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Psihogios AM, Roth M, Gomez C, Hekimian-Brogan E, McQueen C, Yanez B. Partnering With Social Media Influencers to Equitably Improve Adolescent and Young Adult Cancer Outcomes: A Novel Strategy to Support Cancer Care Delivery. JCO Oncol Pract 2024; 20:755-760. [PMID: 38408282 DOI: 10.1200/op.23.00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/07/2024] [Accepted: 01/30/2024] [Indexed: 02/28/2024] Open
Affiliation(s)
| | - Michael Roth
- The University of Texas, MD Anderson Cancer Center, Houston, TX
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Ribeiro N, Tavares P, Ferreira C, Coelho A. Melanoma prevention using an augmented reality-based serious game. PATIENT EDUCATION AND COUNSELING 2024; 123:108226. [PMID: 38442436 DOI: 10.1016/j.pec.2024.108226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES The purpose of this study was to field-test a recently developed AR-based serious game designed to promote SSE self-efficacy, called Spot. METHODS Thirty participants played the game and answered 3 questionnaires: a baseline questionnaire, a second questionnaire immediately after playing the game, and a third questionnaire 1 week later (follow-up). RESULTS The majority of participants considered that the objective quality of the game was high, and considered that the game could have a real impact in SSE promotion. Participants showed statistically significant increases in SSE self-efficacy and intention at follow-up. Of the 24 participants that had never performed a SSE or had done one more than 3 months ago, 12 (50.0%) reported doing a SSE at follow-up. CONCLUSIONS This study provides supporting evidence to the use of serious games in combination with AR to educate and motivate users to perform SSE. Spot seems to be an inconspicuous but effective strategy to promote SSE, a cancer prevention behavior, among healthy individuals. PRACTICE IMPLICATIONS Patient education is essential to tackle skin cancer, particularly melanoma. Serious games, such as Spot, have the ability to effectively educate and motivate patients to perform a cancer prevention behavior.
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Affiliation(s)
- Nuno Ribeiro
- I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal, Ipatimup - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Portugal.
| | - Pedro Tavares
- I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal, Ipatimup - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Portugal, Faculdade de Engenharia da Universidade do Porto, Portugal
| | - Catarina Ferreira
- I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal, Ipatimup - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Portugal, Faculdade de Engenharia da Universidade do Porto, Portugal
| | - António Coelho
- Faculdade de Engenharia da Universidade do Porto, Portugal, INESC TEC - Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ciência, Portugal
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Costa V, Rojo A, López-López S, Pareja-Galeano H, Velásquez A, Perea L, Raya R. Evaluating the Usability and Safety of Virtual Reality Application Combined with the SWalker for Functional Gait Rehabilitation. Games Health J 2024. [PMID: 38757664 DOI: 10.1089/g4h.2023.0172] [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: 05/18/2024] Open
Abstract
Objective: This research evaluates from a usability point of view the combination of a developed fully immersive virtual reality (VR) solution with the SWalker robotic device. It aims to contribute to research in the exploration of immersive experiences overground with a functional gait recovery device. Materials and Methods: We evaluated the system in a pilot study with 20 healthy participants aged 85.1 (SD: 6.29). Participants used the SWalker-VR platform while testing one VR application focused on walking and the other on balance practice. Afterward, the participants answered three usability questionnaires. Results: The platform was validated in terms of safety using the Simulator Sickness Questionnaire, obtaining less than 20 points for all subscales: nausea (4.29 ± 14.47), oculomotor (0.38 ± 14.18), and disorientation (1.39 ± 14.52). For usability evaluation, the System Usability Scale provided an overall score of 70.63 ± 11.64, and the Post-Study System Usability Questionnaire (PSSUQ) rated 1.61 ± 0.54. The usability scores reported by both questionnaires were moderate and good, respectively. These results were similar in overall scores for both groups: participants with low cognitive level and participants with high cognitive level. Finally, the possible causes for the "no answered" responses on the PSSUQ were discussed. Conclusion: It is concluded that the SWalker-VR platform is reported to have adequate usability and high security by older adults. The potential interest of studying the effects of the long-term use of this platform by older adults with gait impairment is expressed. Clinical Trials reference: NCT06025981.
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Affiliation(s)
- Vanina Costa
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Ana Rojo
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Sergio López-López
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain
| | - Helios Pareja-Galeano
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | - Rafael Raya
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
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Hamilton A. Artificial Intelligence and Healthcare Simulation: The Shifting Landscape of Medical Education. Cureus 2024; 16:e59747. [PMID: 38840993 PMCID: PMC11152357 DOI: 10.7759/cureus.59747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 06/07/2024] Open
Abstract
The impact of artificial intelligence (AI) will be felt not only in the arena of patient care and deliverable therapies but will also be uniquely disruptive in medical education and healthcare simulation (HCS), in particular. As HCS is intertwined with computer technology, it offers opportunities for rapid scalability with AI and, therefore, will be the most practical place to test new AI applications. This will ensure the acquisition of AI literacy for graduates from the country's various healthcare professional schools. Artificial intelligence has proven to be a useful adjunct in developing interprofessional education and team and leadership skills assessments. Outcome-driven medical simulation has been extensively used to train students in image-centric disciplines such as radiology, ultrasound, echocardiography, and pathology. Allowing students and trainees in healthcare to first apply diagnostic decision support systems (DDSS) under simulated conditions leads to improved diagnostic accuracy, enhanced communication with patients, safer triage decisions, and improved outcomes from rapid response teams. However, the issue of bias, hallucinations, and the uncertainty of emergent properties may undermine the faith of healthcare professionals as they see AI systems deployed in the clinical setting and participating in diagnostic judgments. Also, the demands of ensuring AI literacy in our healthcare professional curricula will place burdens on simulation assets and faculty to adapt to a rapidly changing technological landscape. Nevertheless, the introduction of AI will place increased emphasis on virtual reality platforms, thereby improving the availability of self-directed learning and making it available 24/7, along with uniquely personalized evaluations and customized coaching. Yet, caution must be exercised concerning AI, especially as society's earlier, delayed, and muted responses to the inherent dangers of social media raise serious questions about whether the American government and its citizenry can anticipate the security and privacy guardrails that need to be in place to protect our healthcare practitioners, medical students, and patients.
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Affiliation(s)
- Allan Hamilton
- Artificial Intelligence Division, Arizona Simulation Technology and Education Center (ASTEC) University of Arizona, Tucson, USA
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5
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McGrady ME, Ketterl TG, Webster RT, Schwartz LE, Brock MY, Szulczewski L, Burke M, Hommel KA, Pai ALH, Mara CA, Steele AC, Regan GG, Norris RE. Feasibility pilot trial of a tailored medication adherence-promotion intervention for adolescents and young adults with cancer: Study design and protocol. Contemp Clin Trials 2024; 139:107483. [PMID: 38431133 PMCID: PMC10960689 DOI: 10.1016/j.cct.2024.107483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/13/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Medication non-adherence is common among adolescents and young adults (AYAs) with cancer and associated with poor health outcomes. AYAs with cancer endorse multiple barriers to adherence that differ across individuals, suggesting that tailoring intervention content to an AYA's specific barriers may have the potential to improve adherence. The purpose of this manuscript is to report on ORBIT-guided Phase I design efforts to create the first tailored adherence-promotion intervention for AYAs with cancer and the study protocol for the ongoing Phase II pilot feasibility trial. METHODS Phase I design included qualitative interviews (n = 15 AYAs) to understand patient preferences for adherence-promotion care, development and refinement of a best-worst scaling exercise barriers tool (n = 5 AYAs), and development of intervention modules and a tailoring algorithm. In the ongoing Phase II pilot feasibility trial, AYAs (ages 15-24 years) with cancer currently taking oral chemotherapy or prophylactic medication will be recruited from three children's hospitals. Feasibility, acceptability, and usability will be assessed and these outcomes along with data on medication adherence will be used to inform the next phases of intervention development and testing. CONCLUSIONS If promising, this program of research ultimately has the potential to equip clinicians with additional strategies for supporting adherence among AYAs with cancer. NCT05706610.
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Affiliation(s)
- Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Tyler G Ketterl
- Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Rachel Tillery Webster
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA; Comprehensive Cancer Center, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Laura E Schwartz
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Margaret Y Brock
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lauren Szulczewski
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Kevin A Hommel
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ahna L H Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Amii C Steele
- Division of Pediatric Psychology and Neuropsychology, Levine Children's Hospital at Atrium Health, Charlotte, NC, USA
| | - Gillian G Regan
- Division of Pediatric Psychology and Neuropsychology, Levine Children's Hospital at Atrium Health, Charlotte, NC, USA
| | - Robin E Norris
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Uluhan C, Akçay Didişen N. Effects of the re-mission video game on fatigue and quality of life levels of adolescents diagnosed with cancer: a randomized controlled trial. PSYCHOL HEALTH MED 2024; 29:603-614. [PMID: 38112283 DOI: 10.1080/13548506.2023.2289471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
The aim of this study was to investigate the effects of the Re-Mission video game on the fatigue and quality of life of adolescents diagnosed with cancer. A total of 46 adolescents aged who received inpatient chemotherapy treatment in the pediatric hematology clinic were enrolled in the study. The data were obtained by using the Personal Information Form, Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 and Quality of Life scale. Intergroup comparisons demonstrated that there was a significant difference between the experimental and control groups in terms of their mean scores for the overall Scale for the Assessment of Fatigue and Quality of Life calculated at the baseline of the study and one month and three months. The use of Re-mission video game positively affected levels of fatigue and quality of life of adolescents aged between 13 and 18 diagnosed with cancer.
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Affiliation(s)
- Canan Uluhan
- Faculty Of Medicine, Department of Pediatric Hematology and Oncology, Ege University, Bornova-İzmir, Turkey
| | - Nurdan Akçay Didişen
- Faculty of Nursing, Department of Pediatric Nursing, Ege University, Bornova-İzmir, Turkey
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Wols A, Pingel M, Lichtwarck-Aschoff A, Granic I. Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies. Clin Psychol Rev 2024; 108:102396. [PMID: 38320420 DOI: 10.1016/j.cpr.2024.102396] [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: 05/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6-24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.
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Affiliation(s)
- Aniek Wols
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Michelle Pingel
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Anna Lichtwarck-Aschoff
- Rijksuniversiteit Groningen, Department of Pedagogical & Educational Sciences, Groningen, the Netherlands
| | - Isabela Granic
- McMaster University, Health, Aging & Society, Hamilton, Ontario, Canada
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Gkintoni E, Vantaraki F, Skoulidi C, Anastassopoulos P, Vantarakis A. Promoting Physical and Mental Health among Children and Adolescents via Gamification-A Conceptual Systematic Review. Behav Sci (Basel) 2024; 14:102. [PMID: 38392455 PMCID: PMC10886329 DOI: 10.3390/bs14020102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
The rapid growth in digital technology usage among children and adolescents has highlighted the need for novel approaches to promote their physical and mental health. This paper investigates the viability of gamification-the application of game mechanics to non-gaming contexts-as a potent instrument for health promotion and mental health support. This conceptual systematic review seeks to examine the various published articles promoting children and adolescents' physical and mental health through gamified techniques. These interventions can provide an interactive and engaging platform for encouraging physical activity, promoting healthy nutrition, enhancing emotional regulation, and promoting mental health. The significance of this topic stems from the pervasive use of electronic games, beginning at a young age, which makes them popular educational tools. For the review to be systematic and reproducible, the PsycINFO, Scopus, PubMed, and Elsevier databases were searched and the PRISMA method was utilized for the analysis. After analyzing the research data, empirical studies assessing the use of gamification in promoting adolescents' physical and mental health are discussed. In conclusion, gamification has demonstrated promise for promoting children's and adolescents' physical and mental health. It improves motivation, commitment, and adherence to healthy behaviors. However, additional research is required to evaluate gamification interventions' long-term effectiveness and sustainability in promoting health behaviors among this population.
