JMIR Publications

JMIR Serious Games

A multidisciplinary journal on gaming and gamification for health education/promotion, teaching and social change.

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Journal Description

JMIR Serious Games (JSG, ISSN 2291-9279) is a sister journal of the Journal of Medical Internet Research (JMIR), one of the most cited journals in health informatics (Impact Factor 2016: 5.175). JSG has a projected impact factor (2016) of 3.32. JSG is a multidisciplinary journal devoted to computer/web/mobile applications that incorporate elements of gaming to solve serious problems such as health education/promotion, teaching and education, or social change.
The journal also considers commentary and research in the fields of video games violence and video games addiction.

JMIR Serious Games is indexed in Pubmed, PubMed Central, and also in Thomson Reuters new Emerging Sources Citation Index (ESCI).

 

Recent Articles:

  • Source: The Authors / Placeit.net; Copyright: JMIR Publications; URL: http://games.jmir.org/2017/4/e22/; License: Creative Commons Attribution (CC-BY).

    Breaking Health Insurance Knowledge Barriers Through Games: Pilot Test of Health Care America

    Abstract:

    Background: Having health insurance is associated with a number of beneficial health outcomes. However, previous research suggests that patients tend to avoid health insurance information and often misunderstand or lack knowledge about many health insurance terms. Health insurance knowledge is particularly low among young adults. Objective: The purpose of this study was to design and test an interactive newsgame (newsgames are games that apply journalistic principles in their creation, for example, gathering stories to immerse the player in narratives) about health insurance. This game included entry-level information through scenarios and was designed through the collation of national news stories, local personal accounts, and health insurance company information. Methods: A total of 72 (N=72) participants completed in-person, individual gaming sessions. Participants completed a survey before and after game play. Results: Participants indicated a greater self-reported understanding of how to use health insurance from pre- (mean=3.38, SD=0.98) to postgame play (mean=3.76, SD=0.76); t71=−3.56, P=.001. For all health insurance terms, participants self-reported a greater understanding following game play. Finally, participants provided a greater number of correct definitions for terms after playing the game, (mean=3.91, SD=2.15) than they did before game play (mean=2.59, SD=1.68); t31=−3.61, P=.001. Significant differences from pre- to postgame play differed by health insurance term. Conclusions: A game is a practical solution to a difficult health issue—the game can be played anywhere, including on a mobile device, is interactive and will thus engage an apathetic audience, and is cost-efficient in its execution.

  • A group of students and Pokémon GO players at the project explanation in one of the university recreation fields. Source: Image created by the Authors; Copyright: The Authors; License: Creative Commons Attribution (CC-BY).

    Examining Motivations to Play Pokémon GO and Their Influence on Perceived Outcomes and Physical Activity

    Abstract:

    Background: Pokémon GO is the most played augmented reality game in history. With more than 44 million players at the peak of its popularity, the game has sparked interest on its effects on the young population’s health. Objective: This pilot study examined motivations to start playing Pokémon GO among a sample of US college students, and how motivations were associated with perceived outcomes of the playing experience and physical activity derived while playing. Methods: In November 2016, we asked a sample of 47 US college students (all Pokémon GO players) to complete online surveys and install an ecological momentary assessment (EMA) tool and step counter on their smartphones. The EMA tool prompted a set of questions on playing behavior and physical activity, 3 times per day (12:00 PM, 7:00 PM, and 10:00 PM), for 7 days. We used a factorial analysis to identify 3 distinctive groups of players based on their motivations to start playing Pokémon GO. We tested differences across motivation groups related to 5 unique outcomes using 1-way analysis of variance. Results: We extracted 3 interpretable factors from the clustering of motivations to start playing Pokémon GO: Pokémon and video game fans (n=26, 55% of the sample), physical activity seekers (n=8, 17%), and curious & social (n=13, 28%). The clusters differed significantly on the enjoyment of different aspects of the game, particularly battling, discovering new places, and meeting new people, as well as differences in agreement that playing improved mood and made them more social. Days when playing Pokémon GO were associated with higher number of steps reported at the end of the day, especially among physical activity seekers, but also for Pokémon and video game fans. All groups perceived traffic as a major threat to playing. Conclusions: Days during which Pokémon GO was played were positively associated with a set of beneficial health behaviors, including higher physical activity levels, more socialization, and better mood. Results, however, depended on personal motivations and expectations when joining the game. These results highlight the importance of taking motivation into account when attempting to extract conclusions from the Pokémon GO phenomenon to enhance future exergames’ designs or health interventions.

