User-Centered Design of Serious Games for Older Adults Following 3 Years of Experience With Exergames for Seniors: A Study Design

Abstract

BackgroundSeniors need sufficient balance and strength to manage in daily life, and sufficient physical activity is required to achieve and maintain these abilities. This can be a challenge, but fun and motivational exergames can be of help. However, most commercial games are not suited for this age group for several reasons. Many usability studies and user-centered design (UCD) protocols have been developed and applied, but to the best of our knowledge none of them are focusing on seniors’ use of games for physical activity. In GameUp, a European cofunded project, some prototype Kinect exergames to enhance the mobility of seniors were developed in a user-centered approach.ObjectiveIn this paper we aim to record lessons learned in 3 years of experience with exergames for seniors, considering both the needs of older adults regarding user-centered development of exergames and participation in UCD. We also provide a UCD protocol for exergames tailored to senior needs.MethodsAn initial UCD protocol was formed based on literature of previous research outcomes. Senior users participated in UCD following the initial protocol. The users formed a steady group that met every second week for 3 years to play exergames and participate in the UCD during the 4 phases of the protocol. Several methods were applied in the 4 different phases of the UCD protocol; the most important methods were structured and semistructured interviews, observations, and group discussions.ResultsA total of 16 seniors with an average age above 80 years participated for 3 years in UCD in order to develop the GameUp exergames. As a result of the lessons learned by applying the different methodologies of the UCD protocol, we propose an adjusted UCD protocol providing explanations on how it should be applied for seniors as users. Questionnaires should be turned into semistructured and structured interviews while user consultation sessions should be repeated with the same theme to ensure that the UCD methods produce a valid outcome. By first following the initial and gradually the adjusted UCD protocol, the project resulted in exergame functionalities and interface features for seniors.ConclusionsThe main lessons learned during 3 years of experience with exergames for seniors applying UCD are that devoting time to seniors is a key element of success so that trust can be gained, communication can be established, and users’ opinions can be recorded. All different game elements should be taken into consideration during the design of exergames for seniors even if they seem obvious. Despite the limitations of this study, one might argue that it provides a best practice guide to the development of serious games for physical activity targeting seniors.

Usability Issues of Clinical and Research Applications of Virtual Reality in Older People: A Systematic Review

“…All of the studies-except one that was principally devoted to the clinical efficacy of the training )were mainly designed for the usability, UX and feasibility of VR systems in aging Castilla et al, 2013;Corno et al, 2014;Epelde et al, 2014;Wüest et al, 2014;Im et al, 2015;Kiselev et al, 2015;Morán et al, 2015;Sáenz-de-Urturi et al, 2015;Shubert et al, 2015;Cook and Winkler, 2016;Brox et al, 2017;Desteghe et al, 2017;Trombetta et al, 2017; FIGURE 4 | Degree of virtual immersion; VR, virtual reality. Sessions lasted from nine to 90 min (mean time = 30 min ca.…”

“…), ranging from one to 36 sessions spread over the course of 1 single day to 4 years; indeed, usability along with effectiveness of training was tested for three , four Rebsamen et al, 2019;van Beek et al, 2019), six , eight , and 12 weeks Desteghe et al, 2017), and three and 4 years . Exergames (i.e., serious games used for balance and fall risk training) were used in most of the motor training Schwenk et al, 2014;Wüest et al, 2014;Kiselev et al, 2015;Sáenz-de-Urturi et al, 2015;Shubert et al, 2015;Brox et al, 2017;Trombetta et al, 2017;Money et al, 2019;Rebsamen et al, 2019;van Beek et al, 2019), physiotherapy exercise in others Im et al, 2015), cognitive-physical dual-task in Pedroli et al (2018), neuropsychological testing in three studies Corno et al, 2014;Plechatá et al, 2019;Valladares-Rodriguez et al, 2019), gesture therapy in Morán et al (2015) and Vanbellingen et al (2017), and psychosocial support/educational in four studies Castilla et al, 2013;Cook and Winkler, 2016;Desteghe et al, 2017).…”

“…An architecture structure model, the user remote console (URC), was used as a theoretical background to design the physical training in Epelde et al (2014), whereas the majority of the studies used psychological models to develop the VR systems. Technology acceptance model (TAM) and modified versions were used in most of the studies Wüest et al, 2014;Morán et al, 2015;Cook and Winkler, 2016 Kiselev et al (2015) and Brox et al (2017). Importantly, some studies adopted technological theoretical frameworks adapted for older people, such as the senior UCD or the senior citizens' acceptance of information systems (SCAIS) Nikitina et al, 2018).…”

“…Concerning quantitative data, system usability scale (SUS) Sáenz-de-Urturi et al, 2015;Shubert et al, 2015;Vanbellingen et al, 2017;Nikitina et al, 2018;Pedroli et al, 2018;Money et al, 2019;Rebsamen et al, 2019;van Beek et al, 2019), TAM-based questionnaires Wüest et al, 2014;Morán et al, 2015;Cook and Winkler, 2016;Rebsamen et al, 2019;Valladares-Rodriguez et al, 2019), UX questionnaires Sáenzde-Urturi et al, 2015;Brox et al, 2017;Desteghe et al, 2017;Rebsamen et al, 2019), UCD-based questionnaire , flow of experience scale , other usability questionnaires Epelde et al, 2014;Trombetta et al, 2017;Plechatá et al, 2019;Valladares-Rodriguez et al, 2019), adherence or motivation to training questionnaires Desteghe et al, 2017;Vanbellingen et al, 2017;Nikitina et al, 2018;Rebsamen et al, 2019;van Beek et al, 2019) or with VR data Kiselev et al, 2015;Desteghe et al, 2017;Vanbellingen et al, 2017;Nikitina et al, 2018;Rebsamen et al, 2019;van Beek et al, 2019), cybersickness assessment Im et al, 2015;Plechatá et al, 2019), technology expertise Rebsamen et al, 2019;Valladares-Rodriguez et al, 2019), and video analysis were used. Regarding qual...…”

“…Another theoretical framework used to approach technology use and acceptance is the user-centered design (UCD). UCD enables technology systems to be made more usable and interactive to end-users, but it can also be applied to assess needs, wants, and limitations of general products (Sebe, 2010;ISO, 2016a;Brox et al, 2017). UCD can be investigated using a variety of qualitative and quantitative methods such as field studies, user requirements analyses, iterative design, usability evaluation, task analyses, focus groups, user interviews, participatory design, and prototypes (Vredenburg et al, 2002).…”