t participant data throughout the study. Lee and Gao [65] looked at the impact of iPad and mobile app-based physical edu- cation on children's physical activity and psychosocial beliefs. They used 157 fourth and fifth-grade primary school children in two elementary schools in the Midwestern U.S. Children were divided into two groups. The first experimental group served as an app integrated group and the second control group used the traditional PE 5G Wireless Communication System in Healthcare Informatics approach. Three PE sessions were measured for both schools. There was a signifi- cant decrease in moderate to vigorous physical activity in the experimental group as compared to the control group. An increase in sedentary time was also observed in the experimental group. The children's psychosocial beliefs were improved in the experi- mental group as compared to the control group, but the change was not significant. The results may be attributed to the short-term app integration. The teachers were advised to align the use of the app with the goals of PE sessions. The app needs to be carefully selected to increase moderate to vigorous physical activity in the children rather than helping teachers in the management and delivery of their classes. 9.10.1 OBESITY PREVENTION STUDIES CONDUCTED IN PACIFIC ISLAND AND TERRITORIES (PICTS) BY USING GAMIFICATION OR WEARABLES There are very few studies that have used mobile applications or wearables for preventing or treating obesity in PICTS. OL@-OR@ mobile phone app and website project [66] was developed and evaluated as a culturally tailored, personalized mobile-phone delivered (mHealth) healthy lifestyle support program for Mãori and Pacific Islanders in New Zealand. Users might set goals and invite their whanau and friends to join them in their quest to make healthy lifestyle changes. It includes tools to encourage healthy eating and physical activity, as well as encouraging messages and suggestions on a regular basis. The program was evaluated by a cluster-randomized co