1
|
Mendonça TS, Carvalho STD, Aljafari A, Hosey MT, Costa LR. Oral Health Education for Children: Development of a Serious Game with a User-Centered Design Approach. Games Health J 2024; 13:268-277. [PMID: 38563685 DOI: 10.1089/g4h.2023.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background: Children can learn efficiently with well-designed serious games. The use of applications to promote health has proliferated, but there is a lack of scientific studies on educational games in oral health. Materials and Methods: We developed the Brazilian version of a British and Jordanian oral health education game for children from the perspectives of Brazilian specialists and users. This descriptive study, with a qualitative and quantitative approach, comprised three phases: I-Experts' discussion of the appropriateness of the previous version of the game to Brazil; II-Development of the first Brazilian version of the game; and III-Evaluation of the first version with 15 children from 4 to 8 years of age. Results: In Phase I, the specialists agreed with the development of the Brazilian version of the game, with minor adjustments on: advice on eating; advice on oral hygiene habits, users' age group, game characters, and game purpose. Phase II: a version with a few changes in images and recommendations, written and spoken in Brazilian Portuguese. Phase III: The global average of correct answers in the game's tasks was 75.3%, ranging from 50.0% to 100%. Children reported having fun with the game, and most understood the content and its interface; their parents found the information relevant and enjoyed the gameplay with their children. Conclusions: The Oral Health Education Game offered basic information for preventing dental caries to Brazilian children aged 4-8 years old in an interactive and fun way; it could support professionals in improving oral health education.
Collapse
Affiliation(s)
- Thaís Silva Mendonça
- Dentistry Graduate Program, Dental School, Faculty of Dentistry (UFG/GO), Goiânia-GO, Brazil
| | | | - Ahmad Aljafari
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Marie Therese Hosey
- Department of Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre of Oral, Clinical and Translational Science, King's College London, London, United Kingdom
| | - Luciane Rezende Costa
- Dentistry Graduate Program, Dental School, Faculty of Dentistry (UFG/GO), Goiânia-GO, Brazil
- Faculty of Dentistry, UFG/GO, Goiânia-GO, Brazil
| |
Collapse
|
2
|
Wan FKW, Mak ATH, Chung CWY, Yip JYW. Development of a Motion-Based Video Game for Postural Training: A Feasibility Study on Older Adults With Adult Degenerative Scoliosis. IEEE Trans Neural Syst Rehabil Eng 2024; 32:2106-2113. [PMID: 38717877 DOI: 10.1109/tnsre.2024.3398029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Forward sagittal alignment affects physical performance, is associated with pain and impacts the health-related quality of life of the elderly. Interventions that help seniors to improve sagittal balance are needed to inhibit the progression of pain and disability. A motion-sensing video game (active game) is developed in this study to monitor sitting and standing postures in real-time and facilitate the postural learning process by using optical sensors to measure body movement and a video game to provide visual feedback. Ten female subjects (mean age: 60.0 ± 5.2 years old; mean BMI: 21.4 ± 1.9) with adult degenerative scoliosis (mean major Cobb's angle: 38.1° ± 22.7°) participate in a 6-week postural training programme with three one-hour postural training sessions a week. Eleven body alignment measurements of their perceived "ideal" sitting and standing postures are obtained before and after each training session to evaluate the effectiveness of postural learning with the game. The participants learn to sit and stand with increased sagittal alignment with a raised chest and more retracted head position. The forward shift of their head and upper body is significantly reduced after each training session. Although this immediate effect only partially sustained after the 6-week program, the participants learned to adjust their shoulder and pelvis level for a better lateral alignment in standing. The proposed postural training system, which is presented as a gameplay with real-time visual feedback, can effectively help players to improve their postures. This pilot feasibility study explores the development and initial assessment of a motion-based video game designed for postural training in older adults with adult degenerative scoliosis, and demonstrates the usability and benefits of active gameplay in motor training.
Collapse
|
3
|
Morales-Cahuancama B, Verdezoto N, Gonzales-Achuy E, Quispe-Gala C, Bautista-Olortegui W, Hinojosa-Mamani P, Aparco JP. Exploring Children's Knowledge of Healthy Eating, Digital Media Use, and Caregivers' Perspectives to Inform Design and Contextual Considerations for Game-Based Interventions in Schools for Low-Income Families in Lima, Peru: Survey Study. JMIR Form Res 2024; 8:e49168. [PMID: 38743472 PMCID: PMC11134240 DOI: 10.2196/49168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The prevalence of overweight and obesity in schoolchildren is increasing in Peru. Given the increased use of digital media, there is potential to develop effective digital health interventions to promote healthy eating practices at schools. This study investigates the needs of schoolchildren in relation to healthy eating and the potential role of digital media to inform the design of game-based nutritional interventions. OBJECTIVE This study aims to explore schoolchildren's knowledge about healthy eating and use of and preferences for digital media to inform the future development of a serious game to promote healthy eating. METHODS A survey was conducted in 17 schools in metropolitan Lima, Peru. The information was collected virtually with specific questions for the schoolchild and their caregiver during October 2021 and November 2021 and following the COVID-19 public health restrictions. Questions on nutritional knowledge and preferences for and use of digital media were included. In the descriptive analysis, the percentages of the variables of interest were calculated. RESULTS We received 3937 validated responses from caregivers and schoolchildren. The schoolchildren were aged between 8 years and 15 years (2030/3937, 55.8% girls). Of the caregivers, 83% (3267/3937) were mothers, and 56.5% (2223/3937) had a secondary education. Only 5.2% (203/3937) of schoolchildren's homes did not have internet access; such access was through WiFi (2151/3937, 54.6%) and mobile internet (1314/3937, 33.4%). In addition, 95.3% (3753/3937) of schoolchildren's homes had a mobile phone; 31.3% (1233/3937) had computers. In relation to children's knowledge on healthy eating, 42.2% (1663/3937) of schoolchildren did not know the recommendation to consume at least 5 servings of fruits and vegetables daily, 46.7% (1837/3937) of schoolchildren did not identify front-of-package warning labels (FOPWLs), and 63.9% (2514/3937) did not relate the presence of an FOPWL with dietary risk. Most schoolchildren (3100/3937, 78.7%) preferred to use a mobile phone. Only 38.3% (1509/3937) indicated they preferred a computer. In addition, 47.9% (1885/3937) of caregivers considered that the internet helps in the education of schoolchildren, 82.7% (3254/3937) of caregivers gave permission for schoolchildren to play games with digital devices, and 38% (1495/3937) of caregivers considered that traditional digital games for children are inadequate. CONCLUSIONS The results suggest that knowledge about nutrition in Peruvian schoolchildren has limitations. Most schoolchildren have access to the internet, with mobile phones being the device type with the greatest availability and preference for use. Caregivers' perspectives on games and schoolchildren, including a greater interest in using digital games, provide opportunities for the design and development of serious games to improve schoolchildren's nutritional knowledge in Peru. Future research is needed to explore the potential of serious games that are tailored to the needs and preferences of both schoolchildren and their caregivers in Peru in order to promote healthy eating.
Collapse
Affiliation(s)
- Bladimir Morales-Cahuancama
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
- Programa Académico de Nutrición y Dietética, Facultad de ciencias de la salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Nervo Verdezoto
- School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | - Elena Gonzales-Achuy
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | - Cinthia Quispe-Gala
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | | | - Paul Hinojosa-Mamani
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | - Juan Pablo Aparco
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
- Escuela Profesional de Nutrición, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| |
Collapse
|
4
|
Abstract
Stroke remains a major cause of disability. Intensive rehabilitation therapy can improve outcomes, but most patients receive limited doses. Telehealth methods can overcome obstacles to delivering intensive therapy and thereby address this unmet need. A specific example is reviewed in detail, focused on a telerehabilitation system that targets upper extremity motor deficits after stroke. Strengths of this system include provision of daily therapy associated with very high patient compliance, safety and feasibility in the inpatient or home setting, comparable efficacy to dose-matched therapy provided in-clinic, and a holistic approach that includes assessment, education, prevention, and activity-based therapy.
Collapse
Affiliation(s)
- Steven C Cramer
- Department of Neurology, UCLA, Los Angeles, CA, USA; California Rehabilitation Institute, 2070 Century Park East, Los Angeles, CA 90067-1907, USA.
| | - Brittany M Young
- Department of Neurology, UCLA, Los Angeles, CA, USA; California Rehabilitation Institute, 2070 Century Park East, Los Angeles, CA 90067-1907, USA
| | - Anne Schwarz
- Department of Neurology, UCLA, Los Angeles, CA, USA; California Rehabilitation Institute, 2070 Century Park East, Los Angeles, CA 90067-1907, USA
| | - Tracy Y Chang
- Department of Neurology, UCLA, Los Angeles, CA, USA; California Rehabilitation Institute, 2070 Century Park East, Los Angeles, CA 90067-1907, USA
| | - Michael Su
- Department of Neurology, UCLA, Los Angeles, CA, USA; California Rehabilitation Institute, 2070 Century Park East, Los Angeles, CA 90067-1907, USA
| |
Collapse
|
5
|
Otani VHO, Novaes RACB, Pedron J, Nabhan PC, Rodrigues TM, Chiba R, Guedes JVC, Marques LM, Vissoci JRN. Framework proposal for Role-Playing Games as mental health intervention: the Critical Skills methodology. Front Psychiatry 2024; 15:1297332. [PMID: 38726380 PMCID: PMC11079307 DOI: 10.3389/fpsyt.2024.1297332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/19/2024] [Indexed: 05/12/2024] Open
Abstract
Gamified interventions are an emerging approach in mental health treatment and prevention. Their positive effects on managing various clinical conditions stem from enhancing social skills. However, cost-effective options like Table-top Role-Playing Games (TTRPGs), which offer similar benefits to other game-based interventions, lack standardized methods for ensuring replicability. In this regard, the method outlined in this study endeavors, in a structured and guided manner drawing from the Consolidated Framework for Implementation Research (CFIR), to establish a six-step protocol for developing an intervention method utilizing TTRPGs. In all Steps, we aim to anchor ourselves in robust literature concerning social skills training (SST), cognitive behavioral therapy (CBT), and gamification comprehensively. Thus, the method presented encompasses the objectives of SST, the strategies of CBT, and the dynamics of gamification via TTRPGs. Furthermore, we demonstrate a possible application of the method to illustrate its feasibility. Ultimately, the final method is structured, evidence-based, easily applicable, cost-effective, and thus viable. Mental health professionals seeking a structured and instructional tool for protocol development will find support in the method proposed here.
Collapse
Affiliation(s)
| | | | - Julia Pedron
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Pedro Chen Nabhan
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Thaísa Malbar Rodrigues
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Ryo Chiba
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | | | - Lucas Murrins Marques
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - João Ricardo Nickenig Vissoci
- Division of Translational Health Sciences, Department of Emergency Medicine, Duke Global Health Institute, Duke University, Durham, NC, United States
| |
Collapse
|
6
|
Klauß H, Kunkel A, Müßgens D, Haaker J, Bingel U. Learning by observing: a systematic exploration of modulatory factors and the impact of observationally induced placebo and nocebo effects on treatment outcomes. Front Psychol 2024; 15:1293975. [PMID: 38699574 PMCID: PMC11064928 DOI: 10.3389/fpsyg.2024.1293975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/26/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction Observational learning (OL) refers to learning through observing other people's behavior. OL has been suggested as an effective and simple tool to evoke treatment expectations and corresponding placebo and nocebo effects. However, the exact mechanisms by which OL shapes treatment outcomes, its moderating factors and possible areas of application remain unclear. We thus reviewed the existing literature with two different literature searches to answer the following questions: Which influencing factors contribute to OL-induced placebo and nocebo effects (in healthy volunteers and patients) and how large are these effects (search 1)? In which medical fields has OL been used so far to modulate treatment expectancy and treatment outcomes in patients, their caregivers, and at-risk groups (search 2)? We also aimed to explore whether and how the assessment of treatment expectations has been incorporated. Methods We conducted two independent and comprehensive systematic literature searches, both carried out on September 20, 2022. Results We identified 21 studies that investigated OL-mediated placebo and nocebo effects for pain and itch, the (placebo) efficacy of sham treatment on anxiety, and the (nocebo) induction of medication side effects (search 1). Studies showed that OL can efficiently induce placebo and nocebo effects across different presentation modes, with medium effect sizes on average: placebo effects, d = 0.79 (range: d = -0.36-1.58), nocebo effects, d = 0.61 (range: d = 0.04-1.5). Although several moderating factors have been investigated, their contribution to OL-induced effects remains unclear because of inconsistent results. Treatment expectation was assessed in only four studies. Regarding medical applications of OL (search 2), we found 12 studies. They showed that OL was effectively applied in preventive, therapeutic and rehabilitative interventions and that it was mainly used in the field of psychosomatics. Discussion OL effects on treatment outcomes can be both positive and negative. Future research should investigate which individuals would benefit most from OL and how OL can be implemented most effectively to induce placebo and avoid nocebo effects in clinical settings. Systematic review registration This work was preregistered at the Center for Open Science as open-ended registration (doi: 10.17605/OSF.IO/FVHKE). The protocol can be found here: https://archive.org/details/osf-registrations-fvhke-v1.
