>> Biray Alsac: All right. When John invited me to present here today, he told me the matter -- how much information I share with you you would definitely not be overwhelmed, which is great, because for me it's a privilege to be here to get experience -- to share your experiences in technology and social software. So you can actually do me a favor with your comments and your feedback and explain how some of this is relevant to the things that you're doing.
I'm obviously not a researcher in technology. My area of expertise is in health behavior change and exercise adherence. So I look at how people make decisions on making behavior changes, especially when it comes to physical activity and exercise and then how they continue making those changes or adhere to those behaviors.
But it wasn't an accident that I fell into social software and technology because I grew up in a household where technology was very prevalent. My dad was a software engineer and my brother is in computer science. So I've always been an avid user of technology.
And when I started watching how people in the fitness industry and how in the exercise field started to put these two together, it was a really fun and exciting fit for me to watch these things grow.
So I titled this Keeping Fit with the Jetsons for several reasons, because we've sort of become in this culture a modern-day Jetson, right? In other words, we like -- we're much like the Jetsons where we're very comfortable in our lives in the sense that we are not very physically demanding of the things that we do. The majority of us, for example, still travel in cars and planes to get to destinations, so it doesn't require us to be very active.
We're also very sedentary in terms of our media use and screen time. We participate in nonphysical activity leisure time activities. And you can see, we watch a lot of television. A huge population of our culture is online in front of the computer. And we play a lot of video games.
In fact, in 2004 there was meta-analysis study looking at screen time and comparing it to body fat percentage. And they found that that was a positive correlation between body fat percentage increasing and the amount of time you spent in these leisure time activities.
And, again, this shouldn't be a surprise, even though this isn't a causal relationship, it's still pretty relevant in terms of what we deal with today.
In other words, among many things, we barely have to do anything. We barely have to move to get the things that we need to get done. We communicate with our coworkers, friends, colleagues, even strangers just sitting down in front of our computers. In fact, everything that we do is within our reach, right at our fingertips. So it's really, really -- it's not really difficult to do the things that we need to get done without being very active.
Good morning.
So in a way we are like the Jetsons. We parallel this cartoon world, we live kind of like this cartoon life. But we're not cartoons and the things that we do will actually impact our health, right? So the things that we do, that we stay in a very sedentary lifestyle will actually impact and increase our risks for diseases and gaining weight and things of that nature.

Perhaps this would be a snapshot of what the Jetsons would have looked like had they not been in syndication for a while and stayed in real time.
Anyway, the Jetson analogy aside, let's talk about how technology influences our lives.
Technology changes the way people process information, interact with individuals in communities and create personal experiences. Definitely don't need me to tell you that.
It's fairly obvious that technology influences us in multiple ways. And certainly these influences happen to become more transparent now when end users like myself have a bigger role in defining the way these technologies -- and defining and even redefining these technologies are useful to us. Sometimes programmers and software developers will develop a platform without knowing exactly how the end user will actually apply that.
So when it comes to increasing physical activity exercise adherence, we're starting to see some interesting ways on social software and interactive technologies are actually engaging together.
We know that eating healthy is good for you and exercise is also very good, yet people still don't seem to do these things. If you look at the Center for Disease Control put out the statistics -- this was last year -- of the prevalence of physical activity in the United
States, and according to the national average about 51.2 percent of the United States population still remain insufficiently active, which means they do not move for 30 minutes a day at all. And about 14 percent of that are completely sedentary.
Now, again, as I mentioned before, everybody knows activity is important, right? We know that eating well is good for you and exercise is good for you. But education and how much knowledge you have still does not equal behavior change. So where's the disconnect? What is going on between these two things?
Again, another statistic, same thing from the Center for Disease Control. We're looking at the prevalence of obesity and overweight in the United States, and about 60 percent of the United States still fall under the obese and overweight category. Yes.
>>: [inaudible]
>> Biray Alsac: For physical activity? The definition would be -- well, physical activity is just bodily movement of your -- about 30 minutes a day at moderate intensity. And moderate intensity would be something like expending 150 to 100 calories per day or additionally. Or it could be calculated in mets or by heart rate. So there's a certain percentage of your intensity that will require moderate intense physical activity, engagement in movement. Yeah. That's a great question.
Okay. So the question really becomes and the point of this conversation today is when it comes to making healthy choices, it helps to understand the psychology behind the decisions that we make. Right? What goes on in the person's mind when they're sedentary and then they actually engage in some type of activity. There's a lot of other things to consider between there before they actually take their first step and decide to move.

