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Stutvoet MD, Levelt L, Hrehovcsik MM, Van't Veer J, Visch VT, Bramer WM, Hillegers MHJ, Veltkamp RC, Nijhof SL, Estévez-López F. Gamification in eHealth for Chronic Disease Self-Management in Youth: A Systematic Review. Games Health J 2024; 13:314-331. [PMID: 38900649 DOI: 10.1089/g4h.2023.0111] [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: 06/22/2024] Open
Abstract
This systematic review primarily aims to provide a summary of the game mechanics implemented in eHealth tools supporting young people's self-management of their chronic diseases. This review secondarily investigates the rationale for implementing game mechanics and the effects of these tools. A systematic search was conducted in Embase, Medline, PsycINFO, and Web of Science, from inception until August 30, 2022. Studies were eligible if focus was on the utilization of gamification in eHealth self-management interventions for young people (age = 10-25 years) with chronic diseases. Primary quantitative, qualitative, and mixed-method studies written in English were included. We identified 34 eHealth tools, of which 20 (59%) were gamified tools and 14 (41%) were serious games. We found that 55 unique game mechanics were implemented. The most commonly used were rewards (50%), score (44%), creative control (41%), and social interaction (32%). In comparison with gamified tools, the number and diversity of game mechanics applied were higher in serious games. For most tools (85%), a general rationale was provided for utilizing gamification, which often was to promote engaging experiences. A rationale for using specific game mechanics was less commonly provided (only for 45% of the game mechanics). The limited availability of experimental research precludes to test the effectiveness of using gamification in eHealth to support self-management in young people with chronic diseases. In this study, we highlight the importance of reporting the rationale for utilizing specific game mechanics in eHealth tools to ensure a proper alignment with evidence-based practice and the need of conducting experimental research. PROSPERO: CRD42021293037.
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Affiliation(s)
- Maartje D Stutvoet
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lisa Levelt
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | | | - Job Van't Veer
- Department of Healthcare, NHL Stenden University of Applied Sciences, Leeuwarden, The Netherlands
| | - Valentijn T Visch
- Department of Human Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Remco C Veltkamp
- Department of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sanne L Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Fernando Estévez-López
- Department of Education, Faculty of Education Sciences; SPORT Research Group (CTS-1024); and CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
- Biomedical Research Unit, Torrecárdenas University Hospital, Almería, Spain
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Cederved C, Ljungman G, Back J, Ångström-Brännström C, Engvall G. Acceptability of a Serious Game About Proton Radiotherapy Designed for Children Aged 5 to 14 Years and Its Potential Impact on Perceived Anxiety: Feasibility and Randomized Controlled Pilot Trial. JMIR Serious Games 2024; 12:e54082. [PMID: 39312188 PMCID: PMC11441341 DOI: 10.2196/54082] [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: 10/29/2023] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 10/02/2024] Open
Abstract
Background Children who are going to undergo radiotherapy have displayed fear and anxiety. Therefore, a web-based serious game was developed as a psychological preparation to investigate if it could affect anxiety levels. In an earlier stage, children with experience of radiotherapy had been part of the developmental process. Objective The study aimed to investigate the feasibility in terms of reach, usability, and acceptability of a serious game about proton radiotherapy and to pilot that it did not increase anxiety levels in children aged 5 to 14 years undergoing radiotherapy. Methods The design was a randomized controlled pilot trial with predefined feasibility criteria. In total, 28 children were assessed for eligibility, and 23 met the inclusion criteria. They were consecutively randomized into 1 of 2 study arms. One child was excluded after randomization. If randomized into arm 1, the children received the intervention before treatment started. Children in arm 2 were treated as controls. Questionnaires with fixed answers were used to assess anxiety levels (an adapted version of the State-Trait Anxiety Inventory for Children) and experiences of gameplay (an adapted version of Player Experience of Need Satisfaction [PENS]). The children were asked to answer questionnaires at 5 different measurement occasions during their radiotherapy treatment. Results In arm 1, age ranged from 5 to 13 (mean 8.4, SD 2.4) years. In arm 2, age ranged from 5 to 11 (mean 7.6, SD 2.3) years. The sample consisted of 15 girls and 7 boys. The feasibility criterion that the children should play the game for 20 minutes or more was not met. Mean playtime for children in arm 1 was 32.1 (SD 23.8) minutes, where 18 children had played for at least 15 minutes. The criterion that 70% (n=16) or more of the participants should return all of the questionnaires was not met; however, more than 73% (n=16) returned the PENS questionnaires. The State-Trait Anxiety Inventory for Children was returned by 73% (n=16) on day 0, 77% (n=17) on day 1, 82% (n=18) on day 3, 82% (n=18) on day 6, and 86% (n=19) on day 15. Conclusions All feasibility criteria set for the study were not met, suggesting that adaptions need to be made if a future study is to be undertaken. Further, the analysis revealed that there was no indication that playing increased the children's self-reported anxiety. The PENS questionnaire adapted for children showed promising results regarding player satisfaction when using the serious game. When studying children with severe conditions and young age, 5 measurement occasions seemed to be too many. Measuring both player satisfaction or experience and knowledge transfer would be preferable in future studies.
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Affiliation(s)
- Catarina Cederved
- Department of Women's and Children's Health, Uppsala University, Sjukhusvägen, 751 85, Uppsala, Sweden
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Gustaf Ljungman
- Department of Women's and Children's Health, Uppsala University, Sjukhusvägen, 751 85, Uppsala, Sweden
| | - Jon Back
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Charlotte Ångström-Brännström
- Department of Women's and Children's Health, Uppsala University, Sjukhusvägen, 751 85, Uppsala, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Gunn Engvall
- Department of Women's and Children's Health, Uppsala University, Sjukhusvägen, 751 85, Uppsala, Sweden
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Sarasmita MA, Lee YH, Chan FY, Chen HY. Digital Serious Games to Promote Behavior Change in Children With Chronic Diseases: Scoping Review and Development of a Self-Management Learning Framework. J Med Internet Res 2024; 26:e49692. [PMID: 39158952 PMCID: PMC11369548 DOI: 10.2196/49692] [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: 06/06/2023] [Revised: 04/13/2024] [Accepted: 06/25/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND Digital serious games (SGs) have rapidly become a promising strategy for entertainment-based health education; however, developing SGs for children with chronic diseases remains a challenge. OBJECTIVE In this study, we attempted to provide an updated scope of understanding of the development and evaluation of SG educational tools and develop a framework for SG education development to promote self-management activities and behavior change in children with chronic diseases. METHODS This study consists of a knowledge base and an analytical base. This study followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. To build the knowledge base, 5 stages of research were developed, including refining the review question (stage 1), searching for studies (stage 2), selecting relevant studies (stage 3), charting the information (stage 4), and collating the results (stage 5). Eligible studies that developed SG prototypes and evaluated SG education for children with chronic diseases were searched for in PubMed, Embase, Google Scholar, and peer-reviewed journals. In the analytical base, the context-mechanism-output approach and game taxonomy were used to analyze relevant behavioral theories and essential game elements. Game taxonomy included social features, presentation, narrative and identity, rewards and punishment, and manipulation and control. A total of 2 researchers selected the domains for the included behavioral theories and game elements. The intended SG framework was finalized by assembling SG fragments. Those SG fragments were appropriately reintegrated to visualize a new SG framework. RESULTS This scoping review summarized data from 16 randomized controlled trials that evaluated SG education for children with chronic diseases and 14 studies on SG frameworks. It showed that self-determination theory was the most commonly used behavioral theory (9/30, 30%). Game elements included feedback, visual and audio designs, characters, narratives, rewards, challenges, competitions, goals, levels, rules, and tasks. In total, 3 phases of a digital SG framework are proposed in this review: requirements (phase 1), design and development (phase 2), and evaluation (phase 3). A total of 6 steps are described: exploring SG requirements (step 1), identifying target users (step 2), designing an SG prototype (step 3), building the SG prototype (step 4), evaluating the SG prototype (step 5), and marketing and monitoring the use of the SG prototype (step 6). Safety recommendations to use digital SG-based education for children in the post-COVID-19 era were also made. CONCLUSIONS This review summarizes the fundamental behavioral theories and game elements of the available literature to establish a new theory-driven step-by-step framework. It can support game designers, clinicians, and educators in designing, developing, and evaluating digital, SG-based educational tools to increase self-management activities and promote behavior change in children with chronic diseases.