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Affiliation(s)
- Evgenia Gkintoni
- Lab of Public Health, Department of Medicine, University of Patras, 26504 Rio, Greece
| | - Fedra Vantaraki
- Lab of Public Health, Department of Medicine, University of Patras, 26504 Rio, Greece
| | | | | | - Apostolos Vantarakis
- Lab of Public Health, Department of Medicine, University of Patras, 26504 Rio, Greece
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Tolks D, Schmidt JJ, Kuhn S. The Role of AI in Serious Games and Gamification for Health: Scoping Review. JMIR Serious Games 2024; 12:e48258. [PMID: 38224472 PMCID: PMC10825760 DOI: 10.2196/48258] [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: 04/19/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Artificial intelligence (AI) and game-based methods such as serious games or gamification are both emerging technologies and methodologies in health care. The merging of the two could provide greater advantages, particularly in the field of therapeutic interventions in medicine. OBJECTIVE This scoping review sought to generate an overview of the currently existing literature on the connection of AI and game-based approaches in health care. The primary objectives were to cluster studies by disease and health topic addressed, level of care, and AI or games technology. METHODS For this scoping review, the databases PubMed, Scopus, IEEE Xplore, Cochrane Library, and PubPsych were comprehensively searched on February 2, 2022. Two independent authors conducted the screening process using Rayyan software (Rayyan Systems Inc). Only original studies published in English since 1992 were eligible for inclusion. The studies had to involve aspects of therapy or education in medicine and the use of AI in combination with game-based approaches. Each publication was coded for basic characteristics, including the population, intervention, comparison, and outcomes (PICO) criteria; the level of evidence; the disease and health issue; the level of care; the game variant; the AI technology; and the function type. Inductive coding was used to identify the patterns, themes, and categories in the data. Individual codings were analyzed and summarized narratively. RESULTS A total of 16 papers met all inclusion criteria. Most of the studies (10/16, 63%) were conducted in disease rehabilitation, tackling motion impairment (eg, after stroke or trauma). Another cluster of studies (3/16, 19%) was found in the detection and rehabilitation of cognitive impairment. Machine learning was the main AI technology applied and serious games the main game-based approach used. However, direct interaction between the technologies occurred only in 3 (19%) of the 16 studies. The included studies all show very limited quality evidence. From the patients' and healthy individuals' perspective, generally high usability, motivation, and satisfaction were found. CONCLUSIONS The review shows limited quality of evidence for the combination of AI and games in health care. Most of the included studies were nonrandomized pilot studies with few participants (14/16, 88%). This leads to a high risk for a range of biases and limits overall conclusions. However, the first results present a broad scope of possible applications, especially in motion and cognitive impairment, as well as positive perceptions by patients. In future, the development of adaptive game designs with direct interaction between AI and games seems promising and should be a topic for future reviews.
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Affiliation(s)
- Daniel Tolks
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
- Centre for Applied Health Science, Leuphana University Lueneburg, Lueneburg, Germany
| | - Johannes Jeremy Schmidt
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
| | - Sebastian Kuhn
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
- Institute for Digital Medicine, University Clinic of Gießen und Marburg, Philipps University Marburg, Marburg, Germany
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Biskupiak Z, Ha VV, Rohaj A, Bulaj G. Digital Therapeutics for Improving Effectiveness of Pharmaceutical Drugs and Biological Products: Preclinical and Clinical Studies Supporting Development of Drug + Digital Combination Therapies for Chronic Diseases. J Clin Med 2024; 13:403. [PMID: 38256537 PMCID: PMC10816409 DOI: 10.3390/jcm13020403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Limitations of pharmaceutical drugs and biologics for chronic diseases (e.g., medication non-adherence, adverse effects, toxicity, or inadequate efficacy) can be mitigated by mobile medical apps, known as digital therapeutics (DTx). Authorization of adjunct DTx by the US Food and Drug Administration and draft guidelines on "prescription drug use-related software" illustrate opportunities to create drug + digital combination therapies, ultimately leading towards drug-device combination products (DTx has a status of medical devices). Digital interventions (mobile, web-based, virtual reality, and video game applications) demonstrate clinically meaningful benefits for people living with Alzheimer's disease, dementia, rheumatoid arthritis, cancer, chronic pain, epilepsy, depression, and anxiety. In the respective animal disease models, preclinical studies on environmental enrichment and other non-pharmacological modalities (physical activity, social interactions, learning, and music) as surrogates for DTx "active ingredients" also show improved outcomes. In this narrative review, we discuss how drug + digital combination therapies can impact translational research, drug discovery and development, generic drug repurposing, and gene therapies. Market-driven incentives to create drug-device combination products are illustrated by Humira® (adalimumab) facing a "patent-cliff" competition with cheaper and more effective biosimilars seamlessly integrated with DTx. In conclusion, pharma and biotech companies, patients, and healthcare professionals will benefit from accelerating integration of digital interventions with pharmacotherapies.
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Affiliation(s)
- Zack Biskupiak
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Victor Vinh Ha
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Aarushi Rohaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
- The Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84113, USA
| | - Grzegorz Bulaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
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Yamaji N, Kobayashi K, Hasegawa D, Ota E. Developing and evaluating a cancer communication picture book for children, families, and health care professionals: A mixed-methods feasibility study. Asia Pac J Oncol Nurs 2024; 11:100345. [PMID: 38188371 PMCID: PMC10770600 DOI: 10.1016/j.apjon.2023.100345] [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: 08/29/2023] [Accepted: 11/16/2023] [Indexed: 01/09/2024] Open
Abstract
Objective Effective communication about cancer with children is a significant challenge for healthcare professionals and families. This study aimed to create a picture book as a tool for facilitating communication about cancer and to assess its feasibility. It also demonstrated the use of mixed methods and convergent designs for intervention development. Methods The study included healthcare professionals (n = 14), children without cancer (aged 4-8 years; n = 21) and their families (n = 18), as well as children with various types of cancer, undergoing maintenance therapy or follow-up (aged 4-12 years; n = 3) and their families (n = 3). Quantitative and qualitative data were separately analyzed, and meta-inferences were made using a joint display. The picture book was refined based on feedback from healthcare professionals, and a similar iterative process was carried out with children and their families. Results Over 85% of the participants considered the picture book, along with a side book, feasible. The picture book was found to be helpful for discussing the topic of cancer with children. It also significantly improved the knowledge of children without cancer (P < 0.01). Most children expressed interest in reading it and believed it was useful for talking to others about cancer. However, some concerns were raised regarding the context and expressions in the picture book. Conclusions This study successfully assessed the feasibility of the developed picture book using a mixed methods approach, offering valuable insights into its implementation and refinement. Further research is needed to evaluate the effectiveness of its use and gather user feedback.
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Affiliation(s)
- Noyuri Yamaji
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Family Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Global Health Nursing, Graduate School of Nursing, St. Luke's International University, Chuo-ku, Tokyo, Japan
| | - Kyoko Kobayashi
- Child Health Nursing, Graduate School of Nursing, St. Luke's International University, Chuo-ku, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing, St. Luke's International University, Chuo-ku, Tokyo, Japan
- Tokyo Foundation for Policy Research, Minato-ku, Tokyo, Japan
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12
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Byrne EM, Pascoe M, Cooper D, Armstrong TS, Gilbert MR. Challenges and limitations of clinical trials in the adolescent and young adult CNS cancer population: A systematic review. Neurooncol Adv 2024; 6:vdad159. [PMID: 38250563 PMCID: PMC10798804 DOI: 10.1093/noajnl/vdad159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
Background The adolescent and young adult (AYA) cancer population, aged 15-39, carries significant morbidity and mortality. Despite growing recognition of unique challenges with this age group, there has been little documentation of unmet needs in their care, trial participation, and quality of life, particularly in those with primary brain tumors. Methods A systematic literature review of 4 databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Studies included editorials, reviews, and practice guidelines on the challenges and limitations faced by the AYA population. Papers had to address CNS tumors. Results Sixty-eight studies met the inclusion criteria. The challenges and limitations in clinical trials in the AYA population were synthesized into 11 categories: molecular heterogeneity, tumor biology, diagnostic delay, access to care, physician factors, patient factors, primary brain tumor (PBT) factors, accrual, limited trials, long term follow up, and trial design. The published papers' recommendations were categorized based on the target of the recommendation: providers, coordination of care, organizations, accrual, and trial design. The AYA cancer population was found to suffer from unique challenges and barriers to care and the construction of trials. Conclusions The AYA CNS cancer population suffers from unique challenges and barriers to care and construction of trials that make it critical to acknowledge AYAs as a distinct patient population. In addition, AYAs with primary brain tumors are underrecognized and underreported in current literature. More studies in the AYA primary brain tumor patient population are needed to improve their care and participation in trials.
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Affiliation(s)
- Emma M Byrne
- Neuro-Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA
| | - Maeve Pascoe
- Neuro-Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA
| | - Diane Cooper
- National Institute of Health Library, National Institute of Health, Bethesda, Maryland, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA
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Abraham O, McCarthy TJ, Zaborek J. Assessing the Impact of a Serious Game (MedSMARxT: Adventures in PharmaCity) in Improving Opioid Safety Awareness Among Adolescents and Parents: Quantitative Study. JMIR Form Res 2023; 7:e51812. [PMID: 38060287 PMCID: PMC10739249 DOI: 10.2196/51812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/05/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The opioid crisis continues to worsen across the United States, affecting people of all demographics. Few evidence-based interventions exist for educating families, particularly those with adolescents, about opioid prescription safety. Serious games have demonstrated impacts in improving medication-related outcomes for various health conditions. The characterizing goal of this serious game is to improve opioid safety knowledge and awareness among adolescents and their families. OBJECTIVE This study evaluated the impact of a serious game, MedSMARxT: Adventures in PharmaCity, designed to foster opioid safety awareness among adolescents and their parents. METHODS A national sample of parents and their adolescent children was recruited through Qualtrics research panels, social media, listservs, and snowball sampling. Eligible participants were adolescents aged between 12 and 18 years and their parents. Study participants were required to reside in the United States; speak, read, and understand English; and have access to a computer with a webcam. Parent-child dyads completed pregame and postgame surveys and participated in gameplay for up to 30 minutes. Primary outcome scales have been previously evaluated by the study team. RESULTS A total of 60 adolescent participants and 68 parent participants met full attention criteria for inclusion in this study. Statistical analysis confirmed that both adolescents' and parents' concept scores improved from baseline regarding opioid safety self-efficacy (adolescent: mean 0.35, SD 0.60; P<.001; parent: mean 0.28, SD 0.42; P<.001), perceived knowledge (adolescent: mean 1.08, SD 1.04; P<.001; parent: mean 0.56, SD 0.55; P<.001), behavioral intent (adolescent: mean 0.26, SD 0.39; P<.001; parent: mean 0.25, SD 0.32; P<.001), safe storage (adolescent: mean 0.12, SD 0.27; P<.001; parent: mean 0.03, SD 0.11; P=.03), disposal knowledge (adolescent: mean 0.10, SD 0.27; P=.006; parent: mean 0.07, SD 0.16; P<.001), and knowledge about misuse behavior (adolescent: mean 0.05, SD 0.14; P=.002; parent: mean 0.04, SD 0.10; P<.001). Participant groups, stratified by who completed and who did not complete gameplay, improved their knowledge and awareness, with no significant differences between subgroups. CONCLUSIONS The use of this serious game to improve opioid prescription safety practices among parents and adolescents was supported by the study findings. MedSMARxT: Adventures in PharmaCity is an intervention with the capability of teaching parents and adolescents about safe opioid prescription practices. Further studies and game refinement are needed to demonstrate the effectiveness of a game-based intervention in clinical settings and community pharmacies.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Tyler James McCarthy
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Jen Zaborek
- Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Aneni K, Fernandes CSF, Hoerner LA, Szapary C, Pendergrass Boomer TM, Fiellin LE. A Video Game Intervention to Prevent Opioid Misuse Among Older Adolescents: Development and Preimplementation Study. JMIR Serious Games 2023; 11:e46912. [PMID: 37921851 PMCID: PMC10656656 DOI: 10.2196/46912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/31/2023] [Accepted: 09/08/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Opioid misuse and mental disorders are highly comorbid conditions. The ongoing substance misuse and mental health crises among adolescents in the United States underscores the importance of widely scalable substance misuse preventive interventions that also address mental health risks. Serious video games offer an engaging, widely scalable method for delivering and implementing preventive interventions. However, there are no video game interventions that focus on preventing opioid misuse among older adolescents, and there are limited existing video game interventions that address mental health. OBJECTIVE This study aims to develop and conduct a formative evaluation of a video game intervention to prevent opioid misuse and promote mental health among adolescents aged 16-19 years (PlaySmart). We conducted formative work in preparation for a subsequent randomized controlled trial. METHODS We conducted development and formative evaluation of PlaySmart in 3 phases (development, playtesting, and preimplementation) through individual interviews and focus groups with multiple stakeholders (adolescents: n=103; school-based health care providers: n=51; and addiction treatment providers: n=6). PlaySmart content development was informed by the health belief model, the theory of planned behavior, and social cognitive theory. User-centered design principles informed the approach to development and play testing. The Exploration, Preparation, Implementation, and Sustainability framework informed preimplementation activities. Thematic analysis was used to identify themes from interviews and focus groups that informed PlaySmart game content and approaches to future implementation of PlaySmart. RESULTS We developed a novel video game PlaySmart for older adolescents that addresses the risk and protective factors for opioid misuse and mental health. Nine themes emerged from the focus groups that provided information regarding game content. Playtesting revealed areas of the game that required improvement, which were modified for the final game. Preimplementation focus groups identified potential barriers and facilitators for implementing PlaySmart in school settings. CONCLUSIONS PlaySmart offers a promising digital intervention to address the current opioid and mental health crises among adolescents in a scalable manner.