So there are theories in health behavior change that address this. And the things that they look at, or the variables that they look at are people's values, people's attitudes towards health and exercise. Their enjoyment factor is a huge thing, so when we look at increasing people's adherence to exercise we'll look at are they enjoying the activity they're doing.
We at look at self-efficacy. We believe that if you increase some person's self-efficacy the chances of them continuing a behavior may also increase as well. Social support network, obviously having friends and relationships, a buddy to go to the gym with, a family member that encourages you to continue with your behaviors are also -- all these values and variables help in terms of getting you to do something and then continuing to do it.
So in terms of how does social software, Web 2.0 tools and exergaming, video games that make you exercise, how do all these things influence these variables? That's what we're going to talk about today. Because in my observations over the past couple years I've seen things where we're seeing social software increasing people's self-efficacy and designing and maintaining exercise behaviors.
We're also seeing them build extensive social networks that encourage and support exercise adherence. And of course we're seeing games make physical activity a much more enjoyable and inviting experience. All of these things have started to help people make decisions about health, become more physically active, and also extend their activity adherence.
So today what I'm going to do is I'm going to pretty much go through some of the examples that I have observed so that you can get an idea how people who are not necessarily fitness professionals, they're just your common, average folks that have access to these technologies online, how have they adopted this and how have they actually used this to their advantage to exactly increase their adherence and make behavior changes.
So we're going to start with something have popular: Flickr. Flickr is your probably most popular repository for photos, images, screen casts, and videos. And how we're seeing them used is people are going on there and creating what's called photo journals or photo diaries for their fitness activities. And they will upload and report their weigh-ins, their heart rates, their fitness activity, their weight loss, their weight gain. Every time they go perform a workout, they start to create this repository, their journey, their visual journey.
We're seeing them log more detail about the foods that they're eating: what they eat, when they eat it. And of course with Flickr you can upload it through your phone, right?
So it's actually an alternative to getting your piece of paper out when the dietitian or the nutritionist says hey, you need to log your foods, it's not really in our generation of technology, anyway, it's not really convenient to pull out a pencil and paper and start logging these foods. But if you can take your phone and take a picture of it and put it on
Flickr, at least you have a place where you're starting to collect and build the repository of food.

The advantage, too, in Flickr is people can actually comment directly on their food, right, and they can also comment underneath your picture as well. This starts to create an engagement. What is it that you're eating? Oh, that meal looks good, what's in it? You can start putting comments and engage with the actual photo itself.
We're starting -- seeing people be more open about putting their weight loss progress on there as well. But the question isn't is this a good -- a repository of information; the question is why do it on a social network, right? Because I can take pictures of myself and log pictures of my food and keep it in my computer if I wanted to. What's the advantage of putting it here in a public form? That's really what happens.
Well, imagine the person who's putting all this information on there and someone else completely unrelated goes in there and says how do you know what to eat? What portion size is this meal? They start asking this person questions. And this person responds saying well, here's what I read, here's what I've done, here are the foods that I'm eating, here's the recipe that I created, and suddenly they become an authority on a certain level or they become the resource, and that increases their self-efficacy, because they feel like they're valued in this arena. So all of a sudden this person feels like they can continue engaging in their behavior, they have something to gain.
The interesting thing about this is that we're in a -- perhaps this is a generational effect.
People are being much more comfortable putting themselves online and exposing themselves in an environment that can be fairly socially kind of scary, right, to put yourself out there in the public like that.
This is an interesting situation because you're opening yourself up for criticism, encouragement, comments, and could these relationships that you create with the people online, with your audience online, could this be a form of peer acceptance perhaps?
Could this be a form of an extension of a friendship or do they expand it to something greater, like a supportive network.
Because when it comes to adopting and adhering to behavior, helpful relationships is a significant part of that. And according to one result -- some results in the -- let's see -- in the study -- a study in the Journal of Sports & Exercise Psychology, they actually illustrated that there is an important connection with peer acceptance and an increase or a motivation in physical activity. So there is something to be said about being accepted within your community to continue your behavior.
The next thing I'd like to go into is YouTube. YouTube is sort of the next level here. It's not as static as a photo repository. It's more dynamic. And what I'd like to show you is about a four-minute video here about -- what I've done is I've looked at all the weight loss blogs that are out there. The people go online, create a journal basically telling you hey,
I'm at this stage of my life, I've lost two pounds, I'm going to work, here's what's happening, and every week they go in there and create a blog about their weight loss journey.
And what I've done is I've created a compilation. And so I want to show you just a snapshot of what people have done, what people have said, what they've shown and what the results were and why they did it on YouTube and not anywhere else.

