010). The effect of activevideo gaming on children's physical activity, behavior preferences and body composition. PediatricExercise Science, 22(4), 535-546.Graves, L., Stratton, G., Ridgers, N., & Cable, N. (2008). Energy expenditure inadolescents playing new generation computer games. British Journal of Sports Medicine, 42, 592594.Gray, D. E. (2009). Doing research in the real world (2?? ed.) London: SAGEPublishing.Guba, E. G. (1990). The paradigm dialog. London: SAGE Publishing.Harvey, K. (ed.) (2014). Encyclopedia of social media and politics. London: SAGE Publishing, p.112.Health Games Research. (2017a). Bronkie the Bronchiasarus. [Online] Retrieved on November 20, 2017 fromhttp://www.healthgamesresearch.org/games/bronkie-the-bronchiasaurusHealth Games Research. (2017b). Hungry Red Planet. [Online] Retrieved on November20, 2017 from http://www.healthgamesresearch.org/games/hungry- red-planetHealth Games Research. (2017c). Packy and Marlon. [Online] Retrieved on November20, 2017 from http://www.healthgamesresearch.org/games/packy- marlonHealth Games Research. (2017d). Zamzee. [Online] Retrieved on November 20, 2017 fromhttp://www.healthgamesresearch.org/games/zamzeeHerndon, C. D., Decambre, M., & McKenna, P. H. (2001). Interactive computer games fortreatment of pelvic floor dysfunction. The Journal of Urology, 166(5), 1893-1898.Heun, R. E.; Heun, L. R., & Schnucker, R. V. (n.d.). Edumetric validation of cognitive style map items and elements: 1. Northeast Missouri State University. [Online] Retrieved October, 29, 2016 fromfiles.eric.ed.gov/fulltext/ED113362.pdfHills, A. P., King, N. A., & Armstrong, T. P. (2007). The contribution of physicalactivity and sedentary behaviours to the growth and development of children and adolescents:implications for overweight and obesity. Sports Medicine. 37(6), 533-545.Hoffman, H. G., Richards, T. L., Bill, A. R., Van Oostrom, T., Magula, J., Seibel, E. J., & Sharar,S. R. (2006). Using fMRI to study the neural correlates of virtualreality analgesia. CNS Spectrums, 11(1), 45-51.Hohmann, L. (2003). Beyond Sofware Architecture Creating and SustainingWinning Solutions. Addison-Wesley Signature Series. Boston: Addison- WesleyProfessional.HopeLab. (2017). Re-Mission 2. [Online] Retrieved on November 20, 2017 fromhttp://www.re-mission2.org/Hunicke, R., LeBlanc, M., & Zubek, R. (2004). MDA: a formal approach to game designand game research. The American Association for Artificial Intelligence Workshop - TechnicalReport. [Online] Retrieved on November 26, 2017 fromhttps://www.cs.northwestern.edu/~hunicke/MDA.pdfHunt, E. F., & Colander, D. C. (2013). Social Science: An introduction to the study of society(15?? ed.). London: Routledge.International Age Rating Coalition. (2016). About IARC. [Online] Retrieved on November 25,2016 from https://www.globalratings.com/about.aspxIrwin, G. L., Siddiqi, A., & Hertzman, C. (2007). Early Child Development: A PowerfulEqualizer (H. E. L. Partnership, Trans.). Vancouver, Canada: World Health Organization, p.38.Kankaanranta, M., & Neittaanmaki, P. (Eds.)(2009). Design and use of serious games.Cham: Springer International Publishing.Kaplan, L. M. (2005). Gastrointestinal management of the bariatric surgery patient.Gastroenterology Clinics of North America, 34, 105-125.Kato, P. M., Cole, S. W., Bradlyn, A. S., & Pollock, B. H. (2008). A video gameimproves behavioral outcomes in adolescents and young adults with cancer: A randomized trial,Pediatrics, 122(2), 305-317.Khoo, Y. K. (2014). Childhood obesity Dr. Alya Hamzah. The Malaysian Medical Gazette. [Online] Retrieved on January 30, 2015 fromhttp://www.mmgazette.com/childhood-obesity-dr-alya-hamzah/Konami [Computer software]. (2009). Tokyo: Nintendo.Kotani, K., Nishida, M., Yamashita, S., Funahashi, T., Fujioka, S., Tokunaga, K.,Ishikawa, K., Tarui, S., & Matsuzawa, Y. (1997). Two decades of annual medicalexaminations in Japanese obese children: Do obese children grow into obese adults? International Journal of Obesity and Related Metabolic Disorders, 21(10), 91221.Krishnan