Serious games for improving knowledge and self-management in young people with chronic conditions: a systematic review and meta-analysis

Charlier, Nathalie; Zupancic, Nele; Fieuws, Steffen; Denhaerynck, Kris; Zaman, Bieke; Moons, Philip

doi:10.1093/jamia/ocv100

Cited by 179 publications

(115 citation statements)

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“…Clinical applications of patient empowerment using mHealth technologies were described for cancer, diabetes and other chronic medical indications [146-149]. Disease-specific serious games which incorporate choices and engagement show improved self-management behaviors in patients [150-152]. …”

Section: Incentivized Therapiesmentioning

confidence: 99%

“…(A) Self-care consists of disease self-management (patient behaviors related to management and prevention of disease symptoms), self-efficacy and empowerment (perceived abilities to cope with, control and manage disease symptoms). Digital technologies become effective means to deliver empowerment and disease self-management content [148, 150]. (B) Patients activate the habit-forming mechanism by a self-administration of an incentive.…”

Section: Fig (1)mentioning

confidence: 99%

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Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases

Bułaj

Ahern²,

Kuhn³

et al. 2016

CCP

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Abstract:Merging pharmaceutical and digital (mobile health, mHealth) ingredients to create new therapies for chronic diseases offers unique opportunities for natural products such as omega-3 polyunsaturated fatty acids (n-3 PUFA), curcumin, resveratrol, theanine, or α-lipoic acid. These compounds, when combined with pharmaceutical drugs, show improved efficacy and safety in preclinical and clinical studies of epilepsy, neuropathic pain, osteoarthritis, depression, schizophrenia, diabetes and cancer. Their additional clinical benefits include reducing levels of TNFα and other inflammatory cytokines. We describe how pleiotropic natural products can be developed as bioactive incentives within the network pharmacology together with pharmaceutical drugs and self-care interventions. Since approximately 50% of chronically-ill patients do not take pharmaceutical drugs as prescribed, psychobehavioral incentives may appeal to patients at risk for medication non-adherence. For epilepsy, the incentive-based network therapy comprises anticonvulsant drugs, antiseizure natural products (n-3 PUFA, curcumin or/and resveratrol) coupled with disease-specific behavioral interventions delivered by mobile medical apps. The add-on combination of antiseizure natural products and mHealth supports patient empowerment and intrinsic motivation by having a choice in self-care behaviors. The incentivized therapies offer opportunities: (1) to improve clinical efficacy and safety of existing drugs, (2) to catalyze patient-centered, disease self-management and behavior-changing habits, also improving health-related quality-of-life after reaching remission, and (3) merging copyrighted mHealth software with natural products, thus establishing an intellectual property protection of medical treatments comprising the natural products existing in public domain and currently promoted as dietary supplements. Taken together, clinical research on synergies between existing drugs and pleiotropic natural products, and their integration with self-care, music and mHealth, expands precision/personalized medicine strategies for chronic diseases via pharmacological-behavioral combination therapies.

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Section: Incentivized Therapiesmentioning

confidence: 99%

Section: Fig (1)mentioning

confidence: 99%

Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases

Bułaj

Ahern²,

Kuhn³

et al. 2016

CCP

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“…Moreover, due to the entertainment aspect, adding serious gaming elements can help to overcome motivational barriers [17]. Serious games have proved effective in improving knowledge and self-management skills in young people with chronic conditions [18], for example, as well as in increasing knowledge about drug and alcohol use in adolescents [19]. Serious games can also have beneficial effects on factors that are considered important for a healthy lifestyle in general such as healthy food choices and physical activity [17].…”

Section: Introductionmentioning

confidence: 99%

The effects of a psychological intervention directed at optimizing immune function: study protocol for a randomized controlled trial

