%0 Journal Article
%@ 2291-9279
%I JMIR Publications
%V 13
%N 
%P e60185
%T Effect of a Gamified Family-Based Exercise Intervention on Adherence to 24-Hour Movement Behavior Recommendations in Preschool Children: Single-Center Pragmatic Trial
%A Legarra-Gorgoñon,Gaizka
%A García-Alonso,Yesenia
%A Ramírez-Vélez,Robinson
%A Alonso-Martínez,Loreto
%A Izquierdo,Mikel
%A Alonso-Martínez,Alicia M
%K children
%K gamification
%K exercise
%K physical fitness
%K domains of physical activity
%K game
%K fitness
%K child
%K family-based
%K exercise program
%K randomized controlled trial
%K strength
%D 2025
%7 4.3.2025
%9 
%J JMIR Serious Games
%G English
%X Background: Adherence to 24-hour movement behavior recommendations, including physical activity (PA), sedentary time, and sleep, is essential for the healthy development of preschool children. Gamified family-based interventions have shown the potential to improve adherence to these guidelines, but evidence of their effectiveness among children is limited. Objective: This study aimed to evaluate the effectiveness of a gamified family-based exercise intervention in promoting adherence to 24-hour movement behavior recommendations among preschool-aged children. Methods: This 12-week study is a single-center, pragmatic randomized controlled trial that included 80 preschool children (56% boys) and their families, who were randomly assigned to either the gamification group (n=40) or the control group (n=40). The “3, 2, 1 Move on Study” incorporates family-oriented physical activities and gamification techniques to increase PA domains, reduce sedentary behavior, and improve sleep patterns. The primary outcome was to increase moderate to vigorous PA (MVPA) by 5 minutes/day, as measured by accelerometer at follow-up. Accelerometer-determined daily time spent (PA domains, sedentary behavior, and sleep), physical fitness (cardiorespiratory, speed-agility, muscular, physical fitness z-score), basic motor competencies (self-movement and object movement), and executive function (memory, cognitive flexibility, and inhibitory control) were also included as secondary outcomes. Results: The 71 participants included in the per-protocol analyses (32 girls, 45%; 39 boys, 55%) had a mean (SD) age of 5.0 (0.5) years. Change in MVPA per day after the intervention (12 weeks) increased in both groups by +25.3 (SD 24.6) minutes/day in the gamification group and +10.0 (SD 31.4) minutes/day in the routine care group, but no significant between-group differences were observed (8.62, 95% CI –5.72 to 22.95 minutes/day, ηp2=.025; P=.23). The analysis of secondary outcomes showed significant between-group mean differences in the change in physical behaviors derived from the accelerometers from baseline to follow-up of 26.44 (95% CI 8.93 to 43.94) minutes/day in favor of light PA (ηp2=.138; P=.01) and 30.88 (95% CI 4.36 to 57.41) minutes/day in favor of total PA, which corresponds to a large effect size (ηp2=.087; P=.02). Likewise, the gamification group substantially increased their score in standing long jump and physical fitness z-score from baseline (P<.05). Conclusions: In the “3, 2, 1 Move on Study,” a gamified intervention showed a modest but relevant increase in MVPA and other domains of 24-hour movement behavior among preschool-aged children. Therefore, gamified family-based interventions may provide a viable alternative to improve adherence to 24-hour movement behavior recommendations. Trial Registration: ClinicalTrials.gov NCT05741879; https://clinicaltrials.gov/study/NCT05741879?tab=history 
%R 10.2196/60185
%U https://games.jmir.org/2025/1/e60185
%U https://doi.org/10.2196/60185