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Affiliation(s)
- Made Ary Sarasmita
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Program Study of Pharmacy, Faculty of Mathematics and Science, Udayana University, Badung, Indonesia
| | - Ya-Han Lee
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Wan Fang Hospital, Taipei, Taiwan
| | - Fan-Ying Chan
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Hsiang-Yin Chen
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Wan Fang Hospital, Taipei, Taiwan
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Holtz BE, Mitchell KM, Holmstrom AJ, Hershey DS, Cotten SR, Dunneback JK, Ellis DA, Wood MA. The effect of an mHealth intervention for adolescents with Type 1 diabetes and their parents. J Telemed Telecare 2024; 30:1155-1162. [PMID: 36177538 DOI: 10.1177/1357633x221125835] [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: 11/17/2022]
Abstract
BACKGROUND Past research has demonstrated that adolescents with Type 1 diabetes (T1D) typically have a decline in health outcomes as they begin to assume more self-management activities. Mobile app interventions have been suggested as one possible way to improve this behavior. PURPOSE The primary aim of this study was to address declines in health outcomes by pilot testing the satisfaction, use and feasibility of an app-based family communication intervention aimed to assist in adolescent self-management of T1D. METHODS Thirty-three adolescent-parent pairs were enrolled in and completed the 12-week pilot study. Participants were randomized 2:1 to intervention (app use) or control group. Pre/post quantitative and qualitative data were collected, including HbA1c and surveys. Paired-sample t-tests and ANOVA statistics were conducted. RESULTS The parents and adolescents reported high satisfaction with the app, and that it was easy to use. Results showed HbA1c stability in the intervention group and significant worsening in the control group. There were also significant improvements in adherence to diabetes management and quality of life for the parents in the intervention group. The adolescents did not show any improvement in quality-of-life measures. CONCLUSION This study suggests that the app intervention is acceptable, shows promise for improving health outcomes for adolescents with T1D, and may improve family communication. The public health implications of this work are that app interventions have a potential role in positively influencing chronic disease outcomes. Additional research with a more extensive and diverse sample is needed to determine generalizability.
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Affiliation(s)
- Bree E Holtz
- Department of Advertising & Public Relations, Michigan State University, East Lansing, MI, USA
| | - Katharine M Mitchell
- Department of Advertising & Public Relations, Michigan State University, East Lansing, MI, USA
| | - Amanda J Holmstrom
- Department of Communication, Michigan State University, East Lansing, MI, USA
| | - Denise S Hershey
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | | | | | - Deborah A Ellis
- Department of Family Medicine, Wayne State University, Detroit, MI, USA
| | - Michael A Wood
- Pediatric Endocrinology, University of Michigan Medical School, Ann Arbor, MI, USA
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Aronson PL, Nolan SA, Schaeffer P, Hieftje KD, Ponce KA, Calhoun CL. Perspectives of Adolescents and Young Adults With Sickle Cell Disease and Clinicians on Improving Transition Readiness With a Video Game Intervention. J Pediatr Hematol Oncol 2024; 46:e147-e155. [PMID: 38237001 DOI: 10.1097/mph.0000000000002810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/21/2023] [Indexed: 02/28/2024]
Abstract
We aimed to learn the experiences of clinicians and adolescents and young adults with sickle cell disease (AYA-SCD) with managing their disease at home and making medical decisions as they transition from pediatric to adult care, and their perceptions of a video game intervention to positively impact these skills. We conducted individual, semistructured interviews with patients (AYA-SCD ages 15 to 26 years) and clinicians who provide care to AYA-SCD at an urban, quaternary-care hospital. Interviews elicited patients' and clinicians' experiences with AYA-SCD, barriers and facilitators to successful home management, and their perspectives on shared decision-making and a video game intervention. To identify themes, we conducted an inductive analysis until data saturation was reached. Participants (16 patients and 21 clinicians) identified 4 main themes: (1) self-efficacy as a critical skill for a successful transition from pediatric to adult care, (2) the importance of patient engagement in making medical decisions, (3) multilevel determinants of optimal self-efficacy and patient engagement, and (4) support for a video game intervention which, by targeting potential determinants of AYA-SCD achieving optimal self-efficacy and engagement in decision-making, may improve these important skills.
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Affiliation(s)
- Paul L Aronson
- Section of Pediatric Emergency Medicine, Departments of Pediatrics and of Emergency Medicine
| | | | | | | | - Kortney A Ponce
- California Health Sciences University, College of Osteopathic Medicine, Clovis, CA
| | - Cecelia L Calhoun
- Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven
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Ou L, Reifsnider E, Chen ACC, Todd M, Amresh A, Mun CJ. Using Gaming to Promote Vaccination Among Youth: A Systematic Review. SAGE Open Nurs 2024; 10:23779608241256998. [PMID: 38903195 PMCID: PMC11188057 DOI: 10.1177/23779608241256998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/26/2024] [Accepted: 05/05/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction While vaccines are crucial for disease prevention, disparities in vaccination coverage persist among youths aged 10 to 29 years, including within the United States. Serious games are emerging as a new strategy to address vaccine hesitancy. This systematic review aimed to aggregate and assess the current evidence on game-based interventions to improve youth vaccination rates, evaluating their impact and identifying factors influencing their effectiveness. Methods This systematic review was conducted through a meticulous search and evaluation of literature from databases including PubMed, Cumulative Index to Nursing and Allied Health Literature database, ProQuest platform, Cochrane Library, and Google Scholar. Studies were included if they (a) were designed with the purpose of improving youth vaccination rates; (b) were published in English; (c) were published between January 2011 and June 2023; and (d) evaluated the effect of game-based interventions. Search terms included Medical Subject Headings terms and keywords of the eligible articles. Results Out of 269 studies, 11 were included in the final analysis of this review. The earliest study dated back to 2013, with 5 being randomized controlled trial and 6 studies incorporating theoretical models in their design or outcome measures. The findings indicated a generally positive effect of game-based interventions on vaccine-related knowledge. However, the impact on actual vaccine uptake was limited. In-game avatar customization and collaboration games were found as effective tools for player engagement. Conclusion The review findings indicated that serious games boost vaccine knowledge but lack strong evidence for influencing youth vaccine uptake. More rigorous research and tailored game designs are needed to determine the effectiveness of game-based interventions and effectively address the diverse needs of youth in vaccine decision-making.
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Affiliation(s)
- Lihong Ou
- Edson College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, AZ, USA
| | - Elizabeth Reifsnider
- Edson College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Michael Todd
- Edson College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, AZ, USA
| | - Ashish Amresh
- College of Engineering, Informatics, and Applied Sciences, Northern Arizona University, Flagstaff, AZ, USA
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, USA
| | - Chung Jung Mun
- Edson College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, AZ, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Holtz BE, Mitchell K. Best Practices for Developing a Diabetes mHealth App. J Diabetes Sci Technol 2024; 18:39-45. [PMID: 37644831 PMCID: PMC10899849 DOI: 10.1177/19322968231195849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The widespread use of smartphones in the United States has led to a surge in mHealth apps designed to support people with various health issues. Yet the effectiveness and long-term impacts of these apps still need to be determined. This article presents a case study of the development of MyT1DHero, an mHealth app for people with type 1 diabetes, to identify best practices for app development. We propose four essential best practices based on the insights gained from this case study: incorporating theoretical frameworks, prioritizing user feedback, engaging key stakeholders, and establishing a robust data-collection foundation. These findings have practical implications for researchers and developers seeking to create effective mHealth interventions. Furthermore, we suggest future research directions to advance the development and implementation of innovative health technologies.
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Affiliation(s)
- Bree E. Holtz
- Department of Advertising and
Public Relations, Michigan State University, East Lansing, MI, USA
| | - Katharine Mitchell
- Department of Advertising and
Public Relations, Michigan State University, East Lansing, MI, USA
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Brady VJ, Mathew Joseph N, Ju HH. Impact of Gaming (Gamification) on Diabetes Self-Care Behaviors and Glycemic Outcomes Among Adults With Type 2 Diabetes. Sci Diabetes Self Manag Care 2023; 49:493-511. [PMID: 37927059 PMCID: PMC10666525 DOI: 10.1177/26350106231208153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
PURPOSE The purpose of this systematic review was to determine if the use of gaming (gamification) among persons with type 2 diabetes improves diabetes self-management behaviors and diabetes outcomes. METHODS A systematic review was conducted using electronic databases including MEDLINE, Embase, Web of Science, and CINAHL. Studies reporting on the impact of gaming on at least 1 of the Association of Diabetes Care and Education Specialists self-care behaviors (ADCES7) were included. RESULTS The review included 9 studies, 8 of which were of strong/high quality. Five of the self-care behaviors were addressed in at least 1 of the included studies. However, taking medications and problem solving were not reported in any of the studies. Physical activity and self-efficacy or quality of life (healthy coping) were the most frequently reported ADCES7 behaviors. Six of the studies used A1C as an outcome measure, with a reduction reported in all the studies except 1. CONCLUSION Type 2 diabetes affects a person holistically, necessitating a range of self-care behaviors to effectively manage the chronic condition. Novel gaming interventions may improve coping mechanisms, lifestyle behaviors, medication engagement, and monitoring of risks and problems, all of which are essential in facilitating optimal diabetes self-management.