Guru, B. (2005). Data analysis. In: Richardson, S., ed. How to research: a guide for undergraduate and graduate students. Singapore: ThomsonLearning.Landreth, G. L. (2012). Play therapy: the art of the relationship (ed.). London:RoutledgeLee, J., & Liu, M. (2016). Design of fantasy and their effect on learning andengagement in a serious game. In Zheng, R. (ed.) Handbook of Research on Serious Games forEducational Applications. Hershey: IGI Global, pp. 197- 216.Lee, J. J. (2007). Emotion and sense of telepresence: The effects of screen viewpoint,self-transcendence style, and NPC in a 3D game environment. In Jacko, J.A. (ed.) Human-ComputerInteraction. HCI Intelligent Multimodal Interaction Environments. Berlin: Springer BerlinHeidelberg.Lee, Y. X. (2015). Fight Obesity. [Tablet computer game]. Tanjong Malim: Universiti PendidikanSultan Idris Lobstein, T., & Frelut, M. L. (2003). Prevalence of overweight amongchildren in Europe, Obesity Reviews, 4(4), 195200.Levy, L., & Novak, J. (2009). Game development essentials: game QA & testing.Clifton Park: Delmar Cengage.Lison, J. F., Cebolla, A., Guixeres, J., Alvarez-Pitti, J., Escobar, P., Bruno, A., Lurbe, E.,Alcaniz, M., & Banos, R. (2015). Competitive active video games: physiological and psychological responses in children and adolescents. Paediatrics & Child Health, 20(7),373-376.Macionis, J. J. (2013). Sociology (15?? ed.). Upper Saddle River: Pearson.Mkil, T., Hakonen, H., Smed, J., Best, A. (2009). Three approaches towards teachinggame production. In Kankaanranta, M., Neittaanmki, P. (eds.) Design and use of seriousgames. Intelligent systems, control, and automation: Science and Engineering Volume 37. Houten:Springer Netherlands, pp 3-18.Malaysian Qualification Agency. (2015). Standards: masters and doctoral degree.Petaling Jaya: Malaysian Qualification Agency.Manninen, T., Kujanp, T., Vallius, L., Korva, T., & Koskinen, P. (2006). Gameproduction process A preliminary sStudy. Technical Report v1.0.Ludocraft/ELIAS-project.Marfisi-Schottman, I., George, S., & Tarpin-Bernard, F. (2010). Tools and methods for efficientlydesigning serious games. In: Meyer, B., ed. Proceedings of the Fourth European Conference onGames Based Learning, University of Aarhus, Copenhagen, October 2122, Reading: AcademicPublishing Limited, pp. 226-234.Marshall, S., Biddle, S. J. H, Gorely, T., Cameron, N. & Murdey, I. (2004).Relationship between media use, body fatness and physical activity in children and youth: ameta-analysis. International Journal of Obesity, 28(10), 1238- 246.Matsunaga, H. (2007). Wii Fit [Computer software]. Kyoto: Nintendo.McClelland, D. C. (1973). Testing for competence rather than for ?intelligence?,American Psychologist, 28, 1-14.Michael, D. & Chen, S. (2006). Serious games: games that educate, train and inform.Boston: Thomson Course Technology.Milteer, R. M., & Ginsburg, K. R. (2012). The importance of play in promoting healthychild development and maintaining strong parent-child bond: focus on children in poverty.Pediatrics, 129, 2011-2953.Mindes, G. (2014). Social studies for Young Children: Preschool and primary curriculumanchor. Playmouth: Rowman & Littlefield Education.Ministry of Health Malaysia. (2010). Malaysian dietary guidelines. Putrajaya:National Coordinating Committee on Food and Nutrition.Murphy, E. C., Carson, L., Neal, W., Baylis, C., Donley, D., & Yeater, R. (2009). Effectsof an exercise intervention using Dance Dance Revolution on endothelial function and other risk factors in overweight children. International Journal of Pediatric Obesity, 4(4). 205-214. doi:10.3109/17477160902846187.National Institutes of Health. (2002). The practical guide: identification, evaluation, andtreatment of overweight and obesity in adults. Washington D.C.: NIH Publication.Nguyen, B., Kornman, K. P., & Baur, L. A. (2011). A review of electronicinterventions for prevention and treatment of overweight and obesity in young people. ObesityReviews, 12(5), 298314.Niehoff, V. (2009). Childhood obesity: a call to action. Bariatric Nursing and SurgicalPatient Care, 4(1), 17-23.Ningbo Women and Childrens Hospital. (2016). Hospital Introduction. [Online] Retrieved onDecember 28, 2016 from www.nbfeyy.com/english/index.aspOConnor, T., Cooper, R., Fitzgerald, S., Dvorznak, M., Boninger, M., VanSickle, D., & Glass, L.