Flathead Rez Exergame

Americans’ increasingly sedentary lifestyle is a contributing factor in rising obesity rates, which are tied to numerous preventable health problems and psychological issues. Decreased physical activity and increasing screen time are contributing to Native American youth obesity levels higher than their peers. The proposed project aims to develop a culturally-grounded “exergame” that would increase outdoor physical activity for Native youth. The game would combine the appeal of exergames like Pokémon Go and the technology of nature recognition apps to get Natives outside virtually collecting traditional foods and supplies to keep their game character alive. The Flathead Rez Exergame would incorporate tribal knowledge and values, such as names of edible plants and sustainable gathering practices. It would increase outdoor activity, which has both physical and mental health benefits, and promote positive cultural identity. As potentially the first Native exergame, it could be a model for other tribes.

One study of Northern Plains tribal youth found they were twice as likely to be overweight and three times as likely to be obese than U.S. youth overall. The literature points to a transition in the last few generations to a poor diet and a sedentary lifestyle as factors in what is becoming an obesity epidemic. Lack of access to traditional foods combined with high poverty rates on reservations have contributed to a diet high in processed foods. Native Americans also partake in less physical activity than White Americans. The state of Montana has a substantial Native American population, with 7 reservations, 13 tribes, and Natives making up about 7% of the state. Responses to the Montana Youth Risk Behavior Survey indicate that there are health disparities between White and Native American high school youth in the state. Native American students reported getting less physical activity and spending more time in front of screens than their White peers. While 24% of White students are overweight or obese, over 40% of Native students’ BMIs fell into that category. Since Native youth are more likely to use technology than Non-Natives, tech-based interventions may be effective for this population.

“Exergames” are video games that require physical activity to play, and they are showing promise with getting people of all ages more active. Some of the attraction of playing digital games include challenge, competition, and socializing, as well as the exercise itself. The proposed exergame will be a mobile phone app that uses GPS navigation to encourage players not only to move, but also to get outdoors. Players must walk their community and visit new locales in order to play and receive in-game benefits. The technology used by nature-recognition apps will be incorporated so players accumulate points by “gathering” the plant and animal food sources they see outside to complete challenges. Tribal language, values, and knowledge of the environment will be incorporated. Culturally-based interventions are more likely to be accepted by tribal communities. One study of technology-based health interventions reported that Tribes desired interventions that were: based in culture, focused on assets and skills, and were interactive. The CSKT tribes have utilized technology as a way to communicate language, culture, history, and knowledge to their members and future generations, through a language learning mobile app and an app-based field guide to the animals of the reservation.

This project would begin with requesting a resolution of support from the Tribal Council to conduct youth focus groups on the development of the exergame. This is considered the Institutional Review Board process for any research involving the Confederated Salish and Kootenai Tribes. Studies have indicated that it is important to get the users’ input in the development of gaming apps for them to be successfully adopted by the community. Youth focus-group participants will be recruited from the tribally-run middle/high school that serves Native students from across the reservation. The focus groups’ purpose will be to understand current gaming behaviors, physical activity habits, and preferences for an exergame. Topics will include: general perceptions and experiences with gaming, online social networking; smartphone features such as maps, GPS, camera, and text messaging; features for physical activity, comfort with outdoor recreation, desire for cultural knowledge, and type of reinforcement desired from an exergame.

Two of the main attributes of exergames – physical activity and socialization, have been shown to improve physical and mental health. Spending time outdoors is associated with higher levels of physical activity. In addition, outdoor recreation has been shown to have mental health benefits such as reduced stress and depression and increased well-being. In addition to improving physical activity levels, an exergame designed specifically for Native youth has the potential to strengthen several protective factors for healthy adolescent development. Studies have shown that Native youth respond to and desire media made for them. Positive media representation for a population such as Native Americans, who are largely invisible in mainstream media, has the potential to benefit identity development and self-esteem among members of the group.

It is important to get users’ input in the development of the exergame in order for it to be successfully adopted by the community. At this stage, the concept of the exergame needs feedback from the youth of the Flathead reservation. A series of focus groups will be conducted as the primary method for community input and data collection for the project. Researchers will analyze the resulting data to look for themes that have emerged from the research in terms of desired elements in an engaging exergame. Professional game developers will be contracted with to create the game, as they have the necessary training and background in design and theory necessary to create the quality of game that youth will want to play. Game developers will take the youth input and incorporate it with theory, best practices, and cultural knowledge to develop alternative game concepts.

