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Zabatiero J, Stone L, McCormack D, Zarb D, Nolan A, Highfield K, Skouteris H, Edwards S, Straker L. "I Use Technologies Strategically With My Family Now": Practices That Parents Value to Promote Physical Activity in Young Children. J Phys Act Health 2024; 21:1121-1131. [PMID: 39322205 DOI: 10.1123/jpah.2024-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/16/2024] [Accepted: 07/30/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND Although widely accessible digital technology (DT) provided multiple opportunities for young children's play, learning, and development, it also raised parents and professionals' concerns regarding its impact on children's physical activity. This study aimed to identify practices involving DT that were valued by parents in helping their young child to be physically active. METHODS Participants were parents of ambulatory young children (less than 5 y of age) engaged with a playgroup. The study involved representatives from 3 service organizations, who compiled a list of digital resources related to using DT to promote children's physical activity that were suitable to be shared and trialed by parents and young children. During a pretrial workshop, researchers, participants, and organization representatives collaboratively developed the intervention, which involved the delivery of selected resources by weekly email, over a 12-week period. Participants provided weekly feedback about their experiences and participated in a postintervention semistructured qualitative interview. RESULTS Thirteen families, with children aged between 15 and 36 months, completed the trial. Participants reported several valued practices to promote their children's physical activity, including those where the child was active while engaging with DT, where child engagement with DT acted as a prompt for later physical activity, where DT assisted parents in planning physical activity, where DT assisted parents in integrating movement with learning and play, and where DT was used to reinforce the child's enthusiasm for physical activity. CONCLUSIONS Parents reported several valued practices where children were physically active, rather than sedentary, while using digital technology.
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Affiliation(s)
- Juliana Zabatiero
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- ARC Center of Excellence for the Digital Child, Australia
| | - Laura Stone
- ABC Kids Early Education, Australia Broadcasting Corporation, Ultimo, NSW, Australia
| | | | | | - Andrea Nolan
- School of Education, Faculty of Arts & Education, Deakin University, Geelong, VIC, Australia
| | - Kate Highfield
- Faculty of Education, University of Canberra, Acton, ACT, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Susan Edwards
- Early Childhood Futures, Institute for Learning Sciences & Teacher Education, Australian Catholic University, East Melbourne, VIC, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
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Liang H, Wang X, An R. Influence of Pokémon GO on Physical Activity and Psychosocial Well-Being in Children and Adolescents: Systematic Review. J Med Internet Res 2023; 25:e49019. [PMID: 37955949 PMCID: PMC10682915 DOI: 10.2196/49019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/16/2023] [Accepted: 09/30/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Pokémon GO, an augmented reality game with widespread popularity, can potentially influence players' physical activity (PA) levels and psychosocial well-being. OBJECTIVE This review aims to systematically examine the scientific evidence regarding the impact of Pokémon GO on PA and psychosocial well-being in children and adolescents. METHODS Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, we conducted keyword and reference searches in the PubMed, CINAHL, Web of Science, and Scopus databases. We performed title and abstract screening, full-text review, evidence synthesis, and identified research gaps. RESULTS Our review included 10 studies that explored the effect of Pokémon GO on PA or psychosocial well-being among children and adolescents. These studies used diverse designs across multiple countries and regions. Pokémon GO use measures encompassed frequency, experience, adherence, and motivation. PA assessment methods ranged from self-reported questionnaires to technology-based evaluations and qualitative approaches. Psychosocial well-being measures included emotional intelligence, personal well-being, self-control, emotionality, and sociability. In general, the estimated impact of Pokémon GO on PA was positive, with gaming elements and engagement correlating with increased PA levels. However, the effect on psychosocial well-being presented mixed results, with positive associations for sociability but a complex relationship involving well-being and internet gaming disorder. The limitations of these studies comprised the absence of randomized controlled trials, heterogeneity in study designs and outcome measures, and potential confounding bias. CONCLUSIONS Overall, Pokémon GO tends to positively affect PA levels, while the impact on psychosocial well-being remains complex and requires further investigation. Future research should investigate the mechanisms connecting Pokémon GO use with PA and psychosocial well-being and the potential risks of excessive gameplay. These findings can help inform public health interventions to harness gaming technologies for promoting PA and enhancing well-being among the younger generation. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42023412032; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=412032.
