JMIR Serious Games最新文献

{"title":"Serious Games Based on Cognitive Bias Modification and Learned Helplessness Paradigms for the Treatment of Depression: Design and Acceptability Study.","authors":"Arka Ghosh, Jagriti Agnihotri, Sradha Bhalotia, Bharat Kumar Sati, Latika Agarwal, Akash A, Swastika Tandon, Komal Meena, Shreyash Raj, Yatin Azad, Silky Gupta, Nitin Gupta","doi":"10.2196/37105","DOIUrl":"https://doi.org/10.2196/37105","url":null,"abstract":"Background Depression is a debilitating mental health disorder, with a large treatment gap. Recent years have seen a surge in digital interventions to bridge this treatment gap. Most of these interventions are based on computerized cognitive behavioral therapy. Despite the efficacy of computerized cognitive behavioral therapy–based interventions, their uptake is low and dropout rates are high. Cognitive bias modification (CBM) paradigms provide a complementary approach to digital interventions for depression. However, interventions based on CBM paradigms have been reported to be repetitive and boring. Objective In this paper, we described the conceptualization, design, and acceptability of serious games based on CBM paradigms and the learned helplessness paradigm. Methods We searched the literature for CBM paradigms that were shown to be effective in reducing depressive symptoms. For each of the CBM paradigms, we ideated how to create a game so that the gameplay was engaging while the active therapeutic component remained unchanged. Results We developed 5 serious games based on the CBM paradigms and the learned helplessness paradigm. The games include various core elements of gamification, such as goals, challenges, feedback, rewards, progress, and fun. Overall, the games received positive acceptability ratings from 15 users. Conclusions These games may help improve the effectiveness and engagement levels of computerized interventions for depression.","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9843839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serious Game for the Screening of Central Auditory Processing Disorder in School-Age Children: Development and Validation Study.","authors":"Ana-Marta Gabaldón-Pérez,&nbsp;María Dolón-Poza,&nbsp;Martina Eckert,&nbsp;Nuria Máximo-Bocanegra,&nbsp;María-Luisa Martín-Ruiz,&nbsp;Iván Pau De La Cruz","doi":"10.2196/40284","DOIUrl":"https://doi.org/10.2196/40284","url":null,"abstract":"<p><strong>Background: </strong>Currently, many central auditory processing disorder screening tests are available for children, and serious games (SGs) are frequently used as a tool for the diagnosis of different neural deficits and disorders in health care. However, it has not been possible to find a proposal that unifies both ideas. In addition, the validation and improvement of SGs, in general, does not take into account the player-game interaction, thus omitting valuable information about the playability and usability of the game.</p><p><strong>Objective: </strong>This study presented Amalia's Planet, a game conceived for use in school environments, which allows a first assessment of a child through their performance of the proposed tasks related to different aspects of auditory performance. In addition, the game defines a series of events in relation to the execution of the tasks, which were evaluated for the subsequent optimization of its performance and the improvement of its usability.</p><p><strong>Methods: </strong>Using screening tools based on the use of SG technologies, a total of 87 school-age children were evaluated to test the various hypotheses proposed in this study. By grouping users according to whether they had personal history of hearing pathologies, the discriminant power, playability, and usability of the final solution were examined using traditional statistical techniques and process mining (PM) algorithms.</p><p><strong>Results: </strong>With a confidence level of 80% for test 2 (P=.19), there was no statistical evidence to reject the null hypothesis that a player's performance is affected by whether the player had a previous auditory pathology. Furthermore, the tool allowed the screening of 2 players initially categorized as healthy because of their low level of performance in the tests and the similarity of their behavior with that of the group of children with a previous pathology. With regard to the validation of the proposed solution, the use of PM techniques made it possible to detect the existence of events that lasted too long, which can lead to player frustration, and to discover small structural flaws in the game.</p><p><strong>Conclusions: </strong>SGs seem to be an appropriate tool for the screening of children at risk of central auditory processing disorder. Moreover, the set of PM techniques provides a reliable source of information regarding the playability and usability of the solution to the development team, allowing its continuous optimization.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10173044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Exergaming on Musculoskeletal Pain in Older Adults: Systematic Review and Meta-analysis.","authors":"Nan Mo,&nbsp;Jin Yu Feng,&nbsp;Hai Xia Liu,&nbsp;Xiao Yu Chen,&nbsp;Hui Zhang,&nbsp;Hui Zeng","doi":"10.2196/42944","DOIUrl":"https://doi.org/10.2196/42944","url":null,"abstract":"<p><strong>Background: </strong>Exercise is effective for musculoskeletal pain. However, physical, social, and environmental factors make it difficult for older adults to persist in exercising. Exergaming is a new pathway that combines exercise with gameplay and may be helpful for older adults to overcome these difficulties and engage in regular exercise.</p><p><strong>Objective: </strong>This systematic review aimed to determine the efficacy of exergaming to improve musculoskeletal pain in older adults.</p><p><strong>Methods: </strong>The search was performed in 5 databases (PubMed, Embase, CINAHL, Web of Science, and Cochrane Library). The risk of bias for randomized controlled studies was assessed using the revised Cochrane Risk of Bias tool in randomized trials (RoB 2), and the methodological quality was assessed using the Physiotherapy Evidence-Based Database scale. Standardized mean difference and 95% CI were calculated using fixed-effects model meta-analyses in the Review Manager version 5.3 (RevMan 5.3).</p><p><strong>Results: </strong>Seven randomized controlled studies were included, which contained 264 older adults. Three of the 7 studies reported significant improvements in pain after the exergaming intervention, but only 1 reported a significant difference between groups after adjustment for baseline (P<.05), and another reported a significant improvement in thermal pain between the 2 groups (P<.001). The results of the meta-analysis of the 7 studies showed no statistically significant improvement in pain compared to the control group (standardized mean difference -0.22; 95% CI -0.47 to 0.02; P=.07).</p><p><strong>Conclusions: </strong>Although the effects of exergames on musculoskeletal pain in older adults are unknown, exergame training is generally safe, fun, and appealing to older adults. Unsupervised exercise at home is feasible and cost-effective. However, most of the current studies have used commercial exergames, and it is recommended that there should be more cooperation between industries in the future to develop professional rehabilitation exergames that are more suitable for older adults. The sample sizes of the studies included are small, the risk of bias is high, and the results should be interpreted with caution. Further randomized controlled studies with large sample sizes, high quality, and rigor are needed in the future.</p><p><strong>Trial registration: </strong>PROSPERO International Prospective Register of Systematic Reviews CRD42022342325; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=342325.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9451991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Conceptual Framework (2D-ME) for Explaining Self-first and Self-third Person Views of Prototyping Dynamics in Serious Games Design: Experimental Case Study.","authors":"Sofia Hadjileontiadou,&nbsp;Sofia B Dias,&nbsp;Leontios Hadjileontiadis","doi":"10.2196/41824","DOIUrl":"https://doi.org/10.2196/41824","url":null,"abstract":"<p><strong>Background: </strong>Design dynamics that evolve during a designer's prototyping process encapsulate important insights about the way the designer is using his or her knowledge, creativity, and reflective thinking. Nevertheless, the capturing of such dynamics is not always an easy task, as they are built through alternations between the self-first and self-third person views.</p><p><strong>Objective: </strong>This study aimed at introducing a conceptual framework, namely 2D-ME, to provide an explainable domain that could express the dynamics across the design timeline during a prototyping process of serious games.</p><p><strong>Methods: </strong>Within the 2D-ME framework, the Technological-Pedagogical-Content Knowledge (TPACK), its adaptation to the serious games (TPACK-Game), and the activity theory frameworks were combined to produce dynamic constructs that incorporate self-first and self-third person extension of the TPACK-Game to Games TPACK, rules, division of labor, and object. The dynamic interplay between such constructs was used as an adaptation engine within an optimization prototype process, so each sequential version of the latter could converge to the designer's initial idea of the serious game. Moreover, higher-order thinking is scaffolded with the internal Activity Interview Script proposed in this paper.</p><p><strong>Results: </strong>An experimental case study of the application of the 2D-ME conceptual framework in the design of a light reflection game was showcased, revealing all the designer's dynamics, both from internal (via a diary) and external (via the prototype version) views. The findings of this case study exemplified the convergence of the prototyping process to an optimized output, by minimizing the mean square error between the conceptual (initial and updated) idea of the prototype, following explainable and tangible constructs within the 2D-ME framework.</p><p><strong>Conclusions: </strong>The generic structure of the proposed 2D-ME framework allows its transferability to various levels of expertise in serious games mastering, and it is used both for the designer's process exploration and training of the novice ones.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Personalized, Chess-Based Training Serious Video Game in the Treatment of Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder: Randomized Controlled Trial.","authors":"María Rodrigo-Yanguas,&nbsp;Marina Martín-Moratinos,&nbsp;Carlos González-Tardón,&nbsp;Fernando Sanchez-Sanchez,&nbsp;Ana Royuela,&nbsp;Marcos Bella-Fernández,&nbsp;Hilario Blasco-Fontecilla","doi":"10.2196/39874","DOIUrl":"https://doi.org/10.2196/39874","url":null,"abstract":"<p><strong>Background: </strong>Compared with traditional approaches, gaming strategies are promising interventions for the treatment of attention-deficit/hyperactivity disorder (ADHD). We developed a serious game, The Secret Trail of Moon (TSTM), for ADHD treatment.</p><p><strong>Objective: </strong>The main objective of this clinical trial was to demonstrate the effectiveness of an add-on, either TSTM or Therapeutic Chess (TC), in previously optimally drug-titrated, clinically stable patients with ADHD.</p><p><strong>Methods: </strong>This study is a prospective, unicentric, randomized clinical trial in clinically stable patients with ADHD, aged 12 to 22 years. The TSTM (n=35) and TC groups (n=34) performed 12 weekly sessions of their respective treatments. The control group (CG) patients (n=35) were called by phone every week, but they received no cognitive intervention. The primary end point was the change from baseline to end point in the parent \"Behavior Rating Inventory of Executive Function-2\" (BRIEF-2; patients' parents) in the per-protocol population (31 serious videogame: 24 TC and 34 CG).</p><p><strong>Results: </strong>Our study failed to probe clear-cut improvements in the global score of the BRIEF-2. However, the TC group showed improvements in measures of emotional control, emotional regulation, and inattention. The TSTM group showed improvements in measures of emotional regulation, inattention, and school context.</p><p><strong>Conclusions: </strong>TSTM and TC did not improve executive function symptoms, but they improved ADHD symptomatology related to emotional regulation. Further studies with bigger samples are required to confirm these preliminary findings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04355065; https://clinicaltrials.gov/ct2/show/NCT04355065.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9496157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design Preferences for a Serious Game-Based Cognitive Assessment of Older Adults in Prison: Thematic Analysis.","authors":"Rhys Mantell,&nbsp;Adrienne Withall,&nbsp;Kylie Radford,&nbsp;Michael Kasumovic,&nbsp;Lauren Monds,&nbsp;Ye In Jane Hwang","doi":"10.2196/45467","DOIUrl":"https://doi.org/10.2196/45467","url":null,"abstract":"<p><strong>Background: </strong>Serious games have the potential to transform the field of cognitive assessment. The use of serious game-based cognitive assessments in prison environments is particularly exciting. This is because interventions are urgently needed to address the rapid increase in the number of currently incarcerated older adults globally and because of the heightened risks of dementia and cognitive decline present in this population. Game-based assessments are assumed to be fun, engaging, and suitable alternatives to traditional cognitive testing, but these assumptions remain mostly untested in older adults. This is especially true for older adults in prison, whose preferences and needs are seldom heard and may deviate from those previously captured in studies on cognition and serious games.</p><p><strong>Objective: </strong>This study aimed to understand the design preferences of older adults in prison for a game-based cognitive assessment.</p><p><strong>Methods: </strong>This study used reflexive thematic analysis, underpinned by critical realism, and applied the technique of abduction. Overall, 4 focus groups with a total of 20 participants were conducted with older adults (aged ≥50 years; aged ≥45 years for Aboriginal and Torres Strait Islander people) across 3 distinct prison environments in Australia.</p><p><strong>Results: </strong>Self-determination theory was used as a theoretical foundation to interpret the results. Overall, 3 themes were generated: Goldilocks-getting gameplay difficulty just right through optimal challenge (the first theme emphasizes the participants' collective desire for an individualized optimal level of difficulty in serious gameplay), Avoiding Childish Graphics-gimmicky gameplay can be condescending (the second theme raises the importance of avoiding immature and childlike gameplay features, as some older end users in prison felt that these can be condescending), and A Balanced Diet-meaningful choice and variety keeps game-based assessments fun (the third theme highlights the strong user preference for meaningful choice and variety in any serious game-based cognitive assessment to maximize in-game autonomy).</p><p><strong>Conclusions: </strong>The collection of these themes provides novel insights into key game design preferences of marginalized older adults.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-design of a Virtual Reality Cognitive Remediation Program for Depression (bWell-D) With Patient End Users and Clinicians: Qualitative Interview Study Among Patients and Clinicians.","authors":"Maria Elena Hernandez Hernandez, Erin Michalak, Nusrat Choudhury, Mark Hewko, Ivan Torres, Mahesh Menon, Raymond W Lam, Trisha Chakrabarty","doi":"10.2196/43904","DOIUrl":"10.2196/43904","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is the leading cause of global disability; however, the existing treatments do not always address cognitive dysfunction-a core feature of MDD. Immersive virtual reality (VR) has emerged as a promising modality to enhance the real-world effectiveness of cognitive remediation.</p><p><strong>Objective: </strong>This study aimed to develop the first prototype VR cognitive remediation program for MDD (\"bWell-D\"). This study gathered qualitative data from end users early in the design process to enhance its efficacy and feasibility in clinical settings.</p><p><strong>Methods: </strong>Semistructured end-user interviews were conducted remotely (n=15 patients and n=12 clinicians), assessing the participants' perceptions and goals for a VR cognitive remediation program. Video samples of bWell-D were also shared to obtain feedback regarding the program. The interviews were transcribed, coded, and analyzed via thematic analysis.</p><p><strong>Results: </strong>End users showed an optimistic outlook toward VR as a treatment modality, and perceived it as a novel approach with the potential of having multiple applications. The participants expressed a need for an engaging VR treatment that included realistic and multisensorial settings and activities, as well as customizable features. Some skepticism regarding its effectiveness was also reported, especially when the real-world applications of the practiced skills were not made explicit, as well as some concerns regarding equipment accessibility. A home-based or hybrid (ie, home and clinic) treatment modality was preferred.</p><p><strong>Conclusions: </strong>Patients and clinicians considered bWell-D interesting, acceptable, and potentially feasible, and provided suggestions to enhance its real-world applicability. The inclusion of end-user feedback is encouraged when developing future VR programs for clinical purposes.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10131700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9270375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented reality serious game design for promoting children's science education cognition: a randomized controlled trial (Preprint)","authors":"Bo Liu, Xinyue Wan, Xiaofang Li, Dian Zhu, Zhao Liu","doi":"10.2196/47807","DOIUrl":"https://doi.org/10.2196/47807","url":null,"abstract":"","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135771642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children and Young People's Involvement in Designing Applied Games: Scoping Review.","authors":"Michael John Saiger,&nbsp;Sebastian Deterding,&nbsp;Lina Gega","doi":"10.2196/42680","DOIUrl":"https://doi.org/10.2196/42680","url":null,"abstract":"<p><strong>Background: </strong>User involvement is widely accepted as key for designing effective applied games for health. This especially holds true for children and young people as target audiences, whose abilities, needs, and preferences can diverge substantially from those of adult designers and players. Nevertheless, there is little shared knowledge about how concretely children and young people have been involved in the design of applied games, let alone consensus guidance on how to do so effectively.</p><p><strong>Objective: </strong>The aim of this scoping review was to describe which user involvement methods have been used in the design of applied games with children and young people, how these methods were implemented, and in what roles children and young people were involved as well as what factors affected their involvement.</p><p><strong>Methods: </strong>We conducted a systematic literature search and selection across the ACM Digital Library, IEEE Xplore, Scopus, and Web of Science databases using State of the Art through Systematic Review software for screening, selection, and data extraction. We then conducted a qualitative content analysis on the extracted data using NVivo.</p><p><strong>Results: </strong>We retrieved 1085 records, of which 47 (4.33%) met the eligibility criteria. The chief involvement methods were participatory design (20/47, 43%) and co-design (16/47, 37%), spanning a wide range of 45 concrete activities with paper prototyping, group discussions, and playtesting being the most frequent. In only half of the studies (24/47, 51%), children and young people participated as true design partners. Our qualitative content analysis suggested 5 factors that affect their successful involvement: comprehension, cohesion, confidence, accessibility, and time constraints.</p><p><strong>Conclusions: </strong>Co-design, participatory design, and similar high-level labels that are currently used in the field gloss over very uneven degrees of participation in design and a wide variety of implementations that greatly affect actual user involvement. This field would benefit from more careful consideration and documentation of the reason of user involvement. Future research should explore concrete activities and configurations that can address the common challenges of involving children and young people, such as comprehension, cohesion, confidence, and accessibility.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10131627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9355605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Gamified Real-time Video Observed Therapies (GRVOTS) Mobile App via the Modified Nominal Group Technique: Development and Validation Study.","authors":"Siti Aishah Abas,&nbsp;Nurhuda Ismail,&nbsp;Yuslina Zakaria,&nbsp;Ismassabah Ismail,&nbsp;Nurul Hidayah Mat Zain,&nbsp;Siti Munira Yasin,&nbsp;Khalid Ibrahim,&nbsp;Asmah Razali,&nbsp;Mas Ahmad Sherzkawee Mohd Yusoff,&nbsp;Norliza Ahmad,&nbsp;Thilaka Chinnayah","doi":"10.2196/43047","DOIUrl":"https://doi.org/10.2196/43047","url":null,"abstract":"<p><strong>Background: </strong>The success rate of tuberculosis (TB) treatment in Malaysia remains below the recommended World Health Organization target of 90% despite the implementation of directly observed therapy, short-course, a physical drug monitoring system, since 1994. With increasing numbers of patients with TB in Malaysia defaulting on treatment, exploring another method to improve TB treatment adherence is vital. The use of gamification and real-time elements via video-observed therapies in mobile apps is one such method expected to induce motivation toward TB treatment adherence.</p><p><strong>Objective: </strong>This study aimed to document the process of designing, developing, and validating the gamification, motivation, and real-time elements in the Gamified Real-time Video Observed Therapies (GRVOTS) mobile app.</p><p><strong>Methods: </strong>The modified nominal group technique via a panel of 11 experts was used to validate the presence of the gamification and motivation elements inside the app, which were assessed based on the percentage of agreement among the experts.</p><p><strong>Results: </strong>The GRVOTS mobile app, which can be used by patients, supervisors, and administrators, was successfully developed. For validation purposes, the gamification and motivation features of the app were validated as they achieved a total mean percentage of agreement of 97.95% (SD 2.51%), which was significantly higher than the minimum agreement score of 70% (P<.001). Further, each component of gamification, motivation, and technology was also rated at 70% or more. Among the gamification elements, fun received the lowest scores, possibly because the nature of serious games does not prioritize the fun element and because the perception of fun varies by personality. The least popular element in motivation was relatedness, as stigma and discrimination hinder interaction features, such as leaderboards and chats, in the mobile app.</p><p><strong>Conclusions: </strong>It has been validated that the GRVOTS mobile app contains gamification and motivation elements, which are intended to encourage medication adherence to TB treatment.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9517570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}