Collapse
Affiliation(s)
- Helena Klauß
- Department of Neurology, Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - Angelika Kunkel
- Department of Neurology, Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - Diana Müßgens
- Department of Neurology, Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Haaker
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Bingel
- Department of Neurology, Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
7
|
Moreira R, Silveira A, Sequeira T, Durão N, Lourenço J, Cascais I, Cabral RM, Taveira Gomes T. Gamification and Oral Health in Children and Adolescents: Scoping Review. Interact J Med Res 2024; 13:e35132. [PMID: 38573750 PMCID: PMC11027059 DOI: 10.2196/35132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/30/2022] [Accepted: 11/08/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Oral health is a determinant of overall well-being and quality of life. Individual behaviors, such as oral hygiene and dietary habits, play a central role in oral health. Motivation is a crucial factor in promoting behavior change, and gamification offers a means to boost health-related knowledge and encourage positive health behaviors. OBJECTIVE This study aims to evaluate the impact of gamification and its mechanisms on oral health care of children and adolescents. METHODS A systematic search covered multiple databases: PubMed/MEDLINE, PsycINFO, the Cochrane Library, ScienceDirect, and LILACS. Gray literature, conference proceedings, and WHOQOL internet resources were considered. Studies from January 2013 to December 2022 were included, except for PubMed/MEDLINE, which was searched until January 2023. A total of 15 studies were selected following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The eligibility criteria were peer-reviewed, full-text, and empirical research related to gamification in oral health care, reports of impact, and oral health care outcomes. The exclusion criteria encompassed duplicate articles; unavailable full texts; nonoriginal articles; and non-digital game-related, non-oral health-related, and protocol studies. Selected studies were scrutinized for gamification mechanisms and outcomes. Two main questions were raised: "Does gamification in oral health care impact oral health?" and "Does oral health care gamification enhance health promotion and literacy?" The PICO (Patient, Intervention, Comparison, Outcome) framework guided the scoping review. RESULTS Initially, 617 records were obtained from 5 databases and gray literature sources. After applying exclusion criteria, 15 records were selected. Sample size in the selected studies ranged from 34 to 190 children and adolescents. A substantial portion (11/15, 73%) of the studies discussed oral self-care apps supported by evidence-based oral health. The most clearly defined data in the apps were "brushing time" (11/11, 100%) and "daily amount brushing" (10/11, 91%). Most studies (11/15, 73%) mentioned oral health care behavior change techniques and included "prompt intention formation" (11/26, 42%), "providing instructions" (11/26, 42%), "providing information on the behavior-health link" (10/26, 38%), "providing information on consequences" (9/26, 35%), "modeling or demonstrating behavior" (9/26, 35%), "providing feedback on performance" (8/26, 31%), and "providing contingent rewards" (8/26, 31%). Furthermore, 80% (12/15) of the studies identified game design elements incorporating gamification features in oral hygiene applications. The most prevalent gamification features were "ideological incentives" (10/12, 83%) and "goals" (9/16, 56%), which were found in user-specific and challenge categories, respectively. CONCLUSIONS Gamification in oral health care shows potential as an innovative approach to promote positive health behaviors. Most studies reported evidence-based oral health and incorporated oral health care behavior change techniques.
Collapse
Affiliation(s)
- Rui Moreira
- School of Medicine and Biomedical Sciences, Instituto de Ciencias Biomédicas Abel Salazar, University of Porto, Porto, Portugal
- Department of Stomatology and Oral Maxillofacial Surgery, University Hospital Center of Santo António, Porto, Portugal
| | - Augusta Silveira
- Faculty of Health Sciences, Fernando Pessoa University, University of Porto, Porto, Portugal
- Institute for Research, Innovation and Development, Fernando Pessoa Foundation, University of Porto, Porto, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Teresa Sequeira
- Faculty of Health Sciences, Fernando Pessoa University, University of Porto, Porto, Portugal
- Institute for Research, Innovation and Development, Fernando Pessoa Foundation, University of Porto, Porto, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Nuno Durão
- Department of Stomatology and Oral Maxillofacial Surgery, University Hospital Center of Santo António, Porto, Portugal
| | - Jessica Lourenço
- Department of Stomatology and Oral Maxillofacial Surgery, University Hospital Center of Santo António, Porto, Portugal
| | - Inês Cascais
- Paediatrics Department, Maternal & Child Center of the North, University Hospital Center of Santo António, Porto, Portugal
| | - Rita Maria Cabral
- Department of Stomatology and Oral Maxillofacial Surgery, University Hospital Center of Santo António, Porto, Portugal
| | - Tiago Taveira Gomes
- Faculty of Health Sciences, Fernando Pessoa University, University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Decision in Health, Medical School of Porto, University of Porto, Porto, Portugal
| |
Collapse
|
8
|
Abraham O, McCarthy TJ, Zaborek J. Assessing the Impact of a Serious Game (MedSMARxT: Adventures in PharmaCity) in Improving Opioid Safety Awareness Among Adolescents and Parents: Quantitative Study. JMIR Form Res 2023; 7:e51812. [PMID: 38060287 PMCID: PMC10739249 DOI: 10.2196/51812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/05/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The opioid crisis continues to worsen across the United States, affecting people of all demographics. Few evidence-based interventions exist for educating families, particularly those with adolescents, about opioid prescription safety. Serious games have demonstrated impacts in improving medication-related outcomes for various health conditions. The characterizing goal of this serious game is to improve opioid safety knowledge and awareness among adolescents and their families. OBJECTIVE This study evaluated the impact of a serious game, MedSMARxT: Adventures in PharmaCity, designed to foster opioid safety awareness among adolescents and their parents. METHODS A national sample of parents and their adolescent children was recruited through Qualtrics research panels, social media, listservs, and snowball sampling. Eligible participants were adolescents aged between 12 and 18 years and their parents. Study participants were required to reside in the United States; speak, read, and understand English; and have access to a computer with a webcam. Parent-child dyads completed pregame and postgame surveys and participated in gameplay for up to 30 minutes. Primary outcome scales have been previously evaluated by the study team. RESULTS A total of 60 adolescent participants and 68 parent participants met full attention criteria for inclusion in this study. Statistical analysis confirmed that both adolescents' and parents' concept scores improved from baseline regarding opioid safety self-efficacy (adolescent: mean 0.35, SD 0.60; P<.001; parent: mean 0.28, SD 0.42; P<.001), perceived knowledge (adolescent: mean 1.08, SD 1.04; P<.001; parent: mean 0.56, SD 0.55; P<.001), behavioral intent (adolescent: mean 0.26, SD 0.39; P<.001; parent: mean 0.25, SD 0.32; P<.001), safe storage (adolescent: mean 0.12, SD 0.27; P<.001; parent: mean 0.03, SD 0.11; P=.03), disposal knowledge (adolescent: mean 0.10, SD 0.27; P=.006; parent: mean 0.07, SD 0.16; P<.001), and knowledge about misuse behavior (adolescent: mean 0.05, SD 0.14; P=.002; parent: mean 0.04, SD 0.10; P<.001). Participant groups, stratified by who completed and who did not complete gameplay, improved their knowledge and awareness, with no significant differences between subgroups. CONCLUSIONS The use of this serious game to improve opioid prescription safety practices among parents and adolescents was supported by the study findings. MedSMARxT: Adventures in PharmaCity is an intervention with the capability of teaching parents and adolescents about safe opioid prescription practices. Further studies and game refinement are needed to demonstrate the effectiveness of a game-based intervention in clinical settings and community pharmacies.
Collapse
Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Tyler James McCarthy
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Jen Zaborek
- Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| |
Collapse
|
9
|
Jaramillo JP, Johanson ME, Kiratli BJ. Adherence and perceptions of a home sports video gaming program in persons with spinal cord injuries: A pilot study. J Spinal Cord Med 2023:1-11. [PMID: 37975789 DOI: 10.1080/10790268.2023.2268328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Sports video-gaming can facilitate increased activity levels in persons with limited exercise options. Understanding how persons with spinal cord injuries (SCI) participate in home-based video-gaming and its potential impact on maintaining or enhancing physical function remains largely unexplored. The purpose of this study was to evaluate adherence, perceptions, and potential physical effects of a home sports video-game program for persons with chronic SCI. PARTICIPANTS Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia). DESIGN This was a prospective study. Wii video-gaming systems that included four sports games were provided to participants for home use. Participants were instructed to play for 8 weeks 3-4 days/week. The video consoles recorded the time and number of sessions played. OUTCOME MEASURES At baseline and at the conclusion of the program, measurements were made of upper extremity strength, perceived exertion, active heart rate, pain, balance, and a functional upper extremity (UE) test. The total time and number of sessions were compared to the prescribed game play as a measure of adherence. Scores from a self-reported survey were used to gauge participants' satisfaction and perceptions of their gaming experience. RESULTS Overall mean gaming adherence was 85% during the first 4 weeks and 69% for the second 4 weeks. There were no significant changes in upper extremity strength, active heart rate, balance, pain, or functional UE test for either group. All of the participants rated video gaming as enjoyable and 85.7% perceived that it could be used as a form of exercise. CONCLUSION The Wii sports home video-gaming intervention elicited overall high adherence rates and was well received by study participants indicating that it may have value as an adjunctive tool for increasing physical activity for individuals with SCI.
Collapse
Affiliation(s)
- Jeffrey P Jaramillo
- Spinal Cord Injury and Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - M Elise Johanson
- Spinal Cord Injury and Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, USA
- University of California San Francisco, San Francisco State University Graduate Program in Physical Therapy, San Francisco, California, USA
| | - B Jenny Kiratli
- Spinal Cord Injury and Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, USA
| |
Collapse
|
10
|
Aneni K, Fernandes CSF, Hoerner LA, Szapary C, Pendergrass Boomer TM, Fiellin LE. A Video Game Intervention to Prevent Opioid Misuse Among Older Adolescents: Development and Preimplementation Study. JMIR Serious Games 2023; 11:e46912. [PMID: 37921851 PMCID: PMC10656656 DOI: 10.2196/46912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/31/2023] [Accepted: 09/08/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Opioid misuse and mental disorders are highly comorbid conditions. The ongoing substance misuse and mental health crises among adolescents in the United States underscores the importance of widely scalable substance misuse preventive interventions that also address mental health risks. Serious video games offer an engaging, widely scalable method for delivering and implementing preventive interventions. However, there are no video game interventions that focus on preventing opioid misuse among older adolescents, and there are limited existing video game interventions that address mental health. OBJECTIVE This study aims to develop and conduct a formative evaluation of a video game intervention to prevent opioid misuse and promote mental health among adolescents aged 16-19 years (PlaySmart). We conducted formative work in preparation for a subsequent randomized controlled trial. METHODS We conducted development and formative evaluation of PlaySmart in 3 phases (development, playtesting, and preimplementation) through individual interviews and focus groups with multiple stakeholders (adolescents: n=103; school-based health care providers: n=51; and addiction treatment providers: n=6). PlaySmart content development was informed by the health belief model, the theory of planned behavior, and social cognitive theory. User-centered design principles informed the approach to development and play testing. The Exploration, Preparation, Implementation, and Sustainability framework informed preimplementation activities. Thematic analysis was used to identify themes from interviews and focus groups that informed PlaySmart game content and approaches to future implementation of PlaySmart. RESULTS We developed a novel video game PlaySmart for older adolescents that addresses the risk and protective factors for opioid misuse and mental health. Nine themes emerged from the focus groups that provided information regarding game content. Playtesting revealed areas of the game that required improvement, which were modified for the final game. Preimplementation focus groups identified potential barriers and facilitators for implementing PlaySmart in school settings. CONCLUSIONS PlaySmart offers a promising digital intervention to address the current opioid and mental health crises among adolescents in a scalable manner.
Collapse
Affiliation(s)
- Kammarauche Aneni
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Claudia-Santi F Fernandes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Lily A Hoerner
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Claire Szapary
- Yale School of Public Health, New Haven, CT, United States
| | | | - Lynn E Fiellin
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
- Yale School of Public Health, New Haven, CT, United States
| |
Collapse
|
11
|
Braga BC, Cash SB, Sarson K, Chang R, Mosca A, Wilson NLW. The gamification of nutrition labels to encourage healthier food selection in online grocery shopping: A randomized controlled trial. Appetite 2023; 188:106610. [PMID: 37269883 DOI: 10.1016/j.appet.2023.106610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023]
Abstract
Food purchase choices, one of the main determinants of food consumption, is highly influenced by food environments. Given the surge in online grocery shopping because of the COVID-19 pandemic, interventions in digital environments present more than ever an opportunity to improve the nutritional quality of food purchase choices. One such opportunity can be found in gamification. Participants (n = 1228) shopped for 12 items from a shopping list on a simulated online grocery platform. We randomized them into four groups in a 2 × 2 factorial design: presence vs. absence of gamification, and high vs. low budget. Participants in the gamification groups saw foods with 1 (least nutritious) to 5 (most nutritious) crown icons and a scoreboard with a tally of the number of crowns the participant collected. We estimated ordinary least squares and Poisson regression models to test the impact of the gamification and budget on the nutritional quality of the shopping basket. In the absence of gamification and low budget, participants collected 30.78 (95% CI [30.27; 31.29]) crowns. In the gamification and low budget condition, participants increased the nutritional quality of their shopping basket by collecting more crowns (B = 4.15, 95% CI [3.55; 4.75], p < 0.001). The budget amount ($50 vs. $30) did not alter the final shopping basket (B = 0.45, 95% CI [-0.02; 1.18], p = 0.057), nor moderated the gamification effect. Gamification increased the nutritional quality of the final shopping baskets and nine of 12 shopping list items in this hypothetical experiment. Gamifying nutrition labels may be an effective strategy to improve the nutritional quality of food choices in online grocery stores, but further research is needed.
