JMIR Publications

ABSTRACT

Background:

Cancer in the United States is a leading cause of mortality. Educating adolescents about cancer risks can improve awareness and introduce healthy lifestyle habits. Public health efforts have made significant progress in easing the burden of cancer through the promotion of early screening and healthy lifestyle advocacy. However, there are limited interventions that educate the adolescent population about cancer prevention. Previous studies have demonstrated the effectiveness of serious games (SGs) to teach adolescents about healthy lifestyle choices, but limited research has examined the utility of using SGs to educate youth specifically on cancer prevention.

Objective:

This study aimed to investigate middle school students’ preferences for the use of SGs for cancer prevention education. The study also characterized the students’ perceptions of desired game design features for a cancer prevention SG.

Methods:

Focus groups were conducted to allow adolescents to review a game playbook and discuss gaming behaviors and preferences for a SG for cancer education. The game playbook was developed based on Cancer, Clear & Simple, a curriculum intended to educate individuals about cancer, prevention, self-care, screening, and detection. In the game, the player learns that they have cancer and is given the opportunity to go back in time to reduce their cancer risk. A focus group discussion guide was developed and consisted of questions about aspects of the playbook and participants’ gaming experience. Adolescents were eligible to participate if they were ages 12 to 14 years, could speak and understand English, and had parents who could read English or Spanish. Each focus group consisted of five to ten adolescents. Focus groups were audio-recorded and professionally transcribed, then content and thematically analyzed by two study team members. Intercoder reliability (kappa coefficient) among the coders was reported as 0.97. Prevalent codes were identified and categorized into themes and subthemes.

Results:

A total of 18 focus groups were conducted with 139 participants from a Wisconsin middle school. Five major themes were identified: educational video games, game content, purpose of game, video gaming experience, and trends in the gaming community. Participants preferred customizable characters and realistic storylines that allowed players to make choices that affect the characters’ outcomes. Middle school students also preferred SGs over other educational methods such as lectures, books, videos, and websites. Participants designed SGs to be available across multiple platforms and suggested the use of SGs for cancer education in their school.

Conclusions:

SGs can be a useful tool to educate adolescents about cancer prevention and risk factors. A cancer education SG should aim to teach adolescents about cancer and cancer prevention while incorporating design preferences of youth in creating the educational intervention. Clinical Trial: Not applicable