Okay. So I think I'm going to put the video on.
[video playing]
>> Biray Alsac: All right. So the interesting thing about this YouTube phenomenon is there are not very much -- there are not very many fitness professionals in this arena, right? The things we're seeing are the communities that are forming outside of our health organizations, outside of our fitness professionals, and there's something to be said there.
They're creating their own encouragement, they're creating their own communities and it's not unlike anything we see on TV.
For example, Biggest Loser is a huge phenomenon, right? People enjoy watching the dramatic sort of evolution of these characters. But biggest loser is a big production.
Someone will say, well, I -- if -- sure, if I were on a campus for three months and everything was paid for and everything was done, of course I would lose weight.
But if you see something like this in front of people who are doing it in a daily basis and you're following the characters and the evolution of these people, it seems to be a little bit more attainable, it seems to be more reachable, it makes an impact on your life in a much more immediate way because you can immediately e-mail them or text -- or create a comment underneath that YouTube video and connect with that individual on a much more immediate level. Yeah.
>>: [inaudible] people watching their progress, they feel obliged to make progress --
>> Biray Alsac: Yeah. Absolutely.
>>: [inaudible]
>> Biray Alsac: And the interesting thing with YouTube, you can see how many hits a particular video has. So how is that interesting in terms of motivating you? You're seeing 140,000 hits on your video. Wow. It suddenly becomes quantifiable to you and you're like there's 140 times my video has been watched, I need to continue doing something.
But it's just not the accountability that you have by putting the video on there. It's the impact you're creating on a much more sort of community level of the people who are watching these videos as well. You can access this video at any time. It's under -- you just look up YouTube can be fit, and you can find it. Or you can find it underneath my channel, which is BeFitt, B-E-F-I-T-T, and some of the videos are underneath there as well.
Here's an interesting dynamic. Fitness professionals are putting up choreography because choreography is one way that fitness professionals engage with each other. But the interesting thing about this, even though this may seem to serve a purpose for a smaller community of fitness professionals, participants who attend these classes are now looking at the repository of choreography that their instructors are putting on, going into class and say can you do that particular choreography.

Now, all of a sudden the engagement between the participant and the instructor is completely different. It's now a choose your own choreography class. It's an engagement that we've never seen before in the fitness environment. Just, again, I wanted to point that out to bring that to your attention.
Okay. Let's move on to Twitter. Twitter is another social networking platform that people use to micro-blog their adventures, and of course Twitter people blog, micro-blog about anything and everything. One of the important factors that you can -- to look at in terms of Twitter is not only is it a micro-blogging platform that you can do from the Web but you can also do it by connecting it to your cell phone and updating your status that way.
Coming back to exercise and fitness, some of the things that we're seeing in Twitter are things like I'm doing a photo documentation of my weight loss on Flickr. Again, another callback to some of the earlier things we were talking about. I'm thinking of starting to run 20 minutes a day, any tips? Tonight I returned to the gym I abandoned several weeks ago. It's bad when you're noticing your fingers getting fat. And there are tons of things like this. If you just do a Twitter search for words like "gym," "fitness" and "exercise," you'll see there's a lot of conversation outside of just a normal network environment about fitness.
But it goes further. What does this mean? Okay, so people are talking about going to the gym or eating well. What does it eventually lead to? Well, there's a guy named Jason
Falls who is a social media explorer as well in the social networking kind of environment.
And what he decided to do was he decided to use Twitter as a motivational tool.
He says, look, I need to lose weight. Anytime I do any type of exercise, I'm going to put it on Twitter and add the hash tag "Twit to Fit." So that way people can follow just specifically that hash tag or that key word, "Twit to Fit." And what he ended up getting is you get -- so basically what you do is you say, okay, I did this workout, and I add the hash tag "Twit to Fit," just ran 2.5 miles, hash tag "Twit to Fit."
And you can actually then pull up a subscription, right, and subscribe to the feed "Twit to
Fit." That's it. So in your reader you can just find out what are people doing. Again, this creates an accountability for the person that's doing this, but at the same time, for someone who is not necessarily following an exercise regimen, they can just get ideas of what people are doing with these types of exercises.
One of the interesting things about it -- oh [inaudible] also extended it and created a Ning network for this particular group which now takes something which was micro, a conversation that's just sort of in pieces, and taken it to the next level. Now, the interesting thing is this next level of a more comprehensive community would have never come before this one existed.
So this one propelled to this one. This community could eventually propel it to something that's maybe offline or maybe propel it to something else. So we're seeing a progression of engagement here in terms of physical activity, support communities that sort of started in Twitter and now moved to a more comprehensive network, then moved on, you know -- it could potentially move on to something else, something bigger.

