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Active Fantasy Sports: Rationale and Feasibility of Leveraging Online Fantasy Sports to Promote Physical Activity

Active Fantasy Sports: Rationale and Feasibility of Leveraging Online Fantasy Sports to Promote... Background: The popularity of active video games (AVGs) has skyrocketed over the last decade. However, research suggests that the most popular AVGs, which rely on synchronous integration between players’ activity and game features, fail to promote physical activity outside of the game or for extended periods of engagement. This limitation has led researchers to consider AVGs that involve asynchronous integration of players’ ongoing physical activity with game features. Rather than build an AVG de novo, we selected an established sedentary video game uniquely well suited for the incorporation of asynchronous activity: online fantasy sports. Objective: The primary aim of this study was to explore the feasibility of a new asynchronous AVG—active fantasy sports—designed to promote physical activity. Methods: We conducted two pilot studies of an active fantasy sports game designed to promote physical activity. Participants wore a low cost triaxial accelerometer and participated in an online fantasy baseball (Study 1, n=9, 13-weeks) or fantasy basketball (Study 2, n=10, 17-weeks) league. Privileges within the game were made contingent on meeting weekly physical activity goals (eg, averaging 10,000 steps/day). Results: Across the two studies, the feasibility of integrating physical activity contingent features and privileges into online fantasy sports games was supported. Participants found the active fantasy sports game enjoyable, as or more enjoyable than traditional (sedentary) online fantasy sports (Study 1: t =4.43, P<.01; Study 2: t =2.09, P=.07). Participants in Study 1 increased 8 9 their average steps/day, t =2.63, P<.05, while participants in Study 2 maintained (ie, did not change) their activity, t =1.57, 8 9 P=.15). In postassessment interviews, social support within the game was cited as a key motivating factor for increasing physical activity. Conclusions: Preliminary evidence supports potential for the active fantasy sports system as a sustainable and scalable intervention for promoting adult physical activity. (JMIR Serious Games 2014;2(2):e13) doi: 10.2196/games.3691 KEYWORDS physical activity; games for health; active video game; exergame; asynchronous; social support; multiplayer; enjoyment; intrinsic motivation; sports http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 1 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al asynchronous AVG may be sedentary while engaging directly Introduction with the gaming interface; the activity occurs asynchronously, (ie, at a different time). While asynchronous AVGs are Background promising for motivating sustained increases in physical activity, Traditional video games have been sedentary in nature, requiring relatively few have been developed (versus synchronous AVGs). small hand or thumb movements and very little physical Several exceptions include the now defunct Ubifit garden [13], exertion. By contrast, active video games (AVGs) (also known Pokewalker, and Gemini [14] games, as well as smartphone as: exergames, exertainment, or active gaming), link integrated game applications like Nike+’s NikeFuel Missions, participants’ physical activity to various aspects of video game and Six to Start’s Zombies Run! series; but to the best of our play, thereby promoting greater physical exertion. In 2011, the knowledge, no rigorous empirical tests of these asynchronous American Heart Association published a science panel AVGs have been published. proceedings report highlighting the promise of AVGs and Although new AVGs could be developed using these theoretical encouraging further research on their efficacy [1]. and empirical strategies, a more economical alternative approach Unfortunately, active video games have to this point proven is to integrate physical activity into sedentary video (or online) relatively limited in their effectiveness. In particular, empirical games that have proven appeal. Currently, one of the most tests of active video games that link players’ physical activity popular and enduring online games among adults in North with game features in real-time (ie, synchronously) have only America are variations of a game platform collectively referred minimally and temporarily increased physical activity [2]. to as fantasy sports. Further, the intensity of the exercise achieved while playing Online Fantasy Sports as a Platform for Building an many of the most popular synchronous active video games (eg, Wii, Kinect, Move) has fallen below the minimal threshold for Asynchronous Active Video Game moderate intensity physical activity [3]. An additional challenge Fantasy sport (also known as rotisserie, roto, or owner is economic; thus far, “neither children nor parents . . . have simulation) is a game that involves participants selecting purchased enough healthy videogames to make it profitable” professional athletes, and earning points based on the real world [2]. performance of those professional athletes. The most common variants of this game involve a group (or league) of participants Theoretical and evidence-based strategies for designing more acting as fantasy team “owners.” Each fantasy team owner drafts effective AVGs have been proposed [1,4,5]. Self-determination and manages a roster of uniquely claimed players over the theory (SDT) is a macro-theory of human motivation that has course of a professional sport season (see Figure 1 in Multimedia been applied to identifying factors that might sustain individuals’ Appendix 1); a typical fantasy “league” might include 8 to 12 motivation in general (eg, in classrooms, the workplace, and in teams, each managed by an individual team owner (see Figure sports) [6], as well as within sedentary video games [5] and 2 in Multimedia Appendix 1). Fantasy team owners have the AVGs specifically [7,8]. SDT postulates that the more often ability to trade, cut, and sign players in a manner analogous to basic psychological needs for autonomy, competence, and the real owners of professional sport teams (see Figure 3 in relatedness are satisfied within a game, the more enjoyable and Multimedia Appendix 1). Online hosts of fantasy sport games satisfying the experience, and thereby more sustainable the provide automated scoring and opportunities for electronically motivation [9]. These three basic psychological needs can be mediated discussion between league owners, including message supported in innumerable ways within games. Games can boards and direct messaging (see Figure 4 in Multimedia support the need for autonomy by providing participants with Appendix 1). opportunities to explore or make choices. When challenges within a game are calibrated to stretch a participant’s ability For a number of reasons, we hypothesized that online fantasy (ie, by optimal challenge), the need for competence is satisfied. sports, a traditionally sedentary online game, might represent Finally, the need for relatedness is supported when people feel a gaming platform uniquely well suited to supporting a scalable, connected to others, which can occur with fictional characters sustainable AVG for increasing physical activity. First, depicted in games, or with real people, as in some multiplayer traditional (sedentary) fantasy sports are extremely popular (>41 video games. Research supporting the integration of social million players in the US and Canada, alone), supporting high support into AVGs has been particularly compelling [10], even potential reach [15]. Second, fantasy sports have established with a virtual other or cyber buddy [11]. enduring appeal, supporting prolonged engagement; participants play in leagues that last for several months, and often play Baranowski and colleagues [2] also identified evidence-based season-after-season for multiple years within the same league. factors that might improve the efficacy of AVGs. Inclusion of Popularity and sustained motivation may be related to the ample a meaningful and engaging narrative seems to help sustain opportunities for experiencing psychological need satisfaction engagement with AVGs [12]. Additionally, asynchronous afforded while playing traditional fantasy sports games. (versus synchronous) integration of participant activity with Specifically, this platform provides game players with many game features may elicit more generalizable and sustainable options for customizing their teams in ways that can reflect their changes in physical activity. Asynchronous AVGs integrate identities (e.g., selecting athletes for reasons that include their video game features with activity that takes place when personalities, shared cultural, or regional affiliations), thereby participants are not engaging directly with the gaming interface supporting autonomy need satisfaction; this platform facilitates (eg, through use of an accelerometer that monitors steps over finding leagues that include similarly skilled opponents, thereby the course of an entire day or week). Participants playing an http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 2 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al optimizing challenge, and competence need satisfaction; and Recruitment fantasy sports leagues are social, providing opportunities for Participants were recruited using a convenience sampling interpersonal interaction and relatedness need satisfaction. procedure that involved reaching out to the principle investigator’s online social network. This included inviting Third, traditional fantasy sports already involve a form of individuals with whom the principal investigator had participated asynchronous integration between physical activity (that of in prior traditional fantasy sports leagues. The investigative professional athletes) and game features; as such, fantasy sports team considered a number of potential issues related to using games may be especially well suited to asynchronous integration this form of convenience sampling (e.g., social desirability bias of participants’ physical activity (as recommended by and experimenter demand characteristics), but opted in favor, Baranowski et al [2]. Fourth, the basic features of traditional given the early formative phase of research and low fidelity fantasy sports are in the public domain and thus economically execution that could be offered at this stage. No financial and practically amenable to augmentation. incentives or other compensation were offered in exchange for Fifth, although traditional fantasy sports are sedentary, 13-weeks of participation. thematically these games involve attending to physical activity Inclusion criteria were highly inclusive; participants had to be data generated by professional athletes. Thus, asking individuals over 18 years of age and able to engage in physical activity to attend to their own physical activity data is copasetic with without significant risk of injury. We intentionally did not traditional fantasy sports in terms of attending to data, and exclude individuals who were meeting the recommended amount specifically data related to physical activity. Further, we of physical activity at baseline in order to mirror real-life fantasy hypothesized that the game’s defining theme of professional sports leagues where players have varying levels of fitness; sports would have several potential