Collapse
Affiliation(s)
- Bianca C Braga
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Katrina Sarson
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Remco Chang
- Computer Science, Halligan Hall, Tufts University, 161 College Avenue, Medford, MA, 02155, USA.
| | - Ab Mosca
- Khoury College of Computer Sciences, Northeastern University, 440 Huntington Avenue, 202 West Village H, Boston, MA, 02115, USA.
| | - Norbert L W Wilson
- Divinity School and Sanford School of Public Policy, 304 Gray, 407 Chapel Drive, Duke Box, #90968, Durham, NC, 27708-0968, USA.
| |
Collapse
|
12
|
Thompson D, Mirabile Y, Islam N, Callender C, Musaad SMA, Miranda J, Moreno JP, Dave JM, Baranowski T. Diet Quality among Pre-Adolescent African American Girls in a Randomized Controlled Obesity Prevention Intervention Trial. Nutrients 2023; 15:2716. [PMID: 37375620 DOI: 10.3390/nu15122716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Consuming an unhealthy diet increases health risks. This study assessed the impact of a culturally adapted behaviorally innovative obesity prevention intervention (The Butterfly Girls and the Quest for Founder's Rock) on diet quality in pre-adolescent non-Hispanic Black/African American girls. The RCT consisted of three groups (experimental, comparison, and waitlist control); block randomization allocated participants to each group. The two treatment groups varied in terms of whether or not they set goals. Data were collected at baseline (prior to receiving the intervention), post 1 (3 months post-baseline), and post 2 (6 months post-baseline). Two dietitian-assisted 24 h dietary recalls were collected at each timepoint. Healthy Eating Index 2015 (HEI-2015) was used to determine diet quality. A total of 361 families were recruited; 342 completed baseline data collection. No significant differences in overall HEI score or component scores were observed. To attain more equitable health outcomes, future efforts to promote dietary intake change among at-risk children should explore other behavior change procedures and employ more child-friendly dietary assessment methods.
Collapse
Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Yiming Mirabile
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Noemi Islam
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Salma M A Musaad
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Julie Miranda
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jennette P Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| |
Collapse
|
13
|
Castro O, Mair JL, Salamanca-Sanabria A, Alattas A, Keller R, Zheng S, Jabir A, Lin X, Frese BF, Lim CS, Santhanam P, van Dam RM, Car J, Lee J, Tai ES, Fleisch E, von Wangenheim F, Tudor Car L, Müller-Riemenschneider F, Kowatsch T. Development of "LvL UP 1.0": a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders. Front Digit Health 2023; 5:1039171. [PMID: 37234382 PMCID: PMC10207359 DOI: 10.3389/fdgth.2023.1039171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/06/2023] [Indexed: 05/28/2023] Open
Abstract
Background Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, "LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs. Materials and Methods A multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development. Results Preliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a mobile device. Conclusions The development process of LvL UP 1.0 led to an evidence-based and user-informed smartphone-based intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers.
Collapse
Affiliation(s)
- Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Aishah Alattas
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Roman Keller
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shenglin Zheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ahmad Jabir
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Xiaowen Lin
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Bea Franziska Frese
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Chang Siang Lim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Prabhakaran Santhanam
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington DC, DC, United States
| | - Josip Car
- Centre for Population Health Sciences, LKCMedicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jimmy Lee
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Research Division, Institute of Mental Health, Singapore, Singapore
- North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - E Shyong Tai
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elgar Fleisch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Florian von Wangenheim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Lorainne Tudor Car
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Falk Müller-Riemenschneider
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charite University Medical Centre Berlin, Berlin, Germany
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| |
Collapse
|
14
|
Cairns JM, Roberts H, Al-Khafaji G, Kwater M. Bringing fictional characters to life: reflections on co-creating a comic book with members of the public. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:28. [PMID: 37131245 PMCID: PMC10152719 DOI: 10.1186/s40900-023-00437-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/18/2023] [Indexed: 05/04/2023]
Abstract
There are growing calls for cancer screening to become more personalised by considering a range of risk factors, rather than a one-size-fits-all, age-based approach. The aim of this public involvement was to co-create a comic book about bowel cancer screening to be used as a visual elicitation tool in research focus groups with members of the public and healthcare professionals, as part of the At Risk study, to discuss their attitudes toward personalised bowel cancer screening, which would involve considering different risk factors. This article critically reflects on the co-creation process to develop the comic book, benefits and challenges, and some lessons learned to inform other researchers considering a similar approach. In total, ten public contributors (5 men and 5 women) from two public involvement networks participated in two successive online workshops to develop six fictional characters, two for each level of bowel cancer risk (low, moderate and high risk). This tool was then used in the At Risk study comprising five focus groups involving 23 participants, including members of the public (n = 12) and healthcare professionals (n = 11). The co-created comic book was a generally well-received research tool able to generate discussion about a complex topic, bowel cancer risk, in an accessible way. It was suggested that the comic book may also be extended beyond the research context to inform bowel cancer screening decisions and raise awareness of risk factors.
Collapse
Affiliation(s)
- Joanne Marie Cairns
- Hull York Medical School, University of Hull, Allam Medical Building, Cottingham, Hull, HU6 7RX, UK.
| | - Helen Roberts
- Hull York Medical School, University of Hull, Allam Medical Building, Cottingham, Hull, HU6 7RX, UK
| | | | | |
Collapse
|
15
|
Chrysi MS, Michopoulos I, Dimitriadis G, Peppa M. A modern web-based health promotion program for patients in Greece with diabetes 2 and obesity: an interventional study. BMC Public Health 2023; 23:639. [PMID: 37013500 PMCID: PMC10069363 DOI: 10.1186/s12889-023-15557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Health promotion programs are most beneficial in chronic diseases such as diabetes and morbid obesity, which can be positively affected by changes in attitudes, beliefs, and lifestyle. OBJECTIVES This study aimed to develop an internet-based modern Health Promotion model using interactive online applications through continuing education and participation. METHODS The goal was to positively impact knowledge, behavior, and quality of life for patients with obesity and/or diabetes. This is a prospective interventional study on patients with obesity or type 2 diabetes. Seventeen two patients who met the inclusion criteria were distributed randomly into two groups (control and intervention) from 2019 to 2021 in Greece. All the participants were given questionaries concerning quality of life anxiety and depression (HADS) attitudes and beliefs, knowledge about their condition and general questions to establish a baseline. A traditional health promotion model was followed for the control group. For participants in the intervention group, a web-based health promotion program was created according to the goals of the research. Participants were instructed to log on 1-2 times a week for 5-15 min, with the understanding that the research team would be monitoring their activities. The website included two knowledge games and personalized educational material based on their needs. RESULTS The sample comprised 72 patients (36 in control and 36 in the intervention groups). The mean age was 47.8 years for the control group and 42.7 years for the intervention group (p = 0.293). Both study groups had a significant increase in knowledge score on diabetes (Control group:3,24, Intervention group 11,88 p < 0,001) and obesity (Control group:4,9, Intervention group 51,63 p < 0,001) along with a positive attitude score towards fighting obesity (Control group: 1,8, Intervention group 13,6 p < 0,001). Still, the overall change was more remarkable for the intervention group, as indicated by the significant interaction effect of the analysis. Anxiety was decreased only in the intervention group (Control group:0,11, Intervention group - 0,17 p < 0,005). Analysis for QOL during follow-up showed that Physical Health and Level of Independence was improved in both study groups but the degree of improvement was more significant in the intervention group (Control group 0,31,Intervention group 0,73 p < 0,001). Psychological Health was improved only in the intervention group, with better scores at 6 and 12 months compared to controls (Control group 0,28,Intervention group 1,42 p < 0,001). Furthermore, Social relationships were improved only in the intervention group (Control group 0,02, Intervention group 0,56 p < 0,001). CONCLUSIONS The results of the present study showed that the participants in the intervention group showed significant improvement in knowledge, attitudes, and beliefs after using the internet as a learning tool. The intervention group also showed significantly reduced anxiety and depression arising from chronic illness. All of this resulted in an improved quality of life regarding physical Health, mental Health, and social relationships. Technology and online-based health promotion programs can revolutionize how we approach the prevention and management of chronic and terminal illnesses by improving accessibility, personalizing care, increasing engagement and motivation, improving data analysis, and disease management.
Collapse
Affiliation(s)
- Maria S Chrysi
- Intensive Care Unit, Hellenic Anticancer Institute, "Saint Savvas" Hospital, Athens, Greece.
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian Athens University Medical School, Athens, 12462, Greece
| | - George Dimitriadis
- 2nd Propaedeutic Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian Athens University Medical School, Athens, 12462, Greece
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Attikon Univeristy Hospital, National and Kapodistrian Athens University Medical School, Athens, Greece
| | - Melpomeni Peppa
- 2nd Propaedeutic Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian Athens University Medical School, Athens, 12462, Greece
| |
Collapse
|
16
|
The Influence of Serious Games in the Promotion of Healthy Diet and Physical Activity Health: A Systematic Review. Nutrients 2023; 15:nu15061399. [PMID: 36986129 PMCID: PMC10056209 DOI: 10.3390/nu15061399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Background: serious games seem to show promising strategies to promote treatment compliance and motivate behavior changes, and some studies have proven to contribute to the literature on serious games. (2) Methods: this systematic review aimed to analyze the effect of serious games in promoting healthy eating behaviors, effectively preventing childhood obesity, and improving physical activity in children. Five electronic bibliographic databases—PubMed, ACM Digital Library, Games for Health Journal, and IEEE Xplore were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. Peer-reviewed journal articles published between 2003 and 2021 were selected for data extraction. (3) Results: a total of 26 studies were identified, representing 17 games. Half of the studies tested interventions for healthy eating and physical education. Most of the intervention’s games were designed according to specific behavioral change theories, predominantly the social cognitive theory. (4) Conclusions: studies confirmed the potential of serious games for obesity prevention but considering the restrictions encountered, we exhort for novel designs with different theoretical perspectives.
Collapse
|
17
|
Elkin JA, McDowell M, Yau B, Machiri SV, Pal S, Briand S, Muneene D, Nguyen T, Purnat TD. The Good Talk! A Serious Game to Boost People's Competence to Have Open Conversations About COVID-19: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e40753. [PMID: 36884269 PMCID: PMC9997707 DOI: 10.2196/40753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is one of the many factors impeding efforts to control the COVID-19 pandemic. Exacerbated by the COVID-19 infodemic, misinformation has undermined public trust in vaccination, led to greater polarization, and resulted in a high social cost where close social relationships have experienced conflict or disagreements about the public health response. OBJECTIVE The purpose of this paper is to describe the theory behind the development of a digital behavioral science intervention-The Good Talk!-designed to target vaccine-hesitant individuals through their close contacts (eg, family, friends, and colleagues) and to describe the methodology of a research study to evaluate its efficacy. METHODS The Good Talk! uses an educational serious game approach to boost the skills and competences of vaccine advocates to have open conversations about COVID-19 with their close contacts who are vaccine hesitant. The game teaches vaccine advocates evidence-based open conversation skills to help them speak with individuals who have opposing points of view or who may ascribe to nonscientifically supported beliefs while retaining trust, identifying common ground, and fostering acceptance and respect of divergent views. The game is currently under development and will be available on the web, free to access for participants worldwide, and accompanied by a promotional campaign to recruit participants through social media channels. This protocol describes the methodology for a randomized controlled trial that will compare participants who play The Good Talk! game with a control group that plays the widely known noneducational game Tetris. The study will evaluate a participant's open conversation skills, self-efficacy, and behavioral intentions to have an open conversation with a vaccine-hesitant individual both before and after game play. RESULTS Recruitment will commence in early 2023 and will cease once 450 participants complete the study (225 per group). The primary outcome is improvement in open conversation skills. Secondary outcomes are self-efficacy and behavioral intentions to have an open conversation with a vaccine-hesitant individual. Exploratory analyses will examine the effect of the game on implementation intentions as well as potential covariates or subgroup differences based on sociodemographic information or previous experiences with COVID-19 vaccination conversations. CONCLUSIONS The outcome of the project is to promote more open conversations regarding COVID-19 vaccination. We hope that our approach will encourage more governments and public health experts to engage in their mission to reach their citizens directly with digital health solutions and to consider such interventions as an important tool in infodemic management. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40753.
