Effective Intervention or Child's Play? A Review of Video Games for Diabetes Education

Health Administration, School of Allied Health Professions, Virginia Commonwealth University, Richmond, Virginia 23298-0203, USA.
Diabetes Technology & Therapeutics (Impact Factor: 2.11). 10/2010; 12(10):815-22. DOI: 10.1089/dia.2010.0030
Source: PubMed


The purpose of this study is (1) to identify diabetes education video games and pilot studies in the literature, (2) to review themes in diabetes video game design and evaluation, and (3) to evaluate the potential role of educational video games in diabetes self-management education.
Studies were systematically identified for inclusion from Medline, Web of Science, CINAHL, EMBASE, Psychinfo, IEEE Xplore, and ACM Digital Library. Features of each video game intervention were reviewed and coded based on an existing taxonomy of diabetes interventions framework.
Nine studies featuring 11 video games for diabetes care were identified. Video games for diabetes have typically targeted children with type 1 diabetes mellitus and used situation problem-solving methods to teach diet, exercise, self-monitored blood glucose, and medication adherence. Evaluations have shown positive outcomes in knowledge, disease management adherence, and clinical outcomes.
Video games for diabetes education show potential as effective educational interventions. Yet we found that improvements are needed in expanding the target audience, tailoring the intervention, and using theoretical frameworks. In the future, the reach and effectiveness of educational video games for diabetes education could be improved by expanding the target audience beyond juvenile type 1 diabetes mellitus, the use of tailoring, and increased use of theoretical frameworks.

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    • "An exception was the review of Baranowski et al. which included games for healthy diet, physical activity and illness self-management (Baranowski et al., 2008). All reviews noted large differences between studies, and concluded that reasons for these differences are as yet unclear (Baranowski et al., 2008; DeShazo et al., 2010; Gamberini et al., 2008; Guse et al., 2012; Guy et al., 2011; Kato, 2010; Kharrazi et al., 2012; Lu et al., 2012; Papastergiou, 2009; Primack et al., 2012; Rahmani and Boren, 2012; Wilkinson et al., 2008). As yet, no meta-analysis of serious games for healthy lifestyle promotion has been reported. "
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    ABSTRACT: Background. Serious digital games can be effective at changing healthy lifestyles, but large differences in their effectiveness exist. The extent of user-involvement in game design may contribute to game effectiveness by creating a better fit with user preferences. Participatory design (PD), which represents active user involvement as informant (users are asked for input and feedback) or co-designer (users as equal partners in the design) early on and throughout the game development, may be associated with higher game effectiveness, as opposed to no user involvement or limited user involvement. Objective. This paper reports the results of a meta-analysis examining the moderating role of PD in the effectiveness of serious digital games for healthy lifestyle promotion Methods. Four databases were searched for peer-reviewed papers, in English, published or in press before October 2014, and using a (group-) randomized controlled trial design. Effectiveness data were derived from another meta-analysis assessing the role of behavior change techniques and game features in serious game effectiveness. Results. Fifty-eight games evaluated in 61 studies were included. As previously reported, serious digital games had positive effects on healthy lifestyles and their determinants. Unexpectedly, PD (g=0.075; 95% CI 0.017; 0.133) throughout game development was related to lower game effectiveness on behavior (Q=6.74, P<.05) than when users were only involved as testers (g=0.520, 95% CI 0.150; 0.890, P<.01). Games developed with PD (g=0.171; 95% CI 0.061; 0.281, P<.01) also related to lower game effectiveness on self-efficacy (Q=7.83, P<.05) than when users were not involved in game design (g=0.384, 95% CI 0.283;0.485, P<.001). Some differences were noted depending on age group, publication year of the study, and on the specific role in PD (informant, co-design), and depending on the game design element. Games developed with PD were more effective in changing behavioral determinants when they included users in design elements on game dynamics (β=0.215, 95% CI 0.075; 0.356, p<.01), and more specifically, as an informant (β=0.235, 95% CI 0.079; 0.329, p<.01). Involving users as informants in PD to create game levels also related to higher game effectiveness (Q=7.02, P<.01). Co-design related to higher effectiveness when used to create the game challenge (Q=11.23, P<.01), but to lower game effectiveness when used to create characters (Q=4.36, P<.05) and the game world (Q=3.99, P<.05). Conclusions. The findings do not support higher effectiveness of games developed with PD. However, significant differences existed among PD games. More support was found for informant roles than for co-design roles. When PD was applied to game dynamics, levels and game challenge, this was associated with higher effectiveness than when it was applied to game aesthetics. Since user involvement may be important influence on reach, adoption and implementation of the intervention, further research and design efforts are needed to enhance effectiveness of serious games developed with PD.
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    • "In their review, DeShazo et al. studied video game interventions for diabetes type 1, including quizzing, skill training and decision-making on PCs, smart phones and consoles. The authors found positive outcomes in knowledge, disease management adherence and clinical outcome [16] "
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    ABSTRACT: Conduct a pilot study on the effect of personalized robot behaviors on the enjoyment of children (8-12) with diabetes and their health knowledge, at the clinic.
    Full-text · Article · Nov 2015
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    • "In their review, DeShazo et al. studied video game interventions for diabetes type 1, including quizzing, skill training and decision-making on PCs, smart phones and consoles. The authors found positive outcomes in knowledge, disease management adherence and clinical outcome [16] "

    Full-text · Dataset · Aug 2015
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