JMIR Publications

ABSTRACT

Background:

Digital serious games (SGs) have rapidly become a promising strategy of entertainment-based health education; however, developing SGs for children with chronic diseases remains a challenge.

Objective:

This study aimed to provide a scope of understanding of SG development and evaluation, and develop a self-management interactive learning and entertainment framework to promote behavioral change in children with chronic diseases.

Methods:

The study consists of knowledge and analytical bases. Eligible studies that developed SG frameworks and evaluated SG interventions for children with chronic diseases were searched for in PubMed, Embase, Google Scholar, and peer-reviewed journals to build the knowledge base. The Context-Mechanism-Output approach and game taxonomy were used to analyze relevant behavioral theories and essential game elements. The intended SG framework was finalized by assembling appropriate behavioral theories and game elements.

Results:

An analysis of 29 studies showed that the Social Determination Theory was the most commonly used behavioral theory (n=9). Game elements included feedback, visual and audio designs, characters, narratives, rewards, challenges, competitions, goals, levels, rules, and tasks. We proposed three phases of a digital SG framework, including requirements (phase 1), design and development (phase 2), and evaluation (phase 3). Six steps were pointed out, including exploring SG requirements, identifying target users, designing a prototype, building the prototype, evaluating the prototype, and marketing and monitoring the prototype’s use.

Conclusions:

The SG framework can facilitate game designers, clinicians, and educators in designing, developing, and evaluating specifically targeted SG interventions to promote behavioral change in children with chronic diseases.