  • Recipe box. Source: Figure 2 from http://games.jmir.org/2017/4/e20; Copyright: the authors; License: Creative Commons Attribution (CC-BY).

    Mommio’s Recipe Box: Assessment of the Cooking Habits of Mothers of Preschoolers and Their Perceptions of Recipes for a Video Game

    Abstract:

    Background: Vegetables are an important part of a healthy diet because they help prevent several chronic diseases. Mothers of preschoolers reported difficulty getting their young children to eat vegetables, and many did not know how to cook child-pleasing recipes. Objective: The cooking habits of mothers of preschoolers, their perceptions of recipes designed for their children, and the involvement of their children in food preparation were assessed to inform a food parenting video game called Mommio. Methods: A cross-sectional survey design was used. Eligibility criteria included mothers of 3- to 5-year-old children who reported difficulty getting their children to eat vegetables. Participants completed a demographic questionnaire with questions about their food preparation practices. They were asked to select up to 4 of the 10 provided recipes they wanted to try and to prepare and report back on their experiences. Results: Most (46) of the 50 recipes included in Mommio’s in-game recipe box were evaluated at least once and some up to 5 times with a total of 85 evaluations. This well-educated, mostly employed, sample of 27 mothers of preschoolers preferred simple, quick recipes. They ate primarily at home, made dinners from scratch, and indicated that the 46 recipes were generally simple, quick, and easy to prepare. Involvement in preparation enhanced their child’s acceptance of the food. Prior food and preparation preferences influenced the children’s acceptance of the dish at the ensuing meal. Conclusions: The high rate of home recipe preparation indicated that including a recipe selection and preparation component in a food parenting video game could be attractive and may enhance effectiveness. Mothers reported that the recipes provided were generally easy to prepare, tasted good, and the instructions were easy to understand, suggesting they could be helpful to the mothers when playing a vegetable parenting game. Some mothers reported that involving their children in recipe preparation influenced their children’s willingness to eat the vegetables. The highest rated recipes are being included in the game, and mothers will be encouraged to involve their children in recipe preparation.

  • The cycling game. Source: The Authors; Copyright: The Authors; URL: http://games.jmir.org/2017/4/e19/; License: Creative Commons Attribution (CC-BY).

    Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study

    Abstract:

    Background: Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of rehabilitation exercises. Objective: The objective of this study was to evaluate Fietsgame (Dutch for cycling game), which translates existing rehabilitation exercises into fun exercise games. The system connects exercise games with a patient’s personal record and a therapist interface by an Internet of Things server. Thus, both the patient and physiotherapist can monitor the patient’s medical status. Methods: This paper describes a pilot study that evaluates the usability of the Fietsgame. The study was conducted in a rehabilitation center with 9 participants, including 2 physiotherapists and 7 patients. The patients were asked to play 6 exercise games, each lasting about 5 min, under the guidance of a physiotherapist. The mean age of the patients was 74.57 years (standard deviation [SD] 8.28); all the patients were in the recovery process after hip surgery. Surveys were developed to quantitatively measure the usability factors, including presence, enjoyment, pain, exertion, and technology acceptance. Comments on advantages and suggested improvements of our game system provided by the physiotherapists and patients were summarized and their implications were discussed. Results: The results showed that after successfully playing the games, 75% to 100% of the patients experienced high levels of enjoyment in all the games except the squats game. Patients reported the highest level of exertion in squats when compared with other exercise games. Lunges resulted in the highest dropout rate (43%) due to interference with the Kinect v2 from support chairs. All the patients (100%) found the game system useful and easy to use, felt that it would be a useful tool in their further rehabilitation, and expressed that they would like to use the game in the future. The therapists indicated that the exercise games highly meet the criteria of motor rehabilitation, and they intend to continue using the game as part of their rehabilitation treatment of patients. Comments from the patients and physiotherapists suggest that real-time corrective feedback when patients perform the exercises wrongly and a more personalized user interface with options for increasing or decreasing cognitive load are needed. Conclusions: The results suggest that Fietsgame can be used as an alternative tool to traditional motor rehabilitation for patients with hip surgery. Lunges and squats are found to be more beneficial for patients who have relatively better balance skills. A follow-up randomized controlled study will be conducted to test the effectiveness of the Fietsgame to investigate how motivating it is over a longer period of time.

