Accepted for/Published in: JMIR Serious Games
Date Submitted: Oct 11, 2025
Open Peer Review Period: Oct 11, 2025 - Dec 6, 2025
Date Accepted: Mar 11, 2026
(closed for review but you can still tweet)
Gamified Feedback-Based Training System for Pediatric Asthma Inhaler Use: Mixed Methods Randomized Crossover Study
ABSTRACT
Background:
Asthma is one of the most common chronic respiratory diseases among children worldwide. Inhalation therapy is the primary treatment, but children often make operational errors and demonstrate poor adherence, which compromises therapeutic outcomes.
Objective:
This study aimed to develop and evaluate BreatheBuddy, a pediatric asthma inhaler training system incorporating gamified feedback to improve inhalation skills and treatment adherence.
Methods:
The system consists of a physical interaction layer and a visual interaction layer. The physical layer integrates an inhaler and a breath sensor to collect inspiratory and expiratory behaviors in real time and transmit the data for analysis. The visual layer provides real-time animations and gamified feedback to guide standardized breathing training, assisting children in adjusting inhalation rhythm and depth. The design followed the Mechanics–Dynamics–Aesthetics (MDA) gamification framework combined with human–computer interaction principles.
Results:
Experimental findings indicated that BreatheBuddy significantly improved the accuracy of children’s inhalation behaviors, enhanced their treatment engagement, and reduced therapy-related anxiety. Consequently, the system increased both medication accuracy and adherence.
Conclusions:
As an assistive training tool, BreatheBuddy offers an innovative solution for pediatric asthma management and establishes a foundation for future clinical applications.
Citation
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Copyright
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