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Affiliation(s)
- Kammarauche Aneni
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Claudia-Santi F Fernandes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Lily A Hoerner
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Claire Szapary
- Yale School of Public Health, New Haven, CT, United States
| | | | - Lynn E Fiellin
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
- Yale School of Public Health, New Haven, CT, United States
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15
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Pendergrass Boomer TM, Hoerner LA, Fernandes CSF, Maslar A, Aiudi S, Kyriakides TC, Fiellin LE. A digital health game to prevent opioid misuse and promote mental health in adolescents in school-based health settings: Protocol for the PlaySmart game randomized controlled trial. PLoS One 2023; 18:e0291298. [PMID: 37683047 PMCID: PMC10490848 DOI: 10.1371/journal.pone.0291298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/10/2023] Open
Abstract
Adolescents who engage in non-opioid substance misuse and/or experience mental health symptoms are at greater risk of misusing opioids and/or developing opioid use disorder. Adolescence is a critical developmental period to both prevent the initiation of opioid misuse and target mental health. To date, there are no digital health games targeting both conditions. We describe the protocol for a randomized controlled trial designed to assess the efficacy of an original digital health game, PlaySmart. Five hundred and thirty-two adolescents aged 16-19 years old, who are at greater risk for initiating opioid misuse are recruited from 10 Connecticut school-based health sites. Participants are randomized to PlaySmart or a set of time/attention control videogames. Randomization was stratified by sex at birth and school grade. Participants play their assigned game or games for up to six weeks (300 minutes) and complete assessment questions over a 12-month period (baseline, post-gameplay, 3, 6, and 12 months). The primary outcome is perception of risk of harm of opioid misuse at 3 months. Secondary outcome measures specific to opioid misuse include intentions, self-efficacy, attitudes, knowledge, and perceived norms. Mental health outcomes include measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), help-seeking behaviors, stigma, measures of self-regulation, self-efficacy to seek professional help for mental health, and knowledge around coping skills. PlaySmart has the potential to significantly reduce the risk of initiation of opioid misuse, improve mental health outcomes, and given its high levels of engagement and accessibility, holds the promise for extensive reach, scale, and impact for adolescents. Trial registration: ClinicalTrials.gov: NCT04941950. Registered on 23 June 2021.
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Affiliation(s)
- Tyra M. Pendergrass Boomer
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Lily A. Hoerner
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Claudia-Santi F. Fernandes
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Yale Child Study Center, New Haven, CT, United States of America
- Department of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States of America
| | - Amber Maslar
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Sherry Aiudi
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Tassos C. Kyriakides
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Lynn E. Fiellin
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Yale Child Study Center, New Haven, CT, United States of America
- Yale School of Public Health, New Haven, CT, United States of America
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16
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Dorfman CS, Shelby RA, Stalls JM, Somers TJ, Keefe FJ, Vilardaga JP, Winger JG, Mitchell K, Ehren C, Oeffinger KC. Improving Symptom Management for Survivors of Young Adult Cancer: Development of a Novel Intervention. J Adolesc Young Adult Oncol 2023; 12:472-487. [PMID: 36178972 PMCID: PMC10457621 DOI: 10.1089/jayao.2022.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Improved symptom management is a critical although unmet post-treatment need for young adult (YA) cancer survivors (aged 18-39 at diagnosis). This study aimed to develop and refine a behavioral symptom management intervention for YA survivors. Methods: Phase I: YA survivors (N = 21) and oncology providers (N = 11) completed individual interviews and an online, self-report assessment to examine symptom experiences, the need for a behavioral symptom management intervention for YAs, and perceptions about potential intervention components, structure, and format. Phase II: YA survivors (N = 10) completed user testing sessions, providing feedback on the prototype intervention materials (paper manual and mobile application), and completed an online assessment. Quantitative data were examined using descriptive statistics. Rapid qualitative analysis, a methodologically rigorous standardized approach, was used. Results: Pain, fatigue, and distress were ranked as top concerns by most YAs and providers. Phase I interviews underscored the need for a symptom management intervention for YAs. YAs and providers highlighted potential coping strategies and program format/structure suggestions (e.g., small group format) to best meet YAs' needs. A prototype intervention was developed combining the following: traditional behavioral symptom coping skills; home-based physical activity; strategies from Acceptance and Commitment Therapy and Meaning-Centered Psychotherapy; and strategies to foster self-compassion. Phase II user testing sessions highlighted strengths and suggestions for refining the prototype materials. Conclusion: Post-treatment symptoms are common for YAs. A tailored behavioral symptom management program was developed and refined with input from YAs and providers and will be examined for feasibility and acceptability in a pilot randomized controlled trial. Clinical Trial: Clinicaltrials.gov identifier NCT04035447.
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Affiliation(s)
- Caroline S. Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Rebecca A. Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann M. Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Francis J. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Jennifer Plumb Vilardaga
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Joseph G. Winger
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kara Mitchell
- Duke Health and Fitness Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Christopher Ehren
- Duke Health and Fitness Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Kevin C. Oeffinger
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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17
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Erickson JM, Kamke-Jordan A, Lancaster IJ, Palou-Torres A, Esch M, Gonzalez A, Charlson J, Bingen K. Medication self-management behaviors of adolescents and young adults with cancer. Support Care Cancer 2023; 31:390. [PMID: 37300714 DOI: 10.1007/s00520-023-07863-8] [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: 02/11/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Adolescents and young adults (AYAs) with cancer are challenged to manage complex medication regimens during treatment. The aims of the study are to (1) describe the medication self-management behaviors of AYAs with cancer and (2) examine the barriers and facilitators to AYAs' optimal use of medications, including their self-efficacy to manage medications. METHODS This cross-sectional study enrolled 30 AYAs (18-29 years) with cancer who were receiving chemotherapy. Participants electronically completed a demographic form, a health literacy screen, and the PROMIS Self-efficacy for Medication Management instrument. They completed a semi-structured interview to answer questions about their medication self-management behaviors. RESULTS Participants (53% female, mean age = 21.9 y) had a variety of AYA cancer diagnoses. Over half (63%) had limited health literacy. Most AYAs had accurate knowledge about their medications and average self-efficacy for managing medications. These AYAs were managing an average of 6 scheduled and 3 unscheduled medications. Oral chemotherapy was prescribed for 13 AYAs; other medications were for prevention of complications and symptom management. Many AYAs relied on a parent for obtaining and paying for medications, used multiple reminders to take medications, and used a variety of strategies to store and organize medications. CONCLUSION AYAs with cancer were knowledgeable and confident about managing complex medication regimens but needed support and reminders. Providers should review medication-taking strategies with AYAs and ensure a support person is available.
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Affiliation(s)
- Jeanne M Erickson
- University of Wisconsin-Milwaukee College of Nursing, Milwaukee, WI, USA.
| | | | | | - Akasha Palou-Torres
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Marloe Esch
- Froedtert & the Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alyssa Gonzalez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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18
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The Influence of Serious Games in the Promotion of Healthy Diet and Physical Activity Health: A Systematic Review. Nutrients 2023; 15:nu15061399. [PMID: 36986129 PMCID: PMC10056209 DOI: 10.3390/nu15061399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Background: serious games seem to show promising strategies to promote treatment compliance and motivate behavior changes, and some studies have proven to contribute to the literature on serious games. (2) Methods: this systematic review aimed to analyze the effect of serious games in promoting healthy eating behaviors, effectively preventing childhood obesity, and improving physical activity in children. Five electronic bibliographic databases—PubMed, ACM Digital Library, Games for Health Journal, and IEEE Xplore were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. Peer-reviewed journal articles published between 2003 and 2021 were selected for data extraction. (3) Results: a total of 26 studies were identified, representing 17 games. Half of the studies tested interventions for healthy eating and physical education. Most of the intervention’s games were designed according to specific behavioral change theories, predominantly the social cognitive theory. (4) Conclusions: studies confirmed the potential of serious games for obesity prevention but considering the restrictions encountered, we exhort for novel designs with different theoretical perspectives.
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19
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van der Schyff EL, Forsyth R, Amon KL, Ridout B, Campbell AJ. Increasing Access to Mental Health Services: Videogame Players' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4772. [PMID: 36981681 PMCID: PMC10049222 DOI: 10.3390/ijerph20064772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/17/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Young men's mental health is at the forefront of global public health concerns. Young males, who have a high incidence of mental health disorders, are a population that accesses services at lower rates than females and makes up the majority of videogame players. By considering the unique perspectives of digitally connected individuals on mental health service delivery, interventions may be designed to address their needs with a higher likelihood of success. This study investigated international male videogamers' perspectives on how their access to mental health services could be improved via an open-ended survey question. From a total of 2515 completed surveys, 761 responded to the qualitative question. Of these, the 71 responses that discussed access to and provision of mental healthcare services are reported in this article. Results suggest that digital mental health services were a promising way to reach this group. Anonymity and confidentiality were found to be important factors when considering online mental health services. Male videogame players identified a preference for both online and in-person services that are delivered synchronously, one-on-one with an expert practitioner, and readily available in settings that individuals find comfortable.
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20
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Modi AC, Patel AD, Mara CA, Schmidt M, Tenney JR, Stevens J. Pilot randomized controlled clinical trial of an adherence social norms intervention for adolescents with epilepsy. Epilepsy Behav 2023; 140:109082. [PMID: 36731289 PMCID: PMC9998352 DOI: 10.1016/j.yebeh.2022.109082] [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] [Received: 11/07/2022] [Revised: 12/21/2022] [Accepted: 12/31/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Non-adherence to anti-seizure medications (ASMs) is common for adolescents with epilepsy, with potentially devastating consequences. Existing adherence interventions in epilepsy do not meet the unique challenges faced by adolescents. Leveraging social norms capitalizes on the increased importance of peer influence while simultaneously targeting the low motivation levels of many adolescents. The current study examined the feasibility, acceptability, and satisfaction of a social norms adherence intervention in adolescents with epilepsy. METHODS A pilot RCT of a mHealth social norms intervention was conducted with adolescents with epilepsy who demonstrated non-adherence (≤95% adherence) during baseline. Adolescents were randomized to either (1) mHealth social norms (reminders, individualized and social norms adherence feedback) or (2) control (reminders and individualized adherence feedback). Primary outcomes included feasibility, acceptability, and satisfaction. Exploratory outcomes included electronically monitored adherence, seizure severity, and health-related quality of life (HRQOL). RESULTS One hundred four adolescents were recruited (53% female; Mage = 15.4 ± 1.4 years; 81% White: Non-Hispanic; 5% Black, 10% Bi/Multiracial; 2% White: Hispanic; 1% Other: Hispanic; 1% Bi/Multiracial-Hispanic). Forty-five percent screen-failed due to high adherence, 16% withdrew, and 38% were randomized to treatment (n = 19) or control (n = 21). Recruitment (75%), retention (78%), and treatment satisfaction were moderately high. Engagement with the intervention was moderate, with 64% of participants engaging with intervention notifications. Exploratory analyses revealed that after controlling for COVID-19 impact, the social norms intervention group maintained higher adherence over time compared to the control group. Small to moderate effect sizes were noted for seizure severity and HRQOL between groups. CONCLUSION This pilot intervention appeared feasible and acceptable. Increases in adherence in the treatment versus control group were modest, but a future larger more adequately powered study is needed to detect effects. Notably, it appeared the COVID pandemic influenced adherence behaviors during our trial.