  • REWIRE neglect exergame Gathering Apples. Source: Image created by the authors; Copyright: The authors; URL: http://games.jmir.org/2017/3/e18/; License: Creative Commons Attribution (CC-BY).

    User Perspectives on Exergames Designed to Explore the Hemineglected Space for Stroke Patients With Visuospatial Neglect: Usability Study

    Abstract:

    Background: Visuospatial neglect due to stroke is characterized by the inability to perceive stimuli emerging in the area opposite to the side of brain damage. Besides adopting conventional rehabilitation methods to treat neglect symptoms, the use of virtual reality (VR) is becoming increasingly popular. We designed a series of 9 exergames aimed to improve exploration of the neglected side of space. When new VR interventions are designed, it is important to assess the usability aspects of such management strategies within the target population. To date, most studies used questionnaires to assess user satisfaction with the intervention or product being tested. However, only a combination of both quantitative and qualitative data allows a full picture of user perspective. Objective: The purpose of this study was to quantitatively and qualitatively assess patient and therapist perspectives of a VR intervention based on the series of 9 exergames designed to explore hemineglected space. Specifically, we wanted to evaluate (1) perceived-user friendliness of the exergames, (2) attitude towards using the exergames, and (3) intention to use the exergames in the future. Methods: A total of 19 participants (7 patients, 12 therapists) evaluated the exergames they had used 5 times a week during 3 weeks. The Technology Acceptance Model (TAM) questionnaire was filled out after the intervention. Based on those responses, we conducted focus group interviews (with therapists) and individual interviews (with patients). To analyze the TAM questionnaires, we used descriptive statistics. We adopted content and comparative analysis to analyze the interviews and drew illustration maps to analyze the focus group interviews. Results: The therapists took a more critical stance with a mean TAM questionnaire total score of 48.6 (SD 4.5) compared to the patients who had a mean total score of 56.1 (SD 12.3). The perceived user-friendliness score was 5.6 (SD 1.4) for patients and 4.9 (SD 1.4) for therapists. The attitude towards using the exergames was rated 4.8 (SD 1.9) by patients and 3.6 (SD 1.4) by therapists, respectively. The intention to use the exergames in the future was rated 3.9 (SD 2.1) by patients and 3.7 (SD 1.8) by therapists. We gained information on how to improve the exergames in the interviews. Conclusions: Patients and therapists perceived the exergames as user-friendly; however, using the games further with the actual test version was not perceived as conceivable. The therapists were generally more critical towards future use than the patients. Therefore, involving both users to achieve acceptable and user-friendly versions of game-based rehabilitation for the future is deemed crucial and warranted. Trial Registration: Clinicaltrials.gov NCT02353962; https://clinicaltrials.gov/ct2/show/NCT02353962 (Archived by WebCite at http://www.webcitation.org/6soxIJlAZ)

  • REWIRE neglect exergames training station (game: Sequence Builder). Source: Image created by the authors; Copyright: Bernadette Tobler-Ammann; URL: http://games.jmir.org/2017/3/e17/; License: Creative Commons Attribution (CC-BY).

    Exergames Encouraging Exploration of Hemineglected Space in Stroke Patients With Visuospatial Neglect: A Feasibility Study

    Abstract:

    Background: Use of exergames can complement conventional therapy and increase the amount and intensity of visuospatial neglect (VSN) training. A series of 9 exergames—games based on therapeutic principles—aimed at improving exploration of the neglected space for patients with VSN symptoms poststroke was developed and tested for its feasibility. Objectives: The goal was to determine the feasibility of the exergames with minimal supervision in terms of (1) implementation of the intervention, including adherence, attrition and safety, and (2) limited efficacy testing, aiming to document possible effects on VSN symptoms in a case series of patients early poststroke. Methods: A total of 7 patients attended the 3-week exergames training program on a daily basis. Adherence of the patients was documented in a training diary. For attrition, the number of participants lost during the intervention was registered. Any adverse events related to the exergames intervention were noted to document safety. Changes in cognitive and spatial exploration skills were measured with the Zürich Maxi Mental Status Inventory and the Neglect Test. Additionally, we developed an Eye Tracker Neglect Test (ETNT) using an infrared camera to detect and measure neglect symptoms pre- and postintervention. Results: The median was 14 out of 15 (93%) attended sessions, indicating that the adherence to the exergames training sessions was high. There were no adverse events and no drop-outs during the exergame intervention. The individual cognitive and spatial exploration skills slightly improved postintervention (P=.06 to P=.98) and continued improving at follow-up (P=.04 to P=.92) in 5 out of 7 (71%) patients. Calibration of the ETNT was rather error prone. The ETNT showed a trend for a slight median group improvement from 15 to 16 total located targets (+6%). Conclusions: The high adherence rate and absence of adverse events showed that these exergames were feasible and safe for the participants. The results of the amount of exergames use is promising for future applications and warrants further investigations—for example, in the home setting of patients to augment training frequency and intensity. The preliminary results indicate the potential of these exergames to cause improvements in cognitive and spatial exploration skills over the course of training for stroke patients with VSN symptoms. Thus, these exergames are proposed as a motivating training tool to complement usual care. The ETNT showed to be a promising assessment for quantifying spatial exploration skills. However, further adaptations are needed, especially regarding calibration issues, before its use can be justified in a larger study sample.

  • Rehabilitation Gaming System used at Home. Source: Image created by the authors; Copyright: SPECS; URL: http://specs.upf.edu/; License: Creative Commons Attribution (CC-BY).

    Domiciliary VR-Based Therapy for Functional Recovery and Cortical Reorganization: Randomized Controlled Trial in Participants at the Chronic Stage Post Stroke

    Abstract:

    Background: Most stroke survivors continue to experience motor impairments even after hospital discharge. Virtual reality-based techniques have shown potential for rehabilitative training of these motor impairments. Here we assess the impact of at-home VR-based motor training on functional motor recovery, corticospinal excitability and cortical reorganization. Objective: The aim of this study was to identify the effects of home-based VR-based motor rehabilitation on (1) cortical reorganization, (2) corticospinal tract, and (3) functional recovery after stroke in comparison to home-based occupational therapy. Methods: We conducted a parallel-group, controlled trial to compare the effectiveness of domiciliary VR-based therapy with occupational therapy in inducing motor recovery of the upper extremities. A total of 35 participants with chronic stroke underwent 3 weeks of home-based treatment. A group of subjects was trained using a VR-based system for motor rehabilitation, while the control group followed a conventional therapy. Motor function was evaluated at baseline, after the intervention, and at 12-weeks follow-up. In a subgroup of subjects, we used Navigated Brain Stimulation (NBS) procedures to measure the effect of the interventions on corticospinal excitability and cortical reorganization. Results: Results from the system’s recordings and clinical evaluation showed significantly greater functional recovery for the experimental group when compared with the control group (1.53, SD 2.4 in Chedoke Arm and Hand Activity Inventory). However, functional improvements did not reach clinical significance. After the therapy, physiological measures obtained from a subgroup of subjects revealed an increased corticospinal excitability for distal muscles driven by the pathological hemisphere, that is, abductor pollicis brevis. We also observed a displacement of the centroid of the cortical map for each tested muscle in the damaged hemisphere, which strongly correlated with improvements in clinical scales. Conclusions: These findings suggest that, in chronic stages, remote delivery of customized VR-based motor training promotes functional gains that are accompanied by neuroplastic changes. Trial Registration: International Standard Randomized Controlled Trial Number NCT02699398 (Archived by ClinicalTrials.gov at https://clinicaltrials.gov/ct2/show/NCT02699398?term=NCT02699398&rank=1)

  • Older adult using a serious game on a tablet. Source: The Authors; Copyright: Rakel Berenbaum; URL: http://games.jmir.org/2017/3/e16/; License: Creative Commons Attribution (CC-BY).

