Health game interventions to enhance physical activity self-efficacy of children: a quantitative systematic review

J Adv Nurs. 2017 Apr;73(4):794-811. doi: 10.1111/jan.13160. Epub 2016 Oct 20.


Aim: To describe and explore health game interventions that enhance the physical activity self-efficacy of children and to evaluate the effectiveness of these interventions.

Background: Physical inactivity among children has increased globally. Self-efficacy is one of the key determinants of physical activity engagement in children. There is a need to explore new and innovative interventions to enhance physical activity self-efficacy that are also acceptable for today's children.

Design: Quantitative systematic review.

Data sources: MEDLINE (Ovid), CINAHL, PsychInfo, EMBASE and the Cochrane Library between 1996-2016.

Review methods: A review was conducted in accordance with the Cochrane Collaboration guidelines. A systematic search was done in June 2016 by two independent reviewers according to the eligibility criteria as follows: controlled trial, comparison of digital game intervention with no game intervention control condition, participants younger than 18 years of age and reported statistical analyses of a physical activity self-efficacy outcome measure.

Results: Altogether, five studies met the eligibility criteria. Four game interventions, employing three active games and one educational game, had positive effects on children's physical activity self-efficacy. An intervention, employing a game-themed mobile application, showed no intervention effects. The variation between intervention characteristics was significant and the quality of the studies was found to be at a medium level.

Conclusion: Although health game interventions seemingly enhance the physical activity self-efficacy of children and have potential as a means of increasing physical activity, more rigorous research is needed to clarify how effective such interventions are in the longer run to contribute to the development of game-based interventions.

Keywords: children; health game; health promotion; nursing; physical activity; self-efficacy; systematic review.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Exercise / psychology*
  • Female
  • Games, Recreational / psychology*
  • Health Promotion / methods*
  • Humans
  • Male
  • Self Efficacy*
  • Video Games / psychology*