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Affiliation(s)
- Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Anup D Patel
- Nationwide Children's Hospital, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States; The Ohio State, Department of Pediatrics, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States.
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Matthew Schmidt
- College of Education, University of Florida, 2423 Normal Hall, Gainesville, FL 32611, United States.
| | - Jeffrey R Tenney
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Jack Stevens
- Nationwide Children's Hospital, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States; The Ohio State, Department of Pediatrics, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States.
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21
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Cheng X, Yan Y, Hu T, Lv Y, Zeng Y. A review of the effect of the light environment of the VDT workspace on the "learning to learn" effect of video game training. Front Neurosci 2023; 17:1093602. [PMID: 36908803 PMCID: PMC9998512 DOI: 10.3389/fnins.2023.1093602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/30/2023] [Indexed: 03/14/2023] Open
Abstract
In recent years, the role of video games in enhancing brain plasticity and learning ability has been verified, and this learning transfer is known as the "learning to learn" effect of video game training. At the same time, against the background of healthy lighting, the influence of non-visual effects of light environment on the human rhythmic system has been gradually confirmed. As a special operation form of Visual Display Terminal (VDT) operation, video game training has a high dependence on VDT equipment and the VDT screen, and the background usually has a huge difference in brightness. Compared with the light environment of ordinary operation space, the light environment of VDT operation space is more complex. This complex light environment's non-visual effects cause human emotions, alertness, fatigue, cognitive ability, and other changes, which may affect the efficiency of the "learning to learn" effect of video game training. This article focuses on the impact of the light environment in the VDT workspace on the "learning to learn" effect of video game training. It first traces the factors that trigger the "learning to learn" effect of video game training, that is, the improvement of people's attention, perception, and cognitive ability. Then, the influencing mechanism and the evaluation method of the VDT workspace space light environment on the human rhythm system are discussed based on the basic theory of photobiological effect. In addition, the VDT display lighting light time pattern, photophysical properties, regulation, and protection mechanism on the human rhythm system are studied to demonstrate the VDT workspace light environment's special characteristics. Finally, combined with the progress of artificial lighting technology and the research results of health lighting, given the "learning to learn" effect of video game training, some thoughts on the design of the light environment of the workplace and future research directions are presented.
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Affiliation(s)
- Xiang Cheng
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing, China
- Key Laboratory of the Ministry of Education of Mountainous City and Towns Construction and New Technology, Chongqing University, Chongqing, China
| | - Yonghong Yan
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing, China
- Key Laboratory of the Ministry of Education of Mountainous City and Towns Construction and New Technology, Chongqing University, Chongqing, China
| | - Tao Hu
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing, China
- Key Laboratory of the Ministry of Education of Mountainous City and Towns Construction and New Technology, Chongqing University, Chongqing, China
| | - Yinghui Lv
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing, China
- Key Laboratory of the Ministry of Education of Mountainous City and Towns Construction and New Technology, Chongqing University, Chongqing, China
| | - Yue Zeng
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing, China
- Key Laboratory of the Ministry of Education of Mountainous City and Towns Construction and New Technology, Chongqing University, Chongqing, China
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Weser V, Opara I, Budge M, Duncan L, Fernandes CSF, Hussett-Richardson S, Sands B, Hieftje K. Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e43666. [PMID: 36689272 PMCID: PMC9903186 DOI: 10.2196/43666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Black adolescent girls aged between 14 and 19 years are more likely than White girls to be diagnosed with a sexually transmitted infection (STI). As STI diagnosis is associated with an increase in the risk for HIV acquisition, an early intervention specifically tailored to Black adolescent girls is warranted. A web-based video game intervention has the potential to reach this demographic. Because studies of social and behavioral determinants of disease demonstrate the protective role of peer group structures on individual outcomes, a multiplayer game can facilitate opportunities to exchange and evaluate information, learn social norms, develop behavioral skills, and allow peers to influence attitudes and behavior. No prior research has examined the feasibility of a web-based multiplayer game intervention for this population. OBJECTIVE This study describes the protocol for a randomized controlled trial (RCT) pilot-testing the feasibility, acceptability, and limited efficacy of a multiplayer game-based intervention for increasing HIV and STI testing and condom use in Black adolescent girls. METHODS We enrolled 79 Black adolescent girls aged 14 to 19 years residing in the United States into a 2-arm parallel RCT. The intervention is a theory-based, community-informed, multiplayer game that can be played with peers on the web using videoconferencing software. The goal of the game is to empower Black adolescent girls to make healthy decisions regarding dating, relationships, and sex, thus reducing HIV and STI infection. Control condition participants received a list of resources after playing a time and attention control game. All study procedures were conducted via the internet. We conveniently sampled Black adolescent girls using web-based advertisements. Study assessments occurred at enrollment, 1 week, 1 month, and 4 months after enrollment. The primary outcome of this study is increased HIV and STI testing by Black adolescent girls. Secondary outcomes include increased condom use, self-efficacy to use condoms, positive attitudes toward condom use, intentions, harm perceptions, HIV and STI and pre-exposure prophylaxis knowledge, positive sexual norms, sexual communication with partners, and reduced incidence of sexual risk behaviors associated with HIV and STI transmission. Secondary outcomes also included assessment of intervention feasibility and acceptability. RESULTS From February to April 2022, a total of 79 Black adolescent girls were enrolled, with 40 (51%) having been randomized into the intervention condition and 39 (49%) into the control condition. At baseline, participant ages ranged from 14 to 19 (mean 16.4, SD 1.23) years. CONCLUSIONS Web-accessible game interventions overcome common impediments of face-to-face interventions presenting a unique opportunity to reach Black adolescent girls and improve their sexual health and self-efficacy. Trial data will provide information about the limited efficacy of the intervention and inform future web-based studies and a larger RCT aimed at improving the sexual health of Black adolescent girls. TRIAL REGISTRATION ClinicalTrials.gov NCT04108988; https://clinicaltrials.gov/ct2/show/NCT04108988. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43666.
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Affiliation(s)
| | - Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Mariana Budge
- Yale School of Medicine, New Haven, CT, United States
| | - Lindsay Duncan
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | | | | | - Brandon Sands
- Yale School of Medicine, New Haven, CT, United States
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You KL, Delaney RK, McKinley N, Healy P, Thomas TH. Who Engages and Why It Matters? INTERNATIONAL JOURNAL OF GAMING AND COMPUTER-MEDIATED SIMULATIONS 2023. [DOI: 10.4018/ijgcms.316968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
While the use and benefits of serious games in health care are increasingly recognized, the impact of individuals' game engagement remains understudied, limiting the potential for impact. This pilot study aims to describe game engagement and its associations with learning outcomes, sociodemographics, and health factors in women with advanced cancer receiving a 12-week self-advocacy serious game intervention. Game engagement was collected from study tablets and weekly self-reported surveys. Participants' game engagement was overall high but with large amounts of variation and did not differ by their sociodemographics and health factors. Participants with lower baseline symptom severity were more likely to repeat game scenarios, and those who engaged in all scenarios had higher connected strength post-intervention. Knowing what prevents patients with advanced cancer from engaging in the serious game enlightens ways to refine the gamified interventions. Future research is suggested to evaluate patients' engagement to deepen understanding of its impacts on learning outcomes.
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Kukafka R, Kim S, Kim SH, Yoo SH, Sung JH, Oh EG, Kim N, Lee J. Digital Health Interventions for Adult Patients With Cancer Evaluated in Randomized Controlled Trials: Scoping Review. J Med Internet Res 2023; 25:e38333. [PMID: 36607712 PMCID: PMC9862347 DOI: 10.2196/38333] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/15/2022] [Accepted: 10/25/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Digital care has become an essential component of health care. Interventions for patients with cancer need to be effective and safe, and digital health interventions must adhere to the same requirements. OBJECTIVE The purpose of this study was to identify currently available digital health interventions developed and evaluated in randomized controlled trials (RCTs) targeting adult patients with cancer. METHODS A scoping review using the JBI methodology was conducted. The participants were adult patients with cancer, and the concept was digital health interventions. The context was open, and sources were limited to RCT effectiveness studies. The PubMed, CINAHL, Embase, Cochrane Library, Research Information Sharing Service, and KoreaMed databases were searched. Data were extracted and analyzed to achieve summarized results about the participants, types, functions, and outcomes of digital health interventions. RESULTS A total of 231 studies were reviewed. Digital health interventions were used mostly at home (187/231, 81%), and the web-based intervention was the most frequently used intervention modality (116/231, 50.2%). Interventions consisting of multiple functional components were most frequently identified (69/231, 29.9%), followed by those with the self-manage function (67/231, 29%). Web-based interventions targeting symptoms with the self-manage and multiple functions and web-based interventions to treat cognitive function and fear of cancer recurrence consistently achieved positive outcomes. More studies supported the positive effects of web-based interventions to inform decision-making and knowledge. The effectiveness of digital health interventions targeting anxiety, depression, distress, fatigue, health-related quality of life or quality of life, pain, physical activity, and sleep was subject to their type and function. A relatively small number of digital health interventions specifically targeted older adults (6/231, 2.6%) or patients with advanced or metastatic cancer (22/231, 9.5%). CONCLUSIONS This scoping review summarized digital health interventions developed and evaluated in RCTs involving adult patients with cancer. Systematic reviews of the identified digital interventions are strongly recommended to integrate digital health interventions into clinical practice. The identified gaps in digital health interventions for cancer care need to be reflected in future digital health research.
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Affiliation(s)
| | - Sanghee Kim
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
| | - Soo Hyun Kim
- Department of Nursing, Inha University, Inchon, Republic of Korea
| | - Sung-Hee Yoo
- College of Nursing, Chonnam National University, Gwangju, Republic of Korea
| | - Ji Hyun Sung
- College of Nursing, Kosin University, Busan, Republic of Korea
| | - Eui Geum Oh
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
| | - Nawon Kim
- Yonsei Medical Library, Yonsei University, Seoul, Republic of Korea
| | - Jiyeon Lee
- College of Nursing and Mo-im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Center of Korea: Affiliation of the Joanna Briggs Institution, Yonsei University, Seoul, Republic of Korea
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Zeng XL, Heneghan MB, Badawy SM. Adherence to Oral Chemotherapy in Acute Lymphoblastic Leukemia during Maintenance Therapy in Children, Adolescents, and Young Adults: A Systematic Review. Curr Oncol 2023; 30:720-748. [PMID: 36661705 PMCID: PMC9858168 DOI: 10.3390/curroncol30010056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/26/2022] [Accepted: 12/31/2022] [Indexed: 01/08/2023] Open
Abstract
Acute lymphoblastic leukemia (ALL) is the most common malignancy in children and young adults. Treatment is long and involves 2-3 years of a prolonged maintenance phase composed of oral chemotherapies. Adherence to these medications is critical to achieving good outcomes. However, adherence is difficult to determine, as there is currently no consensus on measures of adherence or criteria to determine nonadherence. Furthermore, there have been few studies in pediatric B-ALL describing factors associated with nonadherence. Thus, we performed a systematic review of literature on oral chemotherapy adherence during maintenance therapy in ALL following PRISMA guidelines. Published studies demonstrated various objective and subjective methods of assessing adherence without generalizable definitions of nonadherence. However, the results of these studies suggested that nonadherence to oral maintenance chemotherapy was associated with increased risk of relapse. Future studies of B-ALL therapy should utilize a uniform assessment of adherence and definitions of nonadherence to better determine the impact of nonadherence on B-ALL outcomes and identify predictors of nonadherence that could yield targets for adherence improving interventions.
