Design of an Interoperable Framework for NCD-prevention Serious Games and Gamified Apps: Framework Design (Preprint)

Abstract

BACKGROUND Unhealthy behaviors can cause so-called non-communicable diseases (NCDs), which are on the rise. Notable examples include chronic respiratory diseases, diabetes, cardiovascular diseases, and cancers. They are responsible for approximately 41 million deaths annually, which accounts for a staggering 74% of all global deaths. Major risk factors include physical inactivity, the use of tobacco, unhealthy diets, the harmful use of alcohol, and also bad mental health, which can be classified as modifiable behavioral risk factors. Other factors include metabolic and environmental risk factors like air pollution. OBJECTIVE Many struggle to make informed decisions about their health, which affects the risk factors mentioned above and, finally, can lead to contracting one or more NCDs. Serious games and gamified applications that strategically use behavior change techniques (BCTs) and educational content can help users change their behavior on a lasting basis to reduce the aforementioned NCD risk factors. Still, currently, each of them is independently designed and can not interact with other applications. This research presents design and standardization considerations to enable the exchange of medical and game data to maximize their impact and usefulness. METHODS The authors have previously developed serious games and gamified applications to prevent non-communicable diseases (NCDs). These served as the foundation of an interoperable framework for NCD-prevention games and apps. Based on a comprehensive analysis, six key areas were identified, ultimately leading to a framework definition that was then evaluated against the already-developed games and apps. RESULTS This paper presents a novel interoperable framework to support the design and development of serious games and gamified applications that enable individuals to achieve sustainable behavior change and improve their overall health and well-being by defining six key areas, emphasizing interoperability, and exchanging meaningful medical and game data. CONCLUSIONS The presented framework covers the major design and implementation aspects of NCD-prevention games and apps in six key areas. Therefore, researchers should consider these guidelines when creating novel serious games and apps in that area. The framework also intensively encourages the use of standards within the domain of medical informatics to assure the semantic interoperability of patients' data produced. Thus, it promotes the exchange of meaningful data to improve patient care and anonymous data usage for research.