JMIR Serious Games最新文献

{"title":"Home-Based, Low-Intensity, Gamification-Based, Interactive Physical-Cognitive Training for Older Adults Using the ADDIE Model: Design, Development, and Evaluation of User Experience.","authors":"Teerawat Kamnardsiri, Sirintip Kumfu, Peeraya Munkhetvit, Sirinun Boripuntakul, Somporn Sungkarat","doi":"10.2196/59141","DOIUrl":"10.2196/59141","url":null,"abstract":"<p><strong>Background: </strong>Declines in physical and cognitive function are natural biological processes, leading to an increased risk of falls. Promising evidence suggests that combined physical-cognitive exercise has beneficial effects in improving both physical and cognitive health. Although moderate-to-high exercise intensity is commonly recommended, it might be impractical for older adults facing physical limitations or contraindications. Thus, low-intensity exercise is a viable option. The main barriers to engaging in exercise in older adults include transportation, time, motivation, and enjoyment. To overcome these challenges, a home-based, gamification-based training system may provide an effective approach to enhance exercise adherence.</p><p><strong>Objective: </strong>This study aimed to develop and evaluate the usability of a low-intensity, gamification-based, interactive physical-cognitive exercise for older adults in a home-based setting.</p><p><strong>Methods: </strong>The prototype of a game-based physical-cognitive exercise was created following the ADDIE model (analysis, design, development, implementation, and evaluation) and assessed for user experience in older adults. A total of 15 older adults engaged in the game-based physical-cognitive exercise at home for 60 minutes per day, 3 days per week, for 4 weeks. The usability of the game-based training system was evaluated using the system usability scale (SUS) after completion of a 4-week training program. As for satisfaction, the 8-item Physical Activity Enjoyment Scale (PACES) questionnaire was used to assess participants' enjoyment level after 1 week and 4 weeks of training. Descriptive statistics were used to illustrate the SUS score. A Wilcoxon signed-rank test was used to compare the PACES scores between the first week and the end of the 4-week period, with significance set at P<.05.</p><p><strong>Results: </strong>As for experts' consensus, the game-based training consisted of 3 games: Ocean Diver, Road Runner, and Moving and Memorizing. The games had 3 levels of difficulty: beginner, intermediate, and advanced. A computer vision-based system was selected as the delivery platform for a home setting. The total SUS score for all participants was mean 87.22 (SD 5.76), indicating the user's perception of the usability of a system ranging from good to excellent. At the end of the 4-week training, the total PACES score was significantly greater than the first week, suggesting an improvement in enjoyment (first week: mean 44.93, SD 3.99 vs fourth week: mean 50.53, SD 4.70; P=.001).</p><p><strong>Conclusions: </strong>The prototype of low-intensity, gamification-based, interactive physical-cognitive training was designed and developed using the ADDIE model, which included both experts and end users in the process. The findings showed that the exergame prototype was a usable and practical approach for a home-based setting, enhancing older adults' enjoyment and motivation. Fur","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e59141"},"PeriodicalIF":3.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521917","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":"Empowering Social Growth Through Virtual Reality-Based Intervention for Children With Attention-Deficit/Hyperactivity Disorder: 3-Arm Randomized Controlled Trial.","authors":"Ka Po Wong, Bohan Zhang, Cynthia Yuen Yi Lai, Yao Jie Xie, Yan Li, Chen Li, Jing Qin","doi":"10.2196/58963","DOIUrl":"10.2196/58963","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) usually begins in childhood and is often accompanied by impairments in social functioning. Virtual reality (VR) has emerged as an adjunctive tool to embed in social skills training to enhance the social skills of children with ADHD, but its effectiveness requires further investigation.</p><p><strong>Objective: </strong>This study aims to enhance the social skills of children with ADHD by examining the feasibility and effectiveness of VR-based training in comparison to traditional social skills training.</p><p><strong>Methods: </strong>A 3-arm randomized controlled trial was conducted with 90 children with ADHD aged 6-12 years. Participants were randomly assigned to 3 weeks of 12-session VR-based social skills training, traditional social skills training, or a waitlist control group of equivalent duration. Outcome measures included assessments by a clinical psychologist who was blinded to group assignments, the Social Skills Improvement System Rating Scale, the Behavior Rating Inventory of Executive Function, and the Simulator Sickness Questionnaire, conducted at baseline and after the intervention.