Augmented Reality Playgrounds to Promote Physical Activity in Young Children: Feasibility Study Using a Repeated Measures Laboratory Design.

Background: Only 10% of Australian children meet the recommended daily physical activity guidelines. Augmented reality (AR) is increasingly being used in primary education and clinical rehabilitation, with high enjoyment and motivation to participate frequently reported. AR has increased physical activity participation in adult populations, but whether AR can increase physical activity in young children has yet to be investigated. Objective: This study aimed to determine if an indoor AR-enhanced playground is enjoyed by young children and prompts physical activity in both low- and high-structured scavenger hunts. Methods: Seventeen pairs of 5- to 8-year-olds participated in 2 animal search tasks (ie, AR and non-AR) in 2 activity structure levels (ie, low-structured and high-structured) in a 2×2 repeated measures design in an indoor laboratory playground. Children searched for either AR animals (a custom AR app on a smartphone) or toy animals and followed a set obstacle course route (high-structured) or moved wherever they wished (low-structured). Questionnaires assessed child enjoyment, perceived physical activity, and caregiver perception of enjoyment. Thigh-worn accelerometers (SENS; SENS Innovation ApS) assessed postures and movements, and a video camera recorded engagement time. Results: Children rated AR conditions (low-structured: mean 4.4, SD 1.0, and high-structured: mean 4.5, SD 0.9) as more enjoyable than high-structured non-AR (mean 4.1, SD 1.0; P=.03). When asked which condition was the most enjoyable, 15 chose the low-structured AR, followed by the high-structured AR (n=11) and low-structured non-AR (n=8). Caregiver perception of children's enjoyment ratings generally aligned. Ratings of perceived physical activity level were the same in all conditions (mean 4.3, SD 0.7; P>.05). Accelerometry showed that a greater percentage of time was spent in low-intensity postures and movements during AR conditions (AR: mean 50%, SD 13% vs non-AR: mean 35%, SD 14%; P<.001), namely in sitting and standing, and in high-intensity movements during non-AR (AR: mean 21%, SD 12% vs non-AR: mean 32%, SD 18%; P<.001). During low-structured conditions, engagement time was significantly longer with the AR animals compared to the toy animals (AR: mean 263.1, SD 65.7 seconds vs non-AR: mean 197.3, SD 76.5 seconds; P=.002). Conclusions: While the intensity of physical activity was lower during AR, the greater enjoyment and longer engagement time may lead to greater overall accumulation of active play by motivating young children to go to and stay longer at playgrounds. The high-structured AR conditions resulted in higher-intensity physical activity compared to low-structured AR conditions; however, enjoyment ratings from children and caregivers were generally higher in the low-structured AR. Therefore, AR may be suitable to implement in both low- and high-structured play environments. Future research should investigate whether these findings hold true at outdoor playgrounds and examine the impact of novelty over time.