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Affiliation(s)
- Haiyan Liang
- School of Sport Business, Guangzhou Sport University, Guangzhou, China
| | - Xi Wang
- Brown School, Washington University in St Louis, St Louis, MO, United States
| | - Ruopeng An
- Brown School, Washington University in St Louis, St Louis, MO, United States
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Feasibility and Acceptance of Augmented and Virtual Reality Exergames to Train Motor and Cognitive Skills of Elderly. COMPUTERS 2023. [DOI: 10.3390/computers12030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The GAME2AWE platform aims to provide a versatile tool for elderly fall prevention through exergames that integrate exercises, and simulate real-world environments and situations to train balance and reaction time using augmented and virtual reality technologies. In order to lay out the research area of interest, a review of the literature on systems that provide exergames for the elderly utilizing such technologies was conducted. The proposed use of augmented reality exergames on mobile devices as a complement to the traditional Kinect-based approach is a method that has been examined in the past with younger individuals in the context of physical activity interventions, but has not been studied adequately as an exergame tool for the elderly. An evaluation study was conducted with seniors, using multiple measuring scales to assess aspects such as usability, tolerability, applicability, and technology acceptance. In particular, the Unified Theory of Acceptance and Use of Technology (UTAUT) model was used to assess acceptance and identify factors that influence the seniors’ intentions to use the game platform in the long term, while the correlation between UTAUT factors was also investigated. The results indicate a positive assessment of the above user experience aspects leveraging on both qualitative and quantitative collected data.
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Koulouris D, Menychtas A, Maglogiannis I. An IoT-Enabled Platform for the Assessment of Physical and Mental Activities Utilizing Augmented Reality Exergaming. SENSORS 2022; 22:s22093181. [PMID: 35590871 PMCID: PMC9102367 DOI: 10.3390/s22093181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/11/2022] [Accepted: 04/18/2022] [Indexed: 11/30/2022]
Abstract
Augmented reality (AR) and Internet of Things (IoT) are among the core technological elements of modern information systems and applications in which advanced features for user interactivity and monitoring are required. These technologies are continuously improving and are available nowadays in all popular programming environments and platforms, allowing for their wide adoption in many different business and research applications. In the fields of healthcare and assisted living, AR is extensively applied in the development of exergames, facilitating the implementation of innovative gamification techniques, while IoT can effectively support the users’ health monitoring aspects. In this work, we present a prototype platform for exergames that combines AR and IoT on commodity mobile devices for the development of serious games in the healthcare domain. The main objective of the solution was to promote the utilization of gamification techniques to boost the users’ physical activities and to assist the regular assessment of their health and cognitive statuses through challenges and quests in the virtual and real world. With the integration of sensors and wearable devices by design, the platform has the capability of real-time monitoring the users’ biosignals and activities during the game, collecting data for each session, which can be analyzed afterwards by healthcare professionals. The solution was validated in real world scenarios and the results were analyzed in order to further improve the performance and usability of the prototype.