    Designing Serious Computer Games for People With Moderate and Advanced Dementia: Interdisciplinary Theory-Driven Pilot Study

    Abstract:

    Background: The field of serious games for people with dementia (PwD) is mostly driven by game-design principals typically applied to games created by and for younger individuals. Little has been done developing serious games to help PwD maintain cognition and to support functionality. Objectives: We aimed to create a theory-based serious game for PwD, with input from a multi-disciplinary team familiar with aging, dementia, and gaming theory, as well as direct input from end users (the iterative process). Targeting enhanced self-efficacy in daily activities, the goal was to generate a game that is acceptable, accessible and engaging for PwD. Methods: The theory-driven game development was based on the following learning theories: learning in context, errorless learning, building on capacities, and acknowledging biological changes—all with the aim to boost self-efficacy. The iterative participatory process was used for game screen development with input of 34 PwD and 14 healthy community dwelling older adults, aged over 65 years. Development of game screens was informed by the bio-psychological aging related disabilities (ie, motor, visual, and perception) as well as remaining neuropsychological capacities (ie, implicit memory) of PwD. At the conclusion of the iterative development process, a prototype game with 39 screens was used for a pilot study with 24 PwD and 14 healthy community dwelling older adults. The game was played twice weekly for 10 weeks. Results: Quantitative analysis showed that the average speed of successful screen completion was significantly longer for PwD compared with healthy older adults. Both PwD and controls showed an equivalent linear increase in the speed for task completion with practice by the third session (P<.02). Most important, the rate of improved processing speed with practice was not statistically different between PwD and controls. This may imply that some form of learning occurred for PwD at a nonsignificantly different rate than for controls. Qualitative results indicate that PwD found the game engaging and fun. Healthy older adults found the game too easy. Increase in self-reported self-efficacy was documented with PwD only. Conclusions: Our study demonstrated that PwD’s speed improved with practice at the same rate as healthy older adults. This implies that when tasks are designed to match PwD’s abilities, learning ensues. In addition, this pilot study of a serious game, designed for PwD, was accessible, acceptable, and enjoyable for end users. Games designed based on learning theories and input of end users and a multi-disciplinary team familiar with dementia and aging may have the potential of maintaining capacity and improving functionality of PwD. A larger longer study is needed to confirm our findings and evaluate the use of these games in assessing cognitive status and functionality.

  • Source: Image created by the authors; Copyright: The authors; URL: http://games.jmir.org/2017/3/e14/; License: Creative Commons Attribution (CC-BY).

    Rehabilitation-Oriented Serious Game Development and Evaluation Guidelines for Musculoskeletal Disorders

    Abstract:

    Background: The progress in information and communication technology (ICT) led to the development of a new rehabilitation technique called “serious game for functional rehabilitation.” Previous works have shown that serious games can be used for general health and specific disease management. However, there is still lack of consensus on development and evaluation guidelines. It is important to note that the game performance depends on the designed scenario. Objective: The objective of this work was to develop specific game scenarios and evaluate them with a panel of musculoskeletal patients to propose game development and evaluation guidelines. Methods: A two-stage workflow was proposed using determinant framework. The development guideline includes the selection of three-dimensional (3D) computer graphics technologies and tools, the modeling of physical aspects, the design of rehabilitation scenarios, and the implementation of the proposed scenarios. The evaluation guideline consists of the definition of evaluation metrics, the execution of the evaluation campaign, the analysis of user results and feedbacks, and the improvement of the designed game. Results: The case study for musculoskeletal disorders on the healthy control and patient groups showed the usefulness of these guidelines and associated games. All participants enjoyed the 2 developed games (football and object manipulation), and found them challenging and amusing. In particular, some healthy subjects increased their score when enhancing the level of difficulty. Furthermore, there were no risks and accidents associated with the execution of these games. Conclusions: It is expected that with the proven effectiveness of the proposed guidelines and associated games, this new rehabilitation game may be translated into clinical routine practice for the benefit of patients with musculoskeletal disorders.

  • Source: Image created by the authors; Copyright: The authors; URL: https://agw-survey.cs.uni-kl.de/AH/TOC_GT_Article.png; License: Creative Commons Attribution (CC-BY).

    Gamification in Stress Management Apps: A Critical App Review

    Abstract:

    Background: In today’s society, stress is more and more often a cause of disease. This makes stress management an important target of behavior change programs. Gamification has been suggested as one way to support health behavior change. However, it remains unclear to which extend available gamification techniques are integrated in stress management apps, and if their occurrence is linked to the use of elements from behavior change theory. Objective: The aim of this study was to investigate the use of gamification techniques in stress management apps and the cooccurrence of these techniques with evidence-based stress management methods and behavior change techniques. Methods: A total of 62 stress management apps from the Google Play Store were reviewed on their inclusion of 17 gamification techniques, 15 stress management methods, and 26 behavior change techniques. For this purpose, an extended taxonomy of gamification techniques was constructed and applied by 2 trained, independent raters. Results: Interrater-reliability was high, with agreement coefficient (AC)=.97. Results show an average of 0.5 gamification techniques for the tested apps and reveal no correlations between the use of gamification techniques and behavior change techniques (r=.17, P=.20), or stress management methods (r=.14, P=.26). Conclusions: This leads to the conclusion that designers of stress management apps do not use gamification techniques to influence the user’s behaviors and reactions. Moreover, app designers do not exploit the potential of combining gamification techniques with behavior change theory.

