JMIR Serious Games最新文献

Background: Eswatini has one of the highest HIV prevalence rates worldwide (24.8% among people aged ≥15 years), with unprotected heterosexual transmission accounting for more than 90% of new HIV infections in the country. Low HIV risk perception is known to influence risk behavior. Mobile phone technology is growing rapidly, offering opportunities for technology-driven interventions to improve HIV risk perception and prevention.

Objective: We aimed to design and test a serious game to increase HIV risk perception and intention to engage in protective HIV behaviors among young people in Eswatini.

Methods: Our team developed SwaziYolo, a smartphone-based, interactive, educational story game that places the player in the role of a young adult looking for love in Eswatini's capital city. We conducted the Serious Games HIV Prevention Trial (SGPrev-Trial), a 4-week, 2-arm, unblinded, 1:1 randomized controlled trial of SwaziYolo among people aged between 18 and 29 years in Eswatini. The primary outcome was HIV risk perception using a 10-item and subset 8-item Perceived Risk of HIV Infection Scale (PRHS). We used modified intention-to-treat and per-protocol difference-in-difference (DID) estimation to compare the change between groups in the mean PHRS scores before and after intervention.

Results: Of the 380 participants in the study, 122 (64.2%) in the control group and 119 (62.6%) in the intervention group completed the follow-up, and 95 (79.8%) played the game. In the modified intention-to-treat analyses, no significant differences between groups were observed for the 8-item PRHS (DID: mean 1.1, SD 0.72; P=.13) and the 10-item PRHS (DID: mean 1.3, SD 0.80; P=.12) scores. In the per-protocol analyses, HIV risk perception increased significantly among participants who played the game (8-item DID: mean 1.6, SD 0.74; P=.04 and 10-item DID: mean 1.8, SD 0.83; P=.03). Nearly all (94/95, 98.9%) participants strongly agreed or agreed that they would recommend SwaziYolo to their peers.

Conclusions: SwaziYolo was acceptable and increased HIV risk perception among young people in Eswatini who self-selected to play the game. More research is needed to improve and evaluate the SwaziYolo intervention.

Trial registration: UMIN Clinical Trial Registry UMIN000021781; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000025103.

Background: Informal caregivers play a crucial role in home care and many lack formal training, potentially compromising patient safety. Immersive virtual reality (VR) offers an innovative approach to training by simulating real-life caregiving scenarios in a risk-free environment. Prior to implementation, the environments and the technique's feasibility and acceptability must be assessed by the professionals who will use it to train caregivers, establishing a performance benchmark based on experienced health care professionals.

Objective: This study aims to test feasibility and develop exploratory benchmarks and acceptability of immersive VR training for home caregiving tasks, using experienced professionals to establish a reference standard for execution quality.

Methods: This observational study was conducted in health care centers in Andalusia, the Valencian Community, and Madrid (Spain). A structured process was followed, including the identification of key home care tasks, the development of best practice guidelines, creation of immersive VR training materials, and the design of a performance evaluation rubric. Health care professionals (n=75) were recruited using a convenience sampling approach. They performed caregiving tasks in VR, and their performance was recorded and assessed using a standardized rubric, which included 205 predefined errors. Participants also completed a posttraining survey evaluating usability, comprehension, and perceived applicability to real-world caregiving.

Results: A total of 75 professionals participated, completing 257 caregiving simulations in a fully immersive VR environment. A total of 417 errors were identified (417/3142, 13.3% of the maximum number of predefined errors), with a mean average of 5.6 (SD 6.8) errors per participant. The most frequent errors occurred in medication management, insulin administration, diaper changing, broncho aspiration prevention, blood pressure monitoring, and hand hygiene. The perceived usefulness of VR training was rated 8.1 out of 10 points (SD 1.9), with 98.7% (74/75) of the participants stating that the time spent in the simulation was worthwhile and 85.3% (64/75) agreeing that the tasks were appropriately represented.