Collapse
Affiliation(s)
- Javier A Elkin
- Digital Health and Innovation Department, World Health Organization, Geneva, Switzerland
| | - Michelle McDowell
- Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Max Planck Institute for Human Development, Berlin, Germany
| | - Brian Yau
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Shanthi Pal
- Department of Regulation and Prequalification, World Health Organization, Geneva, Switzerland
| | - Sylvie Briand
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Derrick Muneene
- Digital Health and Innovation Department, World Health Organization, Geneva, Switzerland
| | - Tim Nguyen
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Tina D Purnat
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|
18
|
Developing a Video Game as an Awareness and Research Tool Based on SARS-CoV-2 Epidemiological Dynamics and Motivational Perspectives. Transbound Emerg Dis 2023. [DOI: 10.1155/2023/8205408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
In mid-2020, the University of Liège (ULiège, Belgium) commissioned the ULiège Video Game Research Laboratory (Liège Game Lab) and the AR/VR Lab of the HEC-Management School of ULiège to create a serious game to raise awareness of preventive measures for its university community. This project has its origins in two objectives of the institutional policy of ULiège in response to the crisis caused by SARS-CoV-2 to raise awareness among community members of various preventive actions that can reduce the spread of the virus and to inform about the emergence and progression of a pandemic. After almost two years of design, the project resulted in the creation of SARS Wars, a decision-making management game for browsers and smartphones. This article presents the creative process of the game, specifically the integration of an adapted SEIR (susceptible-exposed-infectious-recovered) model, as well as the modeling of intercompartmental circulation dynamics in the game’s algorithm, and the various limitations observed regarding the game’s original missions and possibilities for future work. The SARS-CoV-2 video game project may be considered an innovative way to translate epidemiology into a language that can be used in the scope of citizen sciences. On the one hand, it provides an engaging tool and encourages active participation of the audience. On the other hand, it allows us to have a better understanding of the dynamic changes of a pandemic or an epidemic (crisis preparedness, monitoring, and control) and to anticipate potential consequences in the given parameters at set time (emerging risk identification), while offering insights for impact on some parameters on motivation (social science aspect).
Collapse
|
19
|
Budzynski-Seymour E, Jones M, Steele J. "I Felt I Was Actually Inside the Movie" An Exploratory Study into Children's Views of Staging a Physically Active Experience, with Implications for Future Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3624. [PMID: 36834319 PMCID: PMC9959420 DOI: 10.3390/ijerph20043624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Current levels of inactivity suggest novel approaches are needed to engage children in physical activity (PA), and enjoyment is a strong motivator for children's PA engagement. A physically active experience (PAE) was proposed as a way to use entertainment, education, (e)aesthetics and escapist methods to promote PA to children in a way that is immersive and enables them to actively partake whilst enjoying their experience. In this current mixed methods study, three physically active experiences based on popular children's movies were designed and staged, in order to explore children's views on staging a PAE and provide implications for future PA interventions. Seventeen children (boys n = nine, girls n = eight) between the ages of nine and ten years provided feedback on the experiences. The children watched a pre-recorded video presenting the physically active experiences and then completed a survey including affective forecasting responses, which was followed by participation in an online focus group where views on the experiences were explored further. For all three experiences, the mean anticipated affective response for valence was between "fairly good" and "good", and for arousal between "a bit awake" and "awake". Further, when asked, the children reported wanting to take part in the experiences (experience 1: 82.4%, experience 2: 76.5%, experience 3: 64.7%). The qualitative data revealed that children felt that they would enjoy the sessions, feel immersed in their environment, transported away from reality, and that they would be able to learn something new regarding PA. These results support the implementation of a PAE to engage children in enjoyable PA; future interventions should use these findings to engage children in a PAE, examining their actual responses to the activities.
Collapse
Affiliation(s)
| | - Michelle Jones
- Sport, Physical Education and Coaching, Plymouth Marjon University, Plymouth PL6 8BH, UK
| | - James Steele
- School of Sport, Health, and Social Sciences, Solent University, Southampton SO14 0YN, UK
| |
Collapse
|
20
|
Monarque M, Sabetti J, Ferrari M. Digital interventions for substance use disorders in young people: rapid review. Subst Abuse Treat Prev Policy 2023; 18:13. [PMID: 36805783 PMCID: PMC9937742 DOI: 10.1186/s13011-023-00518-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/26/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Young people are disproportionately more likely than other age groups to use substances. The rise in substance use and related harms, including overdose, during the Covid-19 pandemic has created a critical need for more innovative and accessible substance use interventions. Digital interventions have shown effectiveness and can provide more engaging, less stigmatizing, and accessible interventions that meet the needs of young people. This review provides an overview of recent literature on the nature of recently published digital interventions for young people in terms of technologies used, substances targeted, intended outcomes and theoretical or therapeutic models employed. METHODS Rapid review methodology was used to identify and assess the literature on digital interventions for young people. An initial keyword search was conducted using MEDLINE the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA) and PROSPERO for the years 2015-2020, and later updated to December 2021. Following a title/abstract and full-text screening of articles, and consensus decision on study inclusion, the data extraction process proceeded using an extraction grid developed for the study. Data synthesis relied on an adapted conceptual framework by Stockings, et al. that involved a three-level treatment spectrum for youth substance use (prevention, early intervention, and treatment) for any type of substance. RESULTS In total, the review identified 43 articles describing 39 different digital interventions. Most were early interventions (n = 28), followed by prevention interventions (n = 6) and treatment interventions (n = 5). The identified digital technologies included web-based (n = 14), game-based (n = 10), mobile-based (n = 7), and computer-based (n = 5) technologies, and virtual reality (n = 3). Most interventions targeted alcohol use (n = 20) followed by tobacco/nicotine (n = 5), cannabis (n = 2), opioids (n = 2), ketamine (1) and multiple, or any substances (n = 9). Most interventions used a personalized or normative feedback approach and aimed to effect behaviour change as the intended outcome. Interestingly, a harm reduction approach guided only one of the 39 interventions. CONCLUSIONS While web-based interventions represented the most common type of technology, more recently developed immersive and interactive technologies such as virtual reality and game-based interventions call for further exploration. Digital interventions focused mainly on alcohol use, reflecting less concern for tobacco, cannabis, co-occurring substance use, and illicit drug use. Specifically, the recent exacerbation in the opioid crisis throughout North American underlines the urgent need for more prevention-oriented digital interventions for opioid use. The uptake of digital interventions among youth also depends on the incorporation of harm reduction approaches.
Collapse
Affiliation(s)
- Marika Monarque
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Judith Sabetti
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Manuela Ferrari
- Douglas Mental Health University Institute, Montreal, QC, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Douglas Hospital Research Centre, 6875 Boulevard LaSalle, Perry C3 E-3102, QC H4H 1R3, Montreal, Canada.
| |
Collapse
|
21
|
Schena A, Garotti R, D’Alise D, Giugliano S, Polizzi M, Trabucco V, Riccio MP, Bravaccio C. IAmHero: Preliminary Findings of an Experimental Study to Evaluate the Statistical Significance of an Intervention for ADHD Conducted through the Use of Serious Games in Virtual Reality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3414. [PMID: 36834109 PMCID: PMC9966139 DOI: 10.3390/ijerph20043414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The use of new technologies, such as virtual reality (VR), represents a promising strategy in the rehabilitation of subjects with attention-deficit/hyperactivity disorder (ADHD). We present the results obtained by administering the IAmHero tool through VR to a cohort of subjects with ADHD between 5 and 12 years of age. The trial time was approximately 6 months. In order to assess the beneficial effects of the treatment, standardised tests assessing both ADHD symptoms and executive functions (e.g., Conners-3 scales) were administered both before and at the end of the sessions. Improvements were observed at the end of treatment in both ADHD symptoms (especially in the hyperactivity/impulsivity domain) and executive functions. One of the strengths of the VR approach is related above all to the acceptability of this tool and its flexibility. Unfortunately, to date, there are still few studies on this topic; therefore, future studies are essential to expand our knowledge on the utility and benefits of these technologies in the rehabilitation field.
Collapse
Affiliation(s)
- Annamaria Schena
- Villa delle Ginestre s.r.l. Rehabilitation and FKT Centre, 80040 Volla, Italy
| | - Raffaele Garotti
- Unità Operativa Semplice Dipartimentale of Child Neuropsychiatry, Department of Translational Medical Sciences, 80131 Naples, Italy
| | - Dario D’Alise
- Villa delle Ginestre s.r.l. Rehabilitation and FKT Centre, 80040 Volla, Italy
| | - Salvatore Giugliano
- Villa delle Ginestre s.r.l. Rehabilitation and FKT Centre, 80040 Volla, Italy
| | - Miriam Polizzi
- Unità Operativa Semplice Dipartimentale of Child Neuropsychiatry, Department of Translational Medical Sciences, 80131 Naples, Italy
| | - Virgilio Trabucco
- Villa delle Ginestre s.r.l. Rehabilitation and FKT Centre, 80040 Volla, Italy
| | - Maria Pia Riccio
- Unità Operativa Semplice Dipartimentale of Child Neuropsychiatry, Department of Translational Medical Sciences, 80131 Naples, Italy
| | - Carmela Bravaccio
- Unità Operativa Semplice Dipartimentale of Child Neuropsychiatry, Department of Translational Medical Sciences, 80131 Naples, Italy
| |
Collapse
|
22
|
Gallou-Guyot M, Mandigout S, Marie R, Robin L, Daviet JC, Perrochon A. Feasibility and potential cognitive impact of a cognitive-motor dual-task training program using a custom exergame in older adults: A pilot study. Front Aging Neurosci 2023; 15:1046676. [PMID: 36819724 PMCID: PMC9932982 DOI: 10.3389/fnagi.2023.1046676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Dual-task training may be relevant and efficient in the context of active aging. An issue in training programs lies in enhancing the adherence of participants. This can potentially be improved using games as support. We designed and developed a custom interactive exergame in this way. The objective of this pilot study was to explore the potential use of this exergame and the feasibility of our intervention, including the level of safety and adherence. The result's trends on cognitive and motor capacities, as well as on the level of motivation for physical activity, fear of falling, and quality of life of participants, were also explored. Methods Older adults aged 65 years or older were recruited and realized 30 min of supervised training in groups of 4, 2-3 times a week for 12 weeks. Exercises consisted of incorporated cognitive and motor dual tasks, with an increased difficulty over the weeks. Our program's safety, engagement, attendance, and completion levels were evaluated. Participants' postural control in single-task and dual-task conditions, as well as their performances in mental inhibition, flexibility, working memory, mobility, and postural control, and their levels of motivation for physical activity, fear of falling, and quality of life were also assessed. We realized a per protocol statistical analysis with a p-value set at 0.05. Results Thirty-nine participants (aged 84.6 ± 8.5 years) were recruited. No adverse events, and 89% adherence, 88% attendance, and 87% completion rates were observed. A potentially significant effect of our exergame on working memory in single-task conditions and on the cognitive aspect of dual-task conditions was also observed. We observed no differences in other parameters. Discussion Our exergame seemed feasible and safe and was enjoyed by participants, mainly due to the gamification of our training program. Moreover, our exergame may be efficient for cognitive training in older adults, as well as for the maintenance of motor functions, motivation for physical activity, fear of falling, and quality of life levels. This constitutes the first step for our solution with interesting results that need to be further studied.
Collapse
Affiliation(s)
- Matthieu Gallou-Guyot
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,*Correspondence: Matthieu Gallou-Guyot,
| | | | - Romain Marie
- Institut d’Ingénierie Informatique de Limoges, Limoges, France,3iL Ingénieurs, Limoges, France
| | - Louise Robin
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec City, QC, Canada
| | - Jean-Christophe Daviet
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Pôle Neurosciences Tête et Cou, Service de Médecine Physique et de Réadaptation, Hôpital Jean Rebeyrol, CHU Limoges, Limoges, France
| | - Anaick Perrochon
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France
| |
Collapse
|
23
|
Zary N, Eysenbach G, Marie R, Bourgeois M, Mandigout S. Measured and Perceived Exercise Intensity During the Performance of Single-Task, Cognitive-Motor Dual-Task, and Exergame Training: Transversal Study. JMIR Serious Games 2023; 11:e36126. [PMID: 36729572 PMCID: PMC9936361 DOI: 10.2196/36126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/13/2022] [Accepted: 10/31/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The physical and cognitive loads borne during exergaming may differ from more conventional cognitive-motor dual-task trainings. OBJECTIVE The aim of this pilot transversal study was to compare objectively measured and perceived exercise intensity during exergame, cognitive-motor dual-task, and single-task training sessions. METHODS We recruited apparently healthy young adults who carried out one session of each type of training: exergaming, cognitive-motor dual-tasking, and single-tasking. We used a custom-made exergame as support. The sessions lasted 30 minutes, were spaced at least 24 hours apart, and took place in random order for each group of 4 participants. We used heart rates to assess exercise intensity and the modified Borg scale to assess perception of intensity. In all, 16 apparently healthy young participants carried out all sessions. RESULTS There was no difference between the different types of training in mean heart rates (P=.27), peak heart rates (P=.50), or Borg scale scores (P=.40). Our custom-made exergame's objectively measured and perceived physical load did not differ between cognitive-motor dual-task and single-task training. CONCLUSIONS As a result, our exergame can be considered to be as challenging as more traditional physical training. Future studies should be conducted in older adults with or without cognitive impairments and incorporate an assessment of cognitive performance.