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Affiliation(s)
- Xiaopei L. Zeng
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
| | - Mallorie B. Heneghan
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA
| | - Sherif M. Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
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Magis - A magical adventure: Using a mobile game to deliver an ACT intervention for elementary schoolchildren in classroom settings. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023; 27:26-33. [PMID: 36471822 PMCID: PMC9714081 DOI: 10.1016/j.jcbs.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022]
Abstract
Studies of the effects of the COVID-19 pandemic have shown that this health emergency has affected especially young people. Supporting the well-being of children is thus particularly urgent. However, the high prevalence of ill-being among children requires novel approaches to providing help. Health care resources are limited, and many children did not receive support even before the pandemic. The current study presents a novel approach to delivering brief interventions for school-aged children. A mobile game based on acceptance and commitment therapy was used to increase psychological flexibility and well-being among 10 to 12-year-old schoolchildren. A sample of 106 students played the game in four weekly sessions as part of normal teaching practice in school. The effectiveness of the brief game intervention was examined as a universal intervention among the whole sample and among subgroups created on the basis of baseline psychological flexibility (i.e., based on the need for an intervention). The results show that higher psychological flexibility was associated with less emotional and behavioral problems, higher health-related quality of life, mood, and school satisfaction, and less loneliness (r = 0.46-0.63). While a significant effect was not detected in the whole sample, the subsample of children with initially high psychological inflexibility benefitted from participating in the intervention (Cohen's d = 0.35). These preliminary findings suggest that the brief game-based intervention can increase psychological flexibility among children when the need for an intervention is considered. Further research is necessary to examine the stability of improvements in psychological flexibility.
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Fatoye F, Gebrye T, Mbada CE, Fatoye CT, Makinde MO, Ayomide S, Ige B. Cost effectiveness of virtual reality game compared to clinic based McKenzie extension therapy for chronic non-specific low back pain. Br J Pain 2022; 16:601-609. [PMID: 36452130 PMCID: PMC9703246 DOI: 10.1177/20494637221109108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Low-back pain (LBP) is a major public health problem globally and its direct and indirect healthcare costs are growing rapidly. Virtual reality involving the use of video games or non-game applications are alternatives to conventional face-to-face physical therapy for LBP. The purpose of this study was to assess the cost-effectiveness of Back Extension-Virtual Reality Game (BE-VRG) compared to Clinic-based McKenzie therapy (CBMT) for chronic non-specific LBP in Nigeria. METHODS Patients with chronic non-specific LBP were randomised into either BE-VRG or CBMT group. Patients' level of disability was assessed using Oswestry Disability Index (ODI) at week 4 and week 8. ODI was mapped to SF-6D to generate quality adjusted life years (QALYs) used for cost-effectiveness analysis. Resource use and costs were assessed based on rehabilitation services from a healthcare perspective. Cost-effectiveness analysis which included direct healthcare costs was conducted. Incremental cost per QALY was also calculated. RESULTS Forty-six patients (BE-VRG, n = 22; CBMT, n = 24) with the mean (±SD) age of 32.6 ± (11.5) years for BE-VRG and 48.8 ± (10.2) years for CBMT intervention completed in this study. The mean direct health costs per patient were USD100.67 and USD106.3 for BE-VRG and CBMT, respectively. The mean quality adjusted life years at week 4 and week 8 were (BE-VRG, 0.0574 ± (0.002); CBMT, 0.0548 ± (0.002)); and (BE-VRG; 0.116 ± (0.002); CBMT; 0.114 ± (0.004)), respectively. Incremental cost-effectiveness ratio showed that BE-VRG arm was less costly and more effective than CBMT. CONCLUSION The findings of this study suggest that BE-VRG was cost saving for chronic non-specific LBP compared to CBMT. This evidence could guide policy makers, payers and clinicians in evaluating BE-VRG as a treatment option for people with chronic non-specific LBP.
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Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Tadesse Gebrye
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Chidozie Emmanuel Mbada
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Clara T Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Moses O Makinde
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Salami Ayomide
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Blessing Ige
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Andrew L, Barwood D, Boston J, Masek M, Bloomfield L, Devine A. Serious games for health promotion in adolescents - a systematic scoping review. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 28:5519-5550. [PMID: 36373044 PMCID: PMC9638273 DOI: 10.1007/s10639-022-11414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 05/18/2023]
Abstract
Digital gaming has broad appeal globally, with a reported 2.7 billion gamers worldwide. There is significant interest in using games to enhance learning, with 'serious games' being included in classrooms to engage adolescents' learning across a range of domains. A systematic scoping review of serious games used for health promotion with adolescents was conducted to identify serious games, review the methods used to evaluate these games, and outline evidence available to support the efficacy of these games in improving knowledge, beliefs/attitudes and behaviours in the target groups. Player engagement/enjoyment was reported if assessed. A total of 21 studies were found to have met the inclusion criteria domains: 'healthy lifestyle' 'sexual health' and 'substance use'. A heterogenous approach across studies to game design and development, duration of game play, use of a control group and measurement of outcome(s) was observed. Game efficacy was difficult to assess due to broad generalisations and lack of consistent evaluation methods. Several studies demonstrate serious games can be engaging and pedagogically effective as a learning device and behaviour-change agent. Several studies, however, had less rigorous evaluation and lacked longer-term follow up. The ability for developers to demonstrate positive short- and long-term impacts of serious games with high-quality evidence is essential to the ongoing acceptance and use of these serious games as part of the school curriculum.
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Affiliation(s)
- Lesley Andrew
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027 Australia
| | - Donna Barwood
- School of Education, Edith Cowan University, Joondalup, Australia
| | - Julie Boston
- School of Education, Edith Cowan University, Joondalup, Australia
| | - Martin Masek
- School of Science, Edith Cowan University, Joondalup, Australia
| | - Lauren Bloomfield
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Sparapani VDC, Fels S, Kamal N, Ortiz La Banca R, Nascimento LC. A Video Game for Brazilian T1D Children about Knowledge of Disease and Self-care: A Methodological Study. J Diabetes Sci Technol 2022; 16:1444-1450. [PMID: 34044626 PMCID: PMC9631520 DOI: 10.1177/19322968211017555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Video games are interactive technologies able to support children in health promotion, behavior changes, and chronic disease self-management. The use of health behavior change determinants in video game design can increase its effectiveness. This study describes the process of designing a video game for Brazilian children with T1D clarifying the use of health behavior change determinants that may influence self-management behaviors. METHODS This was a methodological study based on health behavior change theories and the user-centered design approach. The results of a qualitative study conducted with children aged 7 to 12 years identified learning needs about knowledge on diabetes and self-care tasks which contribute to inappropriate behaviors. A Behavioral Diagnosis presented health behavior change determinants, capable of influencing children's learning needs and behaviors, that were considered to design The Heroes of Diabetes-the power of knowledge. RESULTS The results presented the process of designing 4 mini games with its description and theory foundation to reach children's lack of understanding about T1D, insulin's role, SMBG requirements, food groups and physical activity's role in glycemic control. Knowledge, goal settings, extrinsic and intrinsic motivation determinants were related with video games design features. CONCLUSIONS The findings support the use of health behavior change determinants into video game design as a guide to achieve children learning needs and that might influence self-management behaviors.
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Affiliation(s)
- Valéria de Cássia Sparapani
- Department of Nursing, Santa Catarina
Federal University, Florianopolis, SC, Brazil
- Valéria de Cássia Sparapani, PhD, RN,
Department of Nursing, Campus Universitário. Trindade, CEP 88040-970.
Florianópolis, SC 88040-900, Brazil.
| | - Sidney Fels
- Electrical and Computer Engineering,
University of British Columbia, Vancouver, BC, USA
| | - Noreen Kamal
- Department of Industrial Engineering,
Dalhousie University, Halifax, NS, Canada
| | - Rebecca Ortiz La Banca
- Section on Clinical, Behavioral and
Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA,
USA
| | - Lucila Castanheira Nascimento
- Department of Maternal-Infant and
Public Health Nursing, Ribeirao Preto College of Nursing, University of Sao Paulo,
WHO Collaborating Center for Nursing Research Development, SP, Brazil
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Breakey VR, Gupta A, Johnston DL, Portwine C, Laverdiere C, May SL, Dick B, Hundert A, Nishat F, Killackey T, Nguyen C, Lalloo C, Stinson J. A Pilot Randomized Control Trial of Teens Taking Charge: A Web-based Self-management Program for Adolescents with Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:366-378. [PMID: 35759365 DOI: 10.1177/27527530211068778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: There is a lack of self-management tools for adolescents with cancer (AWC). This study evaluated the feasibility of Teens Taking Charge Cancer, a web-based self-management program. Methods: A pilot randomized control trial (RCT) was conducted across 4 pediatric oncology clinics. AWC (12-18 years) and their caregivers were randomized to either the intervention or control group. All were asked to complete 12 website modules over 12 weeks (at their own pace) and received monthly calls from health coaches. The intervention website was based on cognitive behavioral principals, designed as an interactive self-guided online program, while the control consisted of education and included links to 12 general cancer websites. Outcome assessments occurred at enrollment and 12 weeks post-intervention. The primary outcomes included rate of accrual and retention, adherence to the protocol, acceptability and satisfaction with intervention using questionnaire and semi-structured interviews, adverse events and engagement with the intervention. Results: Eighty-one teen-caregiver dyads were enrolled with a retention rate of 33%. In the intervention group 46% (n = 18) logged in at least once over the 12-week period. A mean of 2.4 of 12 modules (SD 3.0) were completed; and no one completed the program. Thirty-three percent of caregivers in the intervention logged into the website at least once and none completed the full program. Discussion: The results from this pilot study suggest that the current design of the Teens Taking Charge Cancer RCT lacks feasiblity. Future web-based interventions for this group should include additional features to promote uptake and engagement with the program.
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Affiliation(s)
| | - Abha Gupta
- 7315The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada
| | | | - Carol Portwine
- 103398McMaster Children's Hospital, Hamilton, ON, Canada
| | - Caroline Laverdiere
- Department of Pediatrics, 5622University of Montreal, Centre hospitalier universitaire Sainte-Justine (CHU Sainte-Justine), Montréal, QC, Canada
| | - Sylvie Le May
- Faculté des sciences infirmières, Université de Montréal, Montreal, QC, Canada
| | - Bruce Dick
- Department of Anesthesiology & Pain Medicine, Division of Pain and Medicine, 7979University of Alberta, Edmonton, AB, Canada
| | - Amos Hundert
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Fareha Nishat
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Tieghan Killackey
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Cynthia Nguyen
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Chitra Lalloo
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Jennifer Stinson
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Kok DL, Dushyanthen S, Peters G, Sapkaroski D, Barrett M, Sim J, Eriksen JG. Screen-based digital learning methods in radiation oncology and medical education. Tech Innov Patient Support Radiat Oncol 2022; 24:86-93. [PMID: 36324858 PMCID: PMC9619030 DOI: 10.1016/j.tipsro.2022.10.003] [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: 07/03/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Abstract
The field of radiation oncology is rapidly advancing through technological and biomedical innovation backed by robust research evidence. In addition, cancer professionals are notoriously time-poor, meaning there is a need for high quality, accessible and tailored oncological education programs. Digital learning (DL) is well-placed to cater to these needs, as it provides teaching options that can be delivered flexibly and on-demand from anywhere in the world. The evidence for usage of these techniques in medical education has expanded rapidly in recent years. However, there remains many reservations in the oncological community to adopting and developing DL, largely due to a poor familiarity with the pedagogical evidence base. This article will review the application of the screen-based DL tools that are at educators' disposal. It will summarize best-practice in developing tailored, made-for-screen videos, gamification, and infographics. It also reviews data behind the following practical tips of 1) strategically combining text with graphics to decrease cognitive load, 2) engaging users through use of interactive elements in digital content, and 3) maximizing impact through thoughtful organization of animations/images. Overall, the digital space evolving is well placed to cater to the evolving educational needs of oncology learners. This review and its practical tips aim to inspire further development in this arena, production of high-yield educational products, use of engaging delivery methods and programs that are tailored to individual learning needs.