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Affiliation(s)
- Veronica Joyce Brady
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Nitha Mathew Joseph
- Department of Undergraduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Hsiao-Hui Ju
- Department of Undergraduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas
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Comparison of effectiveness of Nintendo Wii-based exergaming and home-based fun video exercises in pediatric patients with chronic kidney disease. Int J Rehabil Res 2023; 46:26-34. [PMID: 36416089 DOI: 10.1097/mrr.0000000000000554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Functional capacity and quality of life (QoL) are reduced in children and adults with chronic kidney disease (CKD). Aerobic, strengthening exercises, and exergames are reported as effective in the treatment of symptoms associated with CKD. Unlike adult patients, there are insufficient studies investigating the effects of exercise on disease-related symptoms in pediatric CKD. This study aimed to compare the effects of Nintendo Wii-based exergaming and home-based fun video exercises on functional capacity, muscle strength, physical activity (PA), depression, fatigue, and QoL in pediatric patients with CKD. Twenty-three pediatric patients with CKD were included in the study and randomized to group I (Nintendo Wii Fit) and group II (home-based fun video exercises). Patients in both groups underwent exercise programs twice per week for 6 weeks. Functional capacity, muscle strength, PA, QoL, fatigue, and depression of the patients were evaluated before and after the treatments. Sixteen patients completed the study. After treatment, significant differences were observed in both groups on 6MWT, muscle strength, average daily steps, PedsQoL Child Self-Report PHSS, and the Visual Fatigue Scale. Left knee flexor muscle strength and average step counts were found to be superior in group I. Both exergaming and home-based fun video exercises provide positive effects on functional capacity, muscle strength, fatigue, PA, depression, and QoL in pediatric patients with CKD. We think that these exercise methods can help to protect physical and mental health of patients and should be included in treatment from the early stages of the disease.
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Puzio D, Makowska I, Rymarczyk K. Raising the Child-Do Screen Media Help or Hinder? The Quality over Quantity Hypothesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9880. [PMID: 36011514 PMCID: PMC9408637 DOI: 10.3390/ijerph19169880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Screen media are ubiquitous in human life across all age, cultural and socioeconomic groups. The ceaseless and dynamic growth of technological possibilities has given rise to questions regarding their effect on the well-being of children. Research in this area largely consists of cross-sectional studies; experimental and randomized studies are rare, which makes drawing causative conclusions difficult. However, the prevailing approach towards the use of screen media by children has focused on time limitations. The emerging evidence supports a more nuanced perspective. It appears that the older the child, the more important how the screen media are used becomes. Concentrating on the quality of the screen, time has become increasingly relevant in the recent COVID-19 pandemic, which necessitated a transfer of educational and social functioning from real-life to the digital world. With this review, we aimed at gathering current knowledge on the correlations of different screen media use and development outcomes, as well as providing an overview of potential benefits that new technologies may provide to the pediatric population. To summarize, if one cannot evade screen time in children, how can we use it for children's maximum advantage?
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Affiliation(s)
- Diana Puzio
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-419 Lodz, Poland
| | - Iwona Makowska
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-419 Lodz, Poland
| | - Krystyna Rymarczyk
- Department of Biological Psychology, University of Social Sciences and Humanities in Warsaw, 03-815 Warszawa, Poland
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Abbasi AZ, Azeem S, Farooq MU, Hussain K, Ting DH, Rehman U, Griffiths MD, Pakpour AH. Engagement in educational games and quality of life in early and middle childhood: evidence from a developing country. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03558-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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12
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Espinosa-Curiel IE, Pozas-Bogarin EE, Hernández-Arvizu M, Navarro-Jiménez ME, Delgado-Pérez EE, Martínez-Miranda J, Pérez-Espinosa H. HelperFriend, a Serious Game for Promoting Healthy Lifestyle Behaviors in Children: Design and Pilot Study. JMIR Serious Games 2022; 10:e33412. [PMID: 35522474 PMCID: PMC9123542 DOI: 10.2196/33412] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/14/2021] [Accepted: 04/07/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The use of health games is a promising strategy for educating and promoting healthy lifestyle behaviors among children. OBJECTIVE We aimed to describe the design and development of a serious game, called HelperFriend, and evaluate its feasibility, acceptability, and preliminary effects in children in a pilot study. HelperFriend is a vicarious experiential video game designed to promote 3 lifestyle behaviors among young children: physical activity, healthy eating, and socioemotional wellness. METHODS Participants aged 8 to 11 years were recruited from an elementary school and randomized to receive a healthy lifestyle behavior educational talk (control) or play six 30-minute sessions with HelperFriend (intervention). Assessments were conducted at baseline (T0) and after the intervention (ie, 4 weeks) (T1). The primary outcome was gain in knowledge. The secondary outcomes were intention to conduct healthy behaviors, dietary intake, and player satisfaction. RESULTS Knowledge scores of intervention group participants increased from T0 to T1 for physical activity (t14=2.01, P=.03), healthy eating (t14=3.14, P=.003), and socioemotional wellness (t14=2.75, P=.008). In addition, from T0 to T1, the intervention group improved their intention to perform physical activity (t14=2.82, P=.006), healthy eating (t14=3.44, P=.002), and socioemotional wellness (t14=2.65, P=.009); and there was a reduction in their intake of 13 unhealthy foods. HelperFriend was well received by intervention group. CONCLUSIONS HelperFriend appears to be feasible and acceptable for young children. In addition, this game seems to be a viable tool to help improve the knowledge, the intention to conduct healthy behaviors, and the dietary intake of children; however, a well-powered randomized controlled trial is needed to prove the efficacy of HelperFriend.
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Affiliation(s)
- Ismael Edrein Espinosa-Curiel
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Edgar Efrén Pozas-Bogarin
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Maryleidi Hernández-Arvizu
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Maria Elena Navarro-Jiménez
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Edwin Emeth Delgado-Pérez
- Centro de Estudios e Investigaciones en Comportamiento, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Juan Martínez-Miranda
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Humberto Pérez-Espinosa
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
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13
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Martínez-Miranda J, Espinosa-Curiel IE. Serious games supporting the prevention and treatment of alcohol and drugs consumption in youth: a scoping review (Preprint). JMIR Serious Games 2022; 10:e39086. [PMID: 36006694 PMCID: PMC9459843 DOI: 10.2196/39086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/23/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The consumption of alcohol and drugs, particularly in adolescents and young adults, has increased worldwide in the last several years, representing a significant public health challenge. Serious games have the potential to support preventive and treatment interventions for substance use, facilitating the acquisition of relevant knowledge and the motivation for changes in attitudes and behaviors regarding substance consumption. Objective This scoping review aims to analyze a set of 7 relevant characteristics of current serious games designed to support the prevention and treatment of alcohol and drug consumption in adolescents and young adults—the substance addressed, the type of intervention, the theoretical basis, the computational techniques used, the mechanism for data security and privacy, the evaluation procedure followed, and the main results obtained. Methods The review was performed by following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Data were retrieved from January 2010 to May 2022, using PubMed, Scopus (Elsevier), IEEE Xplore, and ACM Digital as data sources. The eligibility criteria included studies that described serious games designed to support the prevention or treatment of alcohol and drug consumption, targeted a population aged between 12 and 30 years, and included an evaluation procedure. Authors (JMM and IEEC) individually screened the titles and abstracts, and then full articles were reviewed for a final inclusion decision. Results A total of 629 records were obtained, and 29 (4.6%) fulfilled the inclusion criteria. Most of the serious games (14/29, 48%) were focused on the prevention or treatment of alcohol use. The type of intervention that was the most supported was prevention (18/29, 62%), and most studies mentioned the theory, theoretical construct, or therapeutic technique used as a foundation (22/29, 76%). Most of the studies only provided information about the platform for execution (23/29, 79%), and few described the use of computational techniques, such as virtual reality or motion-based interaction (5/29, 17%). A small set of studies (10/29, 34%) explicitly mentioned how data security and privacy were addressed. Most of the reported evaluation protocols were pilot studies (11/29, 38%), followed by randomized controlled trials (10/29, 34%), and the reported results were positive in terms of acceptability, usability, and efficacy. However, more research is needed to assess long-term effects. Conclusions Given the increasing interest in the use of serious games as digital interventions to support the prevention or treatment of substance use, knowing their main features is highly important. This review highlights whether and how current serious games incorporate 7 key features that are useful to consider for the further development of the area.