Collapse
|
24
|
Röglin L, Stoll O, Ketelhut K, Martin-Niedecken AL, Ketelhut S. Evaluating Changes in Perceived Enjoyment throughout a 12-Week School-Based Exergaming Intervention. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010144. [PMID: 36670694 PMCID: PMC9856556 DOI: 10.3390/children10010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
This study assessed whether a high-intensity exergame represents an enjoyable training tool for children in the elementary school setting. Furthermore, it evaluated whether gender, body mass index (BMI), waist-to-height ratio (WHtR), fitness level, weekly physical activity level, and general interest in sports moderate perceived enjoyment during the 12-week intervention. Thirty fifth- and sixth-grade students (10.5 ± 0.7 years; 50% girls) participated in this study. During baseline assessments, anthropometric measurements and a shuttle run test were conducted. Throughout the intervention period, the students participated in 15−20-min exergaming sessions (ES) in the ExerCube twice a week during school hours. Enjoyment was assessed after an ES in weeks 2 and 12. Additionally, enjoyment was evaluated after a physical education (PE) class in week 2. The results reveal no significant changes in enjoyment (p = 0.164) over time. The modest changes over time were significantly affected by BMI (p = 0.027), WHtR (p = 0.007), and weekly activity level (p = 0.016). Compared to the PE class, enjoyment was significantly higher during the ES (p < 0.001). None of the covariates showed a significant effect. Mean HR during the ES reached 87.1 ± 1.9% of students’ individual maximum HR. In conclusion, the ExerCube provides a promising tool for schools to promote enjoyable moderate-to-vigorous physical activity.
Collapse
Affiliation(s)
- Lisa Röglin
- Institute of Sport Science, Martin-Luther-University Halle-Wittenberg, 06108 Halle (Saale), Germany
- Correspondence: (L.R.); (S.K.)
| | - Oliver Stoll
- Institute of Sport Science, Martin-Luther-University Halle-Wittenberg, 06108 Halle (Saale), Germany
| | - Kerstin Ketelhut
- Department of Medical Education and Health, MSB Medical School Berlin, 14197 Berlin, Germany
| | | | - Sascha Ketelhut
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland
- Correspondence: (L.R.); (S.K.)
| |
Collapse
|
25
|
Lagu AMHR, Thaha RM, Syafar M, Hadju V, Kurniati Y. Using Games to Promote Healthy Behavior in Children: A Narrative Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND: Games are a fairly effective method to overcome public health problems, especially in children.
AIM: This study aims to review the use of games to promote healthy behavior in children.
METHODS: The method used is to search for literature published in PubMed in 2017–2021. Search using the keywords: Games, intervention, children, health, and behavior. Based on the search, 452 articles were found. Then, the articles are selected based on inclusion criteria, which are open-access articles, original research, and addressing behavioral problems related to public health.
RESULTS: Based on the inclusion criteria, 18 articles were selected to be analyzed. The 18 articles discussed the use of games to overcome health behavior problems in children. In detail, there are three articles on mental health, eight articles on nutritional behavior, four articles on physical and sedentary activity, one article on dental health, and two articles on hand washing practices.
CONCLUSION: The game method is mostly used to shape nutritional behavior. There are still few articles that discuss clean living behaviors, such as waste management. So that research is needed that looks at the effectiveness of the game method to shape waste management behavior in children.
Collapse
|
26
|
Gallou-Guyot M, Nuic D, Mandigout S, Compagnat M, Welter ML, Daviet JC, Perrochon A. Effectiveness of home-based rehabilitation using active video games on quality of life, cognitive and motor functions in people with Parkinson's disease: a systematic review. Disabil Rehabil 2022; 44:8222-8233. [PMID: 34982599 DOI: 10.1080/09638288.2021.2022780] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE We summarized the effectiveness of home-based active video game interventions on physical and cognitive functions, as well as quality of life in adults with Parkinson's disease. We also assessed the feasibility, safety, adherence, and retention of benefits of these interventions. METHOD We searched studies in eight databases from 1st March to 30th November 2020. Two authors independently performed the selection, data extraction and risk of bias evaluation (PROSPERO ID: CRD42020178138). RESULTS Nine studies were included in this systematic review (412 participants). All in all, home-based active video games were found effective in improving gait and balance functions in people with Parkinson's disease, equivalent to usual care and conventional therapy. No conclusion can be drawn on cognition and quality of life. Home-based active video games seemed feasible, safe, and were enjoyed by people with Parkinson's disease. The optimal dose, the need for supervision and the retention of benefits of these interventions are still to be determined. These results should be interpreted carefully, considering the limited number of included studies and their small sample sizes, the widespread heterogeneity of included studies and their medium average methodological quality. CONCLUSION Future research should focus on the effects of home-based active video games on impairments specific to Parkinson's disease, such as falls, freezing of gait and attention, as well as the dose, need for supervision and retention of the benefits of these interventions.IMPLICATIONS FOR REHABILITATIONHome-based active video games are effective in improving motor functions in people with PD.No conclusion can be drawn regarding cognition in people with PD.No conclusion can be drawn regarding quality of life in people with PD.Home-based active video games seem feasible and safe, and are enjoyed by people with PD.The dose, need for control and retention of the benefits still need to be determined.
Collapse
Affiliation(s)
- M Gallou-Guyot
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
| | - D Nuic
- Institut du Cerveau, Sorbonne Université, CNRS UMR 7225, INSERM 1127, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - S Mandigout
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
| | - M Compagnat
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France.,Pôle Neurosciences tête et cou, Service de Médecine Physique et de Réadaptation, Hôpital Rebeyrol, CHU Limoges, Limoges, France
| | - M L Welter
- Institut du Cerveau, Sorbonne Université, CNRS UMR 7225, INSERM 1127, Hôpital de la Pitié-Salpêtrière, Paris, France.,Département de Neurophysiologie, CHU Rouen, Rouen, France
| | - J C Daviet
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France.,Pôle Neurosciences tête et cou, Service de Médecine Physique et de Réadaptation, Hôpital Rebeyrol, CHU Limoges, Limoges, France
| | - A Perrochon
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
| |
Collapse
|
27
|
Budzynski-Seymour E, Jones M, Steele J. 'A Physically Active Experience': Setting the Stage for a New Approach to Engage Children in Physical Activity Using Themed Entertainment Experiences. Sports Med 2022; 52:2579-2591. [PMID: 35852768 DOI: 10.1007/s40279-022-01722-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 02/01/2023]
Abstract
Despite the multiple health benefits that result from engaging in physical activity, data suggest that children are moving less. Novel approaches to engaging children in physical activity are needed to address this public health concern. Recently, a new definition of physical activity was proposed that emphasizes, among other things, the fact that physical activity is deeply affective, emotional and situated in spaces that shape the experience. With the need to increase engagement in physical activity and this new proposed definition, this paper presents a more novel approach to addressing this problem through staging a physically active experience. The idea draws upon the well-established area of experience economy, which aims to engage those partaking in an educational, (e)aesthetic, escapist, and entertaining way. When staging something as an experience, the focus is on engagement. By staging physical activity as an experience, it is proposed that children can actively partake in physical activity in a way that is focused on the experience offered. This review explains the notion of experience economy and provides examples of how it could be applied to children's physical activity. By creating an aesthetically pleasing, escapist and entertaining environment where children can learn and engage in physical activity, a more engaging positive experience of physical activity can be offered. Future research should examine the staging of physically active experiences for children and evaluate the practical implementation and effectiveness of this new approach to increasing children's engagement in physical activity.
Collapse
|
28
|
Sivakumar B, Lemonde M, Stein M, Goldstein S, Mak S, Arcand J. Evaluating Health Care Provider Perspectives on the Use of Mobile Apps to Support Patients With Heart Failure Management: Qualitative Descriptive Study. JMIR Cardio 2022; 6:e40546. [DOI: 10.2196/40546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Nonadherence to diet and medical therapies in heart failure (HF) contributes to poor HF outcomes. Mobile apps may be a promising way to improve adherence because they increase knowledge and behavior change via education and monitoring. Well-designed apps with input from health care providers (HCPs) can lead to successful adoption of such apps in practice. However, little is known about HCPs’ perspectives on the use of mobile apps to support HF management.
Objective
The aim of this study is to determine HCPs’ perspectives (needs, motivations, and challenges) on the use of mobile apps to support patients with HF management.
Methods
A qualitative descriptive study using one-on-one semistructured interviews, informed by the diffusion of innovation theory, was conducted among HF HCPs, including cardiologists, nurses, and nurse practitioners. Transcripts were independently coded by 2 researchers and analyzed using content analysis.
Results
The 21 HCPs (cardiologists: n=8, 38%; nurses: n=6, 29%; and nurse practitioners: n=7, 33%) identified challenges and opportunities for app adoption across 5 themes: participant-perceived factors that affect app adoption—these include patient age, technology savviness, technology access, and ease of use; improved delivery of care—apps can support remote care; collect, share, and assess health information; identify adverse events; prevent hospitalizations; and limit clinic visits; facilitating patient engagement in care—apps can provide feedback and reinforcement, facilitate connection and communication between patients and their HCPs, support monitoring, and track self-care; providing patient support through education—apps can provide HF-related information (ie, diet and medications); and participant views on app features for their patients—HCPs felt that useful apps would have reminders and alarms and participative elements (gamification, food scanner, and quizzes).
Conclusions
HCPs had positive views on the use of mobile apps to support patients with HF management. These findings can inform effective development and implementation strategies of HF management apps in clinical practice.
Collapse
|
29
|
Keawtep P, Wichayanrat W, Boripuntakul S, Chattipakorn SC, Sungkarat S. Cognitive Benefits of Physical Exercise, Physical-Cognitive Training, and Technology-Based Intervention in Obese Individuals with and without Postmenopausal Condition: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013364. [PMID: 36293943 PMCID: PMC9603710 DOI: 10.3390/ijerph192013364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 06/14/2023]
Abstract
Obesity and estrogen deprivation have been identified as significant risk factors for cognitive impairment. Thus, postmenopausal conditions when paired with obesity may amplify the risks of developing dementia. Physical exercise has been recommended as a primary treatment for preventing obesity-related comorbidities and alleviating menopausal symptoms. This narrative review aimed to summarize the effects of exercise on cognition in obese individuals with and without menopausal condition, along with potential physiological mechanisms linking these interventions to cognitive improvement. Research evidence has demonstrated that exercise benefits not only physical but also cognitive and brain health. Among various types of exercise, recent studies have suggested that combined physical-cognitive exercise may exert larger gains in cognitive benefits than physical or cognitive exercise alone. Despite the scarcity of studies investigating the effects of physical and combined physical-cognitive exercise in obese individuals, especially those with menopausal condition, existing evidence has shown promising findings. Applying these exercises through technology-based interventions may be a viable approach to increase accessibility and adherence to the intervention. More evidence from randomized clinical trials with large samples and rigorous methodology is required. Further, investigations of biochemical and physiological outcomes along with behavioral changes will provide insight into underlying mechanisms linking these interventions to cognitive improvement.
Collapse
Affiliation(s)
- Puntarik Keawtep
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wanachaporn Wichayanrat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sirinun Boripuntakul
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siriporn C. Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai 50200, Thailand
| |
Collapse
|
30
|
Hung L, Mann J, Battersby L, Parappilly B, Butcher C, Vicic A. Gamification of dementia education in hospitals: a knowledge translation project. DEMENTIA 2022; 21:2619-2630. [DOI: 10.1177/14713012221127773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This knowledge translation study qualitatively explores strategies that facilitated hospital staff engagement in online educational games for dementia education. Interdisciplinary staff (n = 2010) in 10 hospitals played online games to learn about basic communication techniques. We identified five facilitating strategies, E-GAME: Easy access to learning, Give both extrinsic and intrinsic rewards, Apply implementation science theory, Multiple tools, and Evaluation. This article offers useful tips for educators to innovate dementia education for practice improvement.