(2000). Evaluation of a manual wheelchair interface to computer games. Neurorehabilitation andNeural Repair, 14, 2130.OConnor, T., Fitzgerald, S., Cooper, R., Thorman, T. A., & Boninger, M.L. (2002). Kinetic andphysiological analysis of the gamewheels system. Journal of Rehabilitation Research &Development, 39(6), 627-634.Orleans, T., & Quinn, B. (2014). Lessons learned from global efforts: Case studychildhood obesity. Durham: National Collaborative in Childhood ObesityResearch.Orry, J. (2009). Wii Fit the UKs best seller of 2009. Retrieved November 25, 2016 from http://www.videogamer.com/wii/mario_kart_wii/news/wii_fit_the_uks_best_seller_ of_2009.htmlPempek, T.A., & Calvert, S.L. (2009). Tipping the balance: use of advergames to promoteconsumption of nutritious foods and beverages by low-income African Americanchildren. Archives of Pediatric and Adolescent Medicine, 163(7), 633-637. doi:10.1001/archpediatrics.2009.71.Perintah Kerajaan Malaysia. (2010). Laws of Malaysia Act 709: Personal Data ProtectionAct 2010. Kuala Lumpur: Percetakan National Malaysia Berhad.Polanco, T. (2016). We have to accept iterative consoles are inevitable. [Online]Retrieve on October 15, 2016 from http://www.geek.com/games/we-have-to-accept-iterative-consoles-are-inevitable-1656483/Popkin, B. M., Adair, L. S. & Ng, S. W. (2014). The global nutrition transition: the pendemic ofobesity in developing countries. Nutrition Reviews, 70(1), 3-21.Poppenk, J.; Kohler, S. & Moscovitch, M. (2010). Revisiting the novelty effect: When familiarity, not novelty, enhances memory. Journal of Experimental Psychology, Learning, Memoryand Cognition, 36(5), 1321-1330.Prensky, M. (2007). Digital game-based learning. Paragon House ed. New York: ParagonHouse.Prensky, M. (2001). Why and how it works: digital game-based learning. New York: McGraw-Hill.Pusat Penyelidikan dan Perkembangan Kanak-kanak Negara (NCDRC) (2016). Polisi dan peraturan Taskadan Tadika NCDRC. Tanjung Malim: NCDRC.Quinn, M. (2011). Introduction of Active Video Gaming Into the Middle School Curriculumas a School-Based Childhood Obesity Intervention. Journal of Pediatric Health Care, 27(1),3-12.Radon, K., Frbeck, B., Thomas, S., Siegfried, W., Nowak, D., & von Kries, R. (2010). Feasibility of activity-promoting video games among obese adolescents and youngadults in a clinical setting. Journal of Science and Medicine in Sport, 14(1), 42-45. doi:10.1016/j.jsams.2010.07.009Raj, M., Sundaram, K. R., Paul, M., Deepa, A. S., & Kumar, R. K. (2007). Obesity in Indianchildren: time trends and relationship with hypertension, The National Medical Journal of India,20(6), 288-293.Rawana, J. S., Morgan, A. S., Nguyen, H., & Craig, S. G. (2010). The relation between eating- and weight-related disturbances and depression in adolescence: a review. Clinical Child and Family Psychology Review, 13(3),213-230.Reineher, T. (2013). Lifestyle intervention in childhood obesity: changes andchallenges. Nature Reviews. Endocrinology, 9(10), 607-614.Robert, C. W., Jeffrey, A. W., Margaret S. P., Kristy D. S., & William H. D. (1997). Predictingobesity in young adulthood from childhood and parental obesity. The New England Journal ofMedicine, 337(13), 869 73.Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R. & Bhadoria, A. S. (2015). Childhoodobesity: causes and consequences, Journal of Family Medicine and Primary Care, 4(2),187-192.Sallis, J. F., McKenzie, T. L., & Conway, T. L. (2003). Environmental interventions for eatingand physical activity. A randomized controlled trial in middle schools, American Journal ofPreventive Medicine, 24(3), 20917.Sawyer, B., & Smith, P. (2008). Serious Game Taxonomy. [Online] Retrieved November 25, 2016 from: www.seriousgames.org/presentations/serious- games-taxonomy-2008_web.pdf.Sbruzzi, G., Eibel, B., Barbiero, S. M., Petkowicz, R. O., Ribeiro, R. A., Cesa, C. C., Martin, C.C., Marobin, R., Schaan, C. W., Souza, W. B., & Pellanda, L. C. (2013). Educational obesitypreventions in childhood obesity: A systematic review with meta-analysis of randomizedclinical trials. Preventive Medicine, 56(5), 254-264.Seburg, E. M., Olson-Bullis, B. A., Bredeson, D. M., Hayes, M. G., & Sherwood, N.E. (2015). A review of primary care-based childhood obesity prevention and treatment interventions.Current Obesity Reports, 4(2), 157-173.Seefeldt, C., & Castle, S. D. (2013). Social studies for the preschool / primary child(9?? Ed.). Upper Saddle River: Pearson.Seremban Municipal Council. (2016). Hospital. [Online] Retrieved on 12 January 2017 fromhttp://www.mpsns.gov.my/en/node/749Shahrel Nizar, B., Tan, W. H., & Mohammad Zaffwan, I. (2014). Emotional design for games: aframework for player-centric approach in the game design process. International Journalof Multimedia and Ubiquitous Engineering, 9(10), 387-398.Shapiro, S. S., & Wilk, M. B. (1965). An analysis of variance test for normality(complete samples). Biometrika, 52(3/4), 591-611.Shell, J. (2015). The art of game design: a book of lenses (2?? ed.). Boca Ration: CRC ess, p.163.Siegel, S., & Castellan, N. J. (1988). Nonparametric statistics for the behavioralsciences. New York: McGraw-Hill.Sifferlin, A. (2016, July 15). When to eat breakfast, lunch and dinner. Time. [Online] Retrieved November 26, 2016 from http://time.com/4408772/best-times- breakfast-lunch-dinner/Solveig, A. C., Michael R. K., & Venkat Narayan, K. M. (2014). Incidence of childhoodobesity in the United States. The New England Journal of Medicine, 370(5), 403-411.Sun, M., Schutz, Y., & Maffeis, C. (2004). Substrate metabolism, nutrient balance and obesitydevelopment in children and adolescents: A target for intervention? Obesity Reviews, 5(4),1838.Sunders, B., Sim, J., Kinstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., &Jinks, K. (2017). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity, doihttps://doi.org/10.1007/s11135-017-0574-8Sung-Chan, P., Sung, Y. W. & Brown, R. C. (2012). Family-based models for childhoodobesity intervention: a systematic review of randomized controlled trials, Obesity Reviews, 14,265-278.Tan, W. H. (2010). Game-based learning in formal educational contexts: How subject matter expertsand game experts could collaborate to design and develop games. (Unpublished PhD thesis).Coventry: University of Warwick.Tan, W. H. (2013). Teaching creativity in Design Aesthetics: an introspection of auniversity lecturer. The Proceedings of the International Conference on Informatics andCreative Multimedia (ICICM), pp. 47-52.Tan, W. H. (2015). Gamifikasi dalam Pendidikan: Pembelajaran berasaskan permainan.Tanjong Malim: Penerbit UPSI.Tan, W. H. (2016). The importance of serious games validation and evaluation.Presentation delivered in the Serious Games Association Gamification Day, 17 November 2016,Singapore.Tan, W. H., Lin, C. Y., & Wang, Y. (2013). Mandarin Communication Learning app: A proof-of-conceptprototype of contextual learning. Journal of Research, Policy & Practice of Teachers andTeacher Education, 3(2), 38-48Tan, W. H., Nurul Fazmidar Mohd Noor., & Wang, Y. (2014). Gamification of inventiveprinciples: A case study of TRIZ puzzle game. Proceedings of the International Symposium onSimulation and Serious Games, 23-24 May,Seoul, Republic of Korea, pp. 159-164.Tan, W. H., Nurul Fazmidar Mohd Noor., & Wang, Y. (2016). Inventive problem-solving puzzle game design and development. International Journal of ComputerVision and Robotics, 6(3), 244-252.Tan, W. H., Johnston-Wilder, S., & Neill, S. (2010). Exploring the educational potential of game-based learning through the eyes of game industry practitioners.International Journal of Technology, Knowledge & Society, 6(1), 41-54.Tanofsky-Kraff, M., Yanovski, S. Z., Wilfley, D. E., Marmarosh, C., Morgan, C. M., & Yanovski, J.A. (2004). Eating-disordered behaviors, body fat, and psychopathology