Caregiver Praise + Gamification for Healthy Nutrition

Overseen By Hollie Raynor, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: The University of Tennessee, Knoxville

Disqualifiers: Major psychiatric diseases, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 4 weeks

80 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how digital tools with positive reinforcement, such as praise and gamification, can help children aged 8-12 improve their eating habits. Participants will track their daily intake of fruits, vegetables, and snacks using a digital log. Some will receive praise from caregivers or interact with a virtual pet. The trial aims to determine if these methods make dietary tracking more engaging and effective. This approach, called Enhancing Child Dietary Self-monitoring, focuses on making healthy eating habits more appealing to children. Families with children who frequently eat from at least two of the targeted food groups and have reliable internet access might be a good fit. As an unphased trial, this study offers families the opportunity to contribute to innovative research that could make healthy eating more enjoyable and effective for kids.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this digital dietary self-monitoring log is safe for children?

Research has shown that when caregivers praise children for their eating habits, it encourages them to try new foods and improve their overall diet. Studies indicate that positive parenting and caregiver praise help children eat better and maintain a healthier weight.

Researchers are also studying gamification, which uses game-like elements such as points and virtual pets, to encourage kids to pay attention to their diets. Research suggests that gamification engages children and positively influences their eating habits. For example, interacting with a virtual pet has motivated kids to change their behavior.

Both caregiver praise and gamification are generally well-received because they focus on positive reinforcement. They do not involve medications or physical treatments, making them safe options for promoting healthy eating habits in children. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the "Caregiver Praise + Gamification for Healthy Nutrition" trial because it explores innovative ways to encourage better eating habits in children. Unlike standard methods that might focus solely on education or dietary guidelines, this trial combines self-monitoring with engaging strategies like caregiver praise and gamification. The introduction of a virtual pet that evolves as kids log their food intake adds an element of fun and motivation, making the process more interactive and rewarding. By involving caregivers in a daily praise routine, the trial also aims to strengthen positive reinforcement, which could lead to more consistent healthy eating behaviors in children. This approach could offer a fresh perspective on promoting nutrition, potentially making it more effective and sustainable for families.

What evidence suggests that this trial's treatments could be effective for enhancing child dietary self-monitoring?

Research has shown that incorporating game-like elements in tracking children's diets can increase their interest. In this trial, one group of participants will use a virtual pet that evolves as they log their food intake, earning points and reaching new levels. Different studies have shown this approach helps keep kids focused on healthy eating. Another group will receive praise from caregivers, which, although less frequently studied, can also motivate children by encouraging good habits. Together, these methods aim to make healthy eating more enjoyable and rewarding for children. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for families with children aged 8-12 who are overweight or obese and regularly consume foods from at least two of the following groups: fruits, vegetables, sweet/salty snacks, and sugary drinks. They must have reliable internet access and an adult caregiver willing to participate.

Inclusion Criteria

Your family can easily use the internet on a phone, computer, or other device that your child is allowed to use.

My child is 8-12 years old, overweight, and we eat certain unhealthy foods regularly.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (virtual)

Orientation and Baseline Assessment

Families attend an orientation session, complete consent/assent, and baseline assessment measures

1 week

1 visit (in-person)

Treatment

Children self-monitor their dietary intake using a digital log with positive reinforcement strategies for 4 weeks

4 weeks

Daily self-monitoring

Follow-up

Participants complete follow-up assessments and receive feedback on dietary intake

1 week

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Enhancing Child Dietary Self-monitoring

Trial Overview The study tests a digital dietary self-monitoring log that encourages kids to track their food intake using praise from caregivers and game-like features. Children will be randomly placed in one of four groups to see which method boosts engagement in healthy eating habits.

How Is the Trial Designed?

Group I: PRAISE+GAME Experimental Treatment 2 Interventions

In addition to conditions of the BASIC group, caregivers will also be asked to provide praise to their child for engaging in DSM over the 4 weeks. Additionally, when the caregiver completes caregiver check-ins in the DSM log, they will receive a prompt to also complete a praise check-in. The child's log will also include a virtual pet that evolves over time as he/she uses the log. As the child earns points, the pet will level up and grow over time.

Group II: PRAISE Experimental Treatment 1 Intervention

In addition to conditions of the BASIC group, caregivers will also be asked to provide praise to their child for engaging in DSM over the 4 weeks. Additionally, when the caregiver completes caregiver check-ins in the DSM log, they will receive a prompt to also complete a praise check-in.

Group III: GAME Experimental Treatment 1 Intervention

In addition to the conditions of the BASIC group, the child's log will also include a virtual pet that evolves over time as he/she uses the log. As the child earns points, the pet will level up and grow over time.