  • Serious game evaluation test. Source: The authors; Copyright: The authors; URL: http://games.jmir.org/2017/2/e11/; License: Creative Commons Attribution (CC-BY).

    Medical Student Evaluation With a Serious Game Compared to Multiple Choice Questions Assessment

    Abstract:

    Background: The gold standard for evaluating medical students’ knowledge is by multiple choice question (MCQs) tests: an objective and effective means of restituting book-based knowledge. However, concerns have been raised regarding their effectiveness to evaluate global medical skills. Furthermore, MCQs of unequal difficulty can generate frustration and may also lead to a sizable proportion of close results with low score variability. Serious games (SG) have recently been introduced to better evaluate students’ medical skills. Objectives: The study aimed to compare MCQs with SG for medical student evaluation. Methods: We designed a cross-over randomized study including volunteer medical students from two medical schools in Paris (France) from January to September 2016. The students were randomized into two groups and evaluated either by the SG first and then the MCQs, or vice-versa, for a cardiology clinical case. The primary endpoint was score variability evaluated by variance comparison. Secondary endpoints were differences in and correlation between the MCQ and SG results, and student satisfaction. Results: A total of 68 medical students were included. The score variability was significantly higher in the SG group (σ2 =265.4) than the MCQs group (σ2=140.2; P=.009). The mean score was significantly lower for the SG than the MCQs at 66.1 (SD 16.3) and 75.7 (SD 11.8) points out of 100, respectively (P<.001). No correlation was found between the two test results (R2=0.04, P=.58). The self-reported satisfaction was significantly higher for SG (P<.001). Conclusions: Our study suggests that SGs are more effective in terms of score variability than MCQs. In addition, they are associated with a higher student satisfaction rate. SGs could represent a new evaluation modality for medical students.

  • Source: Foter.com; URL: http://foter.com/photo/woman-text-messaging-with-laptop-on-wooden-table/; License: Public Domain (CC0).

    Guidelines for the Gamification of Self-Management of Chronic Illnesses: Multimethod Study

    Abstract:

    Background: Gamification is the use of game elements and techniques in nongaming contexts. The use of gamification in health care is receiving a great deal of attention in both academic research and the industry. However, it can be noticed that many gamification apps in health care do not follow any standardized guidelines. Objective: This research aims to (1) present a set of guidelines based on the validated framework the Wheel of Sukr and (2) assess the guidelines through expert interviews and focus group sessions with developers. Methods: Expert interviews (N=6) were conducted to assess the content of the guidelines and that they reflect the Wheel of Sukr. In addition, the guidelines were assessed by developers (N=15) in 5 focus group sessions, where each group had an average of 3 developers. Results: The guidelines received support from the experts. By the end of the sixth interview, it was determined that a saturation point was reached. Experts agreed that the guidelines accurately reflect the framework the Wheel of Sukr and that developers can potentially use them to create gamified self-management apps for chronic illnesses. Moreover, the guidelines were welcomed by developers who participated in the focus group sessions. They found the guidelines to be clear, useful, and implementable. Also, they were able to suggest many ways of gamifying a nongamified self-management app when they were presented with one. Conclusions: The findings suggest that the guidelines introduced in this research are clear, useful, and ready to be implemented for the creation of self-management apps that use the notion of gamification as described in the Wheel of Sukr framework. The guidelines are now ready to be practically tested. Further practical studies of the effectiveness of each element in the guidelines are to be carried out.

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  • Serious games in the context of people with cognitive disabilities: a case study

    Date Submitted: Oct 27, 2017

    Open Peer Review Period: Oct 28, 2017 - Dec 23, 2017

    Background: While traditional video games provide amusement, with the advent of serious games (SG), it has raised the potential and the results that can be achieved from the games, these artifacts, wh...