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Affiliation(s)
| | | | - Ilias Maglogiannis
- Department of Digital Systems, University of Piraeus, 80, M. Karaoli & A. Dimitriou St., 18534 Piraeus, Greece
- Correspondence:
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Farič N, Potts HWW, Rowe S, Beaty T, Hon A, Fisher A. Running App "Zombies, Run!" Users' Engagement with Physical Activity: A Qualitative Study. Games Health J 2021; 10:420-429. [PMID: 34813376 DOI: 10.1089/g4h.2021.0060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Sufficient physical activity (PA) is important for all aspects of health. Smartphone apps and the use of gamification, such as narrative-based augmented reality (AR), have a great potential to engage a variety of people in more PA. Zombies, Run! (ZR) is the world's most popular running exergame app and therefore a suitable model to understand what users find engaging. Objective: To understand people's motivation and experience of using a narrative-based AR exergame app ZR for PA. Materials and Methods: ZR users were randomly selected for interview from a quantitative ZR user's survey. Interviews which were guided by a semistructured topic guide were audio-recorded, transcribed, and analyzed using inductive and deductive thematic analysis. Results: Participants were 15 males and 15 females aged 16-53 years (mean = 36, SD = 10), from 13 countries, with the largest proportions from the United States (30%) and United Kingdom (23%). The majority (73%) used ZR while running, followed by cycling and walking. Four overarching themes that emerged were: "Reasons for starting and staying with ZR," "Preferred features," "Perceived effects of ZR," and "Pros and cons of the app." Sixteen subthemes included the attraction of gamification and narrative appeal, desire to add something fun to PA, or to distract from the negative physiological effects of PA. Users' favorite features were the feelings of immersion and presence through narrative, story line, and characters. The narrative motivated participants to engage in PA for longer sessions and encouraged long-term use. Conclusions: This study identified a number of factors that users found attractive in an AR running exergame, particularly narrative. Our findings suggest that ZR may engage people in exercise by modifying their perception of PA through a story line or narrative, dissociating the players from the effort of exertion. AR narrative-based apps may be an effective way of engaging people with health-related behaviors or habit-forming activities.
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Affiliation(s)
- Nuša Farič
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Henry W W Potts
- Institute of Health Informatics, University College London, United Kingdom
| | - Sarah Rowe
- Division of Psychiatry, University College London, United Kingdom
| | | | | | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Srivastava A, Dasgupta SA, Ray A, Bala PK, Chakraborty S. Relationships between the “Big Five” personality types and consumer attitudes in Indian students toward augmented reality advertising. ASLIB J INFORM MANAG 2021. [DOI: 10.1108/ajim-02-2021-0046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PurposeThe purpose of this paper is to investigate the role of the “Big Five” personality traits (extraversion, openness, agreeableness, conscientiousness and neuroticism) on the adoption of augmented reality (AR), with a particular focus on the role AR may play in interactive marketing.Design/methodology/approachA quantitative-based approach was followed by a questionnaire survey, which was completed by 230 respondents comprising graduate and postgraduate students, using structural equation modelling.FindingsWhile the trait of openness was positively associated with the perceived ease of use of AR, the usefulness of AR and subjective norms, the trait of neuroticism was negatively associated with the perceived ease of use of AR. Extraversion was positively associated with subjective norms. Perceived ease of use of AR, the usefulness of AR and subjective norms were positively associated with attitudes toward AR.Practical implicationsThe data gathered will add a valuable contribution to the currently limited data available on empirical consumer behaviour research, particularly in relation to the adoption of AR for interactive marketing.Originality/valueThe findings of this study will benefit academics working on the adoption of technology in rapidly developing fields such as automation and artificial intelligence; the study also contributes to the emerging interdisciplinary domain of psychology, information systems, marketing and human behaviour.
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Beach C, Montoye AHK, Steeves JA. Differences in Physical Activity During Walking and Two Pokémon Go Playing Styles. Games Health J 2021; 10:130-138. [PMID: 33818134 DOI: 10.1089/g4h.2020.0070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Two self-selected playing styles of Pokémon Go (PG) have been observed: intermittent and continuous. However, it is unknown how playing style impacts volume and pattern of physical activity (PA) compared with a traditional walking bout. Materials and Methods: Twenty experienced PG players followed a 1.77 km walking loop during two randomly ordered, 30-minute walking conditions: PG and traditional walking. Objective measurement tools (pedometer, accelerometer, heart rate monitor, GPS watch) were used to measure steps, caloric expenditure, intensity, heart rate, and distance traveled, and direct observation was used to determine number of stops and playing style. Results: Most PG players used the intermittent playing style (60%). Traditional walking resulted in significantly greater PA than PG. There was a significant interaction between the PG playing style (continuous, intermittent) and condition (PG, traditional walking). There was no difference in PA variables between continuous and intermittent PG during traditional walking; however, total steps (3394.3 ± 255.8 vs. 2779.1 ± 317.5), aerobic steps (3314.3 ± 318.9 vs. 2387.5 ± 771.8), caloric expenditure (146.00 [130.0-201.3] vs. 110.0 [89.3-132.3 Kcals]), distance (2.4 [2.3-2.6] vs. 2.0 [1.8-2.1 km]), and moderate minutes (29.7 [27.5-29.8] vs. 25.8 [23.1-27.1]) were significantly greater, while sedentary minutes (0.2 [0-1.0] vs. 2.7 [1.7-4.3]) and number of stops (0 [0-0.8] vs. 4.5 [2.3-7.0]) were less, for continuous compared with intermittent PG. There was a main effect of condition on PA for intermittent PG players, but not continuous PG players. Conclusion: Continuous PG produced similar PA to traditional walking, while intermittent PG reduced PA, nevertheless PG may be a strategy for increasing PA participation.