In fact, Jason Falls has been contacted for sponsorship-type opportunities, so people are recognizing that there's a community there.
All right. So another thing is called Twittersize. Now, Twittersize, the idea behind
Twittersize is this: if you have five seconds in your day to Twitter, you have five seconds in your day to exercise.
The American Council of Sports Medicine came out with this recommendation in 1997.
It said: In order to reduce the risks for cardiovascular disease or cancer or any type of diseases, you need to exercise for moderate intensity physical activity for 30 minutes a day.
The key word here, though, is those 30 minutes can be all at once or accumulated throughout the course to have day, right? So technically you can exercise or be physically active ten minutes in the morning, ten minutes in the afternoon, and ten minutes at night.
Well, in a society where we're always rushing to do this or do that and time happens to be a barrier to exercise, right, I don't have enough time, I don't have enough time, the ACSM modified these recommendations and said, okay, five minutes, can you give us five minutes. And what they're doing is they're saying just move. That's all we want. We want you to move because people are still not moving.
So the fitness professionals or fitness industry is starting to see a trend here and going, okay, just move five seconds a day. So what they'll do is they'll say Twittersize, and then they'll put a comment like "two squats." So if you're subscribing to Twittersize, those
Twitter feeds that link into that key word Twittersize, you'll get "two squats." So you get up right there and do two squats. That's it. Five seconds of -- I mean, we think we take it for granted when we go, well, will it really improve or affect anything? Yes. It will. It will. Because those two squats will turn into three squats, will turn into a whole set of squats, will turn into -- it will move you towards being more active, it will help you think about activity throughout your day.
And, again, behavior change is not I'm not active, I'm running a marathon. It's not about that. It's about those small movements towards the intention of being active increasing.
It's like a tipping point. And at some point someone will get that moment of clarity and begin doing something a little bit more significant. And that's what we're trying to demonstrate, that social software is sort of getting you to think about it more and more throughout your day. Because it's so much more pervasive, which is great.
Let's go into Facebook. Facebook is also another interesting social network. I won't go into Facebook in terms of describing it too much, but what I will say is the two key things in Facebook are the news feeds that you get from the community that you connect with with your friends and the applications on Facebook. So every time you do anything in
Facebook, you befriend someone, you join a group, you update your status, it goes into your news feed, correct? And every time your friends do something it goes into your news feed.
So there's a bunch of applications and one of those applications is Twitter. If you put
Twitter as an application and you link Twitter to Facebook, what happens is every time

you update your Twitter status your Facebook status updates. So now your network is even bigger. So let's say you did go to the gym or you did an exercise that said "Twit to
Fit," right? It goes into your Facebook status and now everyone in the Facebook is like, well, what's "Twit to Fit," what are you doing, or how -- they're seeing how often you're exercising or your status says something about fitness. So basically you're putting yourself out there in front of a new community.
There is an application, and there are tons of applications on Facebook, but one that I just want to kind of highlight that sort of encompasses this concept is it's called Bluemaxer
[phonetic]. And basically what it is is a simple application that you stick on Facebook and every time you run or cycle or swim, you just basically log your exercise, I did this many miles.
The good thing about it is it links it to your news feed, just like when you join a group or befriend someone, it says so-and-so befriended so-and-so. Every time you update this it will go into your blog or into your news feed and it will say Biray ran 6.2 miles.
Now, this becomes a very interesting thing, is it starts to recur in a news feed. Because it gets in front of the people who may not exercise. And in the point that they ever come to a place where they're like, you know, I should probably start running, you know, I see that Biray is always running, I'm going to ask her.
So we can have all these amazing powerful Web sites that have extensive information about health and exercise, but they're not going to go there first. Well, why? Because people depend on their social structure. People depend on their community.
So if they know that I'm constantly logging about miles, they're going to go, you know, I noticed that you ran all the time. How did you get started. Even if it's just an initial conversation, that in terms of health behavior change is significant. The fact that someone else had a conversation about something you're doing. Okay.
Another thing that's interesting about Bluemaxer is it attaches itself up here -- I don't know if you can see it, my little pointer here. You see the Bluemaxer poke. Now that you've applied this application into your Facebook, every single friend page will have that Bluemaxer poke. So if you're on a friend's page, you can actually poke them and say, hey, have you thought about running today, or hey, have you thought about swimming today. This is an active participation. This is an active form of encouragement that is not coming from a fitness professional or health professional. It's coming from your friend. Okay. Interesting stuff.
Okay. Now, things like MySpace and Bebo and Facebook, those are very broad and a lot of times there's a lot of noise going on in there, and sometimes to focus or key in on any sort of health behavior or health exercise project is a lot -- a lot challenging, a lot more challenging.
So these are networks that are specific to exercise or health. And in these networks not only can you create profiles and have friends just like you can in anything else, you can also upload your nutrition status, you can log your food, you can log your exercise and things like that.