Collapse
Affiliation(s)
- Lillian Hung
- The School of Nursing, University of British Columbia, Vancouver, Canada
| | - Jim Mann
- Citizen with expert experience of living with dementia, Vancouver, Canada
| | | | - Beena Parappilly
- Clinical Nurse Specialist, Providence Health Care, Vancouver, Canada
| | - Colleen Butcher
- Clinical Nurse Specialist, Island Health Authority, Vancouver, Canada
| | | |
Collapse
|
31
|
Limone P, Messina G, Toto GA. Serious games and eating behaviors: A systematic review of the last 5 years (2018–2022). Front Nutr 2022; 9:978793. [PMID: 36159464 PMCID: PMC9493252 DOI: 10.3389/fnut.2022.978793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 07/27/2022] [Indexed: 11/20/2022] Open
Abstract
Background Serious game intervention has emerged over the years as a popular strategy for solving the problem of unhealthy eating behavior. This has prompted several scholars to explore its significant impact on eating behaviors, identifying its positive effect on nutritional knowledge and eating behaviors. However, since this research field is yet nascent, an update in knowledge is required to further inform the real-world practice as an alternative intervention for instating healthy eating behavior. Therefore, this current research utilized a systematic review method to reveal the latest state of this concept of a serious game and eating behavior, to identify the position of the literature and shed light on under-researched and emerging areas by recommending future investigations. Method To achieve the object of this research, four electronic databases- Science Direct, Web of Science (WoS), APA PsyclNFO, and Emerald- were searched using predefined keywords (search string) relating to the review topic. A total of 15,107 results were retrieved from the databases. After title, abstract, and full-text screening, 15 studies were included following inclusion criteria. Key findings The result of this research demonstrated that various designs of serious games comprise an effective intervention for changing eating behavior in both children and adults and addressed the risks of childhood obesity and overweight. The findings also show that the design of the games is co-designed by different specialists such as a nutritionist, psychologist and developer, among others, as either single or multiple players. The effectiveness of the games was attributed to behavior techniques (BT), cognitive theories (CT), and socio-cognitive theories (SCT) of behavior change technique (BCT), incorporating an element of implicit learning in serious games. Feedback and reward were the most reported influencing strategies and self-reporting the evaluation approach. Conclusion This research contributed significantly to the body of knowledge in the field of serious games as the most recent review of evidence in the research area. Evidence from 93.33% of the included studies confirmed the effectiveness of serious games in addressing eating behavior. This study concludes that serious games are an effective intervention for improving healthy eating behavior and decreasing unhealthy eating behavior and that various elements of behavior change techniques are essential components of implicit nutritional learning through the games. In addition, it is concluded that the risk of childhood obesity and overweight can be reduced or prevented by leveraging the strength of these games. The need for future research in this field was also pointed out by this study.
Collapse
|
32
|
Hanna JL, Wright MF, Azar ST. Use of a serious game simulation to build early childhood staff capacity for reducing unintentional childhood injuries. JOURNAL OF SAFETY RESEARCH 2022; 82:85-92. [PMID: 36031282 PMCID: PMC10426750 DOI: 10.1016/j.jsr.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 11/03/2021] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Unintentional home injuries are common and costly, with over 1.6 million occurring among U.S. children ages 0-4 in 2018. Home visitors and other early childhood professionals can provide valuable prevention education and intervention to reduce unintentional injury risk for children. This proof-of-concept study aimed to test the feasibility of the first phase of Home Safety Hero, a software-based serious game simulation that trains users in identification of home safety risks, as a capacity building tool for early childhood professionals. METHODS The game simulation's potential for knowledge promotion and engagement in a sample of home visitors was explored based on play of the first phase. Repeated measures ANOVAs were used to assess learning via reaction time, and engagement was measured via the User Engagement Scale (UES). RESULTS Reaction time (i.e., average time to identify hazards) improved from the first to last levels in both single and mixed category levels in this trial. Participant indicated agreement with four subscales of engagement measured by the UES, and neutral to agree on a fifth subscale, focused attention. CONCLUSIONS We propose that this game simulation can meet the unique training needs of early childhood professionals while promoting home safety knowledge that can improve prevention work with families. Participant feedback was largely positive, and results suggest that the game simulation is engaging and contributes to knowledge. PRACTICAL APPLICATIONS The Home Safety Hero serious game simulation is a flexible training option that appeared to be feasible for reducing time to hazard identification among home visitors in this proof-of-concept study. The design of the game simulation has utility in meeting the specialized training needs of early childhood professionals and potential to build their capacity to provide direct intervention around home safety, reducing risk for unintentional injury among children.
Collapse
Affiliation(s)
- Jennifer L Hanna
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, 201 Cedar Building, University Park 16801, United States.
| | - Michelle F Wright
- Department of Psychology, Pennsylvania State University, Moore Building, University Park, PA 16801, United States.
| | - Sandra T Azar
- Department of Psychology, Pennsylvania State University, 360 Moore Building, University Park 16801, United States.
| |
Collapse
|
33
|
Nørlev J, Sondrup K, Derosche C, Hejlesen O, Hangaard S. Game Mechanisms in Serious Games That Teach Children with Type 1 Diabetes How to Self-Manage: A Systematic Scoping Review. J Diabetes Sci Technol 2022; 16:1253-1269. [PMID: 34024156 PMCID: PMC9445355 DOI: 10.1177/19322968211018236] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The use of serious games is a popular approach to help children with Type 1 diabetes (T1D) learn how to self-manage. Many different game mechanisms exist. However, it is unclear which game mechanisms a serious game should include to teach self-management to children with T1D. Therefore, the aim of this scoping review is to map and describe the game mechanisms used in serious games that teach children with T1D how to self-manage and explain how they contribute to teaching self-management. METHODS A systematic scoping review was conducted to map and describe the important game mechanisms published before 23 September 2020. A comprehensive search was performed in the PubMed, CINAHL, Embase, PsycINFO, Scopus, and Education Database. Relevant literature was selected, synthesized, and reported. RESULTS Of the 800 articles identified, 18 were included in this systematic scoping review. The game mechanisms used in serious games that teach self-management included narrative contexts, feedback, avatars, simulations, goals, levels, and social interactions. DISCUSSION This review identified 7 game mechanisms used in serious games that teach children how to self-manage. A serious game is most effective in teaching self-management when it is T1D-oriented and when multiple game mechanisms are combined. However, the most effective combination of game mechanisms has yet to be determined.
Collapse
Affiliation(s)
- Jannie Nørlev
- The Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Jannie Nørlev, Msc, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7E, 9220 Aalborg Øst, Aalborg, North Denmark Region 9100, Denmark.
| | - Katrine Sondrup
- The Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Christina Derosche
- The Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Ole Hejlesen
- The Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Stine Hangaard
- The Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Steno Diabetes Center North Jutland, Aalborg, Denmark
| |
Collapse
|
34
|
Gamification for behavior change: A scientometric review. Acta Psychol (Amst) 2022; 228:103657. [DOI: 10.1016/j.actpsy.2022.103657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
|
35
|
Tuck N, Pollard C, Good C, Williams C, Lewis G, Hames M, Aamir T, Bean D. Active Virtual Reality for Chronic Primary Pain: Mixed Methods Randomized Pilot Study. JMIR Form Res 2022; 6:e38366. [PMID: 35830224 PMCID: PMC9330488 DOI: 10.2196/38366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/23/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background The modern management of chronic pain is largely focused on improving functional capacity (often despite ongoing pain) by using graded activation and exposure paradigms. However, many people with chronic pain find functional activation programs aversive, and dropout rates are high. Modern technologies such as virtual reality (VR) could provide a more enjoyable and less threatening way for people with chronic pain to engage in physical activity. Although VR has been successfully used for pain relief in acute and chronic pain settings, as well as to facilitate rehabilitation in conditions such as stroke and cerebral palsy, it is not known whether VR can also be used to improve functional outcomes in people with chronic pain. Objective This study aimed to assess the feasibility of conducting an adequately powered randomized controlled trial (RCT) to test the efficacy of VR in a chronic pain treatment center and assess the acceptability of an active VR treatment program for patients in this setting. Methods For this mixed methods pilot study, which was designed to test the feasibility and acceptability of the proposed study methods, 29 people seeking treatment for chronic pain were randomized to an active VR intervention or physiotherapy treatment as usual (TAU). The TAU group completed a 6-week waitlist before receiving standard treatment to act as a no-treatment control group. The VR intervention comprised twice-weekly immersive and embodied VR sessions using commercially available gaming software, which was selected to encourage movement. A total of 7 VR participants completed semistructured interviews to assess their perception of the intervention. Results Of the 99 patients referred to physiotherapy, 53 (54%) were eligible, 29 (29%) enrolled, and 17 (17%) completed the trial, indicating that running an adequately powered RCT in this setting would not be feasible. Despite this, those in the VR group showed greater improvements in activity levels, pain intensity, and pain interference and reported greater treatment satisfaction and perceived improvement than both the waitlist and TAU groups. Relative effect sizes were larger when VR was compared with the waitlist (range small to very large) and smaller when VR was compared with TAU (range none to medium). The qualitative analysis produced the following three themes: VR is an enjoyable alternative to traditional physiotherapy, VR has functional and psychological benefits despite continued pain, and a well-designed VR setup is important. Conclusions The active VR intervention in this study was highly acceptable to participants, produced favorable effects when compared with the waitlist, and showed similar outcomes as those of TAU. These findings suggest that a confirmatory RCT is warranted; however, substantial barriers to recruitment indicate that incentivizing participation and using a different treatment setting or running a multicenter trial are needed.
Collapse
Affiliation(s)
- Natalie Tuck
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- The Pain Management Unit, Department of Anaesthesiology and Perioperative Medicine, Waitematā District Health Board, Auckland, New Zealand
| | - Catherine Pollard
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
| | - Clinton Good
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
| | - Caitlin Williams
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Gwyn Lewis
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Murray Hames
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
| | - Tipu Aamir
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
| | - Debbie Bean
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- The Pain Management Unit, Department of Anaesthesiology and Perioperative Medicine, Waitematā District Health Board, Auckland, New Zealand
| |
Collapse
|
36
|
Maddison R, Baghaei N, Calder A, Murphy R, Parag V, Heke I, Dobson R, Marsh S. Feasibility of Using Games to Improve Healthy Lifestyle Knowledge in Youth Aged 9-16 Years at Risk for Type 2 Diabetes: Pilot Randomized Controlled Trial. JMIR Form Res 2022; 6:e33089. [PMID: 35713955 PMCID: PMC9250061 DOI: 10.2196/33089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Mobile games can be effective and motivating tools for promoting children’s health.
Objective
We aimed to determine the comparative use of 2 prototype serious games for health and assess their effects on healthy lifestyle knowledge in youth aged 9-16 years at risk for type 2 diabetes (T2D).
Methods
A 3-arm parallel pilot randomized controlled trial was undertaken to determine the feasibility and preliminary effectiveness of 2 serious games. Feasibility aspects included recruitment, participant attitudes toward the games, the amount of time the participants played each game at home, and the effects of the games on healthy lifestyle and T2D knowledge. Participants were allocated to play Diabetic Jumper (n=7), Ari and Friends (n=8), or a control game (n=8). All participants completed healthy lifestyle and T2D knowledge questionnaires at baseline, immediately after game play, and 4 weeks after game play. Game attitudes and preferences were also assessed. The primary outcome was the use of the game (specifically, the number of minutes played over 4 weeks).
Results
In terms of feasibility, we were unable to recruit our target of 60 participants. In total, 23 participants were recruited. Participants generally viewed the games positively. There were no statistical differences in healthy lifestyle knowledge or diabetes knowledge over time or across games. Only 1 participant accessed the game for an extended period, playing the game for a total of 33 min over 4 weeks.
Conclusions
It was not feasible to recruit the target sample for this trial. The 2 prototype serious games were unsuccessful at sustaining long-term game play outside a clinic environment. Based on positive participant attitudes toward the games, it is possible to use these games or similar games as short-term stimuli to engage young people with healthy lifestyle and diabetes knowledge in a clinic setting; however, future research is required to explore this area.
Trial Registration
Australia New Zealand Clinical Trials Registry ACTRN12619000380190; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377123
Collapse
Affiliation(s)
- Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Nilufar Baghaei
- Games and Extended Reality Lab, Massey University, Auckland, New Zealand
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Amanda Calder
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Rinki Murphy
- Department of Medicine, Middlemore Hospital, University of Auckland, Auckland, New Zealand
| | - Varsha Parag
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | | | - Rosie Dobson
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Samantha Marsh
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| |
Collapse
|
37
|
Soria Campo A, Wang AI, Moholdt T, Berg J. Physiological and Perceptual Responses to Single-player vs. Multiplayer Exergaming. Front Sports Act Living 2022; 4:903300. [PMID: 35784804 PMCID: PMC9243637 DOI: 10.3389/fspor.2022.903300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/10/2022] [Indexed: 11/20/2022] Open
Abstract
Rationale Since many modern exergames include a multiplayer component, this study aimed to compare the physiological and perceptual responses between playing a cycling exergame alone or with others. Methods In this randomized crossover study, 15 healthy individuals aged between 10 and 30 years completed a single-player and a multiplayer exergaming session. The main outcomes were exercise intensity, measured as oxygen uptake (V°O2) and heart rate (HR), and perceived enjoyment, pleasure, and exertion. Results Peak HR was significantly higher during multiplayer (172 ± 23 beats per minute [bpm]) vs. single-player exergaming (159 ± 27 bpm) with a mean difference of 13 bpm (95% CI: 2 to 24, p = 0.02). Peak V°O2 was 33.6 ± 9.5 mL·kg−1·min−1 and 30.4 ± 9.1 mL·kg−1·min−1 during multiplayer and single-player exergaming, respectively with no statistically significant difference between conditions (3.2, 95% CI: −0.2–6.6 mL·kg−1·min−1, p = 0.06). Average HR, average V°O2 and perceptual responses did not differ between single- and multiplayer exergaming. Conclusion Other than inducing a higher HR, multiplayer exergaming showed no significant benefits on exercise intensity or perceptual responses over single-player exergaming. However, the higher peak HR and a tendency of higher peak V°O2 intensity during multiplayer exergaming imply that multiplayer exergaming may offer some advantages over single-player exergaming that could impact the potential health benefits of exergaming.
