• Marisa M Putnam, Elana M Richmond, Kaitlin L Brunick, Charlotte A Wright, and Sandra L Calvert.
• Children's Digital Media Center, Georgetown University , Washington, District of Columbia.
• Games Health J. 2018 Apr 1; 7 (2): 121-126.

ObjectiveChildhood obesity is a health issue in the United States, associated with marketing practices in which media characters are often used to sell unhealthy products. This study examined exposure to a socially contingent touch-screen gaming app, which replied immediately, reliably, and accurately to children's actions. Children's recall of nutritional content and their liking of the character were assessed.Materials And MethodsFour- and five-year-old children (N = 114) received no-exposure, single-exposure, or repeated-exposure to a character-based iPad app rewarding healthy and penalizing unhealthy behaviors. Children reported how much they liked the character and recalled healthy and unhealthy items from the app. An ordinary least squares regression was conducted on how much children liked the character by condition. Poisson regressions were conducted on the number of items recalled by condition alone, and in an interacted model of treatment condition by liking the character.ResultsChildren liked the character more in the repeated app-exposure condition than in the control group (P = 0.018). Children in the repeated and single app-exposure conditions recalled more healthy (P < 0.001) and unhealthy (P < 0.001) items than the control group. Within treatment conditions, liking the character increased recall of healthy items in the single app-exposure compared to the repeated app-exposure condition (P = 0.005).ConclusionsResults revealed that repeated exposure increased children's learning of nutritional information and liking of the character. The results contribute to our understanding of how to deliver effective nutrition information to young children in a new venue, a gaming app.

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