@Article{info:doi/10.2196/60755,
author="Bloomfield, Lauren
and Boston, Julie
and Masek, Martin
and Andrew, Lesley
and Barwood, Donna
and Devine, Amanda",
title="Evaluating the Efficacy of a Serious Game to Deliver Health Education About Invasive Meningococcal Disease: Clustered Randomized Controlled Equivalence Trial",
journal="JMIR Serious Games",
year="2025",
month="Feb",
day="11",
volume="13",
pages="e60755",
keywords="serious games; meningococcal disease; immersive digital applications; health promotion; gaming; meningitis; infection; bacteria; contagious; infectious; immersive; education; mHealth; mobile health; applications; youth; adolescents",
abstract="Background: Invasive meningococcal disease (IMD) is a serious, vaccine-preventable infectious disease that can be life-threatening. Teaching adolescents about the early detection and prevention of IMD can be challenging in a school environment, with educators reporting they lack confidence or expertise to cover this in the classroom environment. Professional guest educators are an alternative to cover specialist topics such as IMD; however, time and resourcing constraints can mean that these educators are not always available. Serious games may be an alternative to face-to-face education, where complex health information may be delivered via self-directed gameplay. Objective: This study aims to develop a serious game that can replace a face-to-face educator in a classroom setting to educate adolescents aged 12 years to 15 years. This study evaluates the efficacy of the Meningococcal Immunisation Awareness, Prevention and Protection app (MIApp), a serious game designed to replicate the information provided in a 30-minute face-to-face presentation provided by a trained educator. Methods: This clustered, randomized controlled equivalence trial involved students (Years 7-10) from 6 secondary schools across metropolitan Western Australia who completed pre- and postintervention questionnaires with a follow-up at 3 months postintervention to measure the primary outcome of IMD knowledge acquisition following this self-guided intervention. The findings were compared with changes in an active control (comparison) group who received an in-class educational presentation about IMD transmission and protection. A questionnaire was developed to assess 9 key areas of knowledge. Median scores for knowledge pre- and postintervention were collected from a self-administered assessment of this questionnaire and, at 3 months postintervention, were compared between groups. A knowledge score of +/--2/16 was determined a priori to meet the criteria for equivalence. Participants who used MIApp were also asked a series of questions to assess the enjoyment of and engagement with the game. Results: Of the 788 participating students, the median postintervention correct score in both the MIApp and control cohorts was 14/16 (87.5{\%} correct responses), compared with the median pre-intervention correct score of 6/16 (37.5{\%} correct responses), representing a significant (P<.001) increase in IMD knowledge in both groups. Improvements were retained in both groups 3 months after the initial intervention (median correct score: 11/16 in the intervention group; 12/16 in the control group; P=.86), demonstrating the efficacy of MIApp to deliver health education about IMD transmission and protection, although response rates in the follow-up cohort were low (255/788, 32.4{\%}). Conclusions: MIApp met the predetermined threshold for equivalence, demonstrating similar improvements in knowledge posttrial and at the 3-month follow-up. Participating adolescents considered the MIApp game more enjoyable than a presentation, with equivalent improvements in knowledge. Serious games could represent a constructive tool to help teachers impart specialized health education. ",
issn="2291-9279",
doi="10.2196/60755",
url="https://games.jmir.org/2025/1/e60755",
url="https://doi.org/10.2196/60755",
url="http://www.ncbi.nlm.nih.gov/pubmed/39932769"
}