Collapse
Affiliation(s)
- Aarón Soria Campo
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Alf Inge Wang
- Department of Computer Science, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's University Hospital, Trondheim, Norway
| | - Jonathan Berg
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's University Hospital, Trondheim, Norway
- *Correspondence: Jonathan Berg
| |
Collapse
|
38
|
Hill J, Cebulski AR. Leadership learning through games in co-curricular settings. New Dir Stud Leadersh 2022; 2022:31-41. [PMID: 35822213 DOI: 10.1002/yd.20497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Developing leaders through games in the co-curriculum provides an opportunity for creative and innovative program design across learning taxonomies. Game-based learning provides a value-added experience for busy students who are balancing competing demands on their times. Additionally, co-curricular participants are often more receptive to less-traditional pedagogy incorporating technology, social connections, and fun. This article offers practitioners insight into developing and assessing games for co-curricular experiences.
Collapse
Affiliation(s)
- Jessica Hill
- Student Engagement & Career Development, University of Arizona, Tucson, Arizona, USA
| | - Adam R Cebulski
- Division of Student Affairs, Southern Methodist University, Dallas, Texas, USA
| |
Collapse
|
39
|
Rosenberg D, Mano R, Mesch GS. Ethnicity and Perceived Influence of Social Media-Based Health Information on Health Decisions and Behaviors: A Test of the Social Diversification Hypothesis. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2022. [DOI: 10.1080/15398285.2021.1997055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Dennis Rosenberg
- Department of Social Sciences and Philosophy, University of Jyvaskyla, Jyvaskyla, Finland
- School of Public Health, University of Haifa, Haifa, Israel
| | - Rita Mano
- Faculty of Social Welfare and Health Sciences, Department of Human Services, University of Haifa, Haifa, Israel
| | | |
Collapse
|
40
|
A pilot study of game-based learning programs for childhood cancer survivors. BMC Cancer 2022; 22:340. [PMID: 35351044 PMCID: PMC8962149 DOI: 10.1186/s12885-022-09359-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 02/28/2022] [Indexed: 12/01/2022] Open
Abstract
Background Childhood cancer survivors lacking awareness on their potential risks of late effects often fail to seek adequate follow-up care. Patient education matching their preference is of great importance to improve their adherence to survivorship care. In this study, we developed two age-dependent game-based learning programs, which enable continuous approaches for childhood cancer survivors along their intellectual maturation. Then, we assessed the effectiveness of the programs. Methods Childhood cancer survivors over 10 years of age who regularly visited a long-term follow-up clinic were enrolled in this study. They were requested to play either of two different types of game tools, one for school children and another for adolescents and young adults, for one month at home. To evaluate the educational effects of the programs, they were examined for health management awareness, self-esteem, and knowledge on cancer-related late effects before and after the intervention with age-based questionnaires and knowledge tests. Results Among 83 participants, 49 (59.0%) completed the assessments over the period of 12 months. The health management awareness and knowledge levels increased significantly at 1-month after the intervention as compared to the baseline in both school children and adolescents/young adults (for health management awareness, p = 0.011 in elementary school children; p = 0.007 in junior high school children; p < 0.001 in adolescents/young adults; for knowledge levels, p < 0.001 in school children; p < 0.001 in adolescents/young adults). The effect was maintained for 12 months in school children while it decreased in adolescents and young adults with time. Self-esteem significantly increased at 1-month (p = 0.002 in school children; p = 0.020 in adolescents/young adults) and was maintained for 12 months in both age groups. Conclusion The game-based learning programs enhanced health locus of control and self-esteem in childhood cancer survivors. The game-based learning programs could be applied effectively to survivorship care as a new modality of patient education. Trial registration This study was retrospectively registered in UMIN-CTR (UMIN000043603) on March 12, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09359-w.
Collapse
|
41
|
Nørlev J, Derosche C, Sondrup K, Hejlesen O, Hangaard S. Using Distance Communication for the User-Centered Development of a Smartphone-Based Serious Game for Children With Type 1 Diabetes: Participatory Design Approach. JMIR Serious Games 2022; 10:e33955. [PMID: 35348466 PMCID: PMC9006140 DOI: 10.2196/33955] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/19/2022] [Accepted: 02/17/2022] [Indexed: 12/15/2022] Open
Abstract
Background The complications of type 1 diabetes (T1D) can be delayed or prevented in children with T1D who receive proper self-management education. Smartphone-based serious games are increasingly being used as an effective tool for teaching self-management. When developing a serious game, it is important that the development process be user-centered. Traditionally, different face-to-face methods have been used when children participate in the development process. However, face-to-face data collection is not always feasible. In such situations, distance communication can be used when developing a serious game. Objective The objective of this study is to develop a user-centered smartphone-based serious game that teaches self-management focused on carbohydrate intake in children aged 8-14 years with T1D using distance communication in both the development and evaluation of the game. Methods The development and evaluation of a smartphone-based serious game prototype was inspired by the Lean principles, and a user-centered approach was applied. The development process included 1 expert interview and design workshops with children with T1D. On the basis of the interview and design workshop results, a serious game prototype was developed using Microsoft PowerPoint. The evaluation of the serious game prototype included an interview with a dietitian and a playtest with children with T1D. All data were collected using distance communication. Results A user-centered smartphone-based serious game prototype was developed and evaluated. The expert interview with the dietitian formed the basis for the learning outcomes in the game. Four children and their parents contributed to the preferences, needs, requirements, and ideas for selected parts of the game design. The dietitian evaluated the prototype positively and validated its content and accuracy. The serious game prototype was well-received by the children and their parents during the playtest. The serious game prototype was perceived as a useful and engaging way to learn. However, the difficulty level was not appropriate, and the information was too basic for participants who had been diagnosed over a year ago. The use of digital communication platforms did not cause any problems. Conclusions The smartphone-based serious game prototype has the potential to be a useful and attractive tool for teaching disease self-management. The use of distance communication proved to be a useful approach in the development of a serious game.
Collapse
Affiliation(s)
- Jannie Nørlev
- Department of Health Science and Technology, Aalborg University, Aalborg Øst, Denmark
| | - Christina Derosche
- Department of Health Science and Technology, Aalborg University, Aalborg Øst, Denmark
| | - Katrine Sondrup
- Department of Health Science and Technology, Aalborg University, Aalborg Øst, Denmark
| | - Ole Hejlesen
- Department of Health Science and Technology, Aalborg University, Aalborg Øst, Denmark
| | - Stine Hangaard
- Department of Health Science and Technology, Aalborg University, Aalborg Øst, Denmark
- Steno Diabetes Center North Jutland, Aalborg, Denmark
| |
Collapse
|
42
|
Abstract
Over the years, there has been a significant increase in the adoption of game-based interventions for behaviour change associated with many fields such as health, education, and psychology. This is due to the significance of the players’ intrinsic motivation that is naturally generated to play games and the substantial impact they can have on players. Many review papers measure the effectiveness of the use of gaming on changing behaviours; however, these studies neglect the game features involved in the game design process, which have an impact of stimulating behaviour change. Therefore, this paper aimed to identify game design mechanics and features that are reported to commonly influence behaviour change during and/or after the interventions. This paper identified key theories of behaviour change that inform the game design process, providing insights that can be adopted by game designers for informing considerations on the use of game features for moderating behaviour in their own games.
Collapse
|
43
|
Trenfield SJ, Awad A, McCoubrey LE, Elbadawi M, Goyanes A, Gaisford S, Basit AW. Advancing pharmacy and healthcare with virtual digital technologies. Adv Drug Deliv Rev 2022; 182:114098. [PMID: 34998901 DOI: 10.1016/j.addr.2021.114098] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 02/07/2023]
Abstract
Digitalisation of the healthcare sector promises to revolutionise patient healthcare globally. From the different technologies, virtual tools including artificial intelligence, blockchain, virtual, and augmented reality, to name but a few, are providing significant benefits to patients and the pharmaceutical sector alike, ranging from improving access to clinicians and medicines, as well as improving real-time diagnoses and treatments. Indeed, it is envisioned that such technologies will communicate together in real-time, as well as with their physical counterparts, to create a large-scale, cyber healthcare system. Despite the significant benefits that virtual-based digital health technologies can bring to patient care, a number of challenges still remain, ranging from data security to acceptance within the healthcare sector. This review provides a timely account of the benefits and challenges of virtual health interventions, as well an outlook on how such technologies can be transitioned from research-focused towards real-world healthcare and pharmaceutical applications to transform treatment pathways for patients worldwide.
Collapse
|
44
|
Oliveto AH, Wright P, Kumar N, Gokarakonda S, Fischer-Laycock I, Williams J, Thompson RG. Acceptability of a Game-Based Intervention to Prevent Adolescent Prescription Opioid Misuse. Games Health J 2022; 11:104-116. [PMID: 35167352 PMCID: PMC9057874 DOI: 10.1089/g4h.2021.0243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: This study assessed the initial acceptability of SafeUse, a game-based opioid misuse prevention intervention for delivery via smartphone among adolescents. Evidence-based educational and refusal skills training materials were adapted, and game design elements were applied to clinically and scientifically informed scenarios in which opioids are typically introduced to adolescents using standard product development methods to create the SafeUse prototype. Materials and Methods: In a mixed-methods study, 14 adolescents were assessed on their knowledge and perceptions of opioids before and following 5-7 days of access to SafeUse. Participants provided feedback in focus groups on the acceptability, relevance, and understandability of SafeUse and made suggestions for its improvement. Feedback was coded and summarized as to playability, acceptability, appropriateness, content development, and knowledge transfer. Pre- and post-access quantitative data were analyzed using Wilcoxon matched pairs signed-rank tests. Results: Overall, participants liked SafeUse, its characters, graphics, and approach, finding it more appealing than lectures/reading materials and appropriate for school settings. They moderately to extremely "liked the game," "would like to play more game modules," "liked playing through the decisions," thought the game was realistic/relevant and fun, and they learned new information about opioids. Participants reported increased confidence to refuse opioids and decreased likelihood of accepting opioids from someone they know. Knowledge about opioids increased (P < 0.006), and adolescent perception that prescription drugs are safer than illegal drugs decreased (P < 0.003) after playing SafeUse. Conclusion: Findings suggest that SafeUse is acceptable and likely educational to adolescents and worthy of further development and research.
Collapse
Affiliation(s)
- Alison H Oliveto
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Patricia Wright
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nihit Kumar
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Srinivasa Gokarakonda
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ian Fischer-Laycock
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | | | - Ronald G Thompson
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
45
|
Zarglayoun H, Laurendeau-Martin J, Tato A, Vera-Estay E, Blondin A, Lamy-Brunelle A, Chaieb S, Morasse F, Dufresne A, Nkambou R, Beauchamp MH. Assessing and Optimizing Socio-Moral Reasoning Skills: Findings From the MorALERT Serious Video Game. Front Psychol 2022; 12:767596. [PMID: 35126234 PMCID: PMC8815380 DOI: 10.3389/fpsyg.2021.767596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background Social cognition and competence are a key part of daily interactions and essential for satisfying relationships and well-being. Pediatric neurological and psychological conditions can affect social cognition and require assessment and remediation of social skills. To adequately approximate the complex and dynamic nature of real-world social interactions, innovative tools are needed. The aim of this study was to document the performance of adolescents on two versions of a serious video game presenting realistic, everyday, socio-moral conflicts, and to explore whether their performance is associated with empathy or sense of presence, factors known to influence social cognition. Methods Participants (12–17 years, M = 14.39; SD = 1.35) first completed a pre-test measure of socio-moral reasoning based on three dilemmas from a previously validated computer task. Then, they either played an evaluative version (n = 24) or an adaptive (n = 33) version of a video game presenting nine social situations in which they made socio-moral decisions and provided justifications. In the evaluative version, participants’ audio justifications were recorded verbatim and coded manually to obtain a socio-moral reasoning maturity score. In the adaptive version (AV), tailored feedback and social reinforcements were provided based on participant responses. An automatic coding algorithm developed using artificial intelligence was used to determine socio-moral maturity level in real-time and to provide a basis for the feedback and reinforcements in the game. All participants then completed a three-dilemma post-test assessment. Results Those who played the adaptive version showed improved SMR across the pre-test, in-game and post-test moral maturity scores, F(1.97,63.00) = 9.81, pHF < 0.001, ϵ2 = 0.21, but those who played the Evaluative version did not. Socio-moral reasoning scores from both versions combined did not correlate with empathy or sense of presence during the game, though results neared significance. The study findings support preliminary validation of the game as a promising method for assessing and remediating social skills during adolescence.