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Affiliation(s)
- Colby Beach
- Department of Health Sciences and Outdoor Studies, Maryville College, Maryville, Tennessee, USA
| | - Alexander H K Montoye
- Department of Integrative Physiology and Health Science, Alma College, Alma, Michigan, USA
| | - Jeremy A Steeves
- Department of Health Sciences and Outdoor Studies, Maryville College, Maryville, Tennessee, USA
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Ong T, Wilczewski H, Paige SR, Soni H, Welch BM, Bunnell BE. Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint. JMIR Serious Games 2021; 9:e26520. [PMID: 34227992 PMCID: PMC8315161 DOI: 10.2196/26520] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic caused widespread challenges and revealed vulnerabilities across global health care systems. In response, many health care providers turned to telehealth solutions, which have been widely embraced and are likely to become standard for modern care. Immersive extended reality (XR) technologies have the potential to enhance telehealth with greater acceptability, engagement, and presence. However, numerous technical, logistic, and clinical barriers remain to the incorporation of XR technology into telehealth practice. COVID-19 may accelerate the union of XR and telehealth as researchers explore novel solutions to close social distances. In this viewpoint, we highlight research demonstrations of XR telehealth during the COVID-19 pandemic and discuss future directions to make XR the next evolution of remote health care.
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Affiliation(s)
- Triton Ong
- Doxy.me, LLC, Rochester, NY, United States
| | | | | | - Hiral Soni
- Doxy.me, LLC, Rochester, NY, United States
| | - Brandon M Welch
- Doxy.me, LLC, Rochester, NY, United States
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me, LLC, Rochester, NY, United States
- Department of Psychiatry, University of South Florida, Tampa, FL, United States
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Gamification for Family Engagement in Lifestyle Interventions: A Systematic Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:831-844. [PMID: 33786746 DOI: 10.1007/s11121-021-01214-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 10/21/2022]
Abstract
The majority of chronic conditions that plague the USA are modifiable by lifestyle change. Lifestyle interventions that incorporate family members for social support and that use game design elements to engage family members have the potential to improve upon traditional interventions, which have largely been unsustainable. Determining the populations where family member support in a lifestyle intervention are present and the extent of gamification of lifestyle intervention components that engage these family members is an important and underexplored area of work. A systematic review of lifestyle interventions involving family members were reviewed for game design elements using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Game design elements related to engaged learning and motivational affordances from previous literature were included. Sixty-one studies met inclusion criteria. These studies reported on 50 independent interventions that were reviewed. Thirty-one of these interventions addressed lifestyle in those with a chronic condition, and 19 addressed lifestyle in those at high risk for chronic conditions. The majority of the lifestyle interventions included at least one game design element, yet overall there were limited elements utilized together. Compared with successful gamified programs that have greatly impacted a population's health behaviors, there were relatively a limited number of elements reported, particularly those that support social relatedness, such as meaningful storylines. Meaningfulness of the game design elements chosen and their arrangement was not apparent. Technology was under-utilized as a potential modality for intervention component delivery. Developing products to train researchers to properly apply game design elements to intervention components, as well as test their effectiveness, are areas for future research.