advantages. For example, these inclusion criteria help maximize ecological validity and activating thoughts related to physical activity (regarding the potential reach of our intervention. professional sports) might prime greater activation of participants’ goals to increase physical activity by virtue of Protocol shared semantic and associative networks. Nonconscious After the nature of the study was explained and participants priming of goals has previously been shown to increase provided their written informed consent, all participants intensions to pursue those goals [16]. Further, fans of completed a set of preintervention questionnaires. A screening professional sports often identify very strongly with professional tool (Physical Activity Readiness Questionnaire, PAR-Q) was sports teams, often fanatically/intensely so, a motivational administered to confirm that the participants were physically dynamic that has previously been effectively leveraged for prepared to increase their physical activity without significantly promoting physical activity among overweight and obese male risking injury; this measure was designed for adults aged 15-69, soccer fans in Europe in the context of an intervention delivered and asks about 7 physical activity risk factors (eg, chest pain, in-person [17]. Relatedly, the strong appeal of professional dizziness, and joint problems) [20]. All participants passing sports, and as such online fantasy sports, to men (approximately screening then received an accelerometer to wear for at least 80% of fantasy sports participants are male; Fantasy Sports 1-week of baseline recording. During the baseline activity Trade Association FSTA, 2013), may be especially recording phase, participants were asked to maintain their advantageous in light of evidence that men have traditionally activity level. Each participant’s baseline activity was been underrepresented in behavioral health interventions [18], subsequently used to set individually calibrated weekly physical and relatively less willing to engage in health-related online activity goals during the 12-week intervention phase. support communities [19]. Those participants who exceeded the recommended The primary purpose of this pilot research was to test the 10,000-steps/day average during the baseline activity recording feasibility of an active fantasy sports intervention. We tested phase (n=3) were asked to maintain their baseline average each this in the context of two studies, using two versions that were week during the 12-week intervention phase. This policy was focused on different sports (baseball and basketball). Feasibility instituted as a conservative precautionary measure to ensure the was assessed in terms of participants’ self-reported satisfaction safety of our participants, as well as to purposely deemphasize with the game overall and with specific features. An exploratory the value of excessive activity. Those participants who fell short aim of this research tested whether participants increased their of the recommended 10,000-steps/day average during the physical activity while playing the game, as objectively assessed baseline activity recording phase were asked to increase their by accelerometers. activity by 10% each week, up until their weekly goal became 10,000 steps/day and was capped at that level. Methods During the 12-week intervention phase, participants competed Study 1: Active Fantasy Baseball in a fantasy baseball league hosted by Yahoo. The principle investigator, serving as league commissioner, managed Overview game-related consequences using the league commissioner tools To test the feasibility of the proposed active fantasy sports provided by Yahoo (and standard to other major online fantasy system, we conducted a 13-week proof-of-concept field study sport hosts, including ESPN and CNNSI) once a week. from April to June 2013. The focal sport selected was Major Cumulatively, these managerial tasks performed by the principal League Baseball, a sport that was integral to the early investigator required less than 30 minutes each week; these development of traditional (sedentary) fantasy sports. http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 3 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al managerial tasks are described in more detail below. Figure 5 Postintervention Measures in Multimedia Appendix 1 includes screenshots with Participants provided quantitative feedback on their experience accompanying explanations of the league commission tools related to intrinsic motivation for physical activity and for the provided by Yahoo. Game-related consequences tied to physical active fantasy sports game, their attitudes toward different activity during the 12-week intervention phase were two-fold. activity-contingent features of the game and new proposed First, failure to meet a weekly activity goal resulted in the loss features, and their willingness to play active fantasy sports in of one player (professional athlete) from that participant’s team the future. Intrinsic motivation (for exercise in general and for roster. The player dropped was selected at random, but could the active fantasy sports game in particular) was assessed using not include one of the best (high value) players from a list separate 3-item versions of the Intrinsic Motivation Index; maintained and updated weekly by Yahoo (ie, the can’t cut list). Cronbach alpha=0.88, and 0.71, respectively [22]. Attitudes This made the consequences for failing to meet a weekly goal toward specific features and willingness to play were assessed meaningful, but not extreme. Second, at the end of each week, using single item Likert-scale questions created for this study. the league’s waiver wire priority was reset by the principal Study 2: Active Fantasy Basketball investigator based on the rank order of participants’ percent of activity goal completed. If and when two or more team owners Overview request to claim the same player who has recently been dropped A second pilot study was run for 17 weeks from November from another team, the waiver wire priority is used to determine 2013 to February 2014 using a fantasy basketball league which team owner will be awarded that player. Participants (specifically, the National Basketball Association). were updated on their physical activity goal progress (and that of others in the league) twice a week via messages posted to Recruitment the league message board. Participants were able to access their Study 2 participants were recruited using poster advertisements own physical activity data at any time via Fitbit’s website or on a medium size, urban university campus in the smartphone application; similarly, the fantasy league itself was Midwestern-region of the United States. Although participants available to participants via both Yahoo’s website and in Study 1 reported a strong preference for knowing everyone smartphone application. in their league cohort in advance, we felt it was important to Finally, at the end of the 12-week intervention phase, all test the feasibility of the system within a league comprised of participants completed a structured interview with a study staff strangers-at-baseline. Interested individuals emailed the study’s member by phone or in-person. Participants provided feedback principle investigator, received a brief overview of the study, on their experiences using activity-contingent features of the and were screened for eligibility. game, and were also given an opportunity to propose new Protocol features. Procedures were approved by the Institutional Review After recruitment, the protocol for Study 2 essentially mirrored Board at the Illinois Institute of Technology IIT. that for Study 1. Only a few aspects of the protocol were Materials changed. First, the intervention period lasted for 16 weeks (rather than 12). Second, during the intervention period, Preintervention Measures participants who recorded fewer than 4000 steps in a day were Self-reported demographic information provided at baseline given credit for 4000 steps. This change was made in order to included: age, sex, race, education, height, and weight. avoid having participants severely punished in the event that Participants also reported their prior experience playing they left their accelerometer at home on one or more days and traditional versions of online fantasy sports and self-reported because it was more logistically feasible to execute. Third, their physical activity over the month prior to enrolling in the participants were offered the opportunity to win small study using the Godin Leisure Activity Measure [21]. Intrinsic competition-contingent financial incentives based on league motivation, specifically enjoyment for exercise in general, was st nd performance (1 place was awarded US $150; 2 place was assessed using a 3-item version of the Intrinsic Motivation rd Index, Cronbach alpha=0.93 [22]. awarded US $100; 3 place was awarded US $50, with each th subsequent place lowering in increments until the 8 and final Objective Physical Activity place). During the 1-week baseline activity recording phase and 12-week intervention phase, physical activity was objectively Results assessed using a low-cost triaxial accelerometer (a Fitbit Zip). Fitbit’s proprietary algorithms convert raw accelerometer data Study 1: Active Fantasy Baseball into estimates of steps taken, calories burned, and distance Sample Demographics traveled. For the sake of parsimony, we focused exclusively on steps taken and set weekly goals based on average steps/day. Summary Lee, Kim, and Welk [23] found that the FitBit Zip achieved There were 9 adult males who participated with 100% retention energy expenditure estimates within 10.1% of criterion values over the 13-week study. Mean age was 34.89 years (SD 2.26, concurrently obtained from a portable metabolic system (ie, range 32-40). Of the male participants, 8 were White and 1 was Oxycon Mobile). Asian. The sample was highly educated, all participants had “some college” or higher. Mean body mass index was 25.20 http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 4 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al (SD 1.80, range: 22.38-27.70), which falls slightly above the mean 5.59 (SD 1.22), one-sample t =6.36, P<.001. Further, normal range. The average number of online fantasy sports participants rated active fantasy sports as significantly more leagues played prior to the study was 15.70 (SD 19.57, range enjoyable compared to traditional fantasy sports, one-sample 0-64). There were 2 participants who had never played t =4.43, P<.01. Participants self-reported intrinsic motivation traditional fantasy sports before. for exercising in general did not change significantly from preintervention (mean 4.59, SD 1.52) compared to Enjoyment postintervention (mean 5.15, SD 1.57); paired t =1.72, P=.13. Self-reported enjoyment of the active fantasy baseball game Findings are summarized in Table 1. was significantly higher than neutral (3) on the 7-point scale, Table 1. Comparison of demographics and outcomes in studies 1 and 2. Variable Study 1 (n=9) Study 2 (n=10) Active Fantasy Baseball Active Fantasy Basketball n (%) or mean (SD) n (%) or mean (SD) Age in years 34.89 (2.26) 25.50 (3.89) % male 10 (100%) 9 (90%) Leagues played in previously / experience 15.70 (19.57) 3.36 (3.96) BMI 25.20 (1.80) 23.61 (3.18) Godin activity score at baseline 52.88 (30.36) 40.09 (14.69) Steps/day at baseline 8678.44 (1784.50) 6961.70 (2137.85) Steps/day