Schakel

Veldhuijzen

Middendorp

et al. 2017

Trials

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BackgroundPrevious research has provided evidence for the link between psychological processes and psychophysiological health outcomes. Psychological interventions, such as face-to-face or online cognitive behavioral therapy (CBT) and serious games aimed at improving health, have shown promising results in promoting health outcomes. Few studies so far, however, have examined whether Internet-based CBT combined with serious gaming elements is effective in modulating health outcomes. Moreover, studies often did not incorporate psychophysiological or immunological challenges in order to gain insight into physiological responses to real-life challenges after psychological interventions. The overall aim of this study is to investigate the effects of a psychological intervention on self-reported and physiological health outcomes in response to immune and psychophysiological challenges.Methods/designIn a randomized controlled trial, 60 healthy men are randomly assigned to either an experimental condition, receiving guided Internet-based (e-health) CBT combined with health-related serious gaming elements for 6 weeks, or a control condition receiving no intervention. After the psychological intervention, self-reported vitality is measured, and participants are given an immunological challenge in the form of a Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccination. One day after the vaccination, participants are asked to perform several psychophysiological tasks in order to explore the effects of the psychological intervention on participants’ stress response following the immune challenge. To assess the delayed effects of vaccination on self-reported and physiological health outcomes, a follow-up visit is planned 4 weeks later. Total study duration is approximately 14 weeks. The primary outcome measure is self-reported vitality measured directly after the intervention. Secondary outcome measures include inflammatory and endocrine markers, as well as psychophysiological measures of heart rate and skin conductance in response to the psychophysiological tasks after the BCG vaccination.DiscussionThe innovative design features of this study – e.g., combining guided e-health CBT with health-related serious gaming elements and incorporating immunological and psychophysiological challenges – will provide valuable information on the effects of a psychological intervention on both self-reported and physiological health outcomes. This study will offer further insights into the mechanisms underlying the link between psychological factors and health outcomes and is anticipated to contribute to the optimization of health care strategies.Trial registrationNederlands Trial Register, NTR5610. Registered on 4 January 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1983-7) contains supplementary material, which is available to authorized users.

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“…[11][12][13] Systematic reviews have found videogames to be helpful for education and positive reinforcement, resulting in participants' increased knowledge 14 and improved self-management. 15 To our knowledge, although digital game playing has been associated with significant positive effects on physical health outcomes of older adults, 16 no serious digital game has yet been developed to improve HF self-management-related knowledge and behaviors specifically with older adults as the target audience. In this article, we present a Heart Health game prototype-an application for mobile tablets-and we assess the game's usability and evaluate its functionality for improving HF self-management knowledge and behaviors among community-dwelling older adults with HF.…”

mentioning

confidence: 99%

“…Played the game without assistance, n (%) 15 F8, F11) ''HF serious subject.not a game'' (U1) ''Graphics . presented in a fun way'' (F6) ''Would want info from qualified medical persons'' (U7, F6) Reminders Repetitiveness ''Reminders are helpful as you get older and forgetful'' (U6) ''Enjoyed it, been helpful in reminding me.''…”

mentioning

confidence: 99%

Interactive Digital e-Health Game for Heart Failure Self-Management: A Feasibility Study

Radhakrishnan

Toprac

O'Hair

et al. 2016

Games for Health Journal

103

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Objective: To develop and test the prototype of a serious digital game for improving community-dwelling older adults' heart failure (HF) knowledge and self-management behaviors. The serious game innovatively incorporates evidence-based HF guidelines with contemporary game technology. Materials and Methods: The study included three phases: development of the game prototype, its usability assessment, and evaluation of the game's functionality. Usability testing included researchers' usability assessment, followed by research personnel's observations of participants playing the game, and participants' completion of a usability survey. Next, in a pretest-post-test design, validated instruments-the Atlanta Heart Failure Knowledge Test and the Self Care for Heart Failure Index-were used to measure improvement in HF self-management knowledge and behaviors related to HF self-maintenance, self-management, and self-efficacy, respectively. A postgame survey assessed participants' perceptions of the game. Results: During usability testing, with seven participants, 100%, 100%, and 86% found the game easy to play, enjoyable, and helpful for learning about HF, respectively. In the subsequent functionality testing, with 19 participants, 89% found the game interesting, enjoyable, and easy to play. Playing the game resulted in a significant improvement in HF self-management knowledge, a nonsignificant improvement in self-reported behaviors related to HF self-maintenance, and no difference in HF self-efficacy scores. Participants with lower education level and age preferred games to any other medium for receiving information. Conclusion: It is feasible to develop a serious digital game that community-dwelling older adults with HF find both satisfying and acceptable and that can improve their self-management knowledge.

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Serious games for improving knowledge and self-management in young people with chronic conditions: a systematic review and meta-analysis

Abstract: The authors' meta-analysis shows that educational video games can be effective in improving knowledge and self-management in young people with chronic conditions.

Cited by 179 publications

References 40 publications

Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases

Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases

The effects of a psychological intervention directed at optimizing immune function: study protocol for a randomized controlled trial

Interactive Digital e-Health Game for Heart Failure Self-Management: A Feasibility Study

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