Giuseppe Andreoni and Maria Renata Guarneri discuss how the PEGASO project is promoting sustainable behaviours geared towards achieving healthy lifestyles
Challenging teenagers in the context of their own areas of interest, PEGASO Fit 4 Future aims to promote sustainable behaviours geared towards achieving healthy lifestyles. The goals of the PEGASO project were achieved by implementing innovative mobile solutions for prevention in healthcare, thanks to the development of a multi-dimensional and cross-disciplinary ICT system. This included game mechanics to influence behaviours, with the hopes of fighting and preventing obesity in the younger population, encouraging them to become co-producers of their wellness, and take an active role in improving it.
PEGASO leverages a modular behaviour change platform targeted at teenagers. When it comes to preventing obesity and related comorbidities, smartphones are thought of as a central agent for behaviour change. Additional sensors could be used along with a modular approach. The platform is designed to deliver a positive message and act as a tool dedicated to improving teenager’s lifestyles according to 4 dimensions:
Movement, i.e. adopting an active lifestyle. Increasing sedentariness together with unhealthy eating habits in our everyday life are producing negative effects on the health of the younger generations. Particularly in terms of increased body weight and potential development of metabolic diseases;
- Play, i.e. enjoyable continuous engagement and, therefore, compliance;
- Eat, i.e. tasty but balanced nutrition;
- Share, i.e. a social approach.
The project has developed an educational platform able to motivate people through games and group challenges – virtual and real – with a social approach where people influence each other. It has an ecosystem of coordinated mobile apps, a virtual community, an educational game, and wearable devices to monitor physiological parameters.
PEGASO is based on a mobile platform in which the smartphone is the converging technology, i.e. the first and key sensor system. The mobile device also acts as a communication gateway towards the other sensors. In addition, with a modular approach, wearable sensors can be added to the system, according to the users’ preferences:
A bracelet that monitors physical activities, called WWAT (Waterproof Wearable Activity Tracker). Sensors embedded in the bracelet give more precise measurements than the phone and can be worn 24/7.
A WES (Wearable Electronic System). A smart garment that monitors fitness/sports activities. It is expected that while people will not want to wear complex sensor systems every day, they might be willing to put on additional sensors when performing specific activities oriented at improving their level of fitness.
The Feedback System of the PEGASO system is the Companion. The PEGASO Health Companion represents the guidance system and is the main interface between the user and the PEGASO system. The PEGASO Health Companion is a personal digital ‘friend’, acting as a daily life-guide for coaching, caring for, and empowering teenagers in their activities toward healthy habits. Main attributes of the PEGASO Companion are:
- Digital: The Companion exists in the smartphone;
- Personal: The Companion is customised to the single user;
- Friend: The Companion would establish an effective relationship with the user;
- Daily-life guide: The Companion accompanies the users (coaching, caring, and empowering) during their daily activities toward healthy habits: supporting behaviour change to promote healthy lifestyles is the main goal of the Companion and PEGASO project in general, with a special focus on obesity prevention.
The Companion is an ecosystem of different elements, apps, and services. In the PEGASO vision for teenagers, the Companion wants to be a compass to guide towards a healthy lifestyle. From the user perspective, the Companion is structured as follows:
The Companion is the main app that represents the entry point for the user inside the PEGASO universe. A set of other apps is integrated into the Companion. Different apps in support of the development of awareness and motivation towards healthy behaviour are accessed via the Companion:
- eDiary, to record food consumption;
- Challenges, to set goals against the system or among friends;
- Dashboard, providing an overview of current achievements;
- PEGASO City, linked to gamification and city marketplace;
- Mobile Serious game, a key component to providing education and motivation;
- Report app, linking PEGASO to a healthcare system.
Through an innovative and multi-dimensional PEGASO virtual individual Model, a conceptual framework of basic relations between the individual’s status and behaviours in different domains, which are considered to dynamically concur to health, have been built.
This allowed us to set up an efficient user feedback system: The PEGASO Behaviour Recognition is the core of the reasoning system aimed at the identification of behaviours and matching them with target behaviours. The scoring system is based on 3 levels:
- A short-term analysis;
- A long-term analysis;
- An overall risk analysis.
The gaming approach in PEGASO wants to exploit social connectivity (share) and engagement (play). The overall gaming system in PEGASO is managed via the Companion and is based on a 3-fold approach:
- The PEGASO game: a 3D serious game aimed at increasing nutritional awareness and promoting physical activity – motivational component.
- The PEGASO gamified approach: linking ‘real world activity’ with online & gaming applications – social component.
- The PEGASO minigames: addressing specific aspects of healthy behaviour – educational component.
The PEGASO minigames are small games with very specific goals; they can be completed in a short time span and provide information in a playful manner. The main goal is to develop awareness and encourage healthy behaviour, developing intrinsic (autonomous) motivation. Education and awareness are important triggers for developing autonomous motivation. Minigames have been embedded within the PEGASO serious game: examples include SCAVENGING, i.e. to collect as much food as possible and match the food icons belonging to the same nutritional category, or RESEARCH, i.e. to match a single food item, collected through the scavenging mini-game, to a recipe requirement (Fig. 6). Stand-alone minigames have also been developed to be played as separate elements for education and entertainment.
Four hundred students (aged 13-17) in 4 European pilot sites tested the PEGASO System: Lombardy in Italy, Catalunya in Spain, and England and Scotland in the United Kingdom participated in this phase. The evaluation approach was mainly dedicated to the system and technology acceptance, usability, and long-term use. These factors are also a secondary assessment of motivation and engagement. The reliability in assessing teenager’s lifestyles and their changes (with the focus on the eating habits and on physical activities) and related efficacy on the sensors’ network system was investigated too. The subjective assessment was adapted for awareness.
Maria Renata Guarneri
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