Serious games for improving knowledge and self-management in young people with chronic conditions: a systematic review and meta-analysis

OBJECTIVE To conduct a systematic review and meta-analysis of randomized controlled trials assessing the effectiveness of serious games in improving knowledge and/or self-management behaviors in young people with chronic conditions. MATERIALS AND METHODS The authors searched the databases PubMed, Cochrane Library, Web of Sciences, and PsychINFO for articles published between January 1990 and January 2014. Reference lists were hand-searched to retrieve additional studies. Randomized controlled trials that compared a digital game with either standard education or no specific education in a population of children and/or adolescents with chronic conditions were included. RESULTS The authors identified 9 studies in which the effectiveness of serious games in young people with chronic conditions was evaluated using a randomized controlled trials design. Six studies found a significant improvement of knowledge in the game group from pretest to posttest; 4 studies showed significantly better knowledge in the game group than in the control group after the intervention. Two studies reported significantly better self-management in the game group than in the control group after the intervention. Seven studies were included in the meta-analysis. For knowledge, pooled estimate of Hedges' gu was 0.361 (95% confidence intervals, 0.098-0.624), demonstrating that serious games improve knowledge in patients. For self-management, pooled estimate of Hedges' gu was 0.310 (95% confidence intervals, 0.122-0.497), showing that gaming improves self-management behaviors. CONCLUSIONS The authors' meta-analysis shows that educational video games can be effective in improving knowledge and self-management in young people with chronic conditions.

[1]  Liyan Song,et al.  Digital Game-Based Learning , 2014 .

[2]  B. Primack,et al.  Role of video games in improving health-related outcomes: a systematic review. , 2012, American journal of preventive medicine.

[3]  K. Norbergh,et al.  The Integration of Chronic Illness Self-Management , 2012, Qualitative health research.

[4]  Femida Gwadry-Sridhar,et al.  Moving Beyond the Stigma: Systematic Review of Video Games and Their Potential to Combat Obesity , 2011, International journal of hypertension.

[5]  Henriëtte A Moll,et al.  Readiness to transfer to adult care of adolescents with chronic conditions: exploration of associated factors. , 2011, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[6]  Sarah M. Greene,et al.  Twelve evidence-based principles for implementing self-management support in primary care. , 2010, Joint Commission journal on quality and patient safety.

[7]  Lynne T. Harris,et al.  Effective intervention or child's play? A review of video games for diabetes education. , 2010, Diabetes technology & therapeutics.

[8]  Pamela M. Kato,et al.  Video Games in Health Care: Closing the Gap , 2010 .

[9]  Luciana da Silva Nascimento,et al.  [Educative programs based on self-management: an integrative review]. , 2010, Revista gaucha de enfermagem.

[10]  Steven L Gortmaker,et al.  Dynamics of obesity and chronic health conditions among children and youth. , 2010, JAMA.

[11]  Marina Papastergiou,et al.  Exploring the potential of computer and video games for health and physical education: A literature review , 2009, Comput. Educ..

[12]  J. Durlak How to select, calculate, and interpret effect sizes. , 2009, Journal of pediatric psychology.

[13]  Carleen Hawn,et al.  Games for health: the latest tool in the medical care arsenal. , 2009, Health affairs.

[14]  P. M. Kato,et al.  A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer: A Randomized Trial , 2008, Pediatrics.

[15]  James Paul Gee,et al.  What video games have to teach us about learning and literacy , 2007, CIE.

[16]  Susan M Sawyer,et al.  Adolescents with a chronic condition: challenges living, challenges treating , 2007, The Lancet.

[17]  J. Gee,et al.  How Computer Games Help Children Learn , 2006 .

[18]  K. Squire From Content to Context: Videogames as Designed Experience , 2006 .

[19]  Andy Haines,et al.  Self management of arthritis in primary care: randomised controlled trial , 2006, BMJ : British Medical Journal.

[20]  A. McPherson,et al.  A Randomized, Controlled Trial of an Interactive Educational Computer Package for Children With Asthma , 2006, Pediatrics.