Collapse
Affiliation(s)
- Hamza Zarglayoun
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | | | - Ange Tato
- Department of Computer Science, Université du Québec à Montréal, Montreal, QC, Canada
| | - Evelyn Vera-Estay
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Aurélie Blondin
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | | | - Sameh Chaieb
- Department of Communication, University of Montreal, Montreal, QC, Canada
| | - Frédérick Morasse
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Aude Dufresne
- Department of Communication, University of Montreal, Montreal, QC, Canada
| | - Roger Nkambou
- Department of Computer Science, Université du Québec à Montréal, Montreal, QC, Canada
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| |
Collapse
|
46
|
Darville-Sanders G, Anderson-Lewis C, Stellefson M, Lee YH, MacInnes J, Pigg RM, Mercado R, Gaddis C. mHealth video gaming for human papillomavirus vaccination among college men-qualitative inquiry for development. Mhealth 2022; 8:22. [PMID: 35928509 PMCID: PMC9343976 DOI: 10.21037/mhealth-21-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 04/14/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Persistent infection with HPV can cause various cancers; however, HPV vaccination can prevent infections associated with high risk, cancerous strains of the virus. As it relates to HPV, college age men have been identified as one of the catch-up vaccination groups. Among college age men, gaming is an extremely popular extracurricular activity. Further, video games have emerged as a popular public health intervention tool. Therefore, this study aims to collect qualitative data on how to develop, implement and evaluate the effectiveness of a gaming intervention to increase HPV risk perceptions, improve self-efficacy and increase intention to receive the HPV vaccine among male college students (18-26 years old). METHODS Four focus group sessions ranging from eight to ten individuals were conducted among male college students from one large research-intensive university in the South. Using grounded theory, data from focus group interviews were coded using NVivo software to identify emergent themes. RESULTS Participants emphasized that although customization was not viewed as important by college aged males, the ability to tailor in game experiences or experience different things each time they played (creative freedom) was more important. They encouraged that the digital game be created on a mobile platform, incorporate health messages, and be informative to reach their population. Furthermore, they suggested innovative way to disseminate the game, which included having health department/health care providers prescribe the game to patients as an end of clinical interaction strategy. CONCLUSIONS College age men, are natural avid gamers, enjoy game play, and can engage in learning online or offline. While platform preference varies among gamer type, college age men in our study emphasized that mobile based gaming is the most advantageous way to increase knowledge/awareness and encourage positive in game behavior which can impact out of game behaviors such as vaccination. Because of the level of access and natural disposition of mHealth technology seen as an "extension of the self", games for health developers should consider the mobile platform as the ideal for the target demographic.
Collapse
Affiliation(s)
| | - Charkarra Anderson-Lewis
- College of Nursing and Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael Stellefson
- Department of Health Science, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Yu Hao Lee
- Department of Media Production, Management and Technology, College of Journalism and Communications, The University of Florida, Gainesville, FL, USA
| | - Jann MacInnes
- Department of Research and Evaluation Methodology, College of Education, The University of Florida, Gainesville, FL, USA
| | - R. Morgan Pigg
- Professor Emeritus, Department of Health Education & Behavior, College of Health and Human Performance, The University of Florida, Gainesville, FL, USA
| | - Rebeccah Mercado
- College of Medicine, The University of Florida, Gainesville, FL, USA
| | - Cheryl Gaddis
- Department of Public Health, Mercer University, Atlanta, GA, USA
| |
Collapse
|
47
|
Tan A, Koh E, Sankari U, Tang J, Goh CK, Tan NC. Effects of a serious game on knowledge, attitude and practice in vector control and dengue prevention among adults in primary care: A randomised controlled trial. Digit Health 2022; 8:20552076221129099. [PMID: 36185390 PMCID: PMC9520141 DOI: 10.1177/20552076221129099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/10/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Dengue is endemic but vaccination against it is optional in tropical Singapore. Despite vector control measures to curb mosquito breeding, dengue infection continues to be prevalent. A serious game has been developed to raise the community awareness of dengue vector control programme among residents in Singapore. The study aimed to evaluate the effectiveness of this serious game on the knowledge, attitude and practice (KAP) in dengue prevention among adults. It also determined their willingness to be vaccinated against dengue. Methods A randomised controlled trial was conducted among volunteer adults who were visiting a regional primary care clinic in Sengkang, Singapore. 400 participants were randomly allocated to receive information regarding dengue prevention from either playing a serious game (intervention) or visiting a dengue prevention website (control). Before and after receiving information on dengue prevention, participants completed a self-administered online questionnaire within a two-week interval to assess the KAP score and their interest to vaccinate against dengue. Participants, who played serious game, evaluated the game with the System Usability Scale (SUS). Results A total of 374 participants, comprising of 178 participants (89%) from intervention group and 196 participants (98%) from control group, completed both questionnaires. 157 (78.5%) participants in the intervention group completed playing the serious game. Participants in both groups had increased KAP score from baseline, but the mean difference in score (SD) was greater when assessing participants’ daily practice towards dengue prevention in the serious game group compared to the control group (1.0 (2.8) vs 0.3 (1.9), p = .009). There was a positive correlation (rho = 0.275) between mean change in KAP score and highest achievement attained within serious game ( p = .001). The mean SUS (SD) was 61.8 (19.2) among participants who played the serious game. 84.2% of the study population was willing to undertake the dengue vaccination at baseline. Participants in both groups had increased proportion of participants who showed interest in dengue vaccination from baseline but the difference between serious game group and control group were not significant (5.6% vs 2.6%, p = .131). Conclusions Serious game is at least equally effective compared to conventional web-based learning in promoting dengue prevention measures and vaccination intention among adults, and may be considered as a feasible alternative to digitally engage local residents.
Collapse
Affiliation(s)
- Alon Tan
- SingHealth Polyclinics, Singapore, Singapore
| | - Eileen Koh
- SingHealth Polyclinics, Singapore, Singapore
| | | | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth – Duke NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| |
Collapse
|
48
|
de Vlieger NM, Sainsbury L, Smith SP, Riley N, Miller A, Collins CE, Bucher T. Feasibility and Acceptability of 'VitaVillage': A Serious Game for Nutrition Education. Nutrients 2021; 14:nu14010189. [PMID: 35011063 PMCID: PMC8746846 DOI: 10.3390/nu14010189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022] Open
Abstract
Computer games have previously been used to improve nutrition knowledge in children. This paper describes the acceptability and feasibility of a serious game, "VitaVillage", for improving child nutrition knowledge. VitaVillage is a farming-style game in which the player undertakes quests and completes questions aimed at increasing several aspects of nutrition and healthy eating knowledge. Children aged 9-12 years in two primary schools (control vs. intervention) completed a nutrition knowledge questionnaire at baseline (T1) and after 1 week (T2). Participants at the intervention school (n = 75) played VitaVillage for 20 minutes on two occasions. Control participants (n = 94) received no nutrition education. Likeability question scores and written feedback from intervention participants was reported qualitatively. Paired sample t-tests were used to compare T1 and T2 nutrition knowledge changes between control and intervention participants. Engagement with VitaVillage improved children's overall nutrition knowledge (Mean increase of 2.25 points between T1 and T2, Standard Deviation (SD) 6.31, p = 0.035) compared to controls. The game was liked overall (mean score 77 (SD 24.6) on scale of 0-100) and positive feedback was given. Results indicate that VitaVillage has the potential to be successful as a nutrition education tool. In the future, VitaVillage's content and gameplay will be revised, extended and evaluated for its long-term impact on eating behaviour and knowledge changes.
Collapse
Affiliation(s)
- Nienke M. de Vlieger
- College of Engineering, Science and Environment, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (L.S.); (S.P.S.); (T.B.)
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.R.); (C.E.C.)
- Correspondence:
| | - Lachlan Sainsbury
- College of Engineering, Science and Environment, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (L.S.); (S.P.S.); (T.B.)
| | - Shamus P. Smith
- College of Engineering, Science and Environment, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (L.S.); (S.P.S.); (T.B.)
| | - Nicholas Riley
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.R.); (C.E.C.)
- College of Human and Social Futures, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Andrew Miller
- College of Human and Social Futures, The University of Newcastle, Callaghan, NSW 2308, Australia;
- Teachers and Teaching Research Centre, School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Clare E. Collins
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.R.); (C.E.C.)
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Tamara Bucher
- College of Engineering, Science and Environment, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (L.S.); (S.P.S.); (T.B.)
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.R.); (C.E.C.)
| |
Collapse
|
49
|
Yang C, Han X, Jin M, Xu J, Wang Y, Zhang Y, Xu C, Zhang Y, Jin E, Piao C. The Effect of Video Game-Based Interventions on Performance and Cognitive Function in Older Adults: Bayesian Network Meta-analysis. JMIR Serious Games 2021; 9:e27058. [PMID: 34967759 PMCID: PMC8759017 DOI: 10.2196/27058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/22/2021] [Accepted: 10/12/2021] [Indexed: 01/29/2023] Open
Abstract
Background The decline in performance of older people includes balance function, physical function, and fear of falling and depression. General cognitive function decline is described in terms of processing speed, working memory, attention, and executive functioning, and video game interventions may be effective. Objective This study evaluates the effect of video game interventions on performance and cognitive function in older participants in terms of 6 indicators: balance function, executive function, general cognitive function, physical function, processing speed, and fear of falling and depression. Methods Electronic databases were searched for studies from inception to June 30, 2020. Randomized controlled trials and case-controlled trials comparing video game interventions versus nonvideo game control in terms of performance and cognitive function outcomes were incorporated into a Bayesian network meta-analysis. All data were continuous variables. Results In total, 47 studies (3244 participants) were included. In pairwise meta-analysis, compared with nonvideo game control, video game interventions improved processing speed, general cognitive function, and depression scores. In the Bayesian network meta-analysis, interventions with video games improved balance function time (standardized mean difference [SMD] –3.34, 95% credible interval [CrI] –5.54 to –2.56), the cognitive function score (SMD 1.23, 95% CrI 0.82-1.86), processing speed time (SMD –0.29, 95% CrI –0.49 to –0.08), and processing speed number (SMD 0.72, 95% CrI 0.36-1.09), similar to the pairwise meta-analysis. Interventions with video games with strong visual senses and good interactivity ranked first, and these might be more beneficial for the elderly. Conclusions Our comprehensive Bayesian network meta-analysis provides evidence that video game interventions could be considered for the elderly for improving performance and cognitive function, especially general cognitive scores and processing speed. Games with better interactivity and visual stimulation have better curative effects. Based on the available evidence, we recommend video game interventions for the elderly. Trial Registration PROSPERO CRD42020197158; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197158
Collapse
Affiliation(s)
- Chao Yang
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Xiaolei Han
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Mingxue Jin
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Jianhui Xu
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Yiren Wang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Yajun Zhang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | | | - Yingshi Zhang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Enshi Jin
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China.,Information Construction Department, Liaoning National Normal College, Shenyang, China
| | - Chengzhe Piao
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China.,Information Construction Department, Liaoning National Normal College, Shenyang, China
| |
Collapse
|
50
|
Jiang R, Shao B, Si S, Sato R, Tsuneo J. Health Communication in Games at the Early Stage of COVID-19 Epidemic: A Grounded Theory Study Based on Plague, Inc. Games Health J 2021; 10:408-419. [PMID: 34860131 DOI: 10.1089/g4h.2020.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Objectives: An empirical study is carried out based on Plague, Inc. to explore whether the game has raised awareness of public health and urged players to make a better choice about health. Materials and Methods: Twenty-six college students from 24 cities in 11 provinces of China were investigated for a week-long survey. According to grounded theory principles, we coded original records from 69 diary reports using qualitative analysis tools. Results: We constructed nine core categories from participants' journals and drew the mechanism chart of the game as a means of health communication. The results showed that participants had experienced (1) an iterative learning process based on the authenticity and multiperspective features of the game and obtained specific learning outcomes; (2) deep thinking through the association between the game and the real world. And we extracted variables that are highly predictive of behavior change, including cognition of seriousness, cognition of susceptibility, action clue, and self-efficacy. Furthermore, noncore categories (including emotions and gameplay) directly and indirectly impacted players' learning and behavior change. Conclusion: The study shows Plague, Inc. has played a positive role in health communication (mainly reflected in the improvement of players' cognitive level, the establishment of health belief, and behavior changes). Moreover, it is concluded that reflection plays an important role in health communication interventions. However, careful consideration should be given to the use of this game as a means of health intervention due to its limitations and certain deficiencies.
Collapse
Affiliation(s)
- Rui Jiang
- School of Information Science and Technology & Department of Art and Design, Beijing University of Chemical Technology, Beijing, China.,School of Animation and Digital Art, Communication University of China, Beijing, China
| | - Bing Shao
- School of New Media, Jilin University of Arts, Jilin, China
| | - Si Si
- School of Information Science and Technology & Department of Art and Design, Beijing University of Chemical Technology, Beijing, China
| | - Reika Sato
- Department of Digital Games, Osaka Electro-Communication University, Shijonawateshi, Osaka, Japan
| | - Jozen Tsuneo
- Department of Digital Games, Osaka Electro-Communication University, Shijonawateshi, Osaka, Japan
| |
Collapse
|