across the intervention phase 11,364.22 (3426.11) 6267.34 (1877.58) Enjoyment of active fantasy game 5.59 (1.22) 5.23 (1.36) Number of posts to message board 9.22 (8.57) 1.50 (2.42) Number of co-participants known well at baseline 4.22 (2.68) 0.60 (0.52) Preference for knowing co-participants at baseline 2.33 (0.71) 2.10 (1.10) Preference for everyone being equally active at base- 0.67 (1.94) 1.00 (2.00) line Ideal impact of physical activity on the game 5.00 (1.23) 5.70 (1.16) Actual impact of physical activity on the game 3.11 (1.05) 3.70 (1.57) least active owners could not win). The mean response was 5.00 Social Factors (SD 1.23). Next, we asked, “In this pilot study, how much do During postintervention interviews, participants frequently cited you think team owners’ physical activity impacted the league social aspects of the game as especially motivating and outcomes?” (using the identical 7-point scale). The mean enjoyable. The mean number of posts to the league message response was 3.11 (SD 1.05). The mean difference between board per participant was 9.22 (SD 8.57, range 0-25). On these two ratings (mean 1.89) was statistically significant, paired average, they reported knowing 4.22 (SD 2.68) other participants t =3.69, P=.006. in the league before the start of the season (ie, just over half the Physical Activity other participants in the league). When asked, “How much better or worse would this game have been if you knew everyone in Participants’ self-reported and accelerometer-measured physical the league very well before starting the season?” (-3=much activity varied at baseline (the mean Godin activity score was worse; +3=much better), the mean response was +2.33 (SD 52.88, SD 30.36, range 14-119, and mean steps/day 8678.44, 0.71), a strong preference for knowing everyone in the league SD 1784.50, range 5913-11,053). Across the 12-week before the start of the season. Participant mean responses on intervention phase, participants averaged over 30% more the social aspects of the game are listed in Table 1. activity, paired t = 2.63, P≤.05 (12-week mean 11,364.22, SD 3426.11, range 4064-15,949). Relative Impact of Fitness Finally, we asked participants about their preferences with Given that the 3 participants who were already exceeding the regard to the relative influence of their physical activity versus goal of 10,000 steps/day at baseline were asked to maintain sedentary strategy on game outcomes. We asked, “If you could their baseline level of activity, we also calculated the mean choose the degree or amount that team owners’ physical activity change in activity for two subgroups, (ie, those given goals to impacted the outcomes of an active fantasy sports league, how maintain) (n=3, mean change = +2962.67, SD 3136.51) and impactful would you make it?” (1=a very small impact / the those given goals to increase activity (n=6, mean change = least active owner could still win; 7=a very large impact / the +2547.33, SD 1357.78); both groups increased their activity. http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 5 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al 5.70 (SD 1.16). Next, we asked, “In this pilot study, how much Study 2: Active Fantasy Basketball do you think team owners’ physical activity impacted the league Sample Demographics outcomes?” (using the identical 7-point scale). The mean response was 3.70 (SD 1.57). The mean difference between Summary these two ratings (mean 1.89) was statistically significant, paired A total of 15 applicants responded to recruitment materials t =3.00, P=.015, indicating that participants wanted physical expressing interest in the study; 3 did not wish to enroll due to activity to be more impactful on league outcomes. lack of interest. Of the 12 adult participants enrolled in the study, 2 participants dropped out of the study after the first week of Physical Activity the intervention, leaving us with a sample size of 10 (9 males, Participants’ self-reported and accelerometer-measured physical 1 female). The two participants who dropped out had not played activity varied at baseline (the mean Godin activity score was online fantasy sports previously, quickly decided that the game 40.09 (SD 14.69) range 14.00-65.50 and mean steps/day was more complicated than anticipated, and were unwilling or 6961.70, SD 2137.85, range 3346-10,473), and during the unable to invest time in learning the rules. Mean age was 22.50 16-week intervention phase (mean 6267.34, SD 1877.58, range (SD 3.89, range 18-30). Of the participants, 4 were White, 4 4427.97-9607.24). Physical activity did not significantly increase were Asian, 1 was Black, and 1 was Multiracial. The sample during the intervention phase, paired t =1.57, P≤.15. was highly educated; all participants had “some college” or higher. Mean body mass index was 23.61 (SD 3.18, range There was one participant who was already exceeding the goal 19.31-29.18), which is within the normal weight range. The of 10,000 steps/day at baseline and was asked to maintain his average number of online fantasy sports leagues played in prior or her baseline level of activity. Change in activity for that to the study was 3.36 (SD 3.96, range 0-9); 6 participants had participant (n=1, mean change = +865.76) was higher than for never played traditional fantasy sports before. those given goals to increase activity (n=9; mean change =-75.31, SD 1481.79). Enjoyment As in Study 1, self-reported enjoyment of the active fantasy Discussion sports game itself was significantly higher than neutral (3) on the 7-point scale, mean 5.23 (SD 1.36), one-sample t =5.19, Principal Findings P≤001. Furthermore, when asked to compare active fantasy The present investigation demonstrates the feasibility of linking sports relative to traditional (sedentary) fantasy sports in terms physical activity goals to features and privileges within an of enjoyment, participants rated active fantasy sports as extremely popular sedentary video game, online fantasy sports. marginally more enjoyable, one-sample t =2.09, P=.07. There were high rates of retention in both studies (zero attrition Participants’ self-reported intrinsic motivation for exercising in Study 1, two dropouts very early in Study 2), and regular in general did not change significantly from preintervention posting to the league message board in Study 1. Especially (mean 4.63, SD 1.64) compared to during the intervention (mean encouraging findings from this study related to participants’ 4.639, SD 2.18). ratings of the degree to which they enjoyed playing active fantasy sports. Across both studies, participants reported Social Factors enjoying active fantasy sports, and rated it significantly higher The mean number of posts to the league message board was than neutral. In Study 1, participants rated active fantasy sports significantly smaller than in Study 1, mean 1.50 (SD 2.42, range as even more enjoyable than traditional fantasy sports; Study 2 0-6). On average, they reported knowing 0.60 (SD 0.52) other participants rated it as neither more nor less enjoyable than participants in the league before the start of the season. When traditional. Study 2 participants had less previous experience asked, “How much better or worse would this game have been with fantasy sports and knew fewer participants in the league, if you knew everyone in the league very well before starting which likely influenced their enjoyment of the league. the season?” (-3=much worse, +3=much better), the mean response was +2.10 (SD 1.10), a strong preference for knowing Participants in both Studies 1 and 2 reported that knowing other other league members. However, when asked: “How much participants in the league at baseline would be highly desirable. better or worse would this game have been if everyone in the As such, we believe interventions of this kind have the best league was roughly as active as you were at baseline?” (-3=much probability of success if groups of friends can be recruited for worse; +3=much better), the mean response was 1.00 (SD 2.00), participation together. These circumstances also more faithfully indicating no clear preference. reflect the typical way that traditional (sedentary) online fantasy sports leagues form. Relative Impact of Fitness Although the two pilot studies were not designed or powered Finally, we asked participants about their preferences with to test the system’s potential for increasing physical activity, regard to the relative influence of their physical activity versus encouraging findings were observed. The use of accelerometers sedentary strategy on game outcomes. We asked, “If you could provides an objective indicator of changes in physical activity, choose the degree or amount that team owners’ physical activity and can be considered a major strength. In Study 1, participants impacted the outcomes of an active fantasy sports league, how increased their physical activity by over 30% during the active impactful would you make it?” (1=a very small impact / the fantasy baseball season compared to baseline. We note that in least active owner could still win; 7 a very large impact / the both studies, participants who were already meeting the activity lease active owners could not win). The mean response was http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 6 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al goal of 10,000 steps/day at baseline were instructed only to success, future research should investigate this issue further (eg, maintain their level of activity (3 participants in Study 1, 1 qualitative and quantitative analysis of message board usage). participant in Study 2). Fifth, future research may expand the variety of target sports (eg, football, soccer, hockey, golf, rugby, cricket, etc), thereby Limitations potentially increasing reach. Design limitations include the lack of a control or active Potential Public Health Impact comparison condition, and the low fidelity (manual, as opposed to automated) execution of the integration between physical As noted in the introduction, Baranowski and others [2] have activity data and fantasy sports game features. Consequences argued that the public health impact of previous AVGs has been were administered manually by the principle investigator using limited by low uptake and high cost. As such, we think it is standard tools provided by Yahoo to league commissioners. A useful to highlight a number of unique strengths associated with more elegant execution of the system could be achieved by active fantasy sports interventions that support potential reach leveraging open APIs made available by both accelerometer and cost-effectiveness. providers (eg, Fitbit) and fantasy sports league hosts (eg, Yahoo, Importantly, we believe the established massive popularity of Espn, or CNNSI). Despite these limitations, the important traditional (sedentary) fantasy sports provides a powerful contribution of swifter, proof-of-concept trials of this kind is dissemination channel. In 2014, over 41 million adults in the being championed in the emerging field of technology-support United States (US) and Canada alone played online fantasy and mobile health research [24]. sports [15]. For reference, in 2014, the entire population of The samples in both studies were small (n=9, and n=10), and Canada was roughly 34 million. If even a fraction of the were not representative of the general population, especially traditional fantasy sports audience could be persuaded to try with regard to gender. This limits