Let me highlight one for you. Gymine.com [phonetic] is one that I often use with my students in class, actually. I have them go in there -- I teach an online exercise science class and in there they have to create program designs and things like that. And they use
Gymine to create those exercises. And I can actually look in there and see are they tracking their foods like they're supposed to, are they tracking their exercise, because that's part of the component of the class.
And so I -- and the interesting thing is it -- based on the goals that you set, it will give you the grades if you've met those goals or not. So I can go into my gym buddies page, which is like my contacts or my friends, and I can immediately go, okay, they got an A, B, A, B,
A, B. Like I can tell exactly depending -- I don't even need to know their goals, right? It will determine what their grade is according to if they've met their goals or not.
Again, this is nothing new. There are a lot of robust tracking programs out there. But the idea here and the interesting thing about it being in public place is again creates accountability. It's free. That means a lot more people have access to it. There's forums.
There's discussions. There are challenges you can create. And the cool thing about these challenges is they come with Widgets, right, so that you can create a challenge and then grab the embed code of the leader board Widget, stick it on your blog so people who are reading your blog or your Web site are always following -- they don't even have to have an account here on Gymine. They're just following along.
Again, it's just about disseminating information and saturating your world with the behaviors that you're engaging in and seeing the impact.
Gymine also has a cross-posting opportunity to Twitter. So now imagine this: You're in
Gymine. You blog or your post your progress, you went running that morning and so you went into Gymine and submitted your update, I ran. This cross-posts to Twitter and it looks something like "I did one of my custom workouts" with a link that will take you back to my exercise.
So now you know exactly what I'm doing as well if you wanted to. Which then, of course, links to Facebook because, guess what, Twitter links to Facebook as well. Now you're starting to see the power of social media at work here. It's not just an isolated
Twitter, it's not just an isolated engagement or communication in Facebook. It's this whole conversation.
And then if anybody then goes back and joins Gymine or Dailymile or any of these other things, you've seen it kind of gone full circle. Someone who started with intention because they saw what you were doing turned into an attitude shift, turned into them seeking more information, then turned into them going in and going I think I'm going to try this, and then turned into them being active and all of a sudden this conversation that you see across of platforms becomes much more relevant and much more effective.
Okay. Yes.
>>: [inaudible] predict that the social networking actually tackle our obesity problem eventually? It kind of [inaudible] here because the Internet kind of, you know, eats up our physical [inaudible] in a sense.

>> Biray Alsac: It definitely can.
>>: And so in that sense [inaudible].
>> Biray Alsac: Technology is kind of good and bad, correct? It's good in the sense that when you're creating interactive programming, things like exergaming, things like that, those definitely is a good use of technology because it's helping people to be active.
But then you've got a lot of things like e-mail and surfing on the Web and things that suck your time and actually create an opportunity that enables you to continue to stay sedentary. All I'm saying is here's what people are doing with the tools that are out there.
Will this combat the obesity problem? No. But will this help health professionals and fitness professionals to understand the culture that technology creates and then refine their programming to cater something that makes sense to this technology-driven environment? Perhaps.
So it might help tweak the way we create programs. It might help tweak the way health professionals design initiatives or interventions, because we understand that the way people are using social technology is different now than they were before. So it adds on to it.
I want to talk a little bit about podcasting. Podcasting is not necessarily a social software, okay, because it's more production, a production tool. But I teach a jogging class online.
Now, one of the significant challenges when you teach any class online is the fact that you have to create a community among your students.
Now, it's easy -- well, not easy, but it definitely makes more sense if you're teaching a theory-based or a textbook-based course and you sort of translate that into an online course. That seems to be an easy transition. But when you're creating an activity course that's on campus, for example -- we teach a lot of activity courses on campus, so a student could come in and take a cycling course for a credit, you know, or a yoga course for a credit on campus in between their classes.
When you take something like that that's so reliant on you being there on the community and you put it online, you're bringing up a whole 'nother set of challenges, okay? How do you create that accountability, how do you deliver this information to a group that may never ever come on campus but still need an exercise program.
In the commercial fitness industry, there are a lot of downloadable fitness podcasts; in other words, you can go to places like podfitness.com, cardiocoach.com, gymp3.com, these types of podcasts that specifically guide you and coach you through a workout routine. So I download it, I go on the treadmill, it will tell me increase my intensity by this much or speed up your pace or it will coach me through a workout.
But is this really engaging your community? Not really. If I have an eight-week course online, I have to make sure that I'm not just designing eight MP3 files and delivering it and go, Go have at it. I know that social networking and community is very, very important in the adherence of exercise. So I have them podcast back their experiences so they'll call in and say, okay, I just did this workout and it was really great or I have a question.

