A Computer-Based Interactive Narrative and a Serious Game for Children With Asthma: Development and Content Validity Analysis

Abstract

Background Nonadherence to medications, failure to prevent exposure to asthma triggers, lack of knowledge about using medications, and fixed mindsets contribute to poor asthma control in children. Digital learning could provide a new strategy for improving health-related outcomes in children with asthma. Objective The aim of this study is to develop and design a digital educational program, titled Module of Inhaler and Asthma Triggers for Children (MIRACLE), for Indonesian children with asthma. The program comprises an interactive narrative and a serious game. It was proposed to increase the understanding of asthma self-management, instruct on proper inhaler techniques, improve asthma control, and promote a growth mindset for children with asthma. Methods Two phases of research were conducted to develop the program. In the first phase, a literature search and two rounds of the Delphi technique were conducted to obtain agreement from an expert panel regarding elements of asthma self-management and the design of interactive narratives and a serious game. The expert panel item statements were evaluated using the content validity index (CVI). In the second phase, the SERES framework, Norma Engaging Multimedia Design, and Psychological Theory of Growth Mindset were applied to create a storyline, learn objectives, and game challenges. Results In the first phase, 40 experts were invited to participate in Delphi round 1. Forty responses were collected to generate 38 item statements that consisted of part 1, elements of asthma self-management (25 items), and part 2, design of an interactive narrative and a serious game (13 items); 38 experts were involved in Delphi round 2. In total, 24 statements in part 1 and 13 items in part 2 had item-CVI values >0.80. The average CVI was 0.9, which was considered acceptable. Four narrative plots and five game sessions were developed during the second phase. Challenges with the scenario, scoring, and feedback on asthma difficulties were designed to promote a growth mindset for learners. Conclusions We developed a culture-specific, computer-based asthma program containing an interactive narrative and a serious game to deliver asthma self-management and promote a growth mindset among Indonesian children.

Prototyping Process and Usability Testing of a Serious Game for Brazilian Children With Type 1 Diabetes

“…The development of prototypes (PP and MFP) is a low-cost usability method for testing and evaluating Web designs and other applications before creating a high-fidelity version of a game. There are several studies that discuss video game design and its effectiveness 11–13,32,33 . Considering the development of a game with a focus on healthcare, specifically diabetes education, the prototype evaluation is an important step to be accomplished.…”

“…There are several studies that discuss video game design and its effectiveness. [11][12][13]32,33 Considering the development of a game with a focus on healthcare, specifically diabetes education, the prototype evaluation is an important step to be accomplished. Nevertheless, few studies explore the prototype development and testing of games, 20 in particular video games, to educate children with T1D.…”

Los serious games son más que juegos

“…Pueden enseñarles a controlar sus síntomas y a tomar decisiones informadas sobre su salud. 14 GlucoZor es un juego para pacientes con diabetes desarrollado en Francia. Permite a los niños aprender sobre la diabetes y sobre cómo controlar su nivel de azúcar en sangre.…”

Serious games are more than just games

“…They can teach patients to manage their symptoms and make informed decisions about their health. 14 GlucoZor is a game for diabetes patients developed in France. It allows children to learn about diabetes and how to monitor their blood sugar level.…”