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Arjoranta J, Kari T, Salo M. Exploring Features of the Pervasive Game Pokémon GO That Enable Behavior Change: Qualitative Study. JMIR Serious Games 2020; 8:e15967. [PMID: 32449689 PMCID: PMC7281148 DOI: 10.2196/15967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/17/2020] [Accepted: 03/21/2020] [Indexed: 11/13/2022] Open
Abstract
Background Digital gaming is one of the most popular forms of entertainment in the world. While prior literature concluded that digital games can enable changes in players’ behaviors, there is limited knowledge about different types of behavior changes and the game features driving them. Understanding behavior changes and the game features behind them is important because digital games can motivate players to change their behavior for the better (or worse). Objective This study investigates the types of behavior changes and their underlying game features within the context of the popular pervasive game Pokémon GO. Methods We collected data from 262 respondents with a critical incident technique (CIT) questionnaire. We analyzed the responses with applied thematic analysis with ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) software. Results We discovered 8 types of behavior changes and 13 game features relevant to those behavior changes. The behavior changes included added activity in life, enhancing routines, exploration, increased physical activity, strengthening social bonds, lowering social barriers, increased positive emotional expression and self-treatment. The game features included reaching a higher level, catching new Pokémon, evolving new Pokémon, visiting PokéStops, exploring PokéStops, hatching eggs, fighting in gyms, collaborative fighting, exploiting special events, finding specific Pokémon, using items, Pokémon theme, and game location tied to physical location. The behavior changes were connected to specific game features, with game location tied to physical location and catching new Pokémon being the most common and connected to all behavior changes. Conclusions Our findings indicate that the surveyed players changed their behaviors while or after playing Pokémon GO. The respondents reported being more social, expressed more positive emotions, found more meaningfulness in their routines, and had increased motivation to explore their surroundings.
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Affiliation(s)
| | - Tuomas Kari
- University of Jyväskylä, Jyväskylä, Finland.,Institute for Advanced Management Systems Research, Turku, Finland
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Mitchell M, Lau E, White L, Faulkner G. Commercial app use linked with sustained physical activity in two Canadian provinces: a 12-month quasi-experimental study. Int J Behav Nutr Phys Act 2020; 17:24. [PMID: 32098625 PMCID: PMC7043029 DOI: 10.1186/s12966-020-00926-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background Top tier commercial physical activity apps rarely undergo peer-reviewed evaluation. Even fewer are assessed beyond six months, the theoretical threshold for behaviour maintenance. The purpose of this study was to examine whether a multi-component commercial app rewarding users with digital incentives for walking was associated with an increase in physical activity over one year. Methods This 12-month quasi-experimental study was conducted in two Canadian provinces (n = 39,113 participants). Following a two-week baseline period, participants earned digital incentives ($0.04 CAD/day) every day they reached a personalized daily step goal. Mixed-effects models estimated changes in weekly mean daily step count between the baseline period and the last two recorded weeks. Models were fit for several engagement groups and separately by baseline physical activity status within engagement groups. Results Nearly half of participants (43%) were categorized as physically inactive at baseline (fewer than 5000 daily steps), and 60% engaged with the app for at least six months [‘Regular’ (24–51 weeks of step data) or ‘Committed’ sub-groups (52 weeks)]. Weekly mean daily step count increased for physically inactive users regardless of engagement status (P < .0001). The increase was largest for ‘Regular’ and ‘Committed’ participants—1215 and 1821 steps/day, respectively. For physically active participants, step count increases were only observed in the ‘Committed’ sub-group (P < .0001). Effect sizes were modest-to-medium depending on the sub-group analyzed. Conclusions A commercial app providing small but immediate digital incentives for individualized goals was associated with an increased weekly mean daily step count on a population-scale over one year. This effect was more evident for physically inactive and more engaged participants.
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Affiliation(s)
- Marc Mitchell
- Faculty of Health Sciences, School of Kinesiology, Arts & Humanities Building, Western University, Room 3R12B, London, Ontario, N6A 5B9, Canada. .,Carrot Insights Inc., Toronto, ON, Canada.
| | - Erica Lau
- University of British Columbia, Vancouver, BC, Canada
| | | | - Guy Faulkner
- University of British Columbia, Vancouver, BC, Canada
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Baranowski T, Lyons EJ, Thompson D. Experimental Design to Systematically Develop a Knowledge Base for Effective Games for Health. Games Health J 2019; 8:307-312. [DOI: 10.1089/g4h.2019.0057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Elizabeth J. Lyons
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, Texas
| | - Debbe Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
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