    Background: While traditional video games provide amusement, with the advent of serious games (SG), it has raised the potential and the results that can be achieved from the games, these artifacts, whose main differentials are the fact that they are naturally playful and motivators. While in the 1990s, the games aimed only at entertainment, nowadays teaching and learning combine with entertainment and become the main goals to be achieved through the SG. A strong example of SG application is for motivation and help in the formal or special teaching-learning process acting as a pedagogical tool. In this sense, the following question arises: What are the characteristics and interface resources considered adequate to compose the interface of a serious game that have educational objectives directed to people with Williams-Beuren Syndrome? Here's the motivation guide for this article. Objective: Elementary mathematics education for people with Williams Syndrome Methods: An exploratory and descriptive study,using qualitative and quantitative approaches. Results: The results portfolio obtained from the WBS user experience assessment presents the confidence rectangle within the "desirable" quadrant. This is what a project program is, since scientifically this is one of the biggest difficulties reported by unlock authors, it is not possible to teach content and maintain playfulness. Conclusions: The prototype of the game here called SoundMath, was intended to meet a demand for learning elementary arithmetic for people with WBS, from a playful and immersive process. Through the results of the evaluations carried out, this work provides relevant information that can encourage the development of this game, as well as help companies in the educational segment, and contribute to the improvement of the quality of the applications targeted to this type of public. Other important point to be highlighted from this work is with regard to the social aspect that this work encompasses, because it is the development of a solution applied to a daily problem of this public. But we did not just develop; we decided to go beyond and document the entire process of engineering and gamification, based on data obtained throughout this study of design and design of a serious educational game prototype that contained in its layout the ideal characteristics to mediate a teaching-learning process from its use, as well as document and outline a methodological process that may serve as the basis for further studies. Thus, we believe that the results and reflections raised from this study may, in the future, broaden the knowledge about the design of serious games for people with cognitive disabilities. The prototype of the game here called SoundMath, was intended to meet a demand for learning elementary arithmetic for people with WBS, from a playful and immersive process. Through the results of the evaluations carried out, this work provides relevant information that can encourage the development of this game, as well as help companies in the educational segment, and contribute to the improvement of the quality of the applications targeted to this type of public. Other important point to be highlighted from this work is with regard to the social aspect that this work encompasses, because it is the development of a solution applied to a daily problem of this public.

  • Virtual Reality and Well-being: A systematic review of behaviour change and virtual reality systems.

    Date Submitted: Oct 20, 2017

    Open Peer Review Period: Oct 21, 2017 - Dec 16, 2017

    Background: E-health interventions are becoming increasingly used in public health. Computer generated environments viewed through virtual reality (VR) have demonstrated endless possibilities to adap...

    Background: E-health interventions are becoming increasingly used in public health. Computer generated environments viewed through virtual reality (VR) have demonstrated endless possibilities to adapt problematic behaviours that affect well-being. VR is no longer unaffordable for individuals, and with smartphone technology able to track movements and project 3D images, VR is now a mobile tool that can be used at work, home or on the move. Objective: This systematic review aims to explore in what context VR can be an applicable tool for the improvement of well-being, what conditions interventions are aimed it and what forms of VR are commonly being used in research. Methods: A systematic review was carried out that included studies whose interventions were relevant to well-being. Thematic analysis was incorporated to find themes that assist us in answering the objectives set out for this review. Several web-based databases were searched for papers that were published between January 2012 and July 2017. Results: 102 studies were identified, they were concerned with areas of anxiety (n = 76), depression/stress (n = 5), addiction (n = 9), eating disorders/body image (n = 10) and sleep disorders (n = 3). In these papers 22 different virtual reality systems were found, the most common VR HMD (Head-Mounted Display) was the eMagin z800 (n=28). VR exposure therapies that incorporated traditional treatments such as cognitive behaviour therapy (CBT) proved to be effective across conditions, particularly for anxiety and post-traumatic stress disorder (PTSD). Cue exposure therapy (CET) reduced addiction cravings and full body images viewed in VR could revolutionise treatment for anorexia. VR has proven itself to be an applicable platform for behaviour change. Conclusions: With reactions to feared stimuli proving effective in VR, increasingly immersive environments that promote positive stimuli combined with health knowledge could prove to be a valuable tool for public health and well-being. The current state of research highlights the importance of the content within VR programs for improved well-being. Future research should look to incorporate more accessible forms of VR

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