The FIT Game: preliminary evaluation of a gamification approach to increasing fruit and vegetable consumption in school.

Objective: Incentive-based interventions designed to increase fruit and vegetable (FV) consumption tend to yield positive, short-term outcomes. Because consumption most often returns to baseline levels when incentives are removed, sustainable long-duration interventions may be needed to impact public health. Anticipating that low-cost interventions will be more appealing to schools, the present study explored a low-cost, game-based intervention.

Method: An alternating-treatments design was used to evaluate the effects of the FIT Game on objectively measured FV consumption in one elementary school (n=251) in Utah. During the Fall 2013 semester, game-based rewards were provided to heroic characters within a fictional narrative read by teachers on days when the school, as a whole, met a fruit or vegetable consumption goal in accord with the alternating-treatments design.

Results: On intervention days, fruit and vegetable consumption increased by 39% and 33%, (p<0.01, p<0.05; binomial tests), respectively. Teacher surveys indicated that students enjoyed the game and grade 1-3 teachers recommended its use in other schools.

Conclusion: This game-based intervention provides a promising step towards developing a low-cost, effective, and sustainable FV intervention that schools can implement without outside assistance.