[21]  Y. Kanpolat Information age publishing. , 2005, Surgical neurology.

[22]  Michael Zyda,et al.  From visual simulation to virtual reality to games , 2005, Computer.

[23]  Jennifer Preece,et al.  A multilevel analysis of sociability, usability, and community dynamics in an online health community , 2005, TCHI.

[24]  A. Pentland,et al.  The DAILY (Daily Automated Intensive Log for Youth) trial: a wireless, portable system to improve adherence and glycemic control in youth with diabetes. , 2004, Diabetes technology & therapeutics.

[25]  Ben Williamson,et al.  What video games have to teach us about learning and literacy , 2004 .

[26]  K. Lorig,et al.  Self-management education: History, definition, outcomes, and mechanisms , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[27]  P. Naumann,et al.  Computer game for inner-city children does not improve asthma outcomes. , 2003, Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners.

[28]  James Kalbach Persuasive technology: using computers to change what we think and do , 2002, UBIQ.

[29]  James E. Driskell,et al.  Games, Motivation, and Learning: A Research and Practice Model , 2002 .

[30]  T. Bodenheimer,et al.  Patient self-management of chronic disease in primary care. , 2002, JAMA.

[31]  S. Thompson,et al.  Quantifying heterogeneity in a meta‐analysis , 2002, Statistics in medicine.

[32]  D. Kendall,et al.  Assessment of group versus individual diabetes education: a randomized study. , 2002, Diabetes care.

[33]  M. Prensky Do They Really Think Differently , 2001 .

[34]  M. Prensky Digital Natives, Digital Immigrants Part 1 , 2001 .

[35]  C. Wright,et al.  A randomized controlled study of the Arthritis Self-Management Programme in the UK. , 2000, Health education research.

[36]  L. Schneider,et al.  An evaluation of an innovative multimedia educational software program for asthma management: report of a randomized, controlled trial. , 2000, Pediatrics.

[37]  L. K. Bartholomew,et al.  Watch, Discover, Think, and Act: evaluation of computer-assisted instruction to improve asthma self-management in inner-city children. , 2000, Patient education and counseling.

[38]  M. Kreuter,et al.  Tailoring: what's in a name? , 2000, Health education research.

[39]  H. Vet,et al.  The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. , 1998, Journal of clinical epidemiology.

[40]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[41]  J. Leventhal,et al.  Educational intervention by computer in childhood asthma: a randomized clinical trial testing the use of a new teaching intervention in childhood asthma. , 1986, Pediatrics.

[42]  Yvonne Koch,et al.  Lessons In Learning E Learning And Training Perspectives And Guidance For The Enlightened Trainer , 2016 .

[43]  J. D. Fletcher,et al.  Review of research on computer games. , 2011 .

[44]  Samantha A Adams,et al.  Use of "serious health games" in health care: a review. , 2010, Studies in health technology and informatics.

[45]  B. Fogg The ethics of persuasive technology , 2003 .

[46]  E. Deci,et al.  Handbook of Self-Determination Research , 2002 .

[47]  R. Shegog,et al.  Research Paper: Impact of a Computer-assisted Education Program on Factors Related to Asthma Self-management Behavior , 2001, J. Am. Medical Informatics Assoc..

[48]  D. Lieberman,et al.  Educational video game for juvenile diabetes: results of a controlled trial. , 1997, Medical informatics = Medecine et informatique.

[49]  Debra A. Lieberman,et al.  Interactive Video Games for Health Promotion: Effects on Knowledge , 1997 .

[50]  R. Hiss,et al.  Barriers to Care in Non-Insulin-dependent Diabetes Mellitus: The Michigan Experience , 1996, Annals of Internal Medicine.

[51]  K. Lorig,et al.  Health education for self-management has significant early and sustained benefits in chronic arthritis. , 1989, Transactions of the Association of American Physicians.

[52]  D. Hunt Cognition and Learning , 1989 .