the generalizability of the active fantasy sports, this would represent significantly greater findings. However, we note that the sample demographics were reach than previous AVGs. Further, while most AVGs have not relatively consistent with the population of adults who play made social features integral or required, preliminary evidence traditional online fantasy sports (ie, predominately male, suggested that social aspects of the active fantasy sports Caucasian, and well-educated). We also note that participants’ intervention were important. As such, active fantasy sport self-reported height and weight were potentially biased; future interventions may be especially well suited to implementation studies should include measurements of height and weight taken by organizations interested in promoting physical activity (eg, by research staff members with appropriately calibrated schools, or employer sponsored wellness programs). Active instruments. fantasy sports leagues sponsored by organizations could significantly magnify reach and, by leveraging existing social Future Directions ties, may also improve efficacy. The present research suggests a number of directions for future Further supporting the potential reach of active fantasy sport research. First, leveraging open APIs associated with type interventions are a number of factors limiting costs accelerometer providers and fantasy sport hosting websites will associated with software development, labor, and equipment. reduce the burden on research staff, allowing researchers to As noted earlier, the game platform that active fantasy sports collect data from much larger and more representative samples. interventions are built on (traditional fantasy sports) is in the Second, it will be important to test the efficacy of the active public domain and supported by numerous companies (“host” fantasy sports system for increasing physical activity relative websites, including Yahoo, ESPN, and CNNSI). By taking to a usual care or active comparison group (eg, participants advantage of existing, sophisticated game platform infrastructure assigned to receive an accelerometer for self-monitoring provided by numerous hosts, developers achieve significant purposes and a group message board only) using a randomized cost reductions relative to building a comparable AVG de novo. controlled trial. Group-randomization could be employed in The major hosts of traditional online fantasy sports offer open order to recruit groups of participants who know each other API access to external application developers specifically to before enrolling in the study. Third, aspects of the game can encourage innovation of this kind. Furthermore, established potentially be tailored according to the characteristics and hosts currently offer consumers access to traditional fantasy preferences of the participants. For example, participants in sports games without charging fees (major hosts typically use both studies expressed a desire for their physical activity to have an advertising-based revenue model), minimizing an important a greater impact on game outcomes. Optimization study designs barrier for low-income consumers. At present, the overhead and may help us refine which activity contingent features are labor costs associated with administrating an active fantasy maximally effective, test different ways of measuring physical sports intervention are already very low; the intervention was activity (eg, with wearable technology or specialized exercise administered remotely (as opposed to in-person) and involved equipment), and assess different rules for setting activity goals minimal administrative effort (<1 hour per week). By leveraging in order to maximize both optimal challenge and perceived device and host APIs, future iterations of this intervention may fairness. Prior research also shows that levels of competitiveness further automate oversight and reduce costs, especially relative may influence enjoyment of games and thus may have to gold-standard interventions such as individual professional implications for intrinsic motivation [25,26]; future research coaching delivered in-person. A third factor related to cost may tailor game features or match players based on concerns the affordability of equipment used for objectively competitiveness. Fourth, given the preliminary evidence that measuring physical activity. The present versions of the active social factors helped motivated participation and intervention http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 7 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al fantasy sports intervention employed a low cost accelerometer Conclusions (retail price US $60) that was provided to participants. However, To summarize, this study provides strong support for the the cost of dedicated wearable accelerometers is rapidly falling; feasibility of integrating physical activity contingent features similar models are currently available for as low as US $12 per and privileges into an online fantasy sports game platform. unit [27]. Smartphones, which typically include sophisticated Participants found this asynchronous active video game system built-in accelerometers, are increasingly ubiquitous, reducing enjoyable, as or more enjoyable than traditional (sedentary) the cost of activity tracking equipment further still. The cost of online fantasy sports. Social support within the game was cited more sophisticated activity tracking devices (eg, activity trackers as an important factor for both enjoyment and increasing that incorporate heart rate sensors, global positioning system, physical activity. Future research is needed to test the efficacy and accelerometry, including Apple’s iWatch, Fitbit’s Surge, of this system using a randomized controlled trial and and Microsoft’s Band) should similarly fall if the proliferation optimization-type designs, and with a larger, more diverse of wearable activity tracking technology continues. sample of participants. The scalability and reach of active fantasy sport interventions represents a significant strength. Acknowledgments The authors wish to thank Rachel Kornfield for her thoughtful comments on earlier drafts of this manuscript. Some of these findings were presented previously at the Annual Society of Behavioral Medicine Conference, April 23-26, 2014, Philadelphia, PA, and at the Health Experience Refactored (HxR) conference, May 13-14, 2014, Brooklyn, NY. Conflicts of Interest The lead author of this manuscript (Moller) is also the sole inventor of a US Patent Application currently under review at the US Patent and Trademark Office (filed on December 3rd, 2013), titled: “Incorporating objective assessments of fantasy-team-owners’ physical activity into fantasy sport platforms” (Serial No. 14/088,632). Ownership of the referenced intellectual property is vested in Illinois Institute of Technology. For the other authors of this manuscript, no competing financial interests exist. Multimedia Appendix 1 Screenshots of a fantasy sports team roster, a league comprised of multiple fantasy sports teams, a fantasy team owner tool for offering a player trade to another fantasy team owner, a fantasy sports league message board, and fantasy sports league commissioner tools. [PDF File (Adobe PDF File), 3MB-Multimedia Appendix 1] References 1. 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A Scoping Review of Health Game Research: Past, Present, and Future. Games Health J 2012 Apr 18;1(2) [FREE Full text] [doi: 10.1089/g4h.2012.0011] [Medline: 24416638] 5. Rigby S, Ryan RM. Glued to Games: How Video Games Draw Us In and Hold Us Spellbound (New Directions in Media). Santa Barbara, CA: Praeger; 2011. 6. Deci EL, Ryan RM. Handbook of self-determination research. Rochester, NY: University of Rochester Press; 2002. 7. Patrick H, Canevello A. Methodological Overview of A Self-Determination Theory-Based Computerized Intervention to Promote Leisure-Time Physical Activity. Psychol Sport Exerc 2011 Jan;12(1):13-19 [FREE Full text] [doi: 10.1016/j.psychsport.2010.04.011] [Medline: 21103069] 8. Peng W, Lin J, Pfeiffer KA, Winn B. Need Satisfaction Supportive Game Features as Motivational Determinants: An Experimental Study of a Self-Determination Theory Guided Exergame. Media Psychology 2012 May 18;15(2):175-196. [doi: 10.1080/15213269.2012.673850] 9. Sylvester BD, Standage M, Dowd AJ, Martin LJ, Sweet SN, Beauchamp MR. Perceived variety, psychological needs satisfaction and exercise-related well-being. Psychol Health 2014;29(9):1044-1061. [doi: 10.1080/08870446.2014.907900] [Medline: 24669787] http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 8 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al 10. Anderson-Hanley C, Snyder AL, Nimon JP, Arciero PJ. Social facilitation in virtual reality-enhanced exercise: competitiveness moderates exercise effort of older adults. Clin Interv Aging 2011;6:275-280 [FREE Full text] [doi: 10.2147/CIA.S25337] [Medline: 22087067] 11. Feltz DL, Forlenza ST, Winn B, Kerr NL. Cyber Buddy Is Better than No Buddy: A Test of the Köhler Motivation Effect in Exergames. Games for Health Journal 2014 Apr;3(2):98-105. [doi: 10.1089/g4h.2013.0088] 12. Lu AS, Baranowski T, Thompson D, Buday R. Story Immersion of Videogames for Youth Health Promotion: A Review of Literature. Games Health J 2012 Jun;1(3):199-204 [FREE Full text] [doi: 10.1089/g4h.2011.0012] [Medline: 24416639] 13. Consolvo S, Landay JA, McDonald DW. Designing for Behavior Change in Everyday Life. Computer 2009 Jun;42(6):86-89. [doi: 10.1109/MC.2009.185] 14. Stanley KG, Livingstong IJ, Bandurka A, Hashemian M, Mandryk RL. Gemini: A pervasive accumulated context exergame. In: Anacleto J, editor. Entertainment Computing - ICEC 2011: 10th International Conference, ICEC 2011, Vancouver, BC, Canada, October 5-8, 2011, Proceedings (Lecture Notes in ... Applications, incl. Internet/Web, and HCI). London: Springer; 2011:65-76. 15. Fantasy Sports Trade Association. 2014. Industry demographics URL: http://www.fsta.org/?page=Demographics [accessed 2014-11-03] [WebCite Cache ID 6Tofy6zSK] 16. Aarts H, Custers R, Veltkamp M. Goal Priming and the Affective-Motivational Route to Nonconscious Goal Pursuit. Social Cognition 2008 Oct;26(5):555-577. [doi: 10.1521/soco.2008.26.5.555] 17. Hunt K, Wyke S, Gray CM, Anderson AS, Brady A, Bunn C, et al. A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet 2014 Apr 5;383(9924):1211-1221 [FREE Full text] [doi: 10.1016/S0140-6736(13)62420-4] [Medline: 24457205] 18. Pagoto SL, Schneider KL, Oleski JL, Luciani JM, Bodenlos JS, Whited MC. Male inclusion in randomized controlled trials of lifestyle weight loss interventions. Obesity (Silver Spring) 2012 Jun;20(6):1234-1239. [doi: 10.1038/oby.2011.140] [Medline: 21633403] 19. Tyler RE, Williams S. Masculinity in young men's health: Exploring health, help-seeking and health service use in an online environment. J Health Psychol 2014 Apr;19(4):457-470. [doi: 10.1177/1359105312473784] [Medline: 23493865] 20. Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci 1992 Dec;17(4):338-345. [Medline: 1330274] 21. Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 1985 Sep;10(3):141-146. [Medline: 4053261] 22. McAuley E, Duncan T, Tammen VV. Psychometric properties of the Intrinsic Motivation Inventory in a competitive sport setting: a confirmatory factor analysis. Res Q Exerc Sport 1989 Mar;60(1):48-58. [doi: 10.1080/02701367.1989.10607413] [Medline: 2489825] 23. Lee JM, Kim Y, Welk GJ. Validity of consumer-based physical activity monitors. Med Sci Sports Exerc 2014 Sep;46(9):1840-1848. [doi: 10.1249/MSS.0000000000000287] [Medline: 24777201] 24. Kumar S, Nilsen WJ, Abernethy A, Atienza A, Patrick K, Pavel M, et al. Mobile health technology evaluation: the mHealth evidence workshop. Am J Prev Med 2013 Aug;45(2):228-236 [FREE Full text] [doi: 10.1016/j.amepre.2013.03.017] [Medline: 23867031] 25. Song H, Kim J, Tenzek KE, Lee KM. The effects of competition and competitiveness upon intrinsic motivation in exergames. Computers in Human Behavior 2013 Jul;29(4):1702-1708. [doi: 10.1016/j.chb.2013.01.042] 26. Staiano AE, Abraham AA, Calvert SL. Motivating effects of cooperative exergame play for overweight and obese adolescents. J Diabetes Sci Technol 2012 Jul;6(4):812-819 [FREE Full text] [Medline: 22920807] 27. Bennett G. How are fitness trackers like paper towels?. 2014. URL: http://drgarybennett.com/2014/07/22/ how-are-fitness-trackers-like-paper-towels/ [accessed 2014-11-02] [WebCite Cache ID 6TogJXwoP] Abbreviations AVG: active video game SDT: self-determination theory FSTA: Fantasy Sports Trade Association PAR-Q: Physical Activity Readiness Questionnaire IIT: Illinois Institute of Technology http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 9 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al Edited by G Giunti; submitted 08.07.14; peer-reviewed by T Baranowski, D Castaneda; comments to author 06.08.14; revised version received 17.10.14; accepted 17.10.14; published 25.11.14 Please cite as: Moller AC, Majewski S, Standish M, Agarwal P, Podowski A, Carson R, Eyesus B, Shah A, Schneider KL JMIR Serious Games 2014;2(2):e13 URL: http://games.jmir.org/2014/2/e13/ doi: 10.2196/games.3691 PMID: 25654304 ©Arlen C Moller, Sara Majewski, Melanie Standish, Pooja Agarwal, Aleksandra Podowski, Rebecca Carson, Biruk Eyesus, Aakash Shah, Kristin L Schneider. Originally published in JMIR Serious Games (http://games.jmir.org), 25.11.2014. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on http://games.jmir.org, as well as this copyright and license information must be included. http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 10 (page number not for citation purposes) XSL FO RenderX http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JMIR Serious Games JMIR Publications

Active Fantasy Sports: Rationale and Feasibility of Leveraging Online Fantasy Sports to Promote Physical Activity

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Copyright © The Author(s). Licensed under Creative Commons Attribution cc-by 4.0
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2291-9279
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10.2196/games.3691
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Abstract

Background: The popularity of active video games (AVGs) has skyrocketed over the last decade. However, research suggests that the most popular AVGs, which rely on synchronous integration between players’ activity and game features, fail to promote physical activity outside of the game or for extended periods of engagement. This limitation has led researchers to consider AVGs that involve asynchronous integration of players’ ongoing physical activity with game features. Rather than build an AVG de novo, we selected an established sedentary video game uniquely well suited for the incorporation of asynchronous activity: online fantasy sports. Objective: The primary aim of this study was to explore the feasibility of a new asynchronous AVG—active fantasy sports—designed to promote physical activity. Methods: We conducted two pilot studies of an active fantasy sports game designed to promote physical activity. Participants wore a low cost triaxial accelerometer and participated in an online fantasy baseball (Study 1, n=9, 13-weeks) or fantasy basketball (Study 2, n=10, 17-weeks) league. Privileges within the game were made contingent on meeting weekly physical activity goals (eg, averaging 10,000 steps/day). Results: Across the two studies, the feasibility of integrating physical activity contingent features and privileges into online fantasy sports games was supported. Participants found the active fantasy sports game enjoyable, as or more enjoyable than traditional (sedentary) online fantasy sports (Study 1: t =4.43, P<.01; Study 2: t =2.09, P=.07). Participants in Study 1 increased 8 9 their average steps/day, t =2.63, P<.05, while participants in Study 2 maintained (ie, did not change) their activity, t =1.57, 8 9 P=.15). In postassessment interviews, social support within the game was cited as a key motivating factor for increasing physical activity. Conclusions: Preliminary evidence supports potential for the active fantasy sports system as a sustainable and scalable intervention for promoting adult physical activity. (JMIR Serious Games 2014;2(2):e13) doi: 10.2196/games.3691 KEYWORDS physical activity; games for health; active video game; exergame; asynchronous; social support; multiplayer; enjoyment; intrinsic motivation; sports http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 1 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al asynchronous AVG may be sedentary while engaging directly Introduction with the gaming interface; the activity occurs asynchronously, (ie, at a different time). While asynchronous AVGs are Background promising for motivating sustained increases in physical activity, Traditional video games have been sedentary in nature, requiring relatively few have been developed (versus synchronous AVGs). small hand or thumb movements and very little physical Several exceptions include the now defunct Ubifit garden [13], exertion. By contrast, active video games (AVGs) (also known Pokewalker, and Gemini [14] games, as well as smartphone as: exergames, exertainment, or active gaming), link integrated game applications like Nike+’s NikeFuel Missions, participants’ physical activity to various aspects of video game and Six to Start’s Zombies Run! series; but to the best of our play, thereby promoting greater physical exertion. In 2011, the knowledge, no rigorous empirical tests of these asynchronous American Heart Association published a science panel AVGs have been published. proceedings report highlighting the promise of AVGs and Although new AVGs could be developed using these theoretical encouraging further research on their efficacy [1]. and empirical strategies, a more economical alternative approach Unfortunately, active video games have to this point proven is to integrate physical activity into sedentary video (or online) relatively limited in their effectiveness. In particular, empirical games that have proven appeal. Currently, one of the most tests of active video games that link players’ physical activity popular and enduring online games among adults in North with game features in real-time (ie, synchronously) have only America are variations of a game platform collectively referred minimally and temporarily increased physical activity [2]. to as fantasy sports. Further, the intensity of the exercise achieved while playing Online Fantasy Sports as a Platform for Building an many of the most popular synchronous active video games (eg, Wii, Kinect, Move) has fallen below the minimal threshold for Asynchronous Active Video Game moderate intensity physical activity [3]. An additional challenge Fantasy sport (also known as rotisserie, roto, or owner is economic; thus far, “neither children nor parents . . . have simulation) is a game that involves participants selecting purchased enough healthy videogames to make it profitable” professional athletes, and earning points based on the real world [2]. performance of those professional athletes. The most common variants of this game involve a group (or league) of participants Theoretical and evidence-based strategies for designing more acting as fantasy team “owners.” Each fantasy team owner drafts effective AVGs have been proposed [1,4,5]. Self-determination and manages a roster of uniquely claimed players over the theory (SDT) is a macro-theory of human motivation that has course of a professional sport season (see Figure 1 in Multimedia been applied to identifying factors that might sustain individuals’ Appendix 1); a typical fantasy “league” might include 8 to 12 motivation in general (eg, in classrooms, the workplace, and in teams, each managed by an individual team owner (see Figure sports) [6], as well as within sedentary video games [5] and 2 in Multimedia Appendix 1). Fantasy team owners have the AVGs specifically [7,8]. SDT postulates that the more often ability to trade, cut, and sign players in a manner analogous to basic psychological needs for autonomy, competence, and the real owners of professional sport teams (see Figure 3 in relatedness are satisfied within a game, the more enjoyable and Multimedia Appendix 1). Online hosts of fantasy sport games satisfying the experience, and thereby more sustainable the provide automated scoring and opportunities for electronically motivation [9]. These three basic psychological needs can be mediated discussion between league owners, including message supported in innumerable ways within games. Games can boards and direct messaging (see Figure 4 in Multimedia support the need for autonomy by providing participants with Appendix 1). opportunities to explore or make choices. When challenges within a game are calibrated to stretch a participant’s ability For a number of reasons, we hypothesized that online fantasy (ie, by optimal challenge), the need for competence is satisfied. sports, a traditionally sedentary online game, might represent Finally, the need for relatedness is supported when people feel a gaming platform uniquely well suited to supporting a scalable, connected to others, which can occur with fictional characters sustainable AVG for increasing physical activity. First, depicted in games, or with real people, as in some multiplayer traditional (sedentary) fantasy sports are extremely popular (>41 video games. Research supporting the integration of social million players in the US and Canada, alone), supporting high support into AVGs has been particularly compelling [10], even potential reach [15]. Second, fantasy sports have established with a virtual other or cyber buddy [11]. enduring appeal, supporting prolonged engagement; participants play in leagues that last for several months, and often play Baranowski and colleagues [2] also identified evidence-based season-after-season for multiple years within the same league. factors that might improve the efficacy of AVGs. Inclusion of Popularity and sustained motivation may be related to the ample a meaningful and engaging narrative seems to help sustain opportunities for experiencing psychological need satisfaction engagement with AVGs [12]. Additionally, asynchronous afforded while playing traditional fantasy sports games. (versus synchronous) integration of participant activity with Specifically, this platform provides game players with many game features may elicit more generalizable and sustainable options for customizing their teams in ways that can reflect their changes in physical activity. Asynchronous AVGs integrate identities (e.g., selecting athletes for reasons that include their video game features with activity that takes place when personalities, shared cultural, or regional affiliations), thereby participants are not engaging directly with the gaming interface supporting autonomy need satisfaction; this platform facilitates (eg, through use of an accelerometer that