This proposal aims to develop a culturally-grounded exergame for the Confederated Salish and Kootenai Tribes, reflective of community input and designed to increase outdoor physical activity. It would be the first of its kind, and if successful at promoting physical activity and other protective factors, could be a model for other tribes, as well. Engaging youth and community in the process of research for the game is empowering on its own and could promote critical thinking, future collective action, and social change. Youth who participate in the focus groups will be invited to participate in a subsequent game design workshop with Native game-design professionals. The workshop will allow youth the opportunity to think crucially about Native representation in media and produce their own media, while further developing exergame ideas. At the conclusion of the workshop, students’ design concepts will be shared out and recorded. The workshops will allow the students the experience to be media producers, empowering them to create video games that reflect their lives and interests, while simultaneously providing feedback on what appeals to them in video game concepts. Experience as media producers will expose the Native youth involved in the project to the career opportunities in technology fields, potentially inspiring future video game designers, writers, and filmmakers. In turn, they can diversify the tech field and improve representation of their community in the media for future generations.

Pokémon Go is one example of an exergame that uses augmented reality and GPS navigation to encourage players not only to move, but also to get outdoors. Players must walk their neighborhood and visit new locales in order to play, and the farther they walk, the more in-game benefits they receive. Pokémon Go saw huge success in getting inactive people moving, increasing players’ physical activity levels by around 25% (LeBlanc & Chaput, 2017). The Seek app by iNaturalist allows users to identify plants, animals, and fungi with their phone’s camera. As an incentive, they earn badges for observing different species. Spending time outdoors is associated with higher levels of physical activity. In addition, outdoor recreation has been shown to have mental health benefits such as reduced stress and depression and increased well-being (Beyer, Szabo, & Nattinger, 2016; Mutz & Müller, 2016).

A review of tribal physical activity interventions emphasized that cultural values, norms, traditions and pride helped acceptability by the community. One reason tribal culture is seen as so important is that it has been found to be a protective factor for Native youth. Protective factors are the predictors that increase the likelihood of positive health outcomes. Researchers have studied the protective factors that improve health outcomes of Native American youth, especially in terms of mental health and substance use prevention. In addition to an exergame increasing physical activity levels, which has its own mental health benefits, a game designed specifically for Native youth has the potential to strengthen several protective factors. A recent review of literature around physical activity and Native Americans suggests that the social environment is a key correlate to physical activity. One design element popular with other youth focus groups has been the opportunity for socializing with other players, be it through messaging or cooperative activities. Peers are one of the most influential relationships for Native American adolescents, and prosocial interactions with peers are considered a protective factor. If the game can be engaging across age groups, such as Pokémon Go has been, it could provide an opportunity for prosocial involvement with parents, family and the greater community. Parent physical activity has been correlated to child activity in Native American populations. Positive cultural identity and sense of cultural connectedness are also protective factors for Native youth. Cultural elements such as language, traditional knowledge, values and stories could all be incorporated into the game. In addition, seeing themselves reflected on their screens could have positive impacts on their self-concept. Native people are not often represented on TV, film, or other media formats. Less visibility in media can send the message to youth that their group is unimportant or less valued. Positive representations of a group in the media have been found to increase members’ favorable attitudes toward their race/ethnicity. Therefore, a well-designed game has the potential to increase self-worth and positive beliefs about their community, improving mental health.

Currently zero people are involved in the proposed exergame as it is in the concept stage. With the support of MIT Solve, we would anticipate recruiting 50 youth for focus groups within the next year. Within five years, the app should be developed and has the potential to reach the 5000 tribal members on Flathead Reservation, as well as the nearly 25,000 non-member residents in the community.

I have come up with the concept, but my expertise is in Prevention Science, not technology. I would need to hire videogame designers, graphic designers, and other content-area experts to complete the project. 

Zero staff until we move out of the concept stage, however I would anticipate contracting with game designers, graphic designers, and language and culture experts to complete the project. 

While I have yet to develop a team, I have colleagues in mind. One of my former coworkers is a Native man working on his PhD with a focus in game development, and he has connections with other Native game designers. My best friend growing up on Flathead is an enrolled CSKT tribal member and one of the founders of a Native language immersion school here. She develops curriculum for teaching the Salish language under the Seliš Qlispe Culture Committee. Another childhood friend and his daughter are both incredible graphic designers and CSKT tribal members. 

The CSKT have utilized technology as a way to communicate language, culture, history, and knowledge to their members and the next generation, including a language learning mobile app and a field guide to the animals of the reservation. I would anticipate reaching out to the tribal employees who worked on these apps. There are two tribal culture committees that serve as resources of cultural knowledge. If, as anticipated, language and traditional knowledge are desired components of the game, the Culture Committees input will be crucial in order to create a culturally-grounded game.

Lastly, a technology group out of Concordia University in Montreal, Canada, Aboriginal Territories in Cyberspace (AbTeC) has developed a game design curriculum specifically for indigenous youth in order to increase representation in video games. AbTeC’s “Skins” workshops teach Native youth to adapt stories from their communities into video games, with the intent of promoting and preserving stories, language and culture.