@Article{info:doi/10.2196/jmir.9670, author="Ma, Ben D and Ng, Sai Leung and Schwanen, Tim and Zacharias, John and Zhou, Mudi and Kawachi, Ichiro and Sun, Guibo", title="Pok{\'e}mon GO and Physical Activity in Asia: Multilevel Study", journal="J Med Internet Res", year="2018", month="Jun", day="15", volume="20", number="6", pages="e217", keywords="physical activity; Pok{\'e}mon Go; public health intervention; exergame; weather", abstract="Background: Physical activity has long been considered as an important component of a healthy lifestyle. Although many efforts have been made to promote physical activity, there is no effective global intervention for physical activity promotion. Some researchers have suggested that Pok{\'e}mon GO, a location-based augmented reality game, was associated with a short-term increase in players' physical activity on a global scale, but the details are far from clear. Objective: The objective of our study was to study the relationship between Pok{\'e}mon GO use and players' physical activity and how the relationship varies across players with different physical activity levels. Methods: We conducted a field study in Hong Kong to investigate if Pok{\'e}mon GO use was associated with physical activity. Pok{\'e}mon GO players were asked to report their demographics through a survey; data on their Pok{\'e}mon GO behaviors and daily walking and running distances were collected from their mobile phones. Participants (n=210) were Hong Kong residents, aged 13 to 65 years, who played Pok{\'e}mon GO using iPhone 5 or 6 series in 5 selected types of built environment. We measured the participants' average daily walking and running distances over a period of 35 days, from 14 days before to 21 days after game installation. Multilevel modeling was used to identify and examine the predictors (including Pok{\'e}mon GO behaviors, weather, demographics, and built environment) of the relationship between Pok{\'e}mon GO use and daily walking and running distances. Results: The average daily walking and running distances increased by 18.1{\%} (0.96 km, approximately 1200 steps) in the 21 days after the participants installed Pok{\'e}mon GO compared with the average distances over the 14 days before installation (P<.001). However, this association attenuated over time and was estimated to disappear 24 days after game installation. Multilevel models indicated that Pok{\'e}mon GO had a stronger and more lasting association among the less physically active players compared with the physically active ones (P<.001). Playing Pok{\'e}mon GO in green space had a significant positive relationship with daily walking and running distances (P=.03). Moreover, our results showed that whether Pok{\'e}mon GO was played, the number of days played, weather (total rainfall, bright sunshine, mean air temperature, and mean wind speed), and demographics (age, gender, income, education, and body mass index) were associated with daily walking and running distances. Conclusions: Pok{\'e}mon GO was associated with a short-term increase in the players' daily walking and running distances; this association was especially strong among less physically active participants. Pok{\'e}mon GO can build new links between humans and green space and encourage people to engage in physical activity. Our results show that location-based augmented reality games, such as Pok{\'e}mon GO, have the potential to be a global public health intervention tool. ", issn="1438-8871", doi="10.2196/jmir.9670", url="http://www.jmir.org/2018/6/e217/", url="https://doi.org/10.2196/jmir.9670", url="http://www.ncbi.nlm.nih.gov/pubmed/29907559" }