Group IV: BASIC Active Control 1 Intervention

Children will be asked to track their intake of fruits, vegetables, sweet and salty snack foods, and sugary drinks in the web-based dietary self-monitoring (DSM) log for 4 weeks. Each child will be provided with a personal URL to access their log, which can be accessed from any internet-capable device (computer, phone, etc.). Caregivers will be asked to review their child's log each day and complete a caregiver check-in in the DSM log.

Who Is Running the Clinical Trial?

The University of Tennessee, Knoxville

Lead Sponsor

Trials

93

Recruited

19,500+

Published Research Related to This Trial

A study involving 32 young adults revealed that a gamified smartphone app could effectively promote vegetable intake, with participants favoring features like visual guides for tracking vegetable quantities and a simple user interface.

Social media strategies that include appealing food pictures and relatable 'Gen Y' language were found to be the most motivating, suggesting that engaging and visually attractive content is key to encouraging healthier eating habits among young adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring young adult perspectives on the use of gamification and social media in a smartphone platform for improving vegetable intake. Nour, MM., Rouf, AS., Allman-Farinelli, M.[2018]

Fourth grade students who participated in the Squire's Quest! intervention increased their fruit, juice, and vegetable consumption by an average of 1.0 serving per day compared to those in the control group.

The intervention specifically led to significant increases in fruit and 100% fruit juice consumption during snacks and regular vegetable intake at lunch, indicating that targeted meal times can effectively promote healthier eating habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Squire's Quest: intervention changes occurred at lunch and snack meals. Cullen, KW., Watson, K., Baranowski, T., et al.[2015]

Gamification interventions significantly improved children's nutritional knowledge and increased their consumption of fruits and vegetables, as shown in a systematic review of 23 randomized controlled trials.

However, these interventions did not lead to significant changes in body mass index z-scores, indicating that while gamification can enhance knowledge and habits, it may not directly impact weight outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Gamification for the Improvement of Diet, Nutritional Habits, and Body Composition in Children and Adolescents: A Systematic Review and Meta-Analysis. Suleiman-Martos, N., García-Lara, RA., Martos-Cabrera, MB., et al.[2021]

INTAKE24 is an innovative online tool designed for dietary recall that significantly improved user experience and efficiency, reducing the time to complete a dietary recall by nearly half through iterative user feedback from 80 participants aged 11-24.

The tool's design enhancements, such as a simplified interface and improved search functionality, led to better agreement with traditional interviewer-led dietary recalls, indicating its potential effectiveness for large-scale dietary data collection.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Iterative Development of an Online Dietary Recall Tool: INTAKE24. Simpson, E., Bradley, J., Poliakov, I., et al.[2022]

The FIT Game, a no-cost intervention implemented in four elementary schools, significantly increased children's consumption of fruits and vegetables (FV) during an 8-week period, with notable improvements in vegetable and fruit intake and skin carotenoid levels.

These increases in FV consumption were not only significant at the end of the intervention but were also maintained three months later, indicating lasting positive effects without harming children's intrinsic motivation to eat healthily.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial Evaluating the FIT Game's Efficacy in Increasing Fruit and Vegetable Consumption. Wengreen, HJ., Joyner, D., Kimball, SS., et al.[2021]

The study introduces an AI-based app called FRANI, designed to improve dietary data collection and food choices among adolescents in Ghana and Vietnam, addressing the challenges of unhealthy diets in developing countries.

In a pilot study involving 72 adolescents (36 from each country), FRANI's feasibility, acceptability, and usability will be assessed over six weeks, with the potential to enhance nutrition quality and inform future larger trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring adherence, acceptability and likability of an artificial-intelligence-based, gamified phone application to improve the quality of dietary choices of adolescents in Ghana and Vietnam: Protocol of a randomized controlled pilot test. Braga, BC., Arrieta, A., Bannerman, B., et al.[2022]

The study involved 120 children aged 8-13 years who used both the ASA24 and an interviewer-administered recall to assess nutrient intake, showing that child-friendly adaptations to the ASA24 did not significantly alter mean nutrient estimates.

However, the self-administered methods (ASA24 and its child-friendly version) reported significantly higher daily totals for total sugar and vitamin C compared to the interviewer-administered method, suggesting a need to review how dietary information is collected for these nutrients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Simulated adaptations to an adult dietary self-report tool to accommodate children: impact on nutrient estimates. Douglass, D., Islam, N., Baranowski, J., et al.[2021]

A gamification approach in a school-based intervention involving 180 students led to a significant increase in fruit consumption by 66% and vegetable consumption by 44% over 13 school days, demonstrating its effectiveness in promoting healthier eating habits.

