Date of Award

January 2022

Document Type


Degree Name

Doctor of Philosophy (PhD)


Educational Foundations & Research

First Advisor

Robert Stupnisky


The prevalence of obesity tripled from 1975 to 2016 and was declared as a global epidemic by the World Health Organization (WHO) in 1997 (Haththotuwa et al., 2020; "Controlling the global obesity epidemic," 2022). Nutrition education that involves knowledge and behavioral change is one major component addressing the problem ("Controlling the global obesity epidemic," 2022). Therefore, the effectiveness of each learning session is essential (Sharifirad et al., 2013). Thus, many nutrition educators have used gamified nutrition education to improve teaching effectiveness to increase healthy behavior or knowledge (Chow et al., 2020.; Munguba et al., 2008; Azevedo et al., 2019). Two approaches were often used for gamified learning: gamification and GBL (GBL; Browne et al., 2014; Johnson et al., 2016; Chow et al., 2020). Gamification applies a game mechanism to non-game content, while GBL or serious gaming involves a game that was built to achieve educational goals (De Freitas, 2006; Johnson et al., 2016). Despite many positive outcomes promoted by gamified education as a whole (Chow et al., 2020; Hamari et al., 2014), there is disagreement among researchers and professionals regarding how games affect education. This study aims to identify and analyze research literature on the effects of active game, gamification and GBL applied to nutrition knowledge and behavior. The researcher performed a network meta-analysis with three sub-constructs. First, searching journal articles that addressed nutrition education implied an intervention consolidated educational strategies into food choice knowledge, fruit and vegetable consumption, and physical activity to a non-medical background population. Then, the studies were compared on the average effect of treatment indirectly through the control group. Results indicated there were plenty of studies that investigated the effect of gamification or GBL to nutrition education. Out of three focused outcomes: food choice knowledge, fruit and vegetable consumption, and physical activity, only studies focusing on physical activity were able to produce measurable differences by comparing hours per week spent performing physical activity. Comparison of the treatment result showed that gamification had the greatest improvement in facilitating physical activity, but it was non-significant. This suggests that utilizing gamification across the globe would be the more successful intervention strategy, but would require improved heterogeneity of measurements for food knowledge and fruit and vegetable consumption in order to achieve consistent measurable results for comparison.