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Affiliation(s)
- Juan Martínez-Miranda
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Mexico
| | - Ismael Edrein Espinosa-Curiel
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Mexico
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14
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Garani-Papadatos T, Natsiavas P, Meyerheim M, Hoffmann S, Karamanidou C, Payne SA. Ethical Principles in Digital Palliative Care for Children: The MyPal Project and Experiences Made in Designing a Trustworthy Approach. Front Digit Health 2022; 4:730430. [PMID: 35373180 PMCID: PMC8971573 DOI: 10.3389/fdgth.2022.730430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/03/2022] [Indexed: 12/31/2022] Open
Abstract
This paper explores the ethical dimension of the opportunity to offer improved electronic patient-reported outcome (ePRO) systems addressing personal needs of pediatric cancer patients, their parents and caregivers, with regard to technological advance of digital health. This opportunity has been explored in the MyPal research project, which aims to assess a patient-centered service for palliative care relying on the adaptation and extension of digital health tools and concepts available from previous projects. Development and implementation of ePROs need to take place in a safe, secure and responsible manner, preventing any possible harm and safeguarding the integrity of humans. To that end, although the final results will be published at the end of the project, this paper aims to increase awareness of the ethical ramifications we had to address in the design and testing of new technologies and to show the essentiality of protection and promotion of privacy, safety and ethical standards. We have thus reached a final design complying with the following principles: (a) respect for the autonomy of participants, especially children, (b) data protection and transparency, (c) fairness and non-discrimination, (d) individual wellbeing of participants in relation to their physical and psychological health status and e) accessibility and acceptability of digital health technologies for better user-engagement. These principles are adapted from the Ethics Guidelines for a trustworthy Artificial Intelligence (AI) which provide the framework for similar interventions to be lawful, complying with all applicable laws and regulations, ethical, ensuring compliance to ethical principles and values and robust, both from a technical and social perspective.
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Affiliation(s)
- Tina Garani-Papadatos
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | | | - Marcel Meyerheim
- Faculty of Medicine, Clinic of Pediatric Oncology and Hematology, Saarland University Hospital and Saarland University, Homburg, Germany
| | - Stefan Hoffmann
- Serious Games Solutions, a Division of Promotion Software GmbH, Tuebingen, Germany
| | | | - Sheila A Payne
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
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15
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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: 3] [Impact Index Per Article: 1.5] [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.
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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
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16
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Wang X, Kou X, Meng X, Yu J. Effects of a virtual reality serious game training program on the cognitive function of people diagnosed with schizophrenia: A randomized controlled trial. Front Psychiatry 2022; 13:952828. [PMID: 35911215 PMCID: PMC9334918 DOI: 10.3389/fpsyt.2022.952828] [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: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive impairment persists through the course of schizophrenia and affects patients' activities of daily living. AIM This study aims to investigate the effects of a virtual reality (VR) serious game training program on the cognitive function of people diagnosed with schizophrenia. MATERIALS AND METHODS Sixty-four eligible people diagnosed with schizophrenia were recruited and randomly assigned to the intervention group (n = 31) and the control group (n = 33). The control group received standard psychiatric care. The intervention group was trained with an additional VR game twice a day for at least 10 days during hospitalization. Cognitive function was measured at enrollment and before discharge using the Brief Cognitive Assessment Tool for Schizophrenia. RESULTS Compared with those of the control group, the results of the working memory (t = 3.463, Cohen's d = 0.87, p = 0.001) and executive function (TMTA: Z = -2.272, Cohen's d = 0.59, p = 0.023; TMTB:Z = -2.365, Cohen's d = 0.62, p = 0.018) of the intervention group after intervention were significantly better. However, there was no significant difference in the results of social cognition (Z = -1.394, Cohen's d = 0.35, p = 0.163) between the two groups. CONCLUSION Intensive active virtual reality serious game training in addition to standard psychiatric care can significantly improve working memory and executive function in people diagnosed with schizophrenia. IMPLICATIONS FOR PRACTICE When helping improve the cognitive function of people diagnosed with schizophrenia, mental health professionals should identify cognitive domains to be enhanced and develop corresponding serious game training strategies.
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Affiliation(s)
- Xu Wang
- West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaomin Kou
- West China Hospital, Sichuan University, Chengdu, China
| | - Xiandong Meng
- West China Hospital, Sichuan University, Chengdu, China
| | - Jianying Yu
- West China Hospital, Sichuan University, Chengdu, China
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17
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Shiau CWC, Lim SM, Cheng LJ, Lau Y. Effectiveness of Game-Based Self-Management Interventions for Individuals with Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Games Health J 2021; 10:371-382. [PMID: 34860133 DOI: 10.1089/g4h.2020.0203] [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: Self-management is essential for individuals with diabetes. However, traditional self-management interventions may be hard to follow for other patients. Although games can stimulate extrinsic motivations, its application on self-management remains unclear. This review aims to evaluate the effects of game-based self-management interventions on health outcomes. Materials and Methods: We utilize PubMed, CINAHL, Cochrane Central, EMBASE, ProQuest Dissertation and Theses, PsycINFO, and Scopus from their inception until January 20, 2020. Meta-analyses are performed using Comprehensive Meta-analysis 3.0 software. The overall effect is measured using Hedges' g and determined using Z-statistics at significance level of P < 0.05. Heterogeneity is assessed using χ2 and I2 statistics. The risk of bias tool and the grades of recommendation, assessment, development, and evaluation system are used to assess individual and overall quality of evidence, respectively. Results: A total of 2150 records are identified, and 13 randomized controlled trials are selected. Meta-analyses revealed that game-based self-management interventions significantly improved patients' change in glycated hemoglobin (HbA1c) level (g = 0.18, P = 0.02), adherence to physical activities (g = 0.59, P < 0.001), balance (g = 0.94-1.14, P < 0.001), and fall efficacy (g = 1.01, P < 0.001). Significant results were only found for the three-trial meta-analysis for HbA1c changes, but not for the two other HbA1c meta-analyses that included more trials. Furthermore, negligible improvements were observed in glycated hemoglobin at postintervention and follow-up assessments, diabetes knowledge, and self-efficacy. Conclusion: Game-based self-management can consider a supplementary intervention. Overall evidence is ranging from very low to low. Future studies can consider a large sample size with high-quality design according to the Consolidated Standards of Reporting Trials statement criteria.
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Affiliation(s)
| | - Shi Min Lim
- Department of Nursing, National University Hospital, National University Health System, Singapore
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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18
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Revealing the theoretical basis of gamification: A systematic review and analysis of theory in research on gamification, serious games and game-based learning. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106963] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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19
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Penev Y, Dunlap K, Husic A, Hou C, Washington P, Leblanc E, Kline A, Kent J, Ng-Thow-Hing A, Liu B, Harjadi C, Tsou M, Desai M, Wall DP. A Mobile Game Platform for Improving Social Communication in Children with Autism: A Feasibility Study. Appl Clin Inform 2021; 12:1030-1040. [PMID: 34788890 PMCID: PMC8598393 DOI: 10.1055/s-0041-1736626] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background
Many children with autism cannot receive timely in-person diagnosis and therapy, especially in situations where access is limited by geography, socioeconomics, or global health concerns such as the current COVD-19 pandemic. Mobile solutions that work outside of traditional clinical environments can safeguard against gaps in access to quality care.
Objective
The aim of the study is to examine the engagement level and therapeutic feasibility of a mobile game platform for children with autism.
Methods
We designed a mobile application,
GuessWhat
, which, in its current form, delivers game-based therapy to children aged 3 to 12 in home settings through a smartphone. The phone, held by a caregiver on their forehead, displays one of a range of appropriate and therapeutically relevant prompts (e.g., a surprised face) that the child must recognize and mimic sufficiently to allow the caregiver to guess what is being imitated and proceed to the next prompt. Each game runs for 90 seconds to create a robust social exchange between the child and the caregiver.
Results
We examined the therapeutic feasibility of
GuessWhat
in 72 children (75% male, average age 8 years 2 months) with autism who were asked to play the game for three 90-second sessions per day, 3 days per week, for a total of 4 weeks. The group showed significant improvements in Social Responsiveness Score-2 (SRS-2) total (3.97,
p
<0.001) and Vineland Adaptive Behavior Scales-II (VABS-II) socialization standard (5.27,
p
= 0.002) scores.
Conclusion
The results support that the
GuessWhat
mobile game is a viable approach for efficacious treatment of autism and further support the possibility that the game can be used in natural settings to increase access to treatment when barriers to care exist.