monitors steps over finding leagues that include similarly skilled opponents, thereby the course of an entire day or week). Participants playing an http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 2 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al optimizing challenge, and competence need satisfaction; and Recruitment fantasy sports leagues are social, providing opportunities for Participants were recruited using a convenience sampling interpersonal interaction and relatedness need satisfaction. procedure that involved reaching out to the principle investigator’s online social network. This included inviting Third, traditional fantasy sports already involve a form of individuals with whom the principal investigator had participated asynchronous integration between physical activity (that of in prior traditional fantasy sports leagues. The investigative professional athletes) and game features; as such, fantasy sports team considered a number of potential issues related to using games may be especially well suited to asynchronous integration this form of convenience sampling (e.g., social desirability bias of participants’ physical activity (as recommended by and experimenter demand characteristics), but opted in favor, Baranowski et al [2]. Fourth, the basic features of traditional given the early formative phase of research and low fidelity fantasy sports are in the public domain and thus economically execution that could be offered at this stage. No financial and practically amenable to augmentation. incentives or other compensation were offered in exchange for Fifth, although traditional fantasy sports are sedentary, 13-weeks of participation. thematically these games involve attending to physical activity Inclusion criteria were highly inclusive; participants had to be data generated by professional athletes. Thus, asking individuals over 18 years of age and able to engage in physical activity to attend to their own physical activity data is copasetic with without significant risk of injury. We intentionally did not traditional fantasy sports in terms of attending to data, and exclude individuals who were meeting the recommended amount specifically data related to physical activity. Further, we of physical activity at baseline in order to mirror real-life fantasy hypothesized that the game’s defining theme of professional sports leagues where players have varying levels of fitness; sports would have several potential advantages. For example, these inclusion criteria help maximize ecological validity and activating thoughts related to physical activity (regarding the potential reach of our intervention. professional sports) might prime greater activation of participants’ goals to increase physical activity by virtue of Protocol shared semantic and associative networks. Nonconscious After the nature of the study was explained and participants priming of goals has previously been shown to increase provided their written informed consent, all participants intensions to pursue those goals [16]. Further, fans of completed a set of preintervention questionnaires. A screening professional sports often identify very strongly with professional tool (Physical Activity Readiness Questionnaire, PAR-Q) was sports teams, often fanatically/intensely so, a motivational administered to confirm that the participants were physically dynamic that has previously been effectively leveraged for prepared to increase their physical activity without significantly promoting physical activity among overweight and obese male risking injury; this measure was designed for adults aged 15-69, soccer fans in Europe in the context of an intervention delivered and asks about 7 physical activity risk factors (eg, chest pain, in-person [17]. Relatedly, the strong appeal of professional dizziness, and joint problems) [20]. All participants passing sports, and as such online fantasy sports, to men (approximately screening then received an accelerometer to wear for at least 80% of fantasy sports participants are male; Fantasy Sports 1-week of baseline recording. During the baseline activity Trade Association FSTA, 2013), may be especially recording phase, participants were asked to maintain their advantageous in light of evidence that men have traditionally activity level. Each participant’s baseline activity was been underrepresented in behavioral health interventions [18], subsequently used to set individually calibrated weekly physical and relatively less willing to engage in health-related online activity goals during the 12-week intervention phase. support communities [19]. Those participants who exceeded the recommended The primary purpose of this pilot research was to test the 10,000-steps/day average during the baseline activity recording feasibility of an active fantasy sports intervention. We tested phase (n=3) were asked to maintain their baseline average each this in the context of two studies, using two versions that were week during the 12-week intervention phase. This policy was focused on different sports (baseball and basketball). Feasibility instituted as a conservative precautionary measure to ensure the was assessed in terms of participants’ self-reported satisfaction safety of our participants, as well as to purposely deemphasize with the game overall and with specific features. An exploratory the value of excessive activity. Those participants who fell short aim of this research tested whether participants increased their of the recommended 10,000-steps/day average during the physical activity while playing the game, as objectively assessed baseline activity recording phase were asked to increase their by accelerometers. activity by 10% each week, up until their weekly goal became 10,000 steps/day and was capped at that level. Methods During the 12-week intervention phase, participants competed Study 1: Active Fantasy Baseball in a fantasy baseball league hosted by Yahoo. The principle investigator, serving as league commissioner, managed Overview game-related consequences using the league commissioner tools To test the feasibility of the proposed active fantasy sports provided by Yahoo (and standard to other major online fantasy system, we conducted a 13-week proof-of-concept field study sport hosts, including ESPN and CNNSI) once a week. from April to June 2013. The focal sport selected was Major Cumulatively, these managerial tasks performed by the principal League Baseball, a sport that was integral to the early investigator required less than 30 minutes each week; these development of traditional (sedentary) fantasy sports. http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 3 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al managerial tasks are described in more detail below. Figure 5 Postintervention Measures in Multimedia Appendix 1 includes screenshots with Participants provided quantitative feedback on their experience accompanying explanations of the league commission tools related to intrinsic motivation for physical activity and for the provided by Yahoo. Game-related consequences tied to physical active fantasy sports game, their attitudes toward different activity during the 12-week intervention phase were two-fold. activity-contingent features of the game and new proposed First, failure to meet a weekly activity goal resulted in the loss features, and their willingness to play active fantasy sports in of one player (professional athlete) from that participant’s team the future. Intrinsic motivation (for exercise in general and for roster. The player dropped was selected at random, but could the active fantasy sports game in particular) was assessed using not include one of the best (high value) players from a list separate 3-item versions of the Intrinsic Motivation Index; maintained and updated weekly by Yahoo (ie, the can’t cut list). Cronbach alpha=0.88, and 0.71, respectively [22]. Attitudes This made the consequences for failing to meet a weekly goal toward specific features and willingness to play were assessed meaningful, but not extreme. Second, at the end of each week, using single item Likert-scale questions created for this study. the league’s waiver wire priority was reset by the principal Study 2: Active Fantasy Basketball investigator based on the rank order of participants’ percent of activity goal completed. If and when two or more team owners Overview request to claim the same player who has recently been dropped A second pilot study was run for 17 weeks from November from another team, the waiver wire priority is used to determine 2013 to February 2014 using a fantasy basketball league which team owner will be awarded that player. Participants (specifically, the National Basketball Association). were updated on their physical activity goal progress (and that of others in the league) twice a week via messages posted to Recruitment the league message board. Participants were able to access their Study 2 participants were recruited using poster advertisements own physical activity data at any time via Fitbit’s website or on a medium size, urban university campus in the smartphone application; similarly, the fantasy league itself was Midwestern-region of the United States. Although participants available to participants via both Yahoo’s website and in Study 1 reported a strong preference for knowing everyone smartphone application. in their league cohort in advance, we felt it was important to Finally, at the end of the 12-week intervention phase, all test the feasibility of the system within a league comprised of participants completed a structured interview with a study staff strangers-at-baseline. Interested individuals emailed the study’s member by phone or in-person. Participants provided feedback principle investigator, received a brief overview of the study, on their experiences using activity-contingent features of the and were screened for eligibility. game, and were also given an opportunity to propose new Protocol features. Procedures were approved by the Institutional Review After recruitment, the protocol for Study 2 essentially mirrored Board at the Illinois Institute of Technology IIT. that for Study 1. Only a few aspects of the protocol were Materials changed. First, the intervention period lasted for 16 weeks (rather than 12). Second, during the intervention period, Preintervention Measures participants who recorded fewer than 4000 steps in a day were Self-reported demographic information provided at baseline given credit for 4000 steps. This change was made in order to included: age, sex, race, education, height, and weight. avoid having participants severely punished in the event that Participants also reported their prior experience playing they left their accelerometer at home on one or more days and traditional versions of online fantasy sports and self-reported because it was more logistically feasible to execute. Third, their physical activity over the month prior to enrolling in the participants were offered the opportunity to win small study using the Godin Leisure Activity Measure [21]. Intrinsic competition-contingent financial incentives based on league motivation, specifically enjoyment for exercise in general, was st nd performance (1 place was awarded US $150; 2 place was assessed using a 3-item version of the Intrinsic Motivation rd Index, Cronbach alpha=0.93 [22]. awarded US $100; 3 place was awarded US $50, with each th subsequent place lowering in increments until the 8 and final Objective