When you're teaching a class, one of the advantages is, How you doin'? We love to say
"how y'all doin'? Are you having a good time? Any questions?" during the class. We love that feedback. And to eliminate that is not very effective.
So students call in and say I just did my workout, it's really great, I have a question about the speed drill that we did. So I take that MP3 file that they've left for me on the voice mail or whatever and filter it back in next week's routine. So now you're hearing people talk to each other as well as my coaching them through that workout. So now you're using a podcast technology to allow communications in an online forum.
In addition to downloading their podcast exercise, I've also created an Ning network for them so that they can communicate and interact as well. And I've also created -- suggested they create a Dailymile account so that they're also out there in the commercial sort of software -- social software world, creating behavior changes there.
What this says is after my class is over, they're still out there in this network. They've created friends, they've created a community, and they can continue that behavior.
Because usually in online classes in an institution, once the online class is over, that particular network gets shut down and you have to create a new one for the next semester, right? The students can't really connect with each other anymore at that point.
Because this is an activity class, this continues that encouragement.
And because we're doing two-way podcasting activities in this class, this encourages the student to go take this class again knowing that the class will be a different experience each semester.
Now I'd like to talk a little bit more -- kind of shift gears a little bit and go into Second
Life. Second Life obviously is a virtual platform, a three-dimensional platform for people to utilize or to connect with each other and engage.
So then what's the significance do you think of having a gym in Second Life? Because there are gyms out there in Second Life. There are not only gyms but there are places where you can go and engage on a treadmill. There's me on a treadmill. You can also -- there's a lot of places where they put information -- think of Second Life as a three-dimensional Web, right? You have a location URL in a way and you go to it.
If you go into Second Life without knowing where to go, it's kind of boring. So we have location URLs. You can go into a gym and just like anything else, you can have posters and information kind of posted on there. What does this do? This allows a person who hates going to the gym who would never, ever engage in a fitness-related culture, helps them to understand things in an environment they feel comfortable in.
There are, what, nine million residents in Second Life now? It's pretty significant number. And so here you're tapping into an audience telling them about exercise and fitness in a way that they may not -- they may not know.
Now, personally, as you go in -- as you go into Second Life you may think, okay, what's the significance of my avatar going on a treadmill if I'm still sitting there in front of my computer being very sedentary, right? Well, for one, it's educational opportunity. The

more education information that you know, the better equipped you are to make effective decisions.
But two, Second Life is becoming a lot more interactive. For one, in terms of yoga classes they offer, they offer yoga and meditation classes. So because they have voice over IPs and you can talk to people in Second Life, imagine you going in there, your avatar's sitting on a mat, but you can still hear the instructor cue you through a yoga class or a meditation class.
So you're sitting in front of your computer, you're still engaging in some form of wellness activity that's still relevant. Some people are even connecting treadmills to their computers and walking their avatar as they walk on the treadmill. Now, this starts to become into -- this goes into some more interactive technology world, this is where we're starting to go into exergaming kind of ideas.
There is a cycle class in Second Life every Tuesday and Thursday at noon Second Life time. And what they do is -- this is a real instructor. On the other side of this avatar is a real triathlon instructor from the UK and she teaches a class. Now, obviously, you know, you've got a bunch of different avatars, there's a snowman over there in the cycle class.
But basically we all come into this class and we engage in a 30-minute cycle workout.
And people put their cycle -- put their bikes in front of their computers with their wireless keyboards and still interact and engage in real time with students while still getting a great workout.
Now, all I'm saying is there are other avenues we need to tap into in order to connect with people to get them to move. That's it. Is this gonna work? Is it not gonna work? Some people will prefer it, some people won't. Some people will still prefer going to the gym, some people might go this is much convenient for me, I like this, it's an environment that
I know. And given the sort of technological sort of advancements that we've made and the culture that it's created, I think this is also an opportunity we should focus more on.
This lends to exergaming, this idea of engaging with technology, connecting with technology using this sort of software, this platform. And of course we've heard of
Dance Dance Revolution and exergaming and Wii and things like that.
The interesting thing about exergaming, exercise video games, is that it's been around for about 25 years. I don't know if you all new that. Back in 1982 we had the Joyboard.
Yeah. That was where you stand on the board and I think you have ski moguls or something like that and the way you kind of lean back and forth on the board will allow you to kind of engage. Then we had the cross -- the cycle trainer.
Here's something very interesting that I want to read. It's just kind of an interesting tidbit.
In 1982 Atari came out with this game called the Puffer. And it never went to market, but I want to read you the internal memo that went out in Atari that year. It reads like this:
There's a [inaudible] generation of kids and adults out there who are into sports and/or don't get enough exercise. At the same time, there's a huge fitness market. This is 1982.
We have seen how kids can become addicted to our video games, so we're going to hook up an exercise bike to a video game where the bike is the controller. We can make