Teachers found the intervention practical and enjoyable for students, and parents reported that their children were more willing to try new fruits and vegetables at home, indicating a positive impact beyond the school environment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Gamification of dietary decision-making in an elementary-school cafeteria. Jones, BA., Madden, GJ., Wengreen, HJ., et al.[2022]

Untrained individuals can accurately rate the diet quality of food photos using the Traffic Light Diet (TLD) approach, achieving over 75% accuracy in categorizing foods as red, yellow, or green.

Crowdsourcing feedback from a relatively small number of participants (as few as 15) can provide reliable diet quality ratings, suggesting that this method could effectively reduce the burden of dietary self-monitoring.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Crowdsourcing for self-monitoring: Using the Traffic Light Diet and crowdsourcing to provide dietary feedback. Turner-McGrievy, GM., Wilcox, S., Kaczynski, AT., et al.[2022]

The Food Game intervention successfully engaged high school students in Northern Italy through gamification, promoting peer-led activities and competition, although it did not significantly change adherence to the Mediterranean diet.

While there was no notable improvement in dietary adherence, students showed increased pro-environmental behaviors and positive attitudes towards healthy eating, suggesting the program's potential as a motivational strategy for promoting healthier lifestyles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Process Evaluation of Food Game: A Gamified School-Based Intervention to Promote Healthier and More Sustainable Dietary Choices. Aresi, G., Giampaolo, M., Chiavegatti, B., et al.[2023]

Computer- and web-based interventions can effectively improve eating behaviors and diet-related physical outcomes in children and adolescents, as shown in a systematic review of 15 studies.

To enhance the success of these interventions, strategies such as conducting them in schools and providing individually tailored feedback are beneficial, although long-term maintenance of changes remains a challenge.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computer- and web-based interventions to promote healthy eating among children and adolescents: a systematic review. Hamel, LM., Robbins, LB.[2018]

The pilot study involving 45 children aged 5 to 6 years showed that the digital game 'Veggies4myHeart' effectively increased children's willingness to taste red cabbage and improved overall vegetable preference scores after repeated tasting and education sessions.

Teachers found the game to be an acceptable tool for promoting vegetable consumption in schools, indicating potential for broader implementation, although further research is needed to confirm its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Translating and Testing a Digital Game Promoting Vegetable Consumption in Young Children: Usability Study. Bucher Della Torre, S., Lages, M., Dias, SS., et al.[2023]

Citations

1. mdpi.com mdpi.com/2072-6643/17/21/3341

Enhancing Child Digital Dietary Self-Monitoring via ... Caregiver praise was delivered on 12.2 ± 5.8 of 28 days, whereas gamification was delivered on 20.8 ± 12.3 of 28 days. There were no differences in DSM ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT06193967?term=AL-208&viewType=Table&rank=6

NCT06193967 | Enhancing Child Dietary Self-monitoring The goal of this clinical trial is to test the usability, acceptability, and preliminary efficacy of a digital dietary self-monitoring (dDSM) log that uses ...

3. withpower.com withpower.com/trial/phase-pediatric-obesity-2024-3abfc

Caregiver Praise + Gamification for Healthy Nutrition The goal of this clinical trial is to test the usability, acceptability, and preliminary efficacy of a digital dietary self-monitoring (dDSM) log that uses ...

4. researchgate.net researchgate.net/publication/396868917_Enhancing_Child_Digital_Dietary_Self-Monitoring_via_Positive_Reinforcement_Proof-of-Concept_Trial

Enhancing Child Digital Dietary Self-Monitoring via ... Results: Gamification was implemented significantly more than caregiver praise. Caregiver praise was delivered on 12.2 ± 5.8 of 28 days ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4098019/

Pilot Study Results for a Novel Behavior Plus Nutrition ... This pilot study presents results for a parent-based educational intervention targeting mealtime behaviors plus nutrition among families of young children

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Positive parenting approaches and their association with child ... The focus of this review is to summarize what is known regarding benefits of positive parenting styles and practices for child eating and weight outcomes.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11909764/

Childcare staff feeding practices associated with Children's ... The study examined the associations between childcare staff feeding practices and children's willingness-to-try-new-foods.

8. nesr.usda.gov nesr.usda.gov/sites/default/files/2025-01/Caregiver-feeding-practices_growth-obesity-2025DGACSystematicReview.pdf

Parental and Caregiver Feeding Styles and Practices and Parental Feeding Practices, Child Diet, and Child Body Mass Index. Nurs Res ... caregiver feeding styles and children's food consumption patterns.

9. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/obr.13688

The effectiveness of interventions on changing caregivers' ... We conducted a systematic review and meta-analysis to evaluate the effectiveness of existing interventions targeting caregivers of preschool children.