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Affiliation(s)
- David L. Kok
- Peter MacCallum Cancer Centre – Moorabbin Campus, 865 Centre Rd, Bentleigh East Victoria 3165, Australia,Department of Clinical Pathology, University of Melbourne, Parkville Victoria 3010, Australia,Corresponding author at: Peter MacCallum Cancer Centre – Moorabbin Campus, 865 Centre Rd, Bentleigh East Victoria 3165, Australia.
| | - Sathana Dushyanthen
- Department of Clinical Pathology, University of Melbourne, Parkville Victoria 3010, Australia,Centre for Digital Transformation of Health, University of Melbourne, 700 Swanston St, Carlton, Victoria 3053, Australia
| | - Gabrielle Peters
- Department of Therapeutic Radiology, Yale University, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States
| | - Daniel Sapkaroski
- Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne Victoria 3000, Australia
| | - Michelle Barrett
- Victorian Comprehensive Cancer Centre, 305 Grattan St, Melbourne Victoria 3000, Australia
| | - Jenny Sim
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Rd, Clayton Victoria 3800, Australia
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus Municipality, Denmark
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Yamaji N, Suzuki D, Suto M, Sasayama K, Ota E. Communication Tools Used in Cancer Communication with Children: A Scoping Review. Cancers (Basel) 2022; 14:cancers14194624. [PMID: 36230548 PMCID: PMC9563078 DOI: 10.3390/cancers14194624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Despite the potential benefits of effective communication, telling children about unpredictable and life-threatening conditions such as cancer is challenging. This scoping review aimed to map the potential communication tools for children with cancer, their families, and healthcare professionals. We found 25 studies and 21 communication tools. Communication tools might support children to improve their knowledge and psychological outcomes. However, we found a lack of communication tools that were (1) accessible and validated, (2) designed for healthcare professionals, (3) targeted children, families, and healthcare professionals, and (4) were designed to meet the needs of children and families. This review identified areas for further research. Abstract Background: Although communication tools might guide healthcare professionals in communicating with children about cancer, it is unclear what kind of tools are used. This scoping review aimed to map the communication tools used in cancer communication among children with cancer, families, and healthcare professionals. Methods: A comprehensive search using PubMed (including MEDLINE), Embase, CENTRAL, PsycINFO, and CINAHL was conducted on 1 August 2021. We mapped communication tools and their impacts. Results: We included 25 studies (9 experimental studies and 16 feasibility studies) of 29 reports and found 21 communication tools. There was a lack of communication tools that were (1) accessible and validated, (2) designed for healthcare professionals, (3) targeted children, families, and healthcare professionals, and (4) were designed to meet the needs of children and families. Experimental studies showed that the communication tools improved children’s knowledge and psychological outcomes (e.g., health locus of control, quality of life, self-efficacy). Conclusion: We mapped communication tools and identified areas that needed further research, including a lack of tools to guide healthcare professionals and share information with children and families. Further research is needed to develop and evaluate these communication tools. Moreover, it is necessary to investigate how communication tools support children, families, and healthcare professionals.
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Affiliation(s)
- Noyuri Yamaji
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
- Correspondence:
| | - Daichi Suzuki
- Department of Nursing, Faculty of Health and Medical Sciences, Kanagawa Institute of Technology, 1030 Shimo-ogino, Atsugi 243-0292, Japan
| | - Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Kiriko Sasayama
- Global Health Nursing, International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba 286-8686, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
- Tokyo Foundation for Policy Research, Roppongi Grand Tower 34F, 3-2-1 Roppongi, Minato-ku, Tokyo 106-6234, Japan
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Erkul M, Efe E, Güler E. The effect of a peer-assisted video-based training programme and counselling to reduce anxiety in children newly diagnosed with cancer: Non-randomised controlled trial. Eur J Cancer Care (Engl) 2022; 31:e13698. [PMID: 36069654 DOI: 10.1111/ecc.13698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 07/20/2022] [Accepted: 08/12/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the effect of 'peer-assisted video-based education programme' (VTPA) and counselling to reduce anxiety in children newly diagnosed with cancer. METHODS A non-randomised controlled trial design with repeated measures was conducted. The sample of the study consisted of 50 children between the ages of 9 and 18 who were newly diagnosed with cancer in the hospital. Intervention and control groups were created. Children in the intervention group received both VTPA training and counselling practice 3 days a week for 2 months. Data were collected with the State-Trait Anxiety Inventory for Children. The basal assessment in the research was the first meeting with the child, with interval assessments 1 month after, 2 months after and 3 months after the education. RESULTS In the study, it was determined that the state anxiety mean scores of the children in the PAVEP and control groups differed over time (p < 0.05). However, it was determined that there was no difference between the trait anxiety mean scores of the children (p > 0.05). CONCLUSION VTPA with peer assistance and counselling application supported the reduction of state anxiety in children newly diagnosed with cancer over time.
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Affiliation(s)
- Münevver Erkul
- Department of Paediatric Hematology-Oncology, Akdeniz University Hospital, Antalya, Turkey
| | - Emine Efe
- Nursing Faculty, Department of Child Health and Diseases Nursing, Akdeniz University, Antalya, Turkey
| | - Elif Güler
- Department of Paediatric Hematology-Oncology, Akdeniz University Hospital, Antalya, Turkey
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Tuijnman A, Kleinjan M, Olthof M, Hoogendoorn E, Granic I, Engels RC. A Game-Based School Program for Mental Health Literacy and Stigma on Depression (Moving Stories): Cluster Randomized Controlled Trial. JMIR Ment Health 2022; 9:e26615. [PMID: 35976200 PMCID: PMC9434393 DOI: 10.2196/26615] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/31/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Depressive symptoms are highly prevalent among adolescents in Western countries. However, although treatment for depressive symptoms is available, many adolescents do not seek help when they need it. Important barriers to help-seeking among adolescents include low mental health literacy and high stigma. Therefore, we have developed a game-based school program, Moving Stories, which combines mental health literacy training for depression with contact with someone with lived experience both in the digital and nondigital world. OBJECTIVE The aim of this study is to conduct a first test of the effectiveness of the newly developed game-based program, Moving Stories, using a cluster randomized controlled trial. METHODS A total of 185 adolescents participated, divided over 10 classes from 4 schools. Half of the classes were randomly selected to follow the Moving Stories program, whereas the other half were in the control group, where no intervention was provided. The adolescents filled out digital questionnaires at 4 time points, with questions on mental health literacy, stigma, depressive symptoms, and the program itself (before the program, after the program, 3-month follow-up, and 6-month follow-up). Using R (R Foundation for Statistical Computing), we ran linear mixed-effects models for all continuous outcome variables and generalized linear mixed-effects models for all binary outcome variables. RESULTS Compared with the control group, participants in the Moving Stories group improved after the program in personal stigma (b=-0.53, 95% CI -1.02 to -0.03; t179.16=-2.08; P=.04). Effects on personal stigma lasted over time (3-month follow-up: b=-0.57, 95% CI -1.11 to -0.03; t174.39=-2.07; P=.04). Most adolescents in the Moving Stories group participated in the introduction (97/99, 98%) and contact session (93/99, 94%), played the game for 4 or 5 days (83/99, 83%), and indicated that they would recommend the game to their peers (90/98, 92%). CONCLUSIONS The results of this study show the potential of Moving Stories as a stigma reduction program. With changes in the program to improve its effects on mental health literacy, Moving Stories could be implemented in schools to improve help-seeking in adolescents and reduce the negative consequences and burden of depressive symptoms. TRIAL REGISTRATION Dutch Trial Register NTR7033; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7033. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/11255.
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Affiliation(s)
- Anouk Tuijnman
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands.,Trimbos-institute, Utrecht, Netherlands
| | - Marloes Kleinjan
- Trimbos-institute, Utrecht, Netherlands.,Department of Interdisciplinary Social Sciences, Youth Studies, Utrecht University, Utrecht, Netherlands
| | - Merlijn Olthof
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
| | | | - Isabela Granic
- Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | - Rutger Cme Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University, Rotterdam, Netherlands
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Wang Y, Wang Z, Liu G, Wang Z, Wang Q, Yan Y, Wang J, Zhu Y, Gao W, Kan X, Zhang Z, Jia L, Pang X. Application of Serious Games in Health Care: Scoping Review and Bibliometric Analysis. Front Public Health 2022; 10:896974. [PMID: 35757619 PMCID: PMC9231462 DOI: 10.3389/fpubh.2022.896974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background Serious games (SGs) as one kind of intervention that can improve the level of knowledge and change behavior to affect health outcomes has been increasingly applied in health care. Objective Analyze hotspots and trends of the application of SGs in health care and provide reference and direction for further research in the future. Methods The Web of Science (WoS) Core Collection database was used for extracting the literature on SGs in health care for the period from the database established to 11 October, 2021. Scoping review and bibliometric analysis were used to deeply analyze and visualize countries, categories of studies, annual study output, cited authors, cited journals, cited articles, and keywords of healthcare field. Results A total of 1,322 articles were retrieved, then every articles' title and abstract were read one by one, and 795 articles were included after screening with an exponential increase in publication volume. The United States of America made the greatest contribution to global publications regarding SGs in health care. From the total, 20.8% of articles fall under the category of health care sciences services. The target groups were mainly concentrated in children (18.0%), youth (13.8%), the elderly (10.9%), adolescents (9.1%), and adults (3.4%). Baranowski T (n = 103 citations) is the most influential author, followed by Kato PM (n = 73 citations) and Desmet A (n = 58 citations). The top three cited journals were "Plos One" (n = 268 citations), "Games for Health Journal" (n = 209 citations), and "Journal of Medical Internet Research" (n = 197 citations), and the top three cited articles were "A meta-analysis of serious digital games for healthy lifestyle promotion," "A Systematic Review of Serious Games in Training Health Care Professionals," and "Video game training enhances cognitive control in older adults." More and more studies focus on specific age groups, such as children, adolescents, and the elderly. The research hotspots and trends included "rehabilitation," "medical education," and "design." Conclusions The application of SGs in health care remains important areas for future research. "Rehabilitation," "medical education," and "design" reflected the latest research hotpots and future trends.
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Affiliation(s)
- Yue Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhao Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guoqing Liu
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhangyi Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qinglong Wang
- Nursing Department, Tianjin Medical University Chu Hisen-I Memorial Hospital, Tianjin, China
| | - Yishan Yan
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jing Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yue Zhu
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Weijie Gao
- The School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiangling Kan
- Dean's Office, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhiguo Zhang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lixia Jia
- Dean's Office, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaoli Pang
- The School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Cibrian FL, Monteiro E, Schuck SEB, Nelson M, Hayes GR, Lakes KD. Interdisciplinary Tensions When Developing Digital Interventions Supporting Individuals With ADHD. Front Digit Health 2022; 4:876039. [PMID: 35633736 PMCID: PMC9133410 DOI: 10.3389/fdgth.2022.876039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Franceli L. Cibrian
- Fowler School of Engineering, Chapman University, Orange, CA, United States
- *Correspondence: Franceli L. Cibrian
| | - Elissa Monteiro
- Graduate School of Education, University of California, Riverside, Riverside, CA, United States
| | - Sabrina E. B. Schuck
- Pediatrics Department, University of California, Irvine, Irvine, CA, United States
| | - Michele Nelson
- Department of Psychiatry and Neuroscience, University of California, Riverside, Riverside, CA, United States
| | - Gillian R. Hayes
- Pediatrics Department, University of California, Irvine, Irvine, CA, United States
- Informatics Department, University of California, Irvine, Irvine, CA, United States
| | - Kimberley D. Lakes
- Department of Psychiatry and Neuroscience, University of California, Riverside, Riverside, CA, United States
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Meyer R, Wang K, Yearley A, Grob S, Zeitlin J, Bloomfeld J, You M, Lee D, Bonner M, Shah N, Page K. Usability and Acceptability of the QuestLeukemia Mobile Application: A Pilot Study for An Educational and Psychological Intervention for Children with Chronic Illnesses. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:137-142. [PMID: 35467435 DOI: 10.1177/27527530221068422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
It is widely accepted that educational interventions benefit children with chronic diseases (disease awareness and autonomy) or those undergoing medical procedures (decreased anxiety and improved satisfaction). Hematopoietic cell transplantation (HCT) is an intensive procedure to treat life-threatening diseases but is associated with multiple adverse medical experiences. QuestLeukemia (QuestED, Durham, NC) is a mobile app designed to educate pediatric patients preparing for HCT through age-appropriate videos and quizzes. Here we describe the results of the initial pilot study assessing acceptability and feasibility of QuestLeukemia app. Eligible participants were selected from a convenience sample (inpatient HCT unit and outpatient clinic). Participants spent 30-60 min using the app then completed a survey assessing the app for usability, accessibility, and user satisfaction. Participants identified the app as a useful tool for gaining disease-related knowledge and reported greater autonomy over their disease process. On average, patients indicated that the app was easy to use (M = 4.93), enjoyable (M = 4.79), and comprehensive (M = 4.71). Parents followed similar trends of satisfaction with the app. Pediatric HCT providers likewise reported that the app was easy to use (M = 4.22), enjoyable (M = 4.85), and educationally comprehensive (M = 4.77). The QuestLeukemia mobile application prototype provides an easy, enjoyable, and educational tool for pediatric patients undergoing HCT. This application was well received by patients, parents, and providers. These findings will be used to design future iterations of the game in clinical care.