fitness freaks out of kids and game players out of fitness freaks. We can capitalize on the combination of the two powerful markets: video games and aerobic fitness.
So they already knew there was something there. And the only difference is, you know,
1984 came the crash of the video game industry and Atari went bankrupt and we did -- never came [inaudible]. But there's something to be said here.
This has been around for a while. So about 10 years later Dance Dance Revolution came out in 198- -- I'm sorry, 1998. And all of a sudden people are thinking, hmm, this is kind of interesting, people are really starting to become more excited about moving and it's fun. So we started to see a lot of research kind of lend itself to looking at how Dance
Dance Revolution and Wii Fit, things like that, that sort of open the door for more mainstream conversation about how technology and exercise can connect.
In 2002 there was a study done in DDR, okay, this is about four years after DDR started to really become popular. And basically what they did is they measured the aerobic demands of this video game and the results showed that it met and exceeded ACSM's definition of moderate intensity.
Now, up to this point we have seen a lot of research on video games and how it affects your body. We looked at musculoskeletal impacts. We did -- what does it do to your joints and what does it do to your heart rate when you're under stress in a Pac-Man game and what does it do to blood pressure. So it turns out looking at video games and how it affects the body, we've done studies about that. But how it affects your aerobic capacity, your fitness level, these studies are just now surfacing.
In 2005 another study compared DDR game play to traditional modes of activity, like a treadmill. And the results showed that DDR was way more fun than treadmill. I mean, I think we all can agree on that; we don't need a study to show us that I'm sure. But once again it goes back to what I was saying earlier about -- oh -- that's okay. Hey, no worries, this is about technology; we should embrace the fact that technology...
So, again, when I said earlier one of the variables is enjoyment. Enjoyment plays a huge role on people in terms of exercise adherence. If it's fun, they're going to do it. 2005 a landmark study in West Virginia found DDR game play significant in reducing factors for disease, especially when it comes to childhood obesity. They did an extensive study and looked at blood lipids, triglycerides, heart rate, fitness levels, aerobic capacity, all these things. It was a pretty extensive study.
And a year later DDR was implemented in all West Virginia public schools as an effective weight loss initiative. In fact, they went and spent two years then in training all
PE instructors in every single school in West Virginia to implement exergaming into their physical activity programs.
So basically this idea of, okay, it should be no surprise that an active video game is going to make us active. So we started seeing a lot of games come out once again to kind of build off this trend.
In my graduate study program, I studied Dance Dance Revolution and EyeToy: Kinetic, were the two games. And what we looked at is we looked at the reliability of DDR. So