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Affiliation(s)
- Yordan Penev
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Kaitlyn Dunlap
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Arman Husic
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Cathy Hou
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Peter Washington
- Department of Bioengineering, Stanford University, Stanford, California, United States
| | - Emilie Leblanc
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Aaron Kline
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - John Kent
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Anthony Ng-Thow-Hing
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Bennett Liu
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Christopher Harjadi
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Meagan Tsou
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Manisha Desai
- Department of Biomedical Data Science, Stanford University, Stanford, California, United States
| | - Dennis P Wall
- Department of Pediatrics (Systems Medicine), Stanford University, Stanford, California, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States.,Department of Biomedical Data Science, Stanford University, Stanford, California, United States
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20
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Dadaczynski K, Krah V, Frank D, Zügel-Hintz E, Pöhlmann F. Promoting Navigation Health Literacy at the Intersection of Schools and Communities. Development of the Game-Based Intervention Nebolus. Front Public Health 2021; 9:752183. [PMID: 34869169 PMCID: PMC8635644 DOI: 10.3389/fpubh.2021.752183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Emerging empirical evidence indicates a limited health literacy for a substantial proportion of children and adolescents. Although it is generally agreed upon promoting health literacy as early as possible in the lifespan, there is a lack of interventions addressing children and adolescents and their primary living environments. This article describes the development of Nebolus, a game-based intervention aiming to promote navigation health literacy at the intersection of schools and communities. Its intervention foundation lies in a socio-ecological understanding of health as well as in the Entertainment Education approach. Following an extensive literature search on health-related location-based games, a co-creation process was initiated that involved adolescents, community stakeholders, and design/IT professionals in all phases of the intervention development. The final Nebolus intervention includes three core activities: (1) a Nebolus rally app for adolescents aged 12 to 16 years, (2) an online planning tool allowing local health service providers/professionals to set up own Nebolus rallies, and (3) accompanying teaching material on health literacy in the school setting to be used before and after the Nebolus rallies. This article provides an overview of the intervention layout and discusses strengths and challenges of its development and implementation.
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Affiliation(s)
- Kevin Dadaczynski
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
- Centre for Applied Health Science, Leuphana University Lueneburg, Lueneburg, Germany
| | - Verena Krah
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
| | - Demian Frank
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
| | - Elisabeth Zügel-Hintz
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
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21
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Weser VU, Duncan LR, Sands BE, Schartmann A, Jacobo S, François B, Hieftje KD. Evaluation of a virtual reality E-cigarette prevention game for adolescents. Addict Behav 2021; 122:107027. [PMID: 34225030 DOI: 10.1016/j.addbeh.2021.107027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To test preliminary efficacy and acceptability of Invite Only VR: A Vaping Prevention Game (Invite Only VR), an electronic cigarette (e-cigarette) prevention game that uses virtual reality (VR) hardware. METHODS 285 adolescents (146 boys; ages 11-14; M = 12.45 years; SD = 0.57) were enrolled in this non-equivalent control groups design through their middle school. Participants who played Invite Only VR for 1.5 h were compared to treatment as usual at 4 timepoints: baseline, post gameplay, 3 and 6 months. Evidence of the efficacy of the game to influence e-cigarette use, e-cigarette knowledge, nicotine addiction knowledge, perceived addictiveness of e-cigarettes, perceived likelihood of using e-cigarettes, perceptions of harm, self-efficacy to refuse, social approval of e-cigarettes, and e-cigarette social perceptions was assessed using mixed between-within subjects ANOVAS. Intervention acceptability was indicated by measures of gameplay experience/satisfaction, VR experience, and perceived responsibility for game-based decisions. RESULTS From baseline to 6 months, Invite Only VR players improved in e-cigarette knowledge, nicotine addiction knowledge, perceived addictiveness of e-cigarettes, perceptions of harm, and social perceptions about e-cigarette use compared to the control group. No significant changes were observed for the other dependent variables, including e-cigarette use. Ratings of gameplay experience and satisfaction, VR experience, and game-based decisions were high. CONCLUSIONS Invite Only VR may help players develop knowledge about e-cigarettes and nicotine addiction, as well as encourage the development of healthy harm and social perceptions regarding e-cigarette use that persist 6 months beyond gameplay. Adolescents' satisfaction with the VR gameplay indicates preliminary intervention acceptability.
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Affiliation(s)
- Veronica U Weser
- Department of General Medicine, Yale School of Medicine, New Haven, CT, United States; play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States.
| | - Lindsay R Duncan
- play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States; Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Brandon E Sands
- Department of General Medicine, Yale School of Medicine, New Haven, CT, United States; play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States
| | - Andrew Schartmann
- play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States; Department of Music Theory, New England Conservatory, Boston, MA, United States
| | - Sandra Jacobo
- play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States; University of California, Berkeley, United States
| | | | - Kimberly D Hieftje
- Department of General Medicine, Yale School of Medicine, New Haven, CT, United States; play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States
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22
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Usability Evaluation of the Novel Smartphone Application, HPV Vaccine: Same Way, Same Day, Among Pediatric Residents. Acad Pediatr 2021; 21:742-749. [PMID: 33279739 DOI: 10.1016/j.acap.2020.11.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Scalable, deliberate practice training strategies to administer evidence-based recommendations are necessary to improve human papillomavirus (HPV) vaccination rates. We sought to characterize resident clinicians' perceptions regarding the usability of the HPV Vaccine: Same Way, Same Day smartphone application (app). Usability, a critical aspect of digital programs to promote behavior change, was evaluated. METHODS Fifteen third-year pediatric residents were recruited to complete a usability evaluation of the HPV Vaccine: Same Way, Same Day app, which includes simulated role-play scenarios in which users interact, as a pediatrician avatar, with an animated parent hesitant to accept the vaccine for her child. The app provides information about the vaccine and utilizes deliberate practice, a purposeful and systematic approach to improve performance, to teach evidence-based vaccine recommendation practices, including motivational interviewing skills. Data were derived from in-depth, semistructured interviews with pediatric residents. We used a constructivist general inductive approach to illuminate perspectives via inductive coding and pattern identification. Garrison's theoretical construct on self-directed learning was used to cluster themes into conceptual categories. RESULTS We classified interview data in 3 conceptual categories: self-management, internal monitoring and motivational principles. Residents described the app as interactive, easy to use, succinct, informative, engaging, and practical. All residents would recommend the HPV Vaccine: Same Way, Same Day app to a colleague. Residents suggested adding more complex cases for future iterations. CONCLUSIONS From their perspective, pediatric residents reported that an app using deliberate practice principles has the potential to inform and advance providers' counseling skills regarding the HPV vaccine.
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23
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Sensorised Low-Cost Pencils for Developing Countries: A Quantitative Analysis of Handwriting Learning Progress in Children with/without Disabilities from a Sustainable Perspective. SUSTAINABILITY 2020. [DOI: 10.3390/su122410682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Learning to write is a demanding endeavour that requires a combination of linguistic, motor and cognitive skills. Some children suffer from delay or inability to acquire those skills, which often hampers their performance at school and brings about serious consequences for self-esteem, personal expectations and social relationships. The situation worsens in developing countries, due to the lack of resources and specialised personnel. With this background, this paper describes an experiment with a newly-developed sensorised pencil with triangular prism shape, which is shown to yield substantial improvements in children with/without special education needs. A team of experts in the areas of speech therapy, occupational therapy, educational psychology, physiotherapy and pedagogy have expressed very positive opinions about the sensorised pencil and the accompanying software for the acquisition and analysis of quantitative data about handwriting. Furthermore, the device stands out for its low cost in comparison with similar developments, which is a key factor to aid children from low-income families. This fact is explained with a success story of manufacturing and delivering sensorised pencils in the Ecuadorian province of Azuay, framed in a multi-layer sustainable development perspective based on collaboration of several institutions and individuals.
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24
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Espinosa-Curiel IE, Pozas-Bogarin EE, Martínez-Miranda J, Pérez-Espinosa H. Relationship Between Children's Enjoyment, User Experience Satisfaction, and Learning in a Serious Video Game for Nutrition Education: Empirical Pilot Study. JMIR Serious Games 2020; 8:e21813. [PMID: 32940609 PMCID: PMC7530690 DOI: 10.2196/21813] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/21/2020] [Accepted: 09/01/2020] [Indexed: 01/25/2023] Open
Abstract
Background The design and use of serious video games for children have increased in recent years. To maximize the effects of these games, it is essential to understand the children’s experiences through playing. Previous studies identified that enjoyment and user experience satisfaction of the players are principal factors that can influence the success of serious video games and the learning of their players. However, research about the relationship between enjoyment and user experience satisfaction with learning in children 8 to 10 years old is sparse. Objective We examined the relationship of enjoyment and user experience satisfaction with the learning of children aged 8 to 10 years while playing a serious video game for health, FoodRateMaster. This serious video game teaches children about the characteristics of healthy and unhealthy foods and how to identify them in their environment. Methods Children aged 8 to 10 years were recruited from a primary school in Mexico. Participants completed 12 individual gaming sessions with FoodRateMaster in 6 weeks. A food knowledge questionnaire was administered before and after game play to assess the players’ food knowledge. In addition, after the gaming sessions, the children’s enjoyment and user experience satisfaction were evaluated using the EGameFlow questionnaire and the Game User Experience Satisfaction Scale (GUESS) questionnaire. Results We found significant positive associations for children’s (n=60) posttest knowledge with enjoyment (r58=0.36, P=.005) and user experience satisfaction (r58=0.27, P=.04). The children’s posttest knowledge scores were also positively correlated with challenge (r58=0.38, P=.003), knowledge improvement (r58=0.38, P=.003), and goal clarity (r58=0.29, P=.02) EGameFlow subscales and with narrative (r58=0.35, P=.006), creative freedom (r58=0.26, P=.04), and visual esthetics (r58=0.32, P=.01) GUESS subscales. Regression analysis indicated that the EGameFlow (F7,52=2.74, P=.02, R2=0.27) and the GUESS (F8,51=2.20, P=.04, R2=0.26) ratings significantly predicted the children’s posttest knowledge scores. EGameFlow challenge (β=0.40, t52=2.17, P=.04) and knowledge improvement (β=0.29, t52=2.06, P=.04) subscales significantly contributed to predicting children’s learning. None of the GUESS subscales significantly contributed to predicting children’s learning. Conclusions The findings of this study suggest that both enjoyment and user experience satisfaction for children aged 8 to 10 years were positively correlated with their learning and that were significant predictors of it. Challenge, knowledge improvement, narrative, creative freedom, and visual esthetics subscales correlated positively with children’s learning. In addition, challenge and knowledge improvement contributed to predicting their learning. These results are relevant to consider during the design stages of serious games developed for young children’s learning purposes.