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Affiliation(s)
| | - Kira Wang
- 3065Duke University, Durham, NC, USA
| | - Alexander Yearley
- 3065Duke University, Durham, NC, USA
- 1812Harvard Medical School, Durham, NC, USA
| | | | | | | | | | - Diane Lee
- 3065Duke University, Durham, NC, USA
| | - Melanie Bonner
- 213852Duke University Hospital, Durham, NC, USA
- 3065Duke University, Durham, NC, USA
| | - Nirmish Shah
- 213852Duke University Hospital, Durham, NC, USA
- 3065Duke University, Durham, NC, USA
| | - Kristin Page
- 213852Duke University Hospital, Durham, NC, USA
- 3065Duke University, Durham, NC, USA
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Tang Y, Liao Z, Huang S, Hao J, Huang Q, Chen X, Lin S, Li Y, Qi J, Shen H. Development and Validation of a Risk Assessment Tool for Gaming Disorder in China: The Gaming Hazard Assessment Scale. Front Public Health 2022; 10:870358. [PMID: 35480584 PMCID: PMC9035820 DOI: 10.3389/fpubh.2022.870358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the growing research interest in gaming disorder, risk screening tools developed specifically for the Chinese population are still lacking. This study aimed to construct a screening tool to evaluate the risk of gaming disorder (GD) development, by assessing the severity of GD symptoms among Chinese gamers, based on clinical expert interviews, structured interviews with GD patients, a background literature review, and IGD/GD criteria proposed by the DSM-5 and ICD-11. It introduced the Gaming Hazard Assessment Scale—a multidimensional GD risk screening tool—and evaluated the dimension structure, reliability, and validity of the scale among 959 Chinese gamers. A three-level structure, consisting of 18 items scored from 0 to 54, ultimately indicated satisfactory reliability, good validity, and acceptable model fit. The scale will help large-scale initial screening and early identification of patients with a high risk of GD. Further evaluation of the Gaming Hazard Assessment Scale in clinical settings is highly recommended.
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Affiliation(s)
- Ying Tang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Zhenjiang Liao
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Shucai Huang
- Department of Psychiatry, The Fourth People's Hospital of Wuhu, Wuhu, China
| | - Jingyue Hao
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Qiuping Huang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Xinxin Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Shuhong Lin
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - YiFan Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Jing Qi
- Department of Psychiatry, Brain Hospital of Hunan Province, Changsha, China
| | - Hongxian Shen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
- *Correspondence: Hongxian Shen
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Ndulue C, Oyebode O, Iyer RS, Ganesh A, Ahmed SI, Orji R. Personality-targeted persuasive gamified systems: exploring the impact of application domain on the effectiveness of behaviour change strategies. USER MODELING AND USER-ADAPTED INTERACTION 2022; 32:165-214. [PMID: 35281337 PMCID: PMC8900644 DOI: 10.1007/s11257-022-09319-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
Persuasive gamified systems for health are interventions that promote behaviour change using various persuasive strategies. While research has shown that these strategies are effective at motivating behaviour change, there is little knowledge on whether and how the effectiveness of these strategies vary across multiple domains for people of distinct personality traits. To bridge this gap, we conducted a quantitative study with 568 participants to investigate (a) whether the effectiveness of the persuasive strategies implemented vary within each domain (b) whether the effectiveness of various strategies vary across two distinct domains, (c) how people belonging to different personality traits respond to these strategies, and (d) if people high in a personality trait would be influenced by a persuasive strategy within one domain and not in the other. Our results show that there are significant differences in the effectiveness of various strategies across domains and that people's personality plays a significant role in the perceived persuasiveness of different strategies both within and across distinct domains. The Reward strategy (which involves incentivizing users for achieving specific milestones towards the desired behaviour) and the Competition strategy (which involves allowing users to compete with each other to perform the desired behaviour) were effective for promoting healthy eating but not for smoking cessation for people high in Conscientiousness. We provide design suggestions for developing persuasive gamified interventions for health targeting distinct domains and tailored to individuals depending on their personalities.
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Affiliation(s)
- Chinenye Ndulue
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
| | - Oladapo Oyebode
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
| | | | - Anirudh Ganesh
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
| | | | - Rita Orji
- Faculty of Computer Science, Dalhousie University, 6050 University Ave, Halifax, NS B3H 1W5 Canada
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Azizoddin DR, Thomas TH. Game Changer: Is Palliative Care Ready for Games? JCO Clin Cancer Inform 2022; 6:e2200003. [PMID: 35482999 PMCID: PMC9088236 DOI: 10.1200/cci.22.00003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/15/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Desiree R. Azizoddin
- Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
| | - Teresa H. Thomas
- Health Promotion & Development, University of Pittsburgh School of Nursing, Pittsburgh, PA
- Palliative Research Center, University of Pittsburgh, Pittsburgh, PA
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Yamaji N, Suzuki D, Suto M, Sasayama K, Ota E. Communication tools used in cancer communication with children: a scoping review protocol. BMJ Open 2022; 12:e056403. [PMID: 35197351 PMCID: PMC8867319 DOI: 10.1136/bmjopen-2021-056403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Despite the potential benefits of effective communication, telling children about cancer, unpredictable and life-threatening conditions is challenging. This study aimed to summarise the communication tools used in cancer communication among children with cancer, caregivers and healthcare professionals. METHODS AND ANALYSIS We will conduct a scoping review following the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. We will search PubMed (including MEDLINE), Embase, CENTRAL, PsycINFO and CINAHL. We will include the qualitative and quantitative studies that reported the communication tools that tell a child diagnosed with cancer about the cancer-related information. We will summarise the communication tools and the impacts of the tools. ETHICS AND DISSEMINATION Formal ethical approval is not required, as primary data will not be collected in this study. The findings of this study will be disseminated through the presentation at the conference and publication in a peer-reviewed journal.
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Affiliation(s)
- Noyuri Yamaji
- Department of Global Health Nursing, Graduate School of Nursing Science, St Luke's International University, Chuo-ku, Japan
| | - Daichi Suzuki
- Department of Nursing, Kanagawa Institute of Technology, Atsugi, Japan
| | - Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Kiriko Sasayama
- Department of Global Health Nursing, Graduate School of Nursing Science, St Luke's International University, Chuo-ku, Japan
| | - Erika Ota
- Department of Global Health Nursing, Graduate School of Nursing Science, St Luke's International University, Chuo-ku, Japan
- The Tokyo Foundation for Policy Research, Minato-ku, Japan
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Abraham O, Szela L, Brasel K, Hoernke M. Engaging youth in the design of prescription opioid safety education for schools. J Am Pharm Assoc (2003) 2022; 62:441-449. [PMID: 34736864 PMCID: PMC9536462 DOI: 10.1016/j.japh.2021.10.016] [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: 09/03/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Opioid misuse continues to be a major concern in the United States, affecting both adults and adolescents. Unfortunately, even legitimate prescription opioid misuse in adolescence increases the risk for misuse later in life. Although adolescence is a critical period for learning, little is known about adolescents' preferences for opioid safety education. One potential avenue for prescription opioid education is the use of serious games. Serious games can result in better health outcomes and understanding for adolescents and allow them to safely experience real-life scenarios. However, few studies have examined the use of serious games for adolescent opioid education. OBJECTIVE This study explored adolescents' preferences for prescription opioid education and design of a serious game focused on opioid safety education. METHODS A focus group guide was adapted from 2 statewide surveys about participants' perspectives on opioids. Recruitment packets with consent documents and an introduction to the study were sent home to eligible students. Ten focus groups were conducted with 68 middle and high school students in Wisconsin. Adolescents were asked to discuss their preferences for prescription opioid safety education and to design a serious game to educate teens about opioid safety. Focus groups were audio-recorded, professionally transcribed, and underwent content and thematic analyses using NVivo 12 software. RESULTS Three preferred approaches for opioid safety education were identified, including the use of presentations, videos and websites, and serious games. Adolescents desired short presentations delivering personal stories to smaller audiences. They preferred websites and brief, engaging videos from reliable sources because of ease of access. Adolescents also preferred serious games for opioid education that were realistic and relatable. CONCLUSION When educating adolescents on prescription opioids, the use of presentations, particularly personal stories, brief and engaging websites and videos, or serious games with realistic and relatable scenarios should be incorporated.
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Affiliation(s)
- Olufunmilola Abraham
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, 777 Highland Avenue, Madison, WI 53705
| | - Lisa Szela
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, Madison, WI, USA
| | - Kelsey Brasel
- University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| | - Margaret Hoernke
- University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
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Gameful Learning for a More Sustainable World. BUSINESS & INFORMATION SYSTEMS ENGINEERING 2021. [DOI: 10.1007/s12599-021-00731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractMunicipal waste sorting is an important but neglected topic within sustainability-oriented Information Systems research. Most waste management systems depend on the quality of their citizens pre-sorting but lack teaching resources. Thus, it is important to raise awareness and knowledge on correct waste sorting to strengthen current efforts. Having shown promising results in raising learning outcomes and motivation in domains like health and economics, gamification is an auspicious approach to address this problem. The paper explores the effectiveness of gameful design on learning outcomes of waste sorting knowledge with a mobile game app that implements two different learning strategies: repetition and elaboration. In a laboratory experiment, the overall learning outcome of participants who trained with the game was compared to that of participants who trained with standard analogue non-game materials. Furthermore, the effects of two additional, learning-enhancing design elements – repetition and look-up – were analyzed. Learning outcome in terms of long-term retention and knowledge transfer were evaluated through three different testing measures two weeks after the training: in-game, through a multiple-choice test and real-life sorting. The results show that the game significantly enhanced the learning outcome of waste sorting knowledge for all measures, which is particularly remarkable for the real-life measure, as similar studies were not successful with regard to knowledge transfer to real life. Furthermore, look-up is found to be a promising game design element that is not yet established in IS literature and therefore should be considered more thoroughly in future research and practical implementations alike.
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Khalili-Mahani N, Holowka E, Woods S, Khaled R, Roy M, Lashley M, Glatard T, Timm-Bottos J, Dahan A, Niesters M, Hovey RB, Simon B, Kirmayer LJ. Play the Pain: A Digital Strategy for Play-Oriented Research and Action. Front Psychiatry 2021; 12:746477. [PMID: 34975566 PMCID: PMC8714795 DOI: 10.3389/fpsyt.2021.746477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/11/2021] [Indexed: 12/26/2022] Open
Abstract
The value of understanding patients' illness experience and social contexts for advancing medicine and clinical care is widely acknowledged. However, methodologies for rigorous and inclusive data gathering and integrative analysis of biomedical, cultural, and social factors are limited. In this paper, we propose a digital strategy for large-scale qualitative health research, using play (as a state of being, a communication mode or context, and a set of imaginative, expressive, and game-like activities) as a research method for recursive learning and action planning. Our proposal builds on Gregory Bateson's cybernetic approach to knowledge production. Using chronic pain as an example, we show how pragmatic, structural and cultural constraints that define the relationship of patients to the healthcare system can give rise to conflicted messaging that impedes inclusive health research. We then review existing literature to illustrate how different types of play including games, chatbots, virtual worlds, and creative art making can contribute to research in chronic pain. Inspired by Frederick Steier's application of Bateson's theory to designing a science museum, we propose DiSPORA (Digital Strategy for Play-Oriented Research and Action), a virtual citizen science laboratory which provides a framework for delivering health information, tools for play-based experimentation, and data collection capacity, but is flexible in allowing participants to choose the mode and the extent of their interaction. Combined with other data management platforms used in epidemiological studies of neuropsychiatric illness, DiSPORA offers a tool for large-scale qualitative research, digital phenotyping, and advancing personalized medicine.
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Affiliation(s)
- Najmeh Khalili-Mahani
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Division of Social & Transcultural Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Technoculture, Arts and Game Centre, Milieux Institute for Art, Culture and Technology, Concordia University, Montreal, QC, Canada
| | - Eileen Holowka
- Technoculture, Arts and Game Centre, Milieux Institute for Art, Culture and Technology, Concordia University, Montreal, QC, Canada
| | | | - Rilla Khaled
- Technoculture, Arts and Game Centre, Milieux Institute for Art, Culture and Technology, Concordia University, Montreal, QC, Canada
| | - Mathieu Roy
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Myrna Lashley
- Division of Social & Transcultural Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Tristan Glatard
- Department of Computer Science, Concordia University, Montreal, QC, Canada
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Janis Timm-Bottos
- Department of Creative Art Therapies, Concordia University, Montreal, QC, Canada
| | - Albert Dahan
- Department of Anesthesiology, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
| | - Marieke Niesters
- Department of Anesthesiology, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
| | | | - Bart Simon
- Technoculture, Arts and Game Centre, Milieux Institute for Art, Culture and Technology, Concordia University, Montreal, QC, Canada
- Department of Sociology, Concordia University, Montreal, QC, Canada
| | - Laurence J. Kirmayer
- Division of Social & Transcultural Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
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Day M, Harris S, Hussein D, Saka MY, Stride C, Jones M, Makin G, Rowe R. The efficacy of interactive group psychoeducation for children with leukaemia: A randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2021; 104:3008-3015. [PMID: 33985845 DOI: 10.1016/j.pec.2021.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/30/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate an interactive group psychoeducation programme for children treated for leukaemia. METHODS A longitudinal randomised controlled study across four UK hospitals with an immediate (N = 26) and delay control group (N = 32). The intervention covered the pathophysiology of leukaemia, its treatment, side effects and the importance of positive health behaviours. Primary outcomes were parent-reported child health related quality of life (HRQoL) and behavioural difficulties. Secondary outcomes were child-reported HRQoL, cancer-specific HRQoL, child confidence, caregiver burden, and treatment anxiety. Measures were completed pre- and immediately post-intervention, and at 13 and 26-weeks follow-up. Change over time was analysed using multilevel modelling. Acceptability questionnaires rated the intervention on benefits, recommendations, and barriers to participation. RESULTS The intervention significantly improved parent-reported child HRQoL but did not have a significant effect on other outcomes. Acceptability of the intervention was high. CONCLUSIONS This study provides initial evidence that interactive group psychoeducation is acceptable to families and improves HRQoL in children with leukaemia. Difficulties with recruitment removed power to detect effect sizes that are plausible for psychoeducational interventions. PRACTISE IMPLICATIONS Further studies to explore the potential of psychoeducation to improve outcomes for children with leukaemia and an examination of barriers to participation within this population are warranted.
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Affiliation(s)
- Marianne Day
- Department of Psychology, University of Sheffield, UK.
| | - Sally Harris
- Royal Alexandra Children's Hospital, Eastern Road, Brighton BN2 5BE, UK.
| | - Deema Hussein
- King Fahd Medical Research Center, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences King Abdulaziz University, Saudi Arabia.
| | - Mohamad Yassin Saka
- King Fahd Medical Research Center, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences King Abdulaziz University, Saudi Arabia.
| | - Chris Stride
- Institute of Work Psychology, Management School, University of Sheffield, UK.
| | - Myles Jones
- Department of Psychology, University of Sheffield, UK.
| | - Guy Makin
- Division of Cancer Sciences, Faculty of Medicine, Biology and Health, University of Manchester and Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
| | - Richard Rowe
- Department of Psychology, University of Sheffield, UK.
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The effect of visual interventions on illness beliefs and medication adherence for chronic conditions: A scoping review of the literature and mapping to behaviour change techniques (BCTs). Res Social Adm Pharm 2021; 18:3239-3262. [PMID: 34815181 DOI: 10.1016/j.sapharm.2021.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/04/2021] [Accepted: 11/14/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Maintaining health with chronic conditions often involves taking multiple medications; however, approximately 50% of patients with chronic conditions are non-adherent to medication. Patients' illness beliefs inform health behaviour, including medication-taking. Research has shown that visuals accompanying health information increased patient comprehension and the accuracy of illness perceptions. To date, the influence of visuals on illness beliefs and medication adherence has not been comprehensively reviewed. OBJECTIVES The review aimed to collate available literature on visualisation interventions for illness beliefs and medication adherence in chronic conditions and identify key intervention characteristics. METHODS A scoping review was conducted according to recommended guidelines and the PRISMA-ScR statement. Searches used keywords relating to 'illness', 'visual', 'adherence', 'illness perception', 'intervention', and 'medication'. Six databases were searched from inception to 2019; reference-list searching provided additional articles. Articles were included if the study population had a chronic health condition, the intervention included a visual element, had a measure of illness beliefs or medication adherence. Data regarding intervention characteristics and outcomes were extracted. Behaviour change techniques (BCTs) were identified to provide further insight into intervention characteristics. RESULTS Initially, 18,012 articles were identified. Screening led to 293 full-text articles, ultimately resulting in 45 studies for final analysis. Forty-four were quantitative studies, 1 was qualitative. Studies were grouped into those using visuals to conceptualise a condition, medication reminders and educational interventions. Almost two-thirds of visual interventions were effective post-intervention, 3 sustained post-1-year, although many studies only assessed impact immediately post-intervention. BCTs from 'Natural consequences', 'Socialsupport' and 'Feedback and monitoring' categories were prevalent in effective interventions for both outcomes, particularly the 'Salience of consequences' BCT. CONCLUSIONS This comprehensive scoping review found that visual interventions can positively influence illness beliefs and medication adherence. These findings highlight the need to further evaluate the impact and sustainability of visual interventions.
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Psihogios AM, Rabbi M, Ahmed A, McKelvey ER, Li Y, Laurenceau JP, Hunger SP, Fleisher L, Pai AL, Schwartz LA, Murphy SA, Barakat LP. Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement During Cancer Treatment: Protocol for Ecological Momentary Assessment. JMIR Res Protoc 2021; 10:e32789. [PMID: 34677129 PMCID: PMC8571686 DOI: 10.2196/32789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) with cancer demonstrate suboptimal oral chemotherapy adherence, increasing their risk of cancer relapse. It is unclear how everyday time-varying contextual factors (eg, mood) affect their adherence, stalling the development of personalized mobile health (mHealth) interventions. Poor engagement is also a challenge across mHealth trials; an effective adherence intervention must be engaging to promote uptake. OBJECTIVE This protocol aims to determine the temporal associations between daily contextual factors and 6-mercaptopurine (6-MP) adherence and explore the proximal impact of various engagement strategies on ecological momentary assessment survey completion. METHODS At the Children's Hospital of Philadelphia, AYAs with acute lymphoblastic leukemia or lymphoma who are prescribed prolonged maintenance chemotherapy that includes daily oral 6-MP are eligible, along with their matched caregivers. Participants will use an ecological momentary assessment app called ADAPTS (Adherence Assessments and Personalized Timely Support)-a version of an open-source app that was modified for AYAs with cancer through a user-centered process-and complete surveys in bursts over 6 months. Theory-informed engagement strategies will be microrandomized to estimate the causal effects on proximal survey completion. RESULTS With funding from the National Cancer Institute and institutional review board approval, of the proposed 30 AYA-caregiver dyads, 60% (18/30) have been enrolled; of the 18 enrolled, 15 (83%) have completed the study so far. CONCLUSIONS This protocol represents an important first step toward prescreening tailoring variables and engagement components for a just-in-time adaptive intervention designed to promote both 6-MP adherence and mHealth engagement. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/32789.
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Affiliation(s)
- Alexandra M Psihogios
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Mashfiqui Rabbi
- Department of Statistics, Harvard University, Boston, MA, United States
| | - Annisa Ahmed
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Elise R McKelvey
- Children's Hospital of Philadelphia, La Salle University, Philadelphia, PA, United States
| | - Yimei Li
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Stephen P Hunger
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Linda Fleisher
- Health Communications and Health Disparities, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Ahna Lh Pai
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Lisa A Schwartz
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Susan A Murphy
- Department of Statistics, Harvard University, Boston, MA, United States
| | - Lamia P Barakat
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
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Abraham O, Szela L, Khan M, Geddam A. Exploring Middle School Students' Perspectives on Utilizing Serious Games for Cancer Prevention Education: A Focus Group Study. JMIR Serious Games 2021; 10:e31172. [PMID: 34643533 PMCID: PMC8822422 DOI: 10.2196/31172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/27/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cancer in the United States is a leading cause of mortality. Educating adolescents about cancer risks can improve awareness and introduce healthy lifestyle habits. Public health efforts have made significant progress in easing the burden of cancer through the promotion of early screening and healthy lifestyle advocacy. However, there are limited interventions that educate the adolescent population about cancer prevention. Previous studies have demonstrated the effectiveness of serious games (SGs) to teach adolescents about healthy lifestyle choices, but limited research has examined the utility of using SGs to educate youth specifically on cancer prevention. OBJECTIVE This study aimed to investigate middle school students' preferences for the use of SGs for cancer prevention education. The study also characterized the students' perceptions of desired game design features for a cancer prevention SG. METHODS Focus groups were conducted to allow adolescents to review a game playbook and discuss gaming behaviors and preferences for a SG for cancer education. The game playbook was developed based on Cancer, Clear & Simple, a curriculum intended to educate individuals about cancer, prevention, self-care, screening, and detection. In the game, the player learns that they have cancer and is given the opportunity to go back in time to reduce their cancer risk. A focus group discussion guide was developed and consisted of questions about aspects of the playbook and participants' gaming experience. Adolescents were eligible to participate if they were 12 to 14 years, could speak and understand English, and had parents who could read English or Spanish. Each focus group consisted of five to ten adolescents. Focus groups were audio-recorded and professionally transcribed, then content and thematically analyzed by two study team members. Intercoder reliability (kappa coefficient) among the coders was reported as 0.97. Prevalent codes were identified and categorized into themes and subthemes. RESULTS A total of 18 focus groups were conducted with 139 participants from a Wisconsin middle school. Most participants had at least "some" gaming experience. Three major themes were identified: Educational Video Games, Game Content, and Purpose of Game. Participants preferred customizable characters and realistic storylines that allowed players to make choices that affect the characters' outcomes. Middle school students also preferred SGs over other educational methods such as lectures, books, videos, and websites. Participants desired SGs to be available across multiple platforms and suggested the use of SGs for cancer education in their school. CONCLUSIONS Adolescents consider SGs to be an entertaining tool to learn about cancer prevention and risk factors. The design preferences of adolescents should be considered to create a cancer education SG that is acceptable and engaging for youth. CLINICALTRIAL
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Affiliation(s)
- Olufunmilola Abraham
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Ave, Madison, US
| | - Lisa Szela
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Ave, Madison, US
| | - Mahnoor Khan
- School of Pharmacy, University of Wisconsin-Madison, Madison, US
| | - Amrita Geddam
- School of Pharmacy, University of Wisconsin-Madison, Madison, US
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Ahufinger S, Herrero-Martín P. Alien Attack: A Non-Pharmaceutical Complement for ADHD Treatment. ENTROPY 2021; 23:e23101321. [PMID: 34682045 PMCID: PMC8535017 DOI: 10.3390/e23101321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022]
Abstract
Mental health issues are among the most common health issues nowadays, with attention-deficit hyperactivity disorder (ADHD) being the most common neurobehavioral disorder affecting children and adolescents. ADHD is a heterogeneous disease affecting patients in various cognitive domains that play a key role in daily life, academic development, and social abilities. Furthermore, ADHD affects not only patients but also their families and their whole environment. Although the main treatment is based on pharmacotherapy, combined therapies including cognitive training and psychological therapy are often recommended. In this paper, we propose a user-centered application called Alien Attack for cognitive training of children with ADHD, based on working memory, inhibitory control, and reaction-time tasks, to be used as a non-pharmacological complement for ADHD treatment in order to potentiate the patients’ executive functions (EFs) and promote some beneficial effects of therapy.
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Rao P, Sproch A, Ungemach M, Cash M, Blackall GF. Life on Pause: Lessons Learned in Creating an Adolescent and Young Adult Cancer Survivor Podcast. J Adolesc Young Adult Oncol 2021; 11:439-441. [PMID: 34582266 DOI: 10.1089/jayao.2021.0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Pooja Rao
- Division of Pediatric Hematology/Oncology, Penn State Health Children's Hospital, Hershey, Pennsylvania, USA
| | - Abby Sproch
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Michelle Ungemach
- Division of Pediatric Hematology/Oncology, Penn State Health Children's Hospital, Hershey, Pennsylvania, USA
| | - Megan Cash
- Sechler Family Cancer Center, WellSpan Good Samaritan Hospital, Lebanon, Pennsylvania, USA
| | - George F Blackall
- Division of Pediatric Hematology/Oncology, Penn State Health Children's Hospital, Hershey, Pennsylvania, USA
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