</p><p><strong>Results: </strong>The preliminary results support the feasibility and acceptability of VR training for children with ADHD aged 6-12 years. Analysis showed that the VR and traditional social skills training groups experienced a statistically significant improvement in the clinical psychologist assessment of social skills and parent-rated self-control, initiative, and emotional control after the intervention compared with baseline. The VR group performed significantly better than the traditional social skills group on social skills assessed by clinical psychologists (F_2,85=76.77; P<.001) and on parent-rated self-control (F_2,85=18.77; P<.001), initiative (F_2,85=11.93; P<.001), and emotional control (F_2,85=17.27; P<.001). No significant between-group differences were found for parent-rated cooperation and inhibition (all P>.05).</p><p><strong>Conclusions: </strong>The findings provide preliminary evidence supporting the feasibility and superior effectiveness of VR-based social skills training compared to traditional approaches for enhancing social skills and related executive functions in children with ADHD. These results suggest that VR may be a valuable tool to embed within social skills interventions for this population. Further research is warranted to explore the long-term impacts and generalizability of these benefits.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05778526; https://clinicaltrials.gov/study/NCT05778526.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.2196/48208.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e58963"},"PeriodicalIF":3.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521916","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":"Exploring Immersive Multimodal Virtual Reality Training, Affective States, and Ecological Validity in Healthy Firefighters: Quasi-Experimental Study.","authors":"Joana Oliveira, Joana Aires Dias, Rita Correia, Raquel Pinheiro, Vítor Reis, Daniela Sousa, Daniel Agostinho, Marco Simões, Miguel Castelo-Branco","doi":"10.2196/53683","DOIUrl":"10.2196/53683","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Firefighters face stressful life-threatening events requiring fast decision-making. To better prepare for those situations, training is paramount, but errors in real-life training can be harmful. Virtual reality (VR) simulations provide the desired realism while enabling practice in a secure and controlled environment. Firefighters' affective states are also crucial as they are a higher-risk group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the impact on affective states of 2 simulated immersive experiences in a sample of healthy firefighters (before, during, and after the simulation), we pursued a multivariate approach comprising cognitive performance, situational awareness, depression, anxiety, stress, number of previous adverse events experienced, posttraumatic stress disorder (PTSD) severity, and emotions. The efficacy and ecological validity of an innovative VR haptic system were also tested, exploring its impact on performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In collaboration with the Portuguese National Fire Service School, we exposed 22 healthy firefighters to 2 immersive scenarios using the FLAIM Trainer VR system (neutral and arousing scenarios) while recording physiological data in a quasi-experimental study. Baseline cognitive performance, depression, anxiety, stress, number of adverse events, and severity of PTSD symptoms were evaluated. Positive and negative affective states were measured before, between, and after each scenario. Situational awareness, sense of presence, ecological validity, engagement, and negative effects resulting from VR immersion were tested.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline positive affect score was high (mean 32.4, SD 7.2) and increased after the VR tasks (partial η&lt;sup&gt;2&lt;/sup&gt;=0.52; Greenhouse-Geisser F&lt;sub&gt;1.82,32.78&lt;/sub&gt;=19.73; P&lt;.001). Contrarily, mean negative affect score remained low (range 11.0-11.9) throughout the study (partial η&lt;sup&gt;2&lt;/sup&gt;=0.02; Greenhouse-Geisser F&lt;sub&gt;2.13,38.4&lt;/sub&gt;=0.39; P=.69). Participants' feedback on the VR sense of presence was also positive, reporting a high sense of physical space (mean score 3.9, SD 0.8), ecological validity (mean score 3.8, SD 0.6), and engagement (mean score 3.8, SD 0.6). Engagement was related to the number of previously experienced adverse events (r=0.49; P=.02) and positive affect (after the last VR task; r=0.55; P=.02). Conversely, participants reported few negative effects (mean score 1.7, SD 0.6). The negative effects correlated positively with negative affect (after the last VR task; r=0.53; P=.03); and avoidance (r=0.73; P&lt;.001), a PTSD symptom, controlling for relevant baseline variables. Performance related to situational awareness was positive (mean 46.4, SD 34.5), although no relation was found to metacognitively perceived situational awareness (r=-0.12; P=.59).