Published on in Vol 8, No 1 (2022): Jan-Dec

Preprints (earlier versions) of this paper are available at, first published .
Feasibility and Usefulness of Evidence-Based Gaming to Deliver Health Messages to Tweens in a Classroom Setting

Feasibility and Usefulness of Evidence-Based Gaming to Deliver Health Messages to Tweens in a Classroom Setting

Feasibility and Usefulness of Evidence-Based Gaming to Deliver Health Messages to Tweens in a Classroom Setting


1Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States

2Department of Communications, University of Connecticut, Storrs, CT, United States

Corresponding Author:

Valerie B Duffy, PhD, RD

Department of Allied Health Sciences

University of Connecticut

358 Mansfield Road, Box U-1101

Storrs, CT, 06269-1101

United States

Phone: 1 860 486 1997

Fax:1 860 486 5375


Background: Our interdisciplinary team developed a publicly available online game—Eat and Move as I Like (EAMAIL)—for tweens based on the MyPlate evidence-based representation of the Dietary Guidelines.

Objective: We aimed to test the feasibility of using EAMAIL in a classroom setting to promote engagement and self-awareness and motivate healthier diet behaviors in tweens.

Methods: Teachers in one middle school offered EAMAIL on school Chromebooks (institutional review board–approved). The researcher introduced EAMAIL’s login instructions, including nonidentifiable usernames, basic demographics, and home zip codes. Children were instructed to enter EAMAIL’s Story Mode, which had 5 MyPlate-food group levels; children caught healthy foods in color-matching buckets and avoided sweets. Each level delivers informational and motivational messages, asking users to report liking or disliking food groups and making dietary improvements on 7-point facial hedonic scales (from Love it to It’s okay to Hate it). At game completion, children rated the game based on whether it made them want to eat better and play again. Aligned with the Design, Play, and Experience Framework, the researcher made observations to assess child engagement, feelings about the game and the messages, and the motivation to make dietary improvements. Children were encouraged to complete the Story Mode before advancing to Free Play Mode, which had greater game challenges and 15-second interruptions every 2 to 3 minutes to deliver physical activity and health messages. Finally, each child completed a 13-item online survey to assess game-playing experiences, the desire to play again, new knowledge learning, and whether the game motivated healthier behaviors.

Results: EAMAIL was administered to five 30-minute classes involving 54 children (age: mean 11.6 years; female: 75%; White: 58%) and 105 users, and 1187 games were played. By the highest user level reached in Story Mode, 10% of users completed level 1 (Grains), 14% completed level 2 (Vegetables), 11% completed level 3 (Healthier Protein), 17% completed level 4 (Fruits), 15% completed level 5 (Dairy), and 31% completed all levels. Across users’ highest levels, Healthier Protein, on average, was the most liked, and Vegetables was the least liked. Most reported at least Like it to eating more fruits and vegetables (82%), vegetables (73%), healthier protein (79%), fruits (84%), and dairy (80%). All users responded to end-game questions; 64% reported at least Like it to “The game made me want to eat better” and “I would like to play the game again.” These responses were unchanged for most users who completed Story Mode and entered Free Play Mode (n=24); 6 reported worse and 3 reported better. From the postgame online survey, somewhat agreed to strongly agreed was reported by 76% of children with regard to learning about healthy eating and by 50% with regard to the game being fun, the game having positive attributes (pace, challenge, and flow), and whether they would share their game experiences. Researcher observations were consistent with children’s online responses.

Conclusions: EAMAIL appears feasible for teaching tweens in classroom settings about MyPlate, encouraging self-reflection, and motivating healthier eating, with Story Mode maximizing health promotion messages and engagement.

Conflicts of Interest: None declared.

iproc 2022;8(1):e39400



Edited by S Pagoto; This is a non–peer-reviewed article. submitted 09.05.22; accepted 24.06.22; published 08.07.22


©Dana Purcell, Lavar Johnson, Kate Killion, Shane J Sacco, Carolyn A Lin, Valerie B Duffy. Originally published in Iproceedings (, 08.07.2022.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.