Physical Activity place). During the 1-week baseline activity recording phase and 12-week intervention phase, physical activity was objectively Results assessed using a low-cost triaxial accelerometer (a Fitbit Zip). Fitbit’s proprietary algorithms convert raw accelerometer data Study 1: Active Fantasy Baseball into estimates of steps taken, calories burned, and distance Sample Demographics traveled. For the sake of parsimony, we focused exclusively on steps taken and set weekly goals based on average steps/day. Summary Lee, Kim, and Welk [23] found that the FitBit Zip achieved There were 9 adult males who participated with 100% retention energy expenditure estimates within 10.1% of criterion values over the 13-week study. Mean age was 34.89 years (SD 2.26, concurrently obtained from a portable metabolic system (ie, range 32-40). Of the male participants, 8 were White and 1 was Oxycon Mobile). Asian. The sample was highly educated, all participants had “some college” or higher. Mean body mass index was 25.20 http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 4 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al (SD 1.80, range: 22.38-27.70), which falls slightly above the mean 5.59 (SD 1.22), one-sample t =6.36, P<.001. Further, normal range. The average number of online fantasy sports participants rated active fantasy sports as significantly more leagues played prior to the study was 15.70 (SD 19.57, range enjoyable compared to traditional fantasy sports, one-sample 0-64). There were 2 participants who had never played t =4.43, P<.01. Participants self-reported intrinsic motivation traditional fantasy sports before. for exercising in general did not change significantly from preintervention (mean 4.59, SD 1.52) compared to Enjoyment postintervention (mean 5.15, SD 1.57); paired t =1.72, P=.13. Self-reported enjoyment of the active fantasy baseball game Findings are summarized in Table 1. was significantly higher than neutral (3) on the 7-point scale, Table 1. Comparison of demographics and outcomes in studies 1 and 2. Variable Study 1 (n=9) Study 2 (n=10) Active Fantasy Baseball Active Fantasy Basketball n (%) or mean (SD) n (%) or mean (SD) Age in years 34.89 (2.26) 25.50 (3.89) % male 10 (100%) 9 (90%) Leagues played in previously / experience 15.70 (19.57) 3.36 (3.96) BMI 25.20 (1.80) 23.61 (3.18) Godin activity score at baseline 52.88 (30.36) 40.09 (14.69) Steps/day at baseline 8678.44 (1784.50) 6961.70 (2137.85) Steps/day across the intervention phase 11,364.22 (3426.11) 6267.34 (1877.58) Enjoyment of active fantasy game 5.59 (1.22) 5.23 (1.36) Number of posts to message board 9.22 (8.57) 1.50 (2.42) Number of co-participants known well at baseline 4.22 (2.68) 0.60 (0.52) Preference for knowing co-participants at baseline 2.33 (0.71) 2.10 (1.10) Preference for everyone being equally active at base- 0.67 (1.94) 1.00 (2.00) line Ideal impact of physical activity on the game 5.00 (1.23) 5.70 (1.16) Actual impact of physical activity on the game 3.11 (1.05) 3.70 (1.57) least active owners could not win). The mean response was 5.00 Social Factors (SD 1.23). Next, we asked, “In this pilot study, how much do During postintervention interviews, participants frequently cited you think team owners’ physical activity impacted the league social aspects of the game as especially motivating and outcomes?” (using the identical 7-point scale). The mean enjoyable. The mean number of posts to the league message response was 3.11 (SD 1.05). The mean difference between board per participant was 9.22 (SD 8.57, range 0-25). On these two ratings (mean 1.89) was statistically significant, paired average, they reported knowing 4.22 (SD 2.68) other participants t =3.69, P=.006. in the league before the start of the season (ie, just over half the Physical Activity other participants in the league). When asked, “How much better or worse would this game have been if you knew everyone in Participants’ self-reported and accelerometer-measured physical the league very well before starting the season?” (-3=much activity varied at baseline (the mean Godin activity score was worse; +3=much better), the mean response was +2.33 (SD 52.88, SD 30.36, range 14-119, and mean steps/day 8678.44, 0.71), a strong preference for knowing everyone in the league SD 1784.50, range 5913-11,053). Across the 12-week before the start of the season. Participant mean responses on intervention phase, participants averaged over 30% more the social aspects of the game are listed in Table 1. activity, paired t = 2.63, P≤.05 (12-week mean 11,364.22, SD 3426.11, range 4064-15,949). Relative Impact of Fitness Finally, we asked participants about their preferences with Given that the 3 participants who were already exceeding the regard to the relative influence of their physical activity versus goal of 10,000 steps/day at baseline were asked to maintain sedentary strategy on game outcomes. We asked, “If you could their baseline level of activity, we also calculated the mean choose the degree or amount that team owners’ physical activity change in activity for two subgroups, (ie, those given goals to impacted the outcomes of an active fantasy sports league, how maintain) (n=3, mean change = +2962.67, SD 3136.51) and impactful would you make it?” (1=a very small impact / the those given goals to increase activity (n=6, mean change = least active owner could still win; 7=a very large impact / the +2547.33, SD 1357.78); both groups increased their activity. http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 5 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al 5.70 (SD 1.16). Next, we asked, “In this pilot study, how much Study 2: Active Fantasy Basketball do you think team owners’ physical activity impacted the league Sample Demographics outcomes?” (using the identical 7-point scale). The mean response was 3.70 (SD 1.57). The mean difference between Summary these two ratings (mean 1.89) was statistically significant, paired A total of 15 applicants responded to recruitment materials t =3.00, P=.015, indicating that participants wanted physical expressing interest in the study; 3 did not wish to enroll due to activity to be more impactful on league outcomes. lack of interest. Of the 12 adult participants enrolled in the study, 2 participants dropped out of the study after the first week of Physical Activity the intervention, leaving us with a sample size of 10 (9 males, Participants’ self-reported and accelerometer-measured physical 1 female). The two participants who dropped out had not played activity varied at baseline (the mean Godin activity score was online fantasy sports previously, quickly decided that the game 40.09 (SD 14.69) range 14.00-65.50 and mean steps/day was more complicated than anticipated, and were unwilling or 6961.70, SD 2137.85, range 3346-10,473), and during the unable to invest time in learning the rules. Mean age was 22.50 16-week intervention phase (mean 6267.34, SD 1877.58, range (SD 3.89, range 18-30). Of the participants, 4 were White, 4 4427.97-9607.24). Physical activity did not significantly increase were Asian, 1 was Black, and 1 was Multiracial. The sample during the intervention phase, paired t =1.57, P≤.15. was highly educated; all participants had “some college” or higher. Mean body mass index was 23.61 (SD 3.18, range There was one participant who was already exceeding the goal 19.31-29.18), which is within the normal weight range. The of 10,000 steps/day at baseline and was asked to maintain his average number of online fantasy sports leagues played in prior or her baseline level of activity. Change in activity for that to the study was 3.36 (SD 3.96, range 0-9); 6 participants had participant (n=1, mean change = +865.76) was higher than for never played traditional fantasy sports before. those given goals to increase activity (n=9; mean change =-75.31, SD 1481.79). Enjoyment As in Study 1, self-reported enjoyment of the active fantasy Discussion sports game itself was significantly higher than neutral (3) on the 7-point scale, mean 5.23 (SD 1.36), one-sample t =5.19, Principal Findings P≤001. Furthermore, when asked to compare active fantasy The present investigation demonstrates the feasibility of linking sports relative to traditional (sedentary) fantasy sports in terms physical activity goals to features and privileges within an of enjoyment, participants rated active fantasy sports as extremely popular sedentary video game, online fantasy sports. marginally more enjoyable, one-sample t =2.09, P=.07. There were high rates of retention in both studies (zero attrition Participants’ self-reported intrinsic motivation for exercising in Study 1, two dropouts very early in Study 2), and regular in general did not change significantly from preintervention posting to the league message board in Study 1. Especially (mean 4.63, SD 1.64) compared to during the intervention (mean encouraging findings from this study related to participants’ 4.639, SD 2.18). ratings of the degree to which they enjoyed playing active fantasy sports. Across both studies, participants reported Social Factors enjoying active fantasy sports, and rated it significantly higher The mean number of posts to the league message board was than neutral. In Study 1, participants rated active fantasy sports significantly smaller than in Study 1, mean 1.50 (SD 2.42, range as even more enjoyable than traditional fantasy sports; Study 2 0-6). On average, they reported knowing 0.60 (SD 0.52) other participants rated it as neither more nor less enjoyable than participants in the league before the start of the season. When traditional. Study 2 participants had less previous experience asked, “How much better or worse would this game have been with fantasy sports and knew fewer participants in the league, if you knew everyone in the league very well before starting which likely influenced their enjoyment of the league. the season?” (-3=much worse, +3=much better), the mean response was +2.10 (SD 1.10), a strong preference for knowing Participants in both Studies 1 and 2 reported that knowing other other league members. However, when asked: “How much participants in the league at baseline would be highly desirable. better or worse would this game have been if everyone in the As such, we believe interventions of this kind have the best league was roughly as active as you were at baseline?” (-3=much probability of success if groups of friends can be recruited for worse; +3=much better), the mean response was 1.00 (SD 2.00), participation together. These circumstances also more faithfully indicating no clear preference. reflect the typical way that traditional (sedentary) online fantasy sports leagues form. Relative Impact of Fitness Although the two pilot studies were not designed or powered Finally, we asked participants about their preferences with to test the system’s potential for increasing physical activity, regard to the relative influence of their physical activity versus encouraging findings were observed. The use of accelerometers sedentary strategy on game outcomes. We asked, “If you could provides an objective indicator of changes in physical activity, choose the degree or amount that team owners’ physical activity and can be considered a major strength. In Study 1, participants impacted the outcomes of an active fantasy sports league, how increased their physical activity by over 30% during the active impactful would you make it?” (1=a very small impact / the fantasy baseball season compared to baseline. We