Background Children with cancer who have to undergo radiotherapy can experience fear, because they have no prior knowledge of the treatment. One way of teaching children about the treatment and reducing their fear is to prepare them for it through serious games. Involvement of the end user in the design process within medicine is a way of ensuring that the product being developed will fit the intended user. Objective The aim was to outline the contributions made by children and their parents through participatory action research when designing a serious game about radiotherapy. Methods By means of participatory action research, children and their parents participated in the development of a serious game about radiotherapy. Nine children (7-10 years old) were included, each with an accompanying parent. A qualitative approach was used that included interviews and participant observation. Six rounds of iterative development process were used with the children and their parents. Meetings with the children were held either face-to-face or online. Each round resulted in a list of suggestions for changes to the game. A thematic analysis was performed based on the list of proposed changes, underpinned by all gathered data, to highlight how the children’s participation changed the game. Results Two main themes were identified. The first theme was “The children’s participation was affected by their health and treatment” and included the following subthemes: “an opportunity to share emotions and perceptions of radiotherapy” and “the possibility to participate was affected by the severity of the disease.” The second theme was “participation allowed becoming an active part of game development” and included the following subthemes: “the opportunity to express sentiments about the game,” “the emergence of a playable game through the children’s contributions,” and “the necessity of understanding the text.” Conclusions The method used in this study made the children active participants, and our results suggest that this method can be used by health care researchers to cocreate serious games with children. It is necessary to inform the children involved that the process takes time, and that the process can be altered to allow as much participation as possible without placing a burden on them. The children’s illness affected their possibility to take part; thus, it is crucial to accommodate the children’s needs when conducting similar studies. The parents’ participation facilitated the meetings for their children, even though their involvement in the game design was negligible.

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The objective of this study is to explore the inclusiveness of lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents in junior high school from the perspective of LGBTQ adolescents in Sweden. Semi-structured in-depth interviews were conducted with 10 GBTQ adolescents, aged 16 to 19. The study was approved by the Swedish Ethical Review Authority (Dnr: 2019-03816). A Braun and Clark inspired thematic analysis was performed through a theoretical lens inspired by Berger and Luckmann. The analysis resulted in three themes: (a) a navigator among peers as friends and bullies, (b) adults in school supported inclusion in and exclusion from the group of peers, and (c) non-heterosexuality and non-binary gender understanding as teaching projects in junior high school. In summary the LGBTQ adolescents face multiple challenges related to identity development in hetero- and cisnormative school environments, including adults and peers and their (re)actions. Inclusive and exclusive strategies exercised by the self, adults, and peers affect adolescents’ experiences of their school time. Initiatives to increase awareness and knowledge about the LGBTQ subject in school can lead to enhanced inclusion, but also to an enhanced sense of not belonging. Inclusive initiatives can contribute to enhanced inclusion or its opposite, motivating further research into LGBTQ adolescents’ experiences of junior high school from a relational perspective.