Conclusions: Immersive VR training for informal caregivers is a feasible and well-accepted approach, demonstrating high perceived usefulness among health care professionals. The study establishes a preliminary benchmark for home caregiving task execution, providing a basis for future research evaluating informal caregivers' performance and targeted training interventions to enhance patient safety. Further studies are needed to explore the long-term impact of VR training on caregiver competence and home care quality.

Background: Internet gaming disorder (IGD) is prevalent globally and linked to significant negative outcomes. Impoverished rural adolescents face unique risks due to limited supervision and unequal digital resources, with limited longitudinal research conducted in this population. Existing studies show sex differences in IGD prevalence, but their manifestations and mechanisms in rural populations remain unclear.

Objective: This is the first large-sample cross-sectional and prospective cohort study targeting impoverished adolescents in rural areas. It aimed to determine the prevalence of IGD among impoverished rural adolescents, identify sex-specific risk and protective factors, and evaluate the longitudinal predictors of IGD.

Methods: In this study, self-administered questionnaires were used to collect demographic characteristics, affective states, impulsivity, gaming time, and scores for IGD. First, the prevalence of IGD at baseline and follow-up, along with sex differences, was calculated. Correlation analysis was conducted to explore variables associated with IGD. Subsequently, multivariate logistic regression analysis was conducted to identify baseline and follow-up predictors of IGD.

Results: The cross-sectional analysis at baseline included 13,931 valid responses (IGD prevalence: n=725, 5.2%; males: 489/7304, 6.7%; females: 236/6627, 3.6%). A 1-year longitudinal follow-up showed IGD prevalence of 5% (692/13,931; males: 511/7304, 7.0%; females: 181/6627, 2.7%; after multiple imputations). Common baseline factors were gaming time (females: odds ratio [OR] 1.11, 95% CI 1.08-1.14, P<.001; males: OR 1.11, 95% CI 1.09-1.13, P<.001), self-esteem scores (females: OR 0.95, 95% CI 0.92-0.98, P=.002; males: OR 0.95, 95% CI 0.92-0.97, P<.001), depression scores (females: OR 1.14, 95% CI 1.11-1.16, P<.001; males: OR 1.11, 95% CI 1.09-1.13, P<.001), and impulsive behavior (females: OR 1.16, 95% CI 1.10-1.22, P<.001; males: OR 1.10, 95% CI 1.06-1.14, P<.001). Companionship (OR 0.71, 95% CI 0.52-0.97; P=.03) was a protective factor for females, while age (OR 1.08, 95% CI 1.02-1.15; P=.02) and poor self-regulation (OR 1.07, 95% CI 1.03-1.11; P=.001) posed extra risk for males at baseline. Longitudinal predictors were baseline gaming time (females: OR 1.06, 95% CI 1.03-1.09, P<.001; males: OR 1.02, 95% CI 1.00-1.05, P=.03) and impulsive behavior (females: OR 1.38, 95% CI 1.30-1.46, P<.001; males: OR 1.27, 95% CI 1.22-1.31, P<.001). Baseline companionship (OR 0.32, 95% CI 0.23-0.43; P<.001) was a protective factor for females, while baseline poor self-regulation (OR 1.32, 95% CI 1.27-1.37; P<.001) was a predictive factor for males after 1 year.

Conclusions: IGD prevalence was lower in rural than in urban populations and higher in males than in females. Impulsivity, gaming time, and guardian companionship showed sex differences: females relied more o

Background: Individuals with mild intellectual disabilities (ID) often face cognitive and functional challenges, which can lead to low physical activity (PA) and a higher risk of obesity. While virtual reality (VR) exergames show promise for promoting PA in typically developing children, a key barrier for individuals with ID is the lack of a structured teaching methodology. This study argues that a tailored approach is essential to help children with mild ID gain independence in gameplay. By learning specific patterns, they can achieve greater autonomy, which not only facilitates increased PA but also improves motor competence, physical fitness, functional abilities, and overall well-being.