note that in least active owner could still win; 7 a very large impact / the both studies, participants who were already meeting the activity lease active owners could not win). The mean response was http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 6 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al goal of 10,000 steps/day at baseline were instructed only to success, future research should investigate this issue further (eg, maintain their level of activity (3 participants in Study 1, 1 qualitative and quantitative analysis of message board usage). participant in Study 2). Fifth, future research may expand the variety of target sports (eg, football, soccer, hockey, golf, rugby, cricket, etc), thereby Limitations potentially increasing reach. Design limitations include the lack of a control or active Potential Public Health Impact comparison condition, and the low fidelity (manual, as opposed to automated) execution of the integration between physical As noted in the introduction, Baranowski and others [2] have activity data and fantasy sports game features. Consequences argued that the public health impact of previous AVGs has been were administered manually by the principle investigator using limited by low uptake and high cost. As such, we think it is standard tools provided by Yahoo to league commissioners. A useful to highlight a number of unique strengths associated with more elegant execution of the system could be achieved by active fantasy sports interventions that support potential reach leveraging open APIs made available by both accelerometer and cost-effectiveness. providers (eg, Fitbit) and fantasy sports league hosts (eg, Yahoo, Importantly, we believe the established massive popularity of Espn, or CNNSI). Despite these limitations, the important traditional (sedentary) fantasy sports provides a powerful contribution of swifter, proof-of-concept trials of this kind is dissemination channel. In 2014, over 41 million adults in the being championed in the emerging field of technology-support United States (US) and Canada alone played online fantasy and mobile health research [24]. sports [15]. For reference, in 2014, the entire population of The samples in both studies were small (n=9, and n=10), and Canada was roughly 34 million. If even a fraction of the were not representative of the general population, especially traditional fantasy sports audience could be persuaded to try with regard to gender. This limits the generalizability of the active fantasy sports, this would represent significantly greater findings. However, we note that the sample demographics were reach than previous AVGs. Further, while most AVGs have not relatively consistent with the population of adults who play made social features integral or required, preliminary evidence traditional online fantasy sports (ie, predominately male, suggested that social aspects of the active fantasy sports Caucasian, and well-educated). We also note that participants’ intervention were important. As such, active fantasy sport self-reported height and weight were potentially biased; future interventions may be especially well suited to implementation studies should include measurements of height and weight taken by organizations interested in promoting physical activity (eg, by research staff members with appropriately calibrated schools, or employer sponsored wellness programs). Active instruments. fantasy sports leagues sponsored by organizations could significantly magnify reach and, by leveraging existing social Future Directions ties, may also improve efficacy. The present research suggests a number of directions for future Further supporting the potential reach of active fantasy sport research. First, leveraging open APIs associated with type interventions are a number of factors limiting costs accelerometer providers and fantasy sport hosting websites will associated with software development, labor, and equipment. reduce the burden on research staff, allowing researchers to As noted earlier, the game platform that active fantasy sports collect data from much larger and more representative samples. interventions are built on (traditional fantasy sports) is in the Second, it will be important to test the efficacy of the active public domain and supported by numerous companies (“host” fantasy sports system for increasing physical activity relative websites, including Yahoo, ESPN, and CNNSI). By taking to a usual care or active comparison group (eg, participants advantage of existing, sophisticated game platform infrastructure assigned to receive an accelerometer for self-monitoring provided by numerous hosts, developers achieve significant purposes and a group message board only) using a randomized cost reductions relative to building a comparable AVG de novo. controlled trial. Group-randomization could be employed in The major hosts of traditional online fantasy sports offer open order to recruit groups of participants who know each other API access to external application developers specifically to before enrolling in the study. Third, aspects of the game can encourage innovation of this kind. Furthermore, established potentially be tailored according to the characteristics and hosts currently offer consumers access to traditional fantasy preferences of the participants. For example, participants in sports games without charging fees (major hosts typically use both studies expressed a desire for their physical activity to have an advertising-based revenue model), minimizing an important a greater impact on game outcomes. Optimization study designs barrier for low-income consumers. At present, the overhead and may help us refine which activity contingent features are labor costs associated with administrating an active fantasy maximally effective, test different ways of measuring physical sports intervention are already very low; the intervention was activity (eg, with wearable technology or specialized exercise administered remotely (as opposed to in-person) and involved equipment), and assess different rules for setting activity goals minimal administrative effort (<1 hour per week). By leveraging in order to maximize both optimal challenge and perceived device and host APIs, future iterations of this intervention may fairness. Prior research also shows that levels of competitiveness further automate oversight and reduce costs, especially relative may influence enjoyment of games and thus may have to gold-standard interventions such as individual professional implications for intrinsic motivation [25,26]; future research coaching delivered in-person. A third factor related to cost may tailor game features or match players based on concerns the affordability of equipment used for objectively competitiveness. Fourth, given the preliminary evidence that measuring physical activity. The present versions of the active social factors helped motivated participation and intervention http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 7 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al fantasy sports intervention employed a low cost accelerometer Conclusions (retail price US $60) that was provided to participants. However, To summarize, this study provides strong support for the the cost of dedicated wearable accelerometers is rapidly falling; feasibility of integrating physical activity contingent features similar models are currently available for as low as US $12 per and privileges into an online fantasy sports game platform. unit [27]. Smartphones, which typically include sophisticated Participants found this asynchronous active video game system built-in accelerometers, are increasingly ubiquitous, reducing enjoyable, as or more enjoyable than traditional (sedentary) the cost of activity tracking equipment further still. The cost of online fantasy sports. Social support within the game was cited more sophisticated activity tracking devices (eg, activity trackers as an important factor for both enjoyment and increasing that incorporate heart rate sensors, global positioning system, physical activity. Future research is needed to test the efficacy and accelerometry, including Apple’s iWatch, Fitbit’s Surge, of this system using a randomized controlled trial and and Microsoft’s Band) should similarly fall if the proliferation optimization-type designs, and with a larger, more diverse of wearable activity tracking technology continues. sample of participants. The scalability and reach of active fantasy sport interventions represents a significant strength. Acknowledgments The authors wish to thank Rachel Kornfield for her thoughtful comments on earlier drafts of this manuscript. Some of these findings were presented previously at the Annual Society of Behavioral Medicine Conference, April 23-26, 2014, Philadelphia, PA, and at the Health Experience Refactored (HxR) conference, May 13-14, 2014, Brooklyn, NY. Conflicts of Interest The lead author of this manuscript (Moller) is also the sole inventor of a US Patent Application currently under review at the US Patent and Trademark Office (filed on December 3rd, 2013), titled: “Incorporating objective assessments of fantasy-team-owners’ physical activity into fantasy sport platforms” (Serial No. 14/088,632). Ownership of the referenced intellectual property is vested in Illinois Institute of Technology. For the other authors of this manuscript, no competing financial interests exist. Multimedia Appendix 1 Screenshots of a fantasy sports team roster, a league comprised of multiple fantasy sports teams, a fantasy team owner tool for offering a player trade to another fantasy team owner, a fantasy sports league message board, and fantasy sports league commissioner tools. [PDF File (Adobe PDF File), 3MB-Multimedia Appendix 1] References 1. 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URL: http://drgarybennett.com/2014/07/22/ how-are-fitness-trackers-like-paper-towels/ [accessed 2014-11-02] [WebCite Cache ID 6TogJXwoP] Abbreviations AVG: active video game SDT: self-determination theory FSTA: Fantasy Sports Trade Association PAR-Q: Physical Activity Readiness Questionnaire IIT: Illinois Institute of Technology http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 9 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Moller et al Edited by G Giunti; submitted 08.07.14; peer-reviewed by T Baranowski, D Castaneda; comments to author 06.08.14; revised version received 17.10.14; accepted 17.10.14; published 25.11.14 Please cite as: Moller AC, Majewski S, Standish M, Agarwal P, Podowski A, Carson R, Eyesus B, Shah A, Schneider KL JMIR Serious Games 2014;2(2):e13 URL: http://games.jmir.org/2014/2/e13/ doi: 10.2196/games.3691 PMID: 25654304 ©Arlen C Moller, Sara Majewski, Melanie Standish, Pooja Agarwal, Aleksandra Podowski, Rebecca Carson, Biruk Eyesus, Aakash Shah, Kristin L Schneider. Originally published in JMIR Serious Games (http://games.jmir.org), 25.11.2014. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on http://games.jmir.org, as well as this copyright and license information must be included. http://games.jmir.org/2014/2/e13/ JMIR Serious Games 2014 | vol. 2 | iss. 2 | e13 | p. 10 (page number not for citation purposes) XSL FO RenderX

Journal

JMIR Serious GamesJMIR Publications

Published: Nov 25, 2014

Keywords: physical activity; games for health; active video game; exergame; asynchronous; social support; multiplayer; enjoyment; intrinsic motivation; sports

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