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Affiliation(s)
- Ismael Edrein Espinosa-Curiel
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Edgar Efrén Pozas-Bogarin
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Juan Martínez-Miranda
- Consejo Nacional de Ciencia y Tecnología, Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Humberto Pérez-Espinosa
- Consejo Nacional de Ciencia y Tecnología, Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
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Santana CCDAP, Freitas ATVDS, Oliveira Barreto G, Sousa De Avelar I, Mazaro-Costa R, Bueno GN, Ribeiro DC, Damasceno Silva G, Naghettini AV. Serious Game on a Smartphone for Adolescents Undergoing Hemodialysis: Development and Evaluation. JMIR Serious Games 2020; 8:e17979. [PMID: 32924950 PMCID: PMC7522727 DOI: 10.2196/17979] [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: 01/26/2020] [Revised: 06/30/2020] [Accepted: 08/11/2020] [Indexed: 01/03/2023] Open
Abstract
Background Adolescents with chronic kidney disease have a hard time adhering to hemodialysis as a therapy, indicating a need to establish new alternatives for motivation and adherence to treatment. Objective The objective of this study was to develop and evaluate a serious game to stimulate and motivate adolescents undergoing hemodialysis. Methods We describe the technological production followed by a qualitative analysis. We invited 8 adolescents undergoing hemodialysis in the city Goiânia, located in the midwest of Brazil, to participate. The final convenience sample included 7 (87.5% of the target population) adolescents. The process was conducted in 3 phases: creation of a serious game, evaluation of its use, and observation of its motivating effect on behavioral modification with a focus on acquiring the necessary competence for self-care. Results An app (Bim) in the modality of a serious game was developed to be used during hemodialysis; the player was encouraged to take care of a character with daily actions during his or her treatment. The game was made available to adolescents aged 10-14 years. Mobile devices were offered during the hemodialysis treatment for a period of 30-40 minutes, 3 times a week for 60 days. The usage definitions of the game were freely chosen by the participants. The qualitative evaluation of the use of the Bim app showed that it encompasses scenarios and activities that enable the exercise of daily actions for the treatment of patients. The behavioral evaluation showed that the Bim app worked as a motivating stimulus for behavioral adherence to hemodialysis requirements. Conclusions The easy-to-access app interface showed good operability for its users. The description of the character and proposed activities contributed to motivation and ability to cope with hemodialysis care.
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Affiliation(s)
| | | | | | | | | | - Gina Nolêto Bueno
- Departament of Psychology, Pontifical Catholic University of Goiás, Goiânia, Brazil
| | - Diuly Caroline Ribeiro
- Faculty of Medicine, Postgraduate Program Teaching in Health, Goias Federal University, Goiânia, Brazil
| | - Gabriela Damasceno Silva
- Faculty of Medicine, Postgraduate Program Teaching in Health, Goias Federal University, Goiânia, Brazil
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Sobrinho ASF, Scalassara PR, Dajer ME. Low-Cost Joystick for Pediatric Respiratory Exercises. J Med Syst 2020; 44:186. [PMID: 32926332 PMCID: PMC7488224 DOI: 10.1007/s10916-020-01655-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/28/2020] [Indexed: 11/28/2022]
Abstract
The use of body signals for health care applications has become ubiquitous in the last decade. One utilization of such measurements is the monitoring of respiratory flow for physiotherapy assistance. This application is based on relative flow measures which can rely on inexpensive sensors. Based on that, we present a low-cost electronic device that detects blows and suctions with a pressure sensor and emulates a keyboard for interfacing with computers. This joystick allows children to control free internet games by associating blows and suctions with different intensities to keyboard actions. Also, the intensity can be calibrated according to the user’s pulmonary capacities. This feature is adequate for gradual respiratory physiotherapy and can be customized for each patient. In order to verify the operation of the proposed device, practical tests were performed with three online free games, where the joystick functionality was assessed with different therapeutic configurations.
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Affiliation(s)
| | - Paulo Rogério Scalassara
- Department of Electrical Engineering, Federal University of Technology - Paraná, Cornélio Procópio, Brazil
| | - María Eugenia Dajer
- Department of Electrical Engineering, Federal University of Technology - Paraná, Cornélio Procópio, Brazil
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Prosocial digital games for youth: A systematic review of interventions. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2020. [DOI: 10.1016/j.chbr.2020.100039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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28
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La Banca RO, Brandão MCDM, Sparapani VDC, de Souza NS, Neves ET, Cavicchioli MGS, de Lima RAG, Nascimento LC. A Fun Way to Learn About Diabetes: Using Therapeutic Play in a Brazilian Camp. J Pediatr Nurs 2020; 53:e35-e40. [PMID: 32063429 DOI: 10.1016/j.pedn.2020.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE Understanding disease mechanisms inside the body is crucial to engage youth with type 1 diabetes (T1D) in self-care behaviors. This study describes how Instructional Therapeutic Play (ITP) group sessions held by nurses in a Brazilian camp can enhance youth's understanding about T1D. DESIGN AND METHODS Youth with T1D participated in video recorded ITP group sessions guided by the Sensitive Creative Method. First, participants were asked to create an artistic production based upon the query "What happens in the body of a young person who has diabetes?". They described their drawings and shared information, providing opportunities to discuss T1D pathophysiology. Second, campers were told a story about a child who had T1D onset using a rag doll and illustrative figures. Participants were asked to create a second artistic production based upon the same initial query. Finally, campers had another presentation of the drawings, discussion, and sharing through the question "How did the story told help you understand your diabetes?" Transcriptions of ITP sessions were submitted to thematic analysis. RESULTS Twenty participants (9-17yo) were assigned to age/gender matched groups. Four themes were built: Designing insulin production; Experiencing the glycemic vigilance in diabetes management; The ITP session as a safe space to share challenges with nurses and peers; and Unraveling the myths of diabetes with the ITP session. CONCLUSION Therapeutic play sessions enhanced youth's knowledge and unraveled myths of T1D pathophysiology. PRACTICE IMPLICATIONS ITP sessions can be developed by nurses in order to deliver age-appropriate diabetes education to pediatric patients.
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Affiliation(s)
| | - Maria Carolina de Moraes Brandão
- University of São Paulo at Ribeirão Preto College of Nursing, Maternal-Infant and Public Health Nursing Department, Ribeirão Preto, SP, Brazil
| | | | - Neila Santini de Souza
- Federal University of Santa Maria, Department of Health Sciences, Palmeira das Missões, Brazil
| | | | | | - Regina Aparecida Garcia de Lima
- University of São Paulo at Ribeirão Preto College of Nursing, Maternal-Infant and Public Health Nursing Department, Ribeirão Preto, SP, Brazil
| | - Lucila Castanheira Nascimento
- University of São Paulo at Ribeirão Preto College of Nursing, Maternal-Infant and Public Health Nursing Department, Ribeirão Preto, SP, Brazil
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Sharifzadeh N, Kharrazi H, Nazari E, Tabesh H, Edalati Khodabandeh M, Heidari S, Tara M. Health Education Serious Games Targeting Health Care Providers, Patients, and Public Health Users: Scoping Review. JMIR Serious Games 2020; 8:e13459. [PMID: 32134391 PMCID: PMC7082739 DOI: 10.2196/13459] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 09/07/2019] [Accepted: 12/12/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Serious educational games have shown effectiveness in improving various health outcomes. Previous reviews of health education games have focused on specific diseases, certain medical subjects, fixed target groups, or limited outcomes of interest. Given the recent surge in health game studies, a scoping review of health education games is needed to provide an updated overview of various aspects of such serious games. OBJECTIVE This study aimed to conduct a scoping review of the design and evaluation of serious educational games for health targeting health care providers, patients, and public (health) users. METHODS We identified 2313 studies using a unique combination of keywords in the PubMed and ScienceDirect databases. A total of 161 studies were included in this review after removing duplicates (n=55) and excluding studies not meeting our inclusion criteria (1917 based on title and abstract and 180 after reviewing the full text). The results were stratified based on games targeting health care providers, patients, and public users. RESULTS Most health education games were developed and evaluated in America (82/161, 50.9%) and Europe (64/161, 39.8%), with a considerable number of studies published after 2012. We discovered 58.4% (94/161) of studies aiming to improve knowledge learning and 41.6% (67/161) to enhance skill development. The studies targeted various categories of end users: health care providers (42/161, 26.1%), patients (38/161, 23.6%), public users (75/161, 46.6%), and a mix of users (6/161, 3.7%). Among games targeting patients, only 13% (6/44) targeted a specific disease, whereas a growing majority targeted lifestyle behaviors, social interactions, cognition, and generic health issues (eg, safety and nutrition). Among 101 studies reporting gameplay specifications, the most common gameplay duration was 30 to 45 min. Of the 61 studies reporting game repetition, only 14% (9/61) of the games allowed the users to play the game with unlimited repetitions. From 32 studies that measured follow-up duration after the game intervention, only 1 study reported a 2-year postintervention follow-up. More than 57.7% (93/161) of the games did not have a multidisciplinary team to design, develop, or assess the game. CONCLUSIONS Serious games are increasingly used for health education targeting a variety of end users. This study offers an updated scoping review of the studies assessing the value of serious games in improving health education. The results showed a promising trend in diversifying the application of health education games that go beyond a specific medical condition. However, our findings indicate the need for health education game development and adoption in developing countries and the need to focus on multidisciplinary teamwork in designing effective health education games. Furthermore, future health games should expand the duration and repetition of games and increase the length of the follow-up assessments to provide evidence on long-term effectiveness.