Objective: This study aims to evaluate the effectiveness of the WISH (Warm-up, Imitation, Settings, Half-hour exergame session) and WON (Warm-up, Objective evaluation, No problem!) training protocols in improving participant independence, exergame performance, and overall gameplay experience in VR.

Methods: We used a multisession, single-group research design involving 16 training sessions in this pilot study. The 16 sessions were conducted during scheduled physical education classes at a special school in Poland from October 2023 to May 2024. The intervention comprised two main protocols: the WISH protocol (sessions 1-4), an introductory phase focused on familiarization with VR technology and gameplay mechanics, and the WON protocol (sessions 5-16), designed for gradual reduction of trainer assistance to promote gameplay independence.

Results: The statistical analysis confirmed the effectiveness of both the WISH and WON protocols. A Wilcoxon signed-rank test on the WISH protocol revealed a statistically significant improvement in understanding instructions for the warm-up (r=0.87; P=.009), the projector imitation (r=0.91; P=.007), and participant exergame performance (r=0.90; P=.03). Within the WON protocol, the Wilcoxon test also showed a significant increase in participant exergame performance (r=0.89; P=.008). Further analysis using Spearman rank-order correlation indicated a very strong association between increased independence and better exergame performance (ρ=0.91; P=.002) and overall gameplay experience (ρ=0.63; P<.05).

Conclusions: This pilot study suggests that the structured WISH and WON training protocols may have the potential to enhance functional autonomy, exergame performance, and overall gameplay experience in individuals with mild ID. The observed improvements indicate that such structured pedagogical approaches could be beneficial for this population. These preliminary findings warrant further investigation through larger-scale, controlled studies to confirm efficacy and explore the transferability of these benefits to broader contexts and other VR exergames.

[This corrects the article DOI: 10.2196/50326.].

Background: Population aging underlines the critical need to improve health professional training to adequately care for adults aged >60 years. Developing educational resources to support academics and professionals presents a valuable opportunity to enhance understanding of health conditions and improve clinical management. Serious games are designed to develop teaching, training, and learning skills. Their use in the educational setting is warranted, as they integrate digital aspects and gamification to create a playful experience for content acquisition. Deepening this theme in nursing education will improve assistance to the older adult population, leading to more qualified care based on gerontological practices and comprehensive health care for older adults.

Objective: This study aims to develop and validate a serious game on older adult health for undergraduate nursing students.

Methods: This quantitative and descriptive methodological study, conducted between February 2023 and December 2023 at a public university in the Federal District of Brazil, involved the active participation of 27 undergraduate nursing students in their eighth to tenth semesters. The game, Health Unit in Focus (HUF), was developed and validated with their input. It features 75 clinical cases distributed across 3 themes: pharmacology, metabolic syndrome, and semiology. Of the 40 students initially enrolled, 27 completed the study. The app was validated using the System Usability Scale and student feedback, and the results were reported following the Game-Based Intervention Reporting Guidelines (GAMING).

Results: The participants had a mean age of 22.67 (SD 1.44) years, were mostly female (20/27, 74%), and were in their eighth semester (26/27, 96%). The game received an average System Usability Scale score of 85.75 (median 86.57), classified as excellent, as all evaluated items scored >75. Participants considered the game easy to use; accessible; practical; and rich in well-founded, useful content. This high usability score, coupled with the overwhelmingly positive feedback from the students, instills confidence in the game's effectiveness. Furthermore, 100% (27/27) of students agreed that learning through games is effective and expressed interest in incorporating more interactive games into their training. The serious game HUF showed good usability, as its overall score was "excellent," with its highest score in the odd-numbered items that addressed the positive aspects identified in the analysis.

Conclusions: The serious game HUF is not just a valid and reliable tool for training nursing students but also an engaging and interactive approach to learning. Its ability to captivate and involve students in the learning process is a testament to its potential to revolutionize nursing education. It is essential that the development of new methodological resources