we said if you play DDR once and then you play it again, is it going to be equal, right?
Because we want a tool that's not very variable. I mean, if you play it once and then you played again, it's a completely different impact, then it's not a very effective tool because there's too much variability.
And so what we found is intersession play is a pretty consistent mode of activity. But over time intensity will increase because experience has a role in terms of exercise intensity. So the more experienced you are in game play, the higher the intensity of the game. And that makes sense, right? When you first stand on DDR, you're like one, two, you're just kind of looking at the arrows and move your feet with it. But as you get better and better, your movements start to become bigger and then you see those people on
YouTube who are just jumping all over the place playing DDR because experience definitely plays a role in increasing intensity of an extra game.
I also studied EyeToy: Kinetic. EyeToy: Kinetic is where they stuck a camera on an
EyeToy in front of your TV which then took an image of you and put you in the game.
So this would be a live person interacting with the things that were happening in the game. And basically what I looked at is how the different modes of this game, there's like four different games within this game, how did that impact your intensity and how did that impact game play.
Well, if we looked at intensity, these were the four different types of games in this particular design. When we started to notice, okay, the intensity is pretty interesting because once again it falls under the moderate intensive activity level.
The interesting thing we started to look at is, wow, exergames are not all built equally.
Some have more intensity, some have less intensity. So now we can look at all these different games, not just within the [inaudible] but just in everything. Not all exergames are built the same.
So we can look at it and go if you want just moderate intense, you might want to look at this game. If you're looking for somebody with high fitness level and they still want to engage, you might want to start looking at this game instead. So now we're starting to look at how we can categorize these games.
This is a graph of game play results based on points. So if you go back, something like this might have elicited a high heart rate but it didn't get a lot of points. Just again it's all about points and not necessarily just about heart rate. So people are going to more likely look at -- let's see. More look like -- like if this was a very fun game, they got a lot of points. And it increased the -- it gave a high intensity, that's also a benefit as well.
All right. So basically kind of to bring this down to a conclusion, exergames are now being filtered into all sorts of exercise programming. We're seeing things like the Wii encouraged in senior centers, we're seeing places like XRtainment Zone, which is a center just for exergaming. XRcade centers, we're putting it in the fitness centers. So we're seeing a significant impact that exergames are having.
So what I'd like to say is some of the observations and my conclusions on how all these things come together. What now? Great. There's all these things happening out there.

This is very exciting, very fun, some of it relevant, some of it not. What now? What should we do here?
Well, first we need more engagement of health educators and fitness professionals. We need them to understand the culture that this has. What kind of people are exergames bringing -- encouraging. What's the demographic that would rather do a DDR game versus go on the treadmill. Yes. Okay.
We want to know more sort of encouraging ways to get exercise scientists, health professionals, fitness educators to encourage these types of interactions.
Two, more research needs to be -- to support these observations. In other words, how do we quantify this conversation that starts over here in Flickr, then it goes into Twitter, then goes into Facebook that comes back down to Gymine and comes back. But how can we quantify this observation and actually study it and say this is an impact that can be utilized and help behavior processes.
More interventions that incorporate the culture or analyze the impact that these tools have on our behaviors. So I'd like to see things like which made the bigger impact: Someone who logged their stuff on Facebook or someone who logged their stuff on a journal?
Like I want to see some comparisons. I want to see studies that control for technology and control for the culture of technology, to see is it really this culture that's making an impact or is it something else. I want to isolate and understand this better. And, again, we need more studies that focus on the sedentary techno-savvy population, because, again, that's a whole new generation that's coming into play here.
So, in conclusion, how will the Jetsons get fit? Well, sure, maybe they can walk up the stairs in their house and that's fine. But I don't think they may like that very much. They probably want to engage in their environment and technology and things that make them feel better, and I think they might be happier to do that that way.
So that's it. That's all I have for you. If you have any questions, I'd like to kind of open it up for questions. Yes.
>>: My question is I have friends that are in weight loss program and they said they have these sessions, people tell each other about their story. Often time behind the weight, you know, you gain lots of weight, there's psychological reasons.
>> Biray Alsac: Yep.
>>: And the reasons across the board is very diversified. And I think in the real person interaction is kind of easy for user to open up like here in a small group and they know each other well and you can trust them so you can tell your real story, what happened.
But the online community, so are there any, you know, like reason or things that help you to kind of be open to talk this kind of thing, that private more?
>> Biray Alsac: Absolutely. There are -- what I'm sort of suggesting in this is there are much more private robust applications. But they may be either paid services -- I mean, for example, there's a paid service where I can take a picture of my food and it goes to a

nutritionist and I pay her, she observes my food, she observes my eating habits and she and I have a conversation online via Web cam. Okay. So these things certainly occur.
Everything I've showed you so far is just free. It's just free. That's just out there kind of in our public popular technology use and how those communities kind of formed there.
So in terms of privacy and sort of a closed structure, those definitely exist. But in terms of popular social software, I've tried to demonstrate how these sort of technologies have kind of taken their movement on their own in a community that is comfortable in sharing it.
>>: Do you see people talk about why do they get into, you know, the obesity, like why, what is the reason? Childhood [inaudible].
>> Biray Alsac: Oh, of course. There's lots of reasons. Yeah. Of course. I mean, there's lots of contributors to obesity. But obesity is not necessarily -- obesity is a risk factor for the diseases that we get, for cardiovascular and cancer. It's not necessarily the only reason. You can still be lean person or a thin person and still have a high body fat percentage and still be at risk for diseases. So it's just not the obesity.
Anything else? Well, you can always e-mail me if something comes up. I mean, I definitely -- yeah. So thank you for having me.
[applause]