Can Video Games Improve Adherence to Treatment in Children with Chronic Diseases?

Abstract

This research explored the use of interactive information technology applications for children with long term treatment regimens in which adherence is a key factor in the success of the treatment. Behavior change models play a major role in enhancing adherence to treatment in patients with chronic conditions. In this research, a conceptual framework was designed based on the Theory of Planned Behavior. The conceptual framework was mapped to game enjoyment elements to develop a game framework. The framework learned from the patient's situation based on the patient's adherence rate and measured behavioral determinants; and then the game adapted itself to the new situation and created new strategies to empower the patient in order to reinforce positive intention and behavior on the part of the patient.

The game framework was tested with children in two separate user studies including IBD (Inflammatory Bowel Disease) and Type I diabetes patients. Both user studies implemented a mixed between-group and within-subject methodology. Two versions of the game were developed, one with the embedded conceptual framework and another without. Participants were assigned randomly to the treatment and control groups. The treatment group played the game with the conceptual framework and the control group played the game without the theoretical framework. In the middle of the study, each group switched to the other game type and experienced a within-subject change.

The results were analyzed by GLM-ANOV A and Mix-Modeling. GLM-ANOV A showed a significant effect of game type (conceptual framework) on both behavioral intention and adherence to treatment regimens in patients with Inflammatory Bowel Disease and patients with Type I diabetes. Mix-modeling showed a significant effect of game type, time and the interaction between them on both behavioral intention and adherence to treatment regimens in both user studies.