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Affiliation(s)
- Nahid Sharifzadeh
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Kharrazi
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Elham Nazari
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Tabesh
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Edalati Khodabandeh
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Heidari
- Department of Medical Informatics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Tara
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Holtz BE, Mitchell KM, Nuttall AK, Cotten SR, Hershey DD, Dunneback JK, Wood MA. Using User-Feedback to Develop a Website: MyT1DHope, for Parents of Children with T1D. HEALTH COMMUNICATION 2020; 35:281-288. [PMID: 30592228 DOI: 10.1080/10410236.2018.1560579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Effectively caring for a child with type-1 diabetes (T1D) can be extremely demanding and stressful for the entire family. The difficulties of caring for a child with T1D impact the psychological and physical well-being of the parents. Interventions aimed at reducing stress and increasing coping may improve parental outcomes. This project sought to develop a resource to be used as a preliminary intervention step for these parents. This research was conducted in two parts. Part 1 includes three stages of formative evaluation, including a focus group, interviews, and a survey with parents to examine the current landscape of diabetes websites as a resource. Using data from Part 1, Part 2 of the study included the identification of a theory to guide the design of a website, the development of the website, and an 8-week pilot study of the website with parents with a child with T1D. Significant improvements were found in diabetes knowledge and caregivers' satisfaction of life. No changes were found in social support, self-efficacy, or quality of life. Overall, the data show that the parents were generally satisfied with the website. Through this work, researchers were able to develop a deeper understanding of the needs of parents caring for a child with T1D to develop the initial component of a larger intervention.
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Affiliation(s)
- Bree E Holtz
- Department of Advertising & Public Relations, Michigan State University
| | | | - Amy K Nuttall
- Department of Human Development & Family Studies, Michigan State University
| | - Shelia R Cotten
- Department of Media & Information, Michigan State University
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31
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Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Namara MM, Paton MC, Popat H, Shore B, Khamis A, Stanton E, Finemore OP, Tricks A, Te Velde A, Dark L, Morton N, Badawi N. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep 2020; 20:3. [PMID: 32086598 PMCID: PMC7035308 DOI: 10.1007/s11910-020-1022-z] [Citation(s) in RCA: 446] [Impact Index Per Article: 111.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Cerebral palsy is the most common physical disability of childhood, but the rate is falling, and severity is lessening. We conducted a systematic overview of best available evidence (2012-2019), appraising evidence using GRADE and the Evidence Alert Traffic Light System and then aggregated the new findings with our previous 2013 findings. This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019. RECENT FINDINGS Effective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pressure care, stepping stones triple P, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing. Effective medical and surgical interventions include anti-convulsants, bisphosphonates, botulinum toxin, botulinum toxin plus occupational therapy, botulinum toxin plus casting, diazepam, dentistry, hip surveillance, intrathecal baclofen, scoliosis correction, selective dorsal rhizotomy, and umbilical cord blood cell therapy. We have provided guidance about what works and what does not to inform decision-making, and highlighted areas for more research.
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Affiliation(s)
- Iona Novak
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia.
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Michael Fahey
- Department of Paediatric Neurology, Monash Health, Clayton, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Megan Finch-Edmondson
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Claire Galea
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Ashleigh Hines
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Katherine Langdon
- Department of Paediatric Rehabilitation, Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | - Maria Mc Namara
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Madison Cb Paton
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Himanshu Popat
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Benjamin Shore
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amanda Khamis
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Emma Stanton
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Olivia P Finemore
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Alice Tricks
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Anna Te Velde
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Leigha Dark
- Allied and Public Helath, Faculty of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Natalie Morton
- Allied and Public Helath, Faculty of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia
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Torres Sánchez I, Megías Salmerón Y, López López L, Ortiz Rubio A, Rodríguez Torres J, Valenza MC. Videogames in the Treatment of Obstructive Respiratory Diseases: A Systematic Review. Games Health J 2020; 8:237-249. [PMID: 31386586 DOI: 10.1089/g4h.2018.0062] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Introduction: Millions of people suffer from obstructive respiratory conditions globally. Including videogames in rehabilitation programs can be an interesting alternative to traditional programs or a complementary activity. Objective: To explore the use of videogames in the treatment of patients with obstructive respiratory diseases. Methods: A systematic literature search was performed to identify randomized clinical trials evaluating the effects of videogames on health outcomes in patients with respiratory obstructive diseases. The following databases were searched: PubMed, Web of Science, ScienceDirect, and Scopus. The methodological quality of the studies included was assessed with the Downs and Black quality assessment method. Results: Nine articles were included, of which three used videogames as physical training methods and managed to improve exercise capacity, strength, quality of life, and symptoms. The remaining six articles used videogames to educate patients about the disease and showed slight improvements in knowledge of the disease and use of medication. Conclusion: The results of this review show that videogames are a very useful complementary therapy. They can contribute to enhance rehabilitation programs, as they improve exercise capacity, muscle strength, quality of life, severity, control, and knowledge of the disease. Videogames should be supervised by a professional so that programs can be tailored to patients, proposing different activities in the game and controlling the correct performance, and generating an increase in adherence to treatment. Registry: prospective register of systematic reviews (PROSPERO) CRD42018094094.
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Affiliation(s)
- Irene Torres Sánchez
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Yolanda Megías Salmerón
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Laura López López
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Araceli Ortiz Rubio
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Janet Rodríguez Torres
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
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Kokol P, Vošner HB, Završnik J, Vermeulen J, Shohieb S, Peinemann F. Serious Game-based Intervention for Children with Developmental Disabilities. Curr Pediatr Rev 2020; 16:26-32. [PMID: 31393252 DOI: 10.2174/1573396315666190808115238] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Children with developmental disabilities may need support with motor skills such as balance improvement, cognitive skills such as vocabulary learning, or social skills such as adequate interpretation of emotional expressions. Digital interactive games could support the standard treatments. We aimed to review clinical studies which investigated the application of serious games in children with developmental disabilities. METHODS We searched MEDLINE and Scopus on 05 May 2019 limited to the English language. We included people between two and 24 years of age who were affected by neurodevelopmental disorders and who received digital serious game-based medical interventions such as any computer- based or video-based games. We considered any study design reporting primary data. We used title, abstract, and full-text of journal articles to build diagnostic groups, and we described some selected specific game applications. RESULTS The majority of the 145 relevant studies reported on autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and disabilities affecting intellectual abilities (DAIA). 30 of the 145 studies reported a randomized design. We detailed six specific applications aimed at improving abilities in children with ASD, ADHD, cerebral palsy, and Down syndrome. We visualized the diagnostic groups by bibliographic mapping, and limited the text to the title and abstract of journal articles. CONCLUSION We identified promising results regarding anxiety reduction, stress regulation, emotion recognition, and rehabilitation. Currently, there appears to be a lack of clinical evidence that children with neurodevelopmental disorders can benefit from the application of serious games.
