maanantai 1. syyskuuta 2014

Promoting Health With Health Game Interventions


Attitudes towards games as research area has changed in the last decades as Jouni Smed wrote in his blog text earlier in Up Your Game Writings. In addition, during the last years interest in serious games such as health games has increased remarkably. In fact it seems that serious games have become today‘s trend phenomenon and for example health games are developed for many health problems and for health promotion purposes that you can imagine. But as we know the power of games and the scientific evidence that supports the potential of health games (for example see our article: Parisod et al. 2014), why not to use games to promote health?

Even if the wide interest that health games have, there are no rules or standards that determine what kind a reliable health game should be  and what can health care professionals recommend for example for children. This concerns us as Health Scientists. Adding apples and oranges to a previously developed game doesn’t make it a health game. Actually, developing a good and potentially effective health game is not an easy job. First of all you have to know how to develop a game. In addition, you must be familiar with the health issue in question, have profound understanding of health and behavioral change theories to understand how to promote healthy habits or support the change of the unhealthy ones, as well as know your target group’s interests, needs and behavior patterns. To find these elements of a reliable and effective health game and then evaluate their acceptability by end users, feasibility in real life and effectiveness, there is still a lot to do for researchers.


Who are we?

We undersigned are Doctoral students in Nursing Science. As health scientists, our goal is to produce, maintain and promote health of individuals in different environments and life situations. Since healthcare technology has been one part of our department’s research tradition, we got interested in games and their potential to promote health in an innovative, attractive and interesting way. Thus, in spring 2013 few members of IKITIK consortium (www.ikitik.fi) assembled a multidisciplinary team of experts in various areas of health and information technology to explore the World of health games. That is when our TEPE-project took its first steps and started its journey.

Because multidisciplinary collaboration is the key for success in health game research, TEPE–project is carried out in collaboration with the departments of Nursing Science and Information Technology of the University of Turku. The project is also working together with members from the Turku University of Applied Sciences, the department of Food and Environmental Sciences of the University of Helsinki, the Technology Research Center, University of Turku, and the Turku School of Economics. Moreover, TEPE-project has also started international collaboration with different countries in Europe and Asia. 


What are we doing?

To find and evaluate the missing pieces in health game area, TEPE-project aims to design, develop and evaluate game-based interventions together with different target groups, for different health issues and life phases using health literacy promoting and empowering approach. To reach this aim we have several research and educational projects ongoing at Doctoral, Master's and Bachelor's levels.

As there are lots of different topics to do research in the health game area, we have so far concentrated on the health issues essential in childhood and adolescence. As examples of our studies MHSc Heidi Parisod’s Doctoral research aims to find out those elements of smoking preventive health education that would meet the needs of adolescents, support their comprehension and non-smoking behavior, and then evaluate these elements as a health game intervention that will be developed together with adolescents. So far the elements have been explored with a literature review, with an online questionnaire partly using social media and with interviews that are still ongoing.

BHSc Anni Pakarinen’s Doctoral study aims to develop and evaluate physical activity promoting health videogame intervention for tweens. The study is using user centered design process, meaning that target group’s views and perceptions are in main role throughout the whole study. The study is in early phase, exploring tweens’ (10–13 y) perceptions of potential ways to support children to be physically active as well as their views on the elements of physical activity promoting health videogame. Ultimate goal is to develop a health videogame intervention, which could benefit school health care and support health education among tweens.

In addition to maintaining health and promoting healthy lifestyles, health promoting interventions are needed when individuals are facing health problems and diseases. MHSc Lotta Kauhanen’s Doctoral study (FUN project), a parallel randomized clinical trial with follow-up, aims to evaluate the efficacy of active video games with regard to the promotion of physical activity in children with cancer. The ultimate goal of FUN-project is to motivate children with cancer and their families to integrate active lifestyle choices into their everyday life, even during treatment, to decrease the negative impact of high levels of sedentary behavior. The results will help answer the question of whether playing active video games has a positive effect on the health of children with cancer. (Kauhanen et al 2014.) The study recruiting and data collection is currently ongoing.

BHSc Anna-Maija Lindgren’s Master’s thesis (University of Helsinki) aims to explore the kindergarten-aged children's perceptions on vegetables, fruits and berries. The study aims to facilitate designing and developing health game interventions to promote children’s' healthy eating. The other theses projects are also concentrating on promoting children’s and adolescents’ healthy lifestyles and moreover, supporting development of health games decreasing children’s hospital fears.

The educational project of TEPE is WellWe (http://www.utu.fi/fi/Ajankohtaista/Uutiset/Sivut/ict-showroom-2014.aspx). WellWe aims to develop an application with game elements for children, families and professionals in child health clinics. The purpose is that with the help of WellWe-application families can assess their wellbeing; resources, nutrition and physical activity, before entering to child health clinic. The idea is that the clinic could receive the information in advance which helps the health care professionals to assess and support families’ wellbeing according to individual needs. Because of the playful elements, already young children can more easily take part to the discussions and express their views. The project is a multidisciplinary educational Capstone-project including Nursing Science, Information Technology, Information System Science and Graphic design students

Where are we going?
Just over a year ago we assembled our small group that has now become multiple and a lot has already happened under the TEPE-project regardless of its relatively short history. However, as we said there is still a lot to do and discover in the World of health games to promote reliable and credibility use of health games.


Anni Pakarinen, Heidi Parisod & Lotta Kauhanen
Department of Nursing Science, University of Turku


References:

Kauhanen L, Järvelä L, Lähteenmäki P, Arola PM, Heinonen OJ, Axelin A, Lilius J, Vahlberg T & Salanterä S. 2014. Active video games to promote physical activity in children with cancer: a randomized clinical trial with follow-up. BMC Pediatrics 14(94). doi:10.1186/1471-2431-14-94. (http://www.biomedcentral.com/1471-2431/14/94)

Parisod H, Pakarinen A, Kauhanen L, Aromaa M, Leppänen V, Liukkonen T, Smed J & Salanterä S. 2014. Promoting Children's Health with Digital Games: A Review of Reviews. Games for Health Journal 3(3), 145-156. doi:10.1089/g4h.2013.0086.(http://online.liebertpub.com/doi/abs/10.1089/g4h.2013.0086)

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