Toward Gamified Pain Management Apps: Mobile Application Rating Scale-Based Quality Assessment of Pain-Mentor's First Prototype Through an Expert Study.

BACKGROUND: The use of health apps to support the treatment of chronic pain is gaining importance. Most available pain management apps are still lacking in content quality and quantity as their developers neither involve health experts to ensure target group suitability nor use gamification to engage and motivate the user. To close this gap, we aimed to develop a gamified pain management app, Pain-Mentor. OBJECTIVE: To determine whether medical professionals would approve of Pain-Mentor's concept and content, this study aimed to evaluate the quality of the app's first prototype with experts from the field of chronic pain management and to discover necessary improvements. METHODS: A total of 11 health professionals with a background in chronic pain treatment and 2 mobile health experts participated in this study. Each expert first received a detailed presentation of the app. Afterward, they tested Pain-Mentor and then rated its quality using the mobile application rating scale (MARS) in a semistructured interview. RESULTS: The experts found the app to be of excellent general (mean 4.54, SD 0.55) and subjective quality (mean 4.57, SD 0.43). The app-specific section was rated as good (mean 4.38, SD 0.75). Overall, the experts approved of the app's content, namely, pain and stress management techniques, behavior change techniques, and gamification. They believed that the use of gamification in Pain-Mentor positively influences the patients' motivation and engagement and thus has the potential to promote the learning of pain management techniques. Moreover, applying the MARS in a semistructured interview provided in-depth insight into the ratings and concrete suggestions for improvement. CONCLUSIONS: The experts rated Pain-Mentor to be of excellent quality. It can be concluded that experts perceived the use of gamification in this pain management app in a positive manner. This showed that combining pain management with gamification did not negatively affect the app's integrity. This study was therefore a promising first step in the development of Pain-Mentor.

Gamification in Stress Management Apps: A Critical App Review.

BACKGROUND: In today's society, stress is more and more often a cause of disease. This makes stress management an important target of behavior change programs. Gamification has been suggested as one way to support health behavior change. However, it remains unclear to which extend available gamification techniques are integrated in stress management apps, and if their occurrence is linked to the use of elements from behavior change theory. OBJECTIVE: The aim of this study was to investigate the use of gamification techniques in stress management apps and the cooccurrence of these techniques with evidence-based stress management methods and behavior change techniques. METHODS: A total of 62 stress management apps from the Google Play Store were reviewed on their inclusion of 17 gamification techniques, 15 stress management methods, and 26 behavior change techniques. For this purpose, an extended taxonomy of gamification techniques was constructed and applied by 2 trained, independent raters. RESULTS: Interrater-reliability was high, with agreement coefficient (AC)=.97. Results show an average of 0.5 gamification techniques for the tested apps and reveal no correlations between the use of gamification techniques and behavior change techniques (r=.17, P=.20), or stress management methods (r=.14, P=.26). CONCLUSIONS: This leads to the conclusion that designers of stress management apps do not use gamification techniques to influence the user's behaviors and reactions. Moreover, app designers do not exploit the potential of combining gamification techniques with behavior change theory.

Shared Book Reading Promotes Not Only Language Development, But Also Grapheme Awareness in German Kindergarten Children.

Effects of shared book reading on expressive vocabulary and grapheme awareness without letter instruction in German kindergarteners (longitudinal; N = 69, 3;0-4;8 years) were investigated. Expressive vocabulary was measured by using a standardized test; grapheme awareness was measured by asking children to identify one grapheme per trial presented amongst non-letter distractors. Two methods of shared book reading were investigated, literacy enrichment (additional books) and teacher training in shared book reading strategies, both without explicit letter instruction. Whereas positive effects of shared book reading on expressive vocabulary were evident in numerