Breaking the Ice with Group Flow: A Collaborative VR Serious Game for Relationship Enhancement

It is usually hard for unfamiliar partners to rapidly 'break the ice' in the early stage of relationship establishment, which hinders the development of relationship and even affects the team productivity. To solve this problem, we proposed a collaborative serious game for icebreaking by combining immersive virtual reality (VR) with brain-computer interface based on the team flow framework. We designed a multiplayer collaboration task with the theme of fighting COVID-19 and proposed an approach to improve empathy between team members by sharing their real-time mental state in VR;in addition, we propose an EEG-based method for dynamic evaluation and enhancement of group flow experience to achieve better team collaboration. Then, we developed a prototype system and performed a user study. Results show that our method has good ease of use and can significantly reduce the psychological distance among team members. Especially for unfamiliar partners, both functions of mental state sharing and group flow regulation enhancement can significantly reduce the psychological distance. © 2023 IEEE.

Development and evaluation of a virtual reality training for emergency treatment of shortness of breath based on frameworks for serious games.

Background: Virtual reality (VR) can offer an innovative approach to providing training in emergency situations, especially in times of COVID-19. There is no risk of infection, and the procedure is scalable and resource-efficient. Nevertheless, the challenges and problems that can arise in the development of VR training are often unclear or underestimated. As an example, we present the evaluation of the feasibility of development of a VR training session for the treatment of dyspnoea. This is based on frameworks for serious games, and provides lessons learned. We evaluate the VR training session with respect to usability, satisfaction, as well as perceived effectiveness and workload of participants. Methods: The VR training was developed using the established framework (Steps 1-4) for serious games of Verschueren et al. and Nicholson's RECIPE elements for meaningful gamification. Primary validation (Step 4) was performed at the University of Bern, Switzerland, in a pilot study without control group, with a convenience sample of medical students (n=16) and established measurement tools. Results: The theoretical frameworks permitted guided development of the VR training session. Validation gave a median System Usability Scale of 80 (IQR 77.5-85); for the User Satisfaction Evaluation Questionnaire, the median score was 27 (IQR 26-28). After the VR training, there was a significant gain in the participants' confidence in treating a dyspnoeic patient (median pre-training 2 (IQR 2-3) vs. post-training 3 (IQR 3-3), p=0.016).Lessons learned include the need for involving medical experts, medical educators and technical experts at an equivalent level during the entire development process. Peer-teaching guidance for VR training was feasible. Conclusion: The proposed frameworks can be valuable tools to guide the development and validation of scientifically founded VR training. The new VR training session is easy and satisfying to use and is effective - and is almost without motion sickness.

The Change in Exergaming From Before to During the COVID-19 Pandemic Among Young Adults: Longitudinal Study.

BACKGROUND: Exergaming may be an important option to support an active lifestyle, especially during pandemics. OBJECTIVE: Our objectives were (1) to explore whether change in exergaming status (stopped, started or sustained exergaming, or never exergamed) from before to during the COVID-19 pandemic was related to changes in walking, moderate-to-vigorous physical activity (MVPA) or meeting MVPA guidelines and (2) to describe changes among past-year exergamers in minutes per week exergaming from before to during the pandemic. METHODS: A total of 681 participants (mean age 33.6; SD 0.5 years; n=280, 41% male) from the 22-year Nicotine Dependence in Teens (NDIT) study provided data on walking, MVPA, and exergaming before (2017 to 2020) and during (2021) the COVID-19 pandemic. Physical activity (PA) change scores were described by change in exergaming status. RESULTS: We found that 62.4% (n=425) of the 681 participants never exergamed, 8.2% (n=56) started exergaming during the pandemic, 19.7% (n=134) stopped exergaming, and 9.7% (n=66) sustained exergaming. Declines were observed in all 3 PA indicators in all 4 exergaming groups. The more salient findings were that (1) participants who started exergaming during COVID-19 reported the highest MVPA levels before and during the pandemic and declined the least (mean -35 minutes/week), (2) sustained exergamers reported the lowest MVPA levels during the pandemic (median 66 minutes/week) and declined the most in MVPA (mean change of -92 minutes/week) and in meeting MVPA guidelines (-23.6%). During the pandemic, starting exergamers reported 85 minutes of exergaming per week and sustained exergamers increased exergaming by a median 60 minutes per week. CONCLUSIONS: Although starting and sustaining exergaming did not appear to help exergamers maintain prepandemic PA levels, exergaming can contribute a substantial proportion of total PA in young adults and may still represent a useful option to promote PA during pandemics.

The Grow It! app-longitudinal changes in adolescent well-being during the COVID-19 pandemic: a proof-of-concept study.

Adolescent mental health and well-being have been adversely impacted by the COVID-19 pandemic. In this preregistered longitudinal study, we evaluated whether adolescents' well-being improved after playing the multiplayer serious game app Grow It! During the first lockdown (May-June 2020), 1282 Dutch adolescents played the Grow It! app (age = 16.67, SD = 3.07, 68% girls). During the second lockdown (December-May 2020 onwards), an independent cohort of 1871 adolescents participated (age = 18.66, SD = 3.70, 81% girls). Adolescents answered online questionnaires regarding affective and cognitive well-being, depressive symptoms, anxiety, and impact of COVID-19 at baseline. Three to six weeks later, the baseline questionnaire was repeated and user experience questions were asked (N = 462 and N = 733 for the first and second cohort). In both cohorts, affective and cognitive well-being increased after playing the Grow It! app (t = - 6.806, p < 0.001; t = - 6.77, p < 0.001; t = - 6.12, p < 0.001; t = - 5.93, p < 0.001; Cohen's d range 0.20-0.32). At the individual level, 41-53% of the adolescents increased in their affective or cognitive well-being. Adolescents with higher risk profiles (i.e., more depressive symptoms, lower atmosphere at home, and more COVID-19 impact) improved more strongly in their well-being. Positive user evaluations and app engagement were unrelated to changes in affective and cognitive well-being. This proof-of-concept study tentatively suggests that Grow It! supported adolescents during the pandemic.

Effectiveness of Gamification in Knee Replacement Rehabilitation: Protocol for a Randomized Controlled Trial With a Qualitative Approach.

BACKGROUND: Exergames can provide encouraging exercise options. Currently, there is limited evidence regarding home-based exergaming in the postoperative phase of total knee replacement (TKR). OBJECTIVE: This study aimed to investigate the effects of a 4-month postoperative home-based exergame intervention with an 8-month follow-up on physical function and symptoms among older persons undergoing TKR compared with home exercise using a standard protocol. In addition, a concurrent embedded design of a mixed methods study was used by including a qualitative component within a quantitative study of exergame effects. METHODS: This was a dual-center, nonblinded, two-arm, parallel group randomized controlled trial with an embedded qualitative approach. This study aimed to recruit 100 patients who underwent their first unilateral TKR (aged 60-75 years). Participants were randomized to the exergame or standard home exercise arms. Participants followed a custom-made exergame program independently at their homes daily for 4 months. The primary outcomes at 4 months were function and pain related to the knee using the Oxford Knee Score questionnaire and mobility using the Timed Up and Go test. Other outcomes, in addition to physical function, symptoms, and disability, were game user experience, exercise adherence, physical activity, and satisfaction with the operated knee. Assessments were performed at the preoperative baseline and at 2, 4, and 12 months postoperatively. Exergame adherence was followed from game computers and using a structured diary. Self-reported standard exercise was followed for 4 months of intervention and physical activity was followed for 12 months using a structured diary. Qualitative data on patients' perspectives on rehabilitation and exergames were collected through laddering interviews at 4 and 12 months. RESULTS: This study was funded in 2018. Data collection began in 2019 and was completed in January 2022. The COVID-19 pandemic caused an unavoidable situation in the study for recruitment, data collection, and statistical analysis. As of November 2020, a total of 52 participants had been enrolled in the study. Primary results are expected to be published by the end of 2022. CONCLUSIONS: Our study provides new knowledge on the effects of postoperative exergame intervention among older patients with TKR. In addition, this study provides a new understanding of gamified postoperative rehabilitation, home exercise adherence, physical function, and physical activity among older adults undergoing TKR. TRIAL REGISTRATION: ClinicalTrials.gov NCT03717727; https://clinicaltrials.gov/ct2/show/NCT03717727. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/38434.

The integration of digital twin and serious game framework for new normal virtual urban exploration and social interaction

COVID-19 has disconnected humanity, reduced social interaction in physical urban areas, and led to the new normal, which describes the anticipated changes in human life and professionals due to the impact of the pandemic. In addition, as part of digital transformation, the post-pandemic New Normal includes accelerating digital solutions and new standards for virtual urban exploration and planning. This study applies the concept of digital twin and serious game design and uses Minecraft, a game-based platform that inspires creative, inclusive learning through play, for virtual urban exploration and the development of social interaction among participants. Dadaocheng, a historical area of Taipei city, is then studied as a case study with the Geoboxers application to develop the prototype for a co-creation experiment in Minecraft. The prototype development and the results of the experiment are then used in the Analytic Hierarchical Process (AHP) method to evaluate a set of influential criteria proposed in this study through pairwise comparisons by expert panelists. The results of the AHP analysis reveal users' simultaneous preferences for urban planning and social interaction with urban characteristics (22.14%), urban exploration (12.29%), and 3D models (11.97%). Subsequently, the research results showed a need to promote the integration of digital twins and serious game applications as digital tools for urban exploration and social interaction, increasing post-pandemic virtual urban planning and applying new urban design techniques. This study also contributes to the acceleration of digital transformation in urban planning and management. © 2023 The Authors

Newbie at CUHKSZ: A Voxel Art Puzzle Game for Campus Orientation

Due to the COVID-19 epidemic prevention policy, many university freshmen are unable to visit their schools in person. As a remote campus orientation tool, we propose Newbie at CUHKSZ, a voxel art puzzle game, for the incoming students to explore The Chinese University of Hong Kong, Shenzhen (CUHKSZ) in an interactive way. We crowd-sourced the digital model of the CUHKSZ campus and created Non-Player Characters (NPCs) as digital twins of our staffs in the virtual campus. Furthermore, we designed school traditions related puzzle tasks to lead an interactive campus tour and deliver humanistic values. The design of Newbie at CUHKSZ sheds light on a new way to engage the incoming students in a remote campus orientation event. © 2023 IEEE.

Games in Times of a Pandemic: Structured Overview of COVID-19 Serious Games.

BACKGROUND: The COVID-19 pandemic introduced an urgent need for effective strategies to disseminate crucial knowledge and improve people's subjective well-being. Complementing more conventional approaches to knowledge dissemination, game-based interventions were developed to create awareness and educate people about the pandemic, hoping to change their attitudes and behavior. OBJECTIVE: This study provided an overview and analysis of digital and analog game-based interventions in the context of the COVID-19 pandemic. As major pandemics and other large-scale disruptive events are expected to increase in frequency in the coming decades, this analysis aimed to inform the design, uptake, and effects of similar future interventions. METHODS: From November 2021 to April 2022, Scopus, Google, and YouTube were searched for articles and videos describing COVID-19-themed game-based interventions. Information regarding authorship, year of development or launch, country of origin, license, deployment, genre or type, target audience, player interaction, in-game goal, and intended transfer effects was extracted. Information regarding intervention effectiveness was retrieved where possible. RESULTS: A diverse assortment of 23 analog and 43 digital serious games was identified, approximately one-third of them (25/66, 38%) through scientific articles. Most of these games were developed by research institutions in 2020 (13/66, 20%) and originated in Europe and North America (38/66, 58%). A limited number (20/66, 30%) were tested on relatively small samples, using a diversity of research methods to assess the potential changes in participants' knowledge, attitudes, and behaviors as well as their gameplay experience. Although most of the evaluated games (11/20, 55%) effectively engaged and motivated the players, increased awareness, and improved their understanding of COVID-19-related issues, the games' success in influencing people's behavior was often unclear or limited. CONCLUSIONS: To increase the impact of similar future interventions aimed at disseminating knowledge and influencing people's attitudes and behaviors during a large-scale crisis, some considerations are suggested. On the basis of the study results and informed by existing game theories, recommendations are made in relation to game development, deployment, and distribution; game users, design, and use; game design terminology; and effectiveness testing for serious games.

The Good Talk! A Serious Game to Boost People's Competence to Have Open Conversations About COVID-19: Protocol for a Randomized Controlled Trial.

BACKGROUND: Vaccine hesitancy is one of the many factors impeding efforts to control the COVID-19 pandemic. Exacerbated by the COVID-19 infodemic, misinformation has undermined public trust in vaccination, led to greater polarization, and resulted in a high social cost where close social relationships have experienced conflict or disagreements about the public health response. OBJECTIVE: The purpose of this paper is to describe the theory behind the development of a digital behavioral science intervention-The Good Talk!-designed to target vaccine-hesitant individuals through their close contacts (eg, family, friends, and colleagues) and to describe the methodology of a research study to evaluate its efficacy. METHODS: The Good Talk! uses an educational serious game approach to boost the skills and competences of vaccine advocates to have open conversations about COVID-19 with their close contacts who are vaccine hesitant. The game teaches vaccine advocates evidence-based open conversation skills to help them speak with individuals who have opposing points of view or who may ascribe to nonscientifically supported beliefs while retaining trust, identifying common ground, and fostering acceptance and respect of divergent views. The game is currently under development and will be available on the web, free to access for participants worldwide, and accompanied by a promotional campaign to recruit participants through social media channels. This protocol describes the methodology for a randomized controlled trial that will compare participants who play The Good Talk! game with a control group that plays the widely known noneducational game Tetris. The study will evaluate a participant's open conversation skills, self-efficacy, and behavioral intentions to have an open conversation with a vaccine-hesitant individual both before and after game play. RESULTS: Recruitment will commence in early 2023 and will cease once 450 participants complete the study (225 per group). The primary outcome is improvement in open conversation skills. Secondary outcomes are self-efficacy and behavioral intentions to have an open conversation with a vaccine-hesitant individual. Exploratory analyses will examine the effect of the game on implementation intentions as well as potential covariates or subgroup differences based on sociodemographic information or previous experiences with COVID-19 vaccination conversations. CONCLUSIONS: The outcome of the project is to promote more open conversations regarding COVID-19 vaccination. We hope that our approach will encourage more governments and public health experts to engage in their mission to reach their citizens directly with digital health solutions and to consider such interventions as an important tool in infodemic management. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/40753.

Serious Game Development of COVID-19 Social Distancing Simulator using Agent-based Modelling

A social distancing protocol has been acknowledged and encouraged practically everywhere, since the global COVID-19 epidemic in 2020. This research resulted in the Serious game to simulate social distance using agent-based modeling so that it can be used as a medium of entertainment and educate the public during the Pandemic COVID-19 conditions by developing simulation games using UNITY 3D to educate in the middle of the COVID-19 pandemic and reduce transmission rates on an individual scale. © 2022,Telfor Journal..All Rights Reserved.

How a mRNA COVID-19 Vaccine works inside a Cell: A Virtual Reality Serious Game

Vaccine hesitancy and uptake have been important issues in controlling the current COVID-19 pandemic in many regions around the globe, but the increase in vaccination rates has been slow or even halted in some countries. Therefore, people who have hesitated in getting the vaccine need to be addressed. One driver influencing vaccination uptake is closing the knowledge gap among the public by equipping them with a deeper understanding of how a vaccine works inside our cells to activate the immune system and develop immunity. Viral immunology is highly conceptual and requires an appreciation of molecular biology in the cell. To give individuals an intuitive awareness of the operation of a mRNA-type virus vaccine for COVID-19, we designed and developed a Virtual Reality (VR) based serious game called 'Cell Traveler'. Through this innovative VR serious game, the player can control and interact with a sequence of critical real-life events inside a cell triggered by the injected mRNA COVID-19 vaccine. In this paper, we describe the prototype of the 'Cell Traveler'. We utilize the concepts of serious game to create an experience to encourage students and the public to develop deeper mRNA vaccine knowledge through a memorable and fun experience. © 2022 IEEE.

ARCoD: A Serious Gaming Approach to Measure Cognitive Distortions

Cognitive Distortion, defined as erroneous and in-accurate thoughts [4] can cause fatal mental impairment. Identifying the presence of cognitive distortions is the fundamental initiative to treat mental health disorders such as anxiety and depression. As a consequence of COVID-19 and the other changes in social aspects, there is an escalation in the number of patients with mental illness. Although there are abundant effective psychotherapy strategies available, a substantial number of people avoid them due to misconceptions and stigma. Serious games can be a feasible solution to purvey mental healthcare to a significant percentage of people. The availability of smartphones unveils the opportunity to provide therapeutic facilities via digital gaming. Technology like Augmented Reality with its interactive features, has unlocked numerous opportunities in the mental health domain. In this paper, we have remodeled our previously proposed game, ARCoD, accessible on smartphones to measure Cognitive Distortions. We hypothesized that, through this game, it is possible to assess the level of 5 different Cognitive Distortions (Arbitrary Inference, Catastrophizing, Black and White Thinking, Emotional Reasoning, and Labeling) in an individual playing the game. The experimental outcome demonstrates that the level of Cognitive Distortions assessed from the game is exceedingly similar to the measurement accumulated from an established scale-Cognitive Distortion Scale (CDS). © 2022 IEEE.

A Cooperative and Competitive Serious Game for Operations and Supply Chain Management – Didactical Concept and Final Evaluation

—In the last decades, Serious Games (SGs) have been implemented more and more in the engineering field, for both educational and professional purposes. The interest in digital SGs has increased even more in the last years of covid-19 pandemic, due to their location-independent availability and to the possibility to use SGs to apply theoretical knowledge and involve the users in a challenging way. Since the beginning of project Open Digital Laboratory For You (DigiLab4U) in October 2018, the University of Parma started to develop a brand-new SG with a strong focus on Operation and Supply Chain Management. The game has been studied as a multiplayer cooperative and competitive game which projects learners in a fictitious universe where multiple companies compete against each other in the same market. The realization of the game started from the definition of the didactical concept, underwent the user acceptance testing phases (alpha and beta tests) up until reach the release and the corresponding final evaluation feedback. © 2022,International journal of online and biomedical engineering. All Rights Reserved.

Examining the training and education potential of the metaverse: Results from an empirical study of next generation SAFe training

Restrictions imposed by the COVID-19 pandemic have forced many to seek alternative means of training and learning, which ended up with increasing investment in the notion of the metaverse. Metaverse is envisioned as the next iteration of the Internet in which the virtual and the real world are blended to materialize a highly immersive experience. Not surprisingly, perhaps, next-generation training and education systems are concerned with methods to integrate themselves into metaverse environments. In particular, participants are looking for more interactive and flexible training while maintaining a degree of educational content and high quality for their training plans and interactive workflows. In this paper, we conducted research to explore the role of metaverse in employee training. To this end, we utilized a variant of PlaySAFe (i.e., a 3D game) to investigate its metaverse adoption and usage. A qualitative design was adopted, using semistructured interviews to explore practitioners' experiences using the new version of PlaySAFe. After having it played in an industrial setting, we interviewed a group of software practitioners to compare the actual and expected features. This research has explored the pros and cons of using the current technologies for the practical groundwork of SAFe training. Findings from this research suggest that the metaverse holds the potential to deliver improved practical alignment in training and education programs, but that at the present time, practitioners expect more metaverse compatible features.

An immersive virtual reality-based application for treating ADHD: A remote evaluation of acceptance and usability.

Introduction: Virtual reality (VR) is a digital technology currently considered to implement rehabilitation programs for children with ADHD, a disorder characterised by inattention, overactivity and impulsiveness. This study presents the results of the acceptance and usability of a VR application developed for children with ADHD aiming to provide an environment capable of supporting the development of the different attentional components. Due to COVID-19 restrictions, this study had the secondary aim of assessing whether a remote evaluation was feasible and meaningful. Methods: A sample of 20 clinical experts (neuro and psychomotor therapists of the developmental age) was involved in assessing the proposed environment. Two different tools have been applied: the Technology Acceptance Model (TAM-3) questionnaire and a semi-structured interview were self-administered. Six sessions were planned in total, and each one lasted 30 min. Results: With respect to the acceptance of the system, the mean of the answers given is for most of the constructs greater than 4, showing agreement among experts. Cronbach alpha and correlations of subscales seem to confirm the reliability of measures. According to results from the interviews, the developed application has shown versatility in being able to be applied to the heterogeneity of the disorder and it was also possible to obtain valuable insights on possible additional features and functionalities. Regarding the secondary aim, the collected outcomes were positive: all the participants were satisfied with what they could perceive about the application. Conclusions: The results of this work pave the way for a future validation study with children due to the active participation of clinicians and their unanimous positive judgement confirming that the application was considered user-friendly and well accepted.