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We show that VR is an effective alternative to in-person training as it was considered ecologically v","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e53683"},"PeriodicalIF":3.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500779","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":"Gamification in the Design of Virtual Patients for Swedish Military Medics to Support Trauma Training: Interaction Analysis and Semistructured Interview Study.","authors":"Natalia Stathakarou, Andrzej A Kononowicz, Erik Mattsson, Klas Karlgren","doi":"10.2196/63390","DOIUrl":"10.2196/63390","url":null,"abstract":"<p><strong>Background: </strong>This study explores gamification in the design of virtual patients (VPs) to enhance the training of Swedish military medics in trauma care. The challenges related to prehospital trauma care faced on the battlefield require tailored educational tools that support military medics' education and training.</p><p><strong>Objective: </strong>The aim of the study is to investigate how to design VPs with game elements for Swedish military medics to support learning in military trauma care. By understanding the reasoning and perceptions of military medics when interacting with VPs, this study aims to provide insights and recommendations for designing VPs with game elements that are specifically tailored to their needs.</p><p><strong>Methods: </strong>The study involved 14 Swedish military medics of the Home Guard-National Security Forces participating in a tactical combat care course. Participants interacted with 3 different VP cases designed to simulate military trauma scenarios. Data were collected through think-aloud sessions and semistructured interviews. The data were analyzed using interaction analysis, structured by the unawareness, problem identification, explanation, and alternative strategies or solutions (uPEA) framework, and reflexive thematic analysis to explore participants' reasoning processes and perceptions and identify possible game elements to inform the VP design.</p><p><strong>Results: </strong>Mapping the military medics' reasoning to the uPEA framework revealed that study participants became more creative after making a mistake followed by feedback and after receiving a prompt to make a new decision. The thematic analysis revealed 6 themes: motivation, \"keep on trying\"; agency in interaction with VPs; realistic tactical experience; confidence, \"I know that the knowledge I have works\"; social influence on motivation; and personalized learning. Participants suggested that game elements such as scoring; badges; virtual goods; progress bars; performance tables; content unlocking; hints; challenge; control; imposed choice; narrative; avatars; sensation; randomness; difficulty adapting; competition; leaderboards; social pressure; progression; and renovation can promote engagement, motivation, and support confidence in decision-making.</p><p><strong>Conclusions: </strong>Gamification in the design of VPs represents a promising approach to military medical training, offering a platform for medics to practice medical and tactical decision-making in a risk-free environment. The insights gained by the study may encourage designing VPs with game elements, as well as including possibly wrong decisions, their consequences, and relevant feedback, that may support military medics' reflections and decision-making.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e63390"},"PeriodicalIF":3.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465964","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":"Game-Based eHealth Interventions for the Reduction of Fatigue in People With Chronic Diseases: Systematic Review and Meta-Analysis.","authors":"Leonie S Warlo, Souraya El Bardai, Andrica de Vries, Marie-Lise van Veelen, Suzan Moors, Edmond Hhm Rings, Jeroen S Legerstee, Bram Dierckx","doi":"10.2196/55034","DOIUrl":"10.2196/55034","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a common and debilitating side effect of chronic diseases, significantly impacting patients' quality of life. While physical exercise and psychological treatments have been shown to reduce fatigue, patients often struggle with adherence to these interventions in clinical practice. Game-based eHealth interventions are believed to address adherence issues by making the intervention more accessible and engaging.</p><p><strong>Objective: </strong>This study aims to compile empirical evidence on game-based eHealth interventions for fatigue in individuals with chronic diseases and to evaluate their effectiveness in alleviating fatigue.</p><p><strong>Methods: </strong>A comprehensive literature search was performed across Embase, MEDLINE ALL, PsycINFO, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar in August 2021. Study characteristics and outcomes from the included studies were extracted, and a random-effects meta-analysis was conducted. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity.</p><p><strong>Results: </strong>Of 1742 studies identified, 17 were included in the meta-analysis. These studies covered 5 different chronic diseases: multiple sclerosis (n=10), cancer (n=3), renal disease (n=2), stroke (n=1), and Parkinson disease (n=1). All but 1 study used exergaming interventions. The meta-analysis revealed a significant moderate effect size in reducing fatigue favoring the experimental interventions (standardized mean difference [SMD] -0.65, 95% CI -1.09 to -0.21, P=.003) compared with control conditions consisting of conventional care and no care. However, heterogeneity was high (I2=85.87%). Subgroup analyses were conducted for the 2 most prevalent diseases. The effect size for the multiple sclerosis subgroup showed a trend in favor of eHealth interventions (SMD -0.47, 95% CI -0.95 to 0.01, P=.05, I2=63.10%), but was not significant for the cancer group (SMD 0.61, 95% CI -0.36 to 1.58, P=.22). Balance exercises appeared particularly effective in reducing fatigue (SMD -1.19, 95% CI -1.95 to -0.42, P=.002).</p><p><strong>Conclusions: </strong>Game-based eHealth interventions appear effective in reducing fatigue in individuals with chronic diseases. Further research is needed to reinforce these findings and explore their impact on specific diseases. Additionally, there is a lack of investigation into interventions beyond exergaming within the field of game-based learning.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e55034"},"PeriodicalIF":3.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465963","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 Virtual Reality Therapy for Patients With Breast Cancer During Chemotherapy: Randomized Controlled Trial.","authors":"Mengdan Li, Zhifu Yu, Hui Li, Li Cao, Huihui Yu, Ning Deng, Yunyong Liu","doi":"10.2196/53825","DOIUrl":"10.2196/53825","url":null,"abstract":"<p><strong>Background: </strong>Patients with breast cancer endure high levels of psychological and physical pain. Virtual reality (VR) may be an acceptable, safe intervention to alleviate the negative emotions and pain of patients with cancer.</p><p><strong>Objective: </strong>We aimed to test the long-term effects of VR on psychological distress and quality of life (QOL) with traditional care in Chinese patients with breast cancer. We also explored the intervention mechanism and the acceptability of VR.</p><p><strong>Methods: </strong>A total of 327 eligible participants were randomly assigned to a VR intervention group or a control group. The Distress Thermometer, QLQ-C30 (Quality of Life Questionnaire version 3.0), and Virtual Reality Symptom Questionnaire were assessed at baseline, postintervention (3 mo), and follow-up (6 mo). Analysis followed the intention-to-treat (ITT) principle. The generalized estimating equations model was used to analyze the longitudinal data, and the PROCESS macro was used to analyze the mediating effect.</p><p><strong>Results: </strong>Compared with the control group, patients with breast cancer in the VR group had lower distress scores (P=.007), and higher health-related QOL scores (physical, role, emotional, cognitive, and social functioning) after 6 months (P<.05). Psychological distress had mediating effects on the longitudinal association between VR and the health-related QOL (indirect effect=4.572-6.672, all P<.05).</p><p><strong>Conclusions: </strong>VR intervention technology may help reduce distress and improve QOL for patients with breast cancer over time. By incorporating a mediating analysis, we showed that the QOL benefits of VR intervention was manifested through positive effects on psychological distress risk factors.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e53825"},"PeriodicalIF":4.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465962","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":"Social Gaming to Decrease Loneliness in Older Adults: Recruitment Challenges and Attrition Analysis in a Digital Mixed Methods Feasibility Study.","authors":"Bas D L Châtel, Jeroen H M Janssen, Geeske M E E Peeters, Rense Corten, Rob Tieben, Menno Deen, Elmy J M Hendriks, Marcel G M Olde Rikkert","doi":"10.2196/52640","DOIUrl":"10.2196/52640","url":null,"abstract":"<p><strong>Background: </strong>Digital mental health interventions could sustainably and scalably prevent and reduce loneliness in older adults. We designed an app containing 29 text-based games and a questionnaire-administering chatbot to stimulate intergenerational contact.</p><p><strong>Objective: </strong>This study aims to evaluate the feasibility of a social gaming app in reducing loneliness among older adults by evaluating recruitment strategies, data collection procedures, and gameplay activity.</p><p><strong>Methods: </strong>This mixed methods study recruited participants via newsletters, articles, and a social media campaign. We used semistructured interviews and descriptive analysis of questionnaire answers and game data to assess feasibility. Key measures included recruitment reach and efficiency, participant demographics, in-app activity, and app usability and engagement feedback.</p><p><strong>Results: </strong>The social media campaign reached 192,641 potential participants, resulting in 1363 game downloads. A total of 155 participants (aged 65 years and older: n=34, 21.9% and aged less than 65 years: n=121, 78.1%) provided informed consent, yielding a conversion rate of 0.08%. The recruitment campaign focusing on distanced playful interaction had a significantly (P<.001) higher click-through rate (1.98%) than a campaign focusing on research participation (click-through rate=0.51%; P<.001). The overall conversion rate from advertisement exposure to research participation was 0.08%. Participants had a mean age of 48 (SD 16) years. The 65 years and older group averaged 70 (SD 5) years, while the less 65 years group averaged 42 (SD 12) years. Additionally, 45.2% (57/126) reported at least moderate levels of loneliness at baseline. Of the initial 554 players, 91 (16.4%) remained active after the first week, and 32 (5.8%) remained active for more than 90 days. Active participants tended to interact with those within their own age group, as indicated by a Pearson correlation of r=0.31 between the ages of the message sender and receiver. Interviews with 12 (48%) participants (aged 65-79 years; female: n=12, 83%) revealed barriers such as excessive chatbot questions and a mismatch between the target group and app design focus. Questionnaire completion rates dropped from 46% at baseline to 10% at follow-up.</p><p><strong>Conclusions: </strong>These findings underscore the challenges of recruitment and retention for older adults in a fully digital social gaming intervention. Effective recruitment strategies and targeted app design are crucial for engagement. Based on these insights, future interventions should focus on simplified interfaces, clear guidance for gameplay, and addressing the specific needs and preferences of older adults, thereby enhancing the effectiveness of digital mental health interventions.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e52640"},"PeriodicalIF":3.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465966","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 Development for Public Health: Participatory Design Approach to COVID-19 Quarantine Policy Education.","authors":"Myunghwan Kwak, Byeong-Je Kim, Ji-Bum Chung","doi":"10.2196/54968","DOIUrl":"10.2196/54968","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Public health education plays a crucial role in effectively addressing infectious diseases such as COVID-19. However, existing educational materials often provide only foundational information, and traditional group education faces challenges due to social distancing policies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Addressing these gaps, our study introduces a serious game called \"Flattening the Curve.\" This interactive experience immerses learners in the role of quarantine policy managers, offering unique insights into the effects and challenges of social distancing policies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The development of the game adhered to the SERES framework, ensuring a scientifically designed foundation. To achieve its learning objectives, the game incorporated learning and game mechanics including an agent-based infection model, a social distancing policy model, and an economic model, which were developed based on previous literature. After defining a broad concept of scientific and design foundations, we used a participatory design process. This study included 16 undergraduates and took place over one semester. Participants played the game, gave feedback, and answered surveys. The game was improved based on participants' feedback throughout the process. Participants' feedback was analyzed based on the Design, Play, and Experience framework. Surveys were conducted before and after the activity and analyzed to assess participants' evaluation of and satisfaction with the game.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The game successfully achieved its learning objectives, encompassing a comprehensive understanding of infectious disease characteristics; the disease transmission process; the necessity and efficacy of quarantine policies and their delicate balance with economic factors; and the concept of flattening the curve. To achieve this, the game includes the following: (1) an agent-based infection model based on the modified Susceptible-Exposed-Infectious-Hospitalized-Recovered (SEIHR) model with five infectious disease scenarios; (2) a quarantine policy model with social distancing, travel control, and intensive care unit management; and (3) an economic model that allows users to consider the impact of quarantine policies on a community's economy. In response to participatory design feedback, the game underwent meticulous modifications, including refining game systems, parameters, design elements, the user interface, and interactions. Key feedback included requests for more scenarios and engaging yet simple game elements, as well as suggestions for improving the scoring system and design features. Notably, concerns about the fairness of the outcome evaluation system (star rating system), which could incentivize prioritizing economic activity over minimizing casualties, were raised and addressed by replacing the star rating system with a progress-based vaccine development system. Quantitative evaluation results refle","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e54968"},"PeriodicalIF":3.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465965","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":"Interactive Serious Game to Teach Basic Life Support Among Schoolchildren in Brazil: Design and Rationale.","authors":"Uri Adrian Prync Flato, Emilio José Beffa Dos Santos, Isabella Bispo Diaz T Martins, Vinicius Gazin Rossignoli, Thais Dias Midega, Lucas Kallas-Silva, Ricardo Ferreira Mendes de Oliveira, Adriana do Socorro Lima Figueiredo Flato, Mario Vicente Guimarães, Hélio Penna Guimarães","doi":"10.2196/55333","DOIUrl":"10.2196/55333","url":null,"abstract":"","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e55333"},"PeriodicalIF":3.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390681","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":"The Role of Relevance in Shaping Perceptions of Sleep Hygiene Games Among University Students: Mixed Methods Study.","authors":"Zilu Liang, Edward Melcer, Kingkarn Khotchasing, Samantha Chen, Daeun Hwang, Nhung Huyen Hoang","doi":"10.2196/64063","DOIUrl":"10.2196/64063","url":null,"abstract":"<p><strong>Background: </strong>Sleep games are an emerging topic in the realm of serious health game research. However, designing features that are both enjoyable and effective at engaging users, particularly university students, to develop healthy sleep habits remains a challenge.</p><p><strong>Objective: </strong>This study aims to investigate user preferences for 3 sleep game prototypes, that is, Hero's Sleep Journey, Sleep Tamagotchi, and Sleepland, and to explore their popularity and perceived utility in promoting sleep health.</p><p><strong>Methods: </strong>A mixed methods approach was used in this study. Quantitative and qualitative data were collected through a co-design workshop involving 47 university students. Participants were presented with storyboard cards of game features and were asked to provide an overall rating on each game, as well as ratings for individual features. They were also encouraged to provide free-form comments on the features and suggest improvements. In addition, participants were asked to express their preferences among the 3 games regarding which game they would most like to play and which one they found most useful for promoting sleep health.</p><p><strong>Results: </strong>Surprisingly, while Hero's Sleep Journey was the most popular choice among participants, Sleep Tamagotchi was perceived as the most beneficial for improving sleep health. Relevance emerged as an overarching theme in the qualitative data analysis, with 3 interconnected dimensions: psychological relevance to users' personal lives, logical relevance to sleep health, and situational relevance to users' circumstantial context. We discussed how the 3 dimensions of relevance address the autonomy and relatedness constructs outlined in the self-determination theory and proposed 3 design recommendations.</p><p><strong>Conclusions: </strong>Our serious sleep game prototypes demonstrated the potential to engage university students to develop healthy sleep hygiene. Future sleep game designs should aim to create a sense of relevance to users' personal lives, sleep health goals, and situational contexts. Rather than a one-size-fits-all approach, it is essential to develop a wide range of game genres and features to cater to diverse users. Aligning game features with sleep health goals and educating users on the design rationale through sleep knowledge are also important aspects. Furthermore, allowing users to customize their game experience and manage technology boundaries is necessary to nurture a sense of control and autonomy in the process of forming good sleep hygiene.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e64063"},"PeriodicalIF":3.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390682","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}