in overweight and normal-weight children. Journal of Consulting and Clinical Psychology,72(1), 53-61.Thompson, D. (2014). What serious video games can offer child obesity prevention.JMIR Serious Games, 2(2), e8.Trost, S. G., Sundal, D., Foster, G. D., Lent, M. R., & Vojta, D. (2014). Effects of a pediatricweight management program with and without active video games a randomized trial. JAMA Pediatrics, 168(5), 407-413.doi:10.1001/jamapediatrics.2013.3436Uli, N., Sundararajan, S. & Vuttler, L. (2008). Treatment of childhood obesity.Current Opinion in Endocrinology, Diabetes and Obesity, 15(1), 37-47.UPSI Education Research Laboratory. (2016). Serious game validation services. [Online].Retrieved January 15, 2016 from http://www.uerl.upsi.edu.my/U.S. News and World Report. (2017). Dietary approaches to stop hypertension. [Online]Retrieved November 26, 2017 from https://health.usnews.com/best- diet/dash-dietUSK. (2016). Unterhaltungssoftware Selbstkontrolle. [Online] Retrieved May 15, 2016 fromhttp://www.usk.de/en/Vandelanotte, C., De Bourdeaudhuij, I., Sallis, J. F., Spittaels, H., & Brug, J. (2005). Efficacyof sequential or simultaneous interactive computer-tailored obesity preventions forincreasing physical activity and decreasing fat intake. Annals Behavioral Medicine, 29(2),138146.Vandewater, E., Shim, M., & Caplovitz, A. (2004). Linking obesity and activity level withchildrens television and video game use. Journal of Adolescence, 27, 7185.Vasterling, J., Jenkins, R. A., Tope, D. M., & Burish, T. G. (1993). Cognitivedistraction and relaxation training for the control of side effects due to cancerchemotherapy. Journal of Behavioral Medicine. 16(1), 65-80.Venkatesh, V., & Davis, F. D. (2000). A Theoretical Extension of the TechnologyAcceptance Model: Four Longitudinal Field Studies. Management Science, 46(2), 186-204.Vilozni, D., Barker, M., Jellouschek, H., Heimann, G. & Blau, H. (2001). Aninteractive computer-animated system (SpiroGame) facilitates spirometry in preschool children. American Journal of Respiratory and Critical Care Medicine, 164(12),2200-2205.Wang, J. (29 May, 2014). 62 million people in China obese, sparking fears of?alarming financial burden: China has the fourth greatest increase in childhoodobesity. South China Morning Post (Hong Kong Ed.). [Online] Retrieved January 15, 2015 fromhttp://www.scmp.com/lifestyle/health/article/1521011/21-billion-people-are-obese-china-and-us-among-worlds-fattest-newWareham, J. N., Van, S. E., & Ekeleund, U. (2005). Physical activity and obesityprevention: A review of the current evidence. The Proceedings of the Nutrition Society, 64(2),22947.Westera, W., Nadolski, R. J., Hummel, H. G. K., & Wopereis, I. G. J. H. (2008).Serious games for higher education: A framework for reducing design complexity.Journal of Computer Assisted Learning, 24(5), 420-432.Widman, L., McDonald, C., & Abresch, T. (2006). Effectiveness of an upper extremity exercise device integrated with computer gaming for aerobic training in adolescentswith spinal cord dysfunction. Journal of Spinal Cord Medicine, 29(4), 363370.Wille, N., Bullinger, M., Holl, R., Hoffmeister, U., Mann, R., Goldapp, C., Reinehr, T.,Westenhfer, J., Egmond-Froehlich, A., & Ravens-Sieberer, U. (2010). Health-relatedquality of life in overweight and obese youths: Results of a multicenter study. Healthand Quality of Life Outcomes, 8, 36. http://doi.org/ 10.1186/1477-7525-8-36World Health Organization. (WHO, 2015). Obesity and overweight. [Online] Retrieved on April 8, 2015 fromhttp://www.who.int/mediacentre/factsheets/fs311/en/York, T. (2012). Making lean startup tactics work for games. [Online] Retrieved on May 1, 2013 fromhttps://www.gamasutra.com/view/feature/168647Yong, M. W. (2014). Nutrition Your Life. [Personal computer game]. Tanjong Malim: UniversitiPendidikan Sultan Idris.Zametkin, A. Z., Zoon, C. K., Klein, H. W., Munson, S. (2004). Psychiatric aspects of child andadolescent obesity: a review of the past 10 years. Journal of thedemy of Child and Adolescent Psychiatry, 43(2), 134-150.