Academy Camp VR: Serious Game Constructions as Active Learning Experiences for Children

We have been running children’s play and learning camps since 2011, but we are withholding physical gathering after 2020 during the COVID-19 pandemic. The problem with online videoconference camps is that it is difficult to design activities that encourage children to move spontaneously and engage with the world around them. Starting in 2021, we have launched a series of VR (virtual reality) camps with each camp aiming for the construction of a VR world. We believe that by having the children actively involved in the creation of the 3D objects that make up the worlds and in game design, we are fostering a sense of efficacy that allows them to actively work on the world surrounding them and change it. In this paper, we summarize our attempts, especially our experience of constructing a VR world with children in which the immune system of the human body is turned into a serious game. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. OBJECTIVE: This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. METHODS: A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. RESULTS: A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD -0.54, 95% CI -0.79 to -0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD -0.61, 95% CI -0.95 to -0.26; P<.001) than in hospital settings (SMD -0.46, 95% CI -0.85 to -0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD -0.60, 95% CI -0.95 to -0.25; P<.001) and games for both (SMD -0.73, 95% CI -1.29 to -0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. CONCLUSIONS: Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. TRIAL REGISTRATION: PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5.

A Virtual Reality Serious Game for Children with Dyslexia: DixGame

Children with reading and writing difficulties, such as dyslexia, have been directly affected by the Covid-19 situation because they could not have the teacher’s face-to-face support. Consequently, new devices and technological applications are being used in educational contexts to improve the interest of learning. This paper presents the design of a Virtual Reality Serious Game called DixGame. This game is a pedagogical tool specifically oriented to children between 8 and 12 years old with dyslexia. Two immersive mini-games are included in this game: a Whack-a-mole and a Memory, which try to improve different skills keeping the children focused on tasks. Whack-a-mole aims to work on the attention and visual and reading agility by recognizing correct letters and words. Memory aims to improve memory and attention ability by pairing letter-cards. The mini-game structure permits to incorporate new levels or games and the progressive increment of difficulty allows the autonomous treatment. © 2022, Springer Nature Switzerland AG.

Evaluating a Dental Public-Health Game across Two Learning Contexts

Serious games have been shown to be effective learning tools in various disciplines, including dental education. Serious-game learning environments allow learners to improve knowledge and skills. GRAPHIC (Games Research Applied to Public Health with Innovative Collaboration), a serious game for dental public health, was designed to simulate a town, enabling students to apply theoretical knowledge to a specific population by selecting health promotion initiatives to improve the oral health of the town population. This study employed a literature-based evaluation framework and a sequential explanatory mixed-methods research design to evaluate the use of GRAPHIC among final-year dental undergraduates across two learning contexts: King’s College London in the United Kingdom and Mahidol University in Thailand. Two hundred and sixty-one students completed all designated tasks, and twelve participated in semi-structured interviews. The findings demonstrated knowledge improvement after game completion based on pre- and post-knowledge assessments, and the students’ perceptions of the game as an interactive and motivational learning experience. The evaluation identified five serious-game dimensions and clear alignment between these dimensions, demonstrating the impact of serious games in dental public health and, more widely, in healthcare education.

A Biofeedback-Based Mobile App With Serious Games for Young Adults With Anxiety in the United Arab Emirates: Development and Usability Study.

BACKGROUND: Following the outbreak of COVID-19, several studies have reported that young adults encountered a rise in anxiety symptoms, which could negatively affect their quality of life. Promising evidence suggests that mobile apps with biofeedback, serious games, breathing exercises, and positive messaging, among other features, are useful for anxiety self-management and treatment. OBJECTIVE: This study aimed to develop and evaluate the usability of a biofeedback-based app with serious games for young adults with anxiety in the United Arab Emirates (UAE). METHODS: This study consists of two phases: Phase I describes the design and development of the app, while Phase II presents the results of a usability evaluation by experts. To elicit the app's requirements during Phase I, we conducted (1) a survey to investigate preferences of young adults in the UAE for mobile games for stress relief; (2) an analysis of serious games for anxiety; and (3) interviews with mental health professionals and young adults in the UAE. In Phase II, five experts tested the usability of the developed app using a set of Nielsen's usability heuristics. RESULTS: A fully functional biofeedback-based app with serious games was co-designed with mental health professionals. The app included 4 games (ie, a biofeedback game, card game, arcade game, and memory game), 2 relaxation techniques (ie, a breathing exercise and yoga videos), and 2 additional features (ie, positive messaging and a mood tracking calendar). The results of Phase II showed that the developed app is efficient, simple, and easy to use. Overall, the app design scored an average of 4 out of 5. CONCLUSIONS: The elicitation techniques used in Phase I resulted in the development of an easy-to-use app for the self-management of anxiety. Further research is required to determine the app's usability and effectiveness in the target population.