Mapping Behavioral Health Serious Game Interventions for Adults With Chronic Illness: Scoping Review

Abstract

Background Serious games for health are increasingly being used to address health outcomes in patients with chronic illnesses. These studies vary in their study designs, patient populations, frameworks, outcome variables, and degree of specificity of the serious game intervention. Objective This scoping review aims to clarify the conceptual features of the existing research related to serious games designed to improve cognitive and behavioral outcomes in adults with chronic illness. Methods We applied the Preferred Reporting Items of Systematic Reviews and Meta-Analysis for scoping reviews methodology, including an a priori research question. We searched 4 electronic databases to identify articles published through November 2019. Inclusion criteria encompassed (1) adults 18 years or older; (2) patients with a diagnosis of chronic illness; (3) a serious game intervention; and (4) defined patient outcomes that assess patients’ behavioral, cognitive, or health outcomes. Results Of the 3305 articles identified, 38 were included in the review. We charted and analyzed the theoretical frameworks, key concepts, and outcome variables of these studies with summaries of features across articles. The majority of studies used a randomized controlled trial design (23/38, 61%), included a custom serious game intervention (22/38, 58%), and lacked a theoretical framework (25/38, 66%). Common outcome variables included quality of life (16/38, 42%), mood (15/38, 39%), cognitive function (13/38, 34%), symptoms (12/38, 32%), and physical activity (9/38, 24%). Key differences between studies included whether or not serious games aimed to train versus teach patients, be widely accessible versus tailored interventions, or replace versus complement current treatments. Conclusions This scoping review defines the current landscape of research in serious games for health research targeting behavioral and cognitive outcomes in adults with chronic disease. Studies have addressed a variety of patient populations and diverse patient outcomes. Researchers wanting to build on the current research should integrate theoretical frameworks into the design of the intervention and trial to more clearly articulate the active ingredients and mechanisms of serious games.

Who Engages and Why It Matters?

“…The necessary level of users' engagement to achieve serious games' learning and behavioral objectives remain empirical questions (Hookham & Nesbitt, 2019;Thomas et al, 2020b). Game engagement can be operationalized by the length of time a user spends on the game (time) (Gorini et al, 2015), the frequency of repeating various game features (depth) (Sharifzadeh et al, 2020), or the completion rates of all game features (breadth) (Simmich et al, 2021).…”

Game Changer: Is Palliative Care Ready for Games?

“…The scientific landscape is moving toward more intensive designs in which game reporting becomes uniform and transparent, 31 and evaluations are focused on efficacy and mechanism testing. 32 Researchers interested in serious game interventions should use frameworks specific to technology-based interventions (eg, the Behavioral Intervention Technology Model) or serious games. 33,34 Frameworks like these can not only help to structure evidence-based game development but also help to identify the active ingredients within a game.…”

A Software Engineering Framework for Reusable Design of Personalized Serious Games for Health: Development Study

“…For example, serious games are used for the treatment of mental health disorders, such as anxiety disorders or depression [5,[8][9][10], physical [11][12][13][14] or cognitive rehabilitation [15][16][17], or the education of health professionals and patients [18][19][20][21][22]. Multiple reviews exist on this emerging field that state that serious games can be an effective tool for health, but the research remains in its infancy, limited by design and evaluation challenges [5,10,20,21,[23][24][25].…”