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Affiliation(s)
- Peter Kokol
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Helena Blažun Vošner
- Community Healthcare Centre Dr. Adolf Drolc, Maribor, Slovenia.,Faculty of Health and Social Sciences Slovenj Gradec, University of Maribor, Slovenj Gradec, Slovenia
| | - Jernej Završnik
- Community Healthcare Centre Dr. Adolf Drolc, Maribor, Slovenia
| | - Joeri Vermeulen
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Samaa Shohieb
- Faculty of Computers and Information, Mansoura University, Aldaqahlia, Egypt
| | - Frank Peinemann
- Children's Hospital, University Hospital, Cologne, Germany.,FOM University of Applied Science for Economics & Management, Essen, Germany
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Mitchell KM, Holtz BE, McCarroll A. Patient-Centered Methods for Designing and Developing Health Information Communication Technologies: A Systematic Review. Telemed J E Health 2019; 25:1012-1021. [PMID: 30576258 DOI: 10.1089/tmj.2018.0236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background: Chronic disease management and maintaining healthy behaviors to prevent disease are important lifelong considerations. Adherence to prescribed management and behaviors often falls short of physician recommendations, which can result in negative health outcomes. Information communication technologies (ICTs) offer an approach to combat this issue. However, uptake and sustainability of ICTs have mixed results. One reason could be that technologies are often created without an understanding of the complexities of patient needs. Therefore, the intent of this study is to explore the current landscape of patient-centered design and development of health ICTs through a systematic review. Materials and Methods: Systematic literature searches were conducted in the databases EBSCO, PubMed, and Web of Science between October 2016 and February 2017. Each paper was critically evaluated for each data extraction classification, and was categorized based on the chronic disease or health focus, method of patient-centered design, resulting themes, and use of theory. Results: The study search resulted in 3,748 articles total. After duplicates and articles not meeting criteria were removed, 57 articles were selected for assessment. Four main themes emerged: participant experience, technological requirements, behavioral and knowledge components, and social components. Conclusions: Adhering to chronic disease management and healthy behaviors are both crucial to attain positive health outcomes. ICTs can play an interesting role in aiding disease management and healthy behavior promotion, but involving end-users and applying a theoretical foundation in the design and development of these technologies should be considered.
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Affiliation(s)
- Katharine M Mitchell
- Department of Advertising and Public Relations, Michigan State University, East Lansing, Michigan
| | - Bree E Holtz
- Department of Advertising and Public Relations, Michigan State University, East Lansing, Michigan
| | - Alexis McCarroll
- Department of Media and Information, Michigan State University, East Lansing, Michigan
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Real FJ, Beck AF, DeBlasio D, Zackoff M, Henize A, Xu Y, Davis D, Cruse B, Klein MD. Dose Matters: A Smartphone Application to Improve Asthma Control Among Patients at an Urban Pediatric Primary Care Clinic. Games Health J 2019; 8:357-365. [PMID: 31157983 DOI: 10.1089/g4h.2019.0011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective: As the most common chronic condition of childhood, asthma is a frequent target for family education. However, current educational strategies rarely tailor to learning style or literacy level. Thus, we developed and implemented a smartphone application (app) leveraging gamified features entitled CHANGE Asthma ("Clinic, Home, And on the Go Education for Asthma"). We subsequently assessed its impact on asthma control. Methods: Patients aged 4-11 years with a previously documented childhood asthma control test (C-ACT) score of <20, indicating poor control, were recruited to participate in this randomized control pilot study. The intervention group downloaded CHANGE Asthma; asthma control was assessed at enrollment and at follow-up. The changes in C-ACT score in both groups were compared using analysis of covariance (primary outcome). App usage was monitored for 4 months following download, and the relationship between usage time, and the change in C-ACT score was assessed via linear regression. Results: The control and intervention groups both included 20 caregivers with 75% of participants completing follow-up. Although C-ACT scores among intervention participants significantly improved at follow-up, compared to their own baseline (P = 0.04), the change of C-ACT score did not significantly differ from that of the control group (P = 0.78). Among the intervention participants, there was a positive, dose-dependent relationship between app usage time and positive change in C-ACT score (P = 0.03). Conclusion: Usage of a gamified app was associated with a dose-dependent improvement in asthma control over time, suggesting that further evaluation of apps for asthma education, and perhaps for other chronic conditions, is warranted.
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Affiliation(s)
- Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Andrew F Beck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Dominick DeBlasio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Matthew Zackoff
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Adrienne Henize
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - David Davis
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Bradley Cruse
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Melissa D Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Metcalf CS, Huntsman M, Garcia G, Kochanski AK, Chikinda M, Watanabe E, Underwood T, Vanegas F, Smith MD, White HS, Bulaj G. Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs. Front Neurol 2019; 10:277. [PMID: 30972009 PMCID: PMC6446215 DOI: 10.3389/fneur.2019.00277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/04/2019] [Indexed: 12/29/2022] Open
Abstract
Digital therapeutics (software as a medical device) and mobile health (mHealth) technologies offer a means to deliver behavioral, psychosocial, disease self-management and music-based interventions to improve therapy outcomes for chronic diseases, including pain and epilepsy. To explore new translational opportunities in developing digital therapeutics for neurological disorders, and their integration with pharmacotherapies, we examined analgesic and antiseizure effects of specific musical compositions in mouse models of pain and epilepsy. The music playlist was created based on the modular progression of Mozart compositions for which reduction of seizures and epileptiform discharges were previously reported in people with epilepsy. Our results indicated that music-treated mice exhibited significant analgesia and reduction of paw edema in the carrageenan model of inflammatory pain. Among analgesic drugs tested (ibuprofen, cannabidiol (CBD), levetiracetam, and the galanin analog NAX 5055), music intervention significantly decreased paw withdrawal latency difference in ibuprofen-treated mice and reduced paw edema in combination with CBD or NAX 5055. To the best of our knowledge, this is the first animal study on music-enhanced antinociceptive activity of analgesic drugs. In the plantar incision model of surgical pain, music-pretreated mice had significant reduction of mechanical allodynia. In the corneal kindling model of epilepsy, the cumulative seizure burden following kindling acquisition was lower in animals exposed to music. The music-treated group also exhibited significantly improved survival, warranting further research on music interventions for preventing Sudden Unexpected Death in Epilepsy (SUDEP). We propose a working model of how musical elements such as rhythm, sequences, phrases and punctuation found in K.448 and K.545 may exert responses via parasympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Based on our findings, we discuss: (1) how enriched environment (EE) can serve as a preclinical surrogate for testing combinations of non-pharmacological modalities and drugs for the treatment of pain and other chronic diseases, and (2) a new paradigm for preclinical and clinical development of therapies leading to drug-device combination products for neurological disorders, depression and cancer. In summary, our present results encourage translational research on integrating non-pharmacological and pharmacological interventions for pain and epilepsy using digital therapeutics.
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Affiliation(s)
- Cameron S. Metcalf
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake, UT, United States
| | - Merodean Huntsman
- Department of Medicinal Chemistry, University of Utah, Salt Lake, UT, United States
| | - Gerry Garcia
- Greatful Living Productions, Salt Lake, UT, United States
| | - Adam K. Kochanski
- Department of Atmospheric Sciences, University of Utah, Salt Lake, UT, United States
| | - Michael Chikinda
- The Gifted Music School, Salt Lake, UT, United States
- The School of Music, University of Utah, Salt Lake, UT, United States
| | | | - Tristan Underwood
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake, UT, United States
| | - Fabiola Vanegas
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake, UT, United States
| | - Misty D. Smith
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake, UT, United States
- The School of Dentistry, University of Utah, Salt Lake, UT, United States
| | - H. Steve White
- School of Pharmacy, University of Washington, Seattle, WA, United States
| | - Grzegorz Bulaj
- Department of Medicinal Chemistry, University of Utah, Salt Lake, UT, United States
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Affiliation(s)
- Neal Kaufman
- 1 Fielding School of Public Health, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
- 2 Canary Health, Inc, Los Angeles, CA
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Benzing V, Schmidt M. Exergaming for Children and Adolescents: Strengths, Weaknesses, Opportunities and Threats. J Clin Med 2018; 7:E422. [PMID: 30413016 PMCID: PMC6262613 DOI: 10.3390/jcm7110422] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 10/31/2018] [Accepted: 11/02/2018] [Indexed: 12/12/2022] Open
Abstract
Exergaming, or active video gaming, has become an emerging trend in fitness, education and health sectors. It is defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). Since exergaming is becoming more popular, claims have been made on the usefulness of exergaming. It has, for example, been entitled as being "the future of fitness" by the American College of Sports Medicine, promoting PA and health in children and adolescents. However, research also suggests that long-term engagement in exergaming is difficult to achieve, and there is a noticeable reservation towards exergaming by parents, teachers and caregivers. To provide an overview and to outline the future directions of exergaming, the aim of this review was to critically illustrate the strengths, weaknesses, opportunities and threats of exergaming to promote PA and health in children and youth. The available evidence indicates that exergaming has the potential to improve health via an increase in PA. However, it seems that this potential is frequently underexploited, and further developments such as customized exergames are needed.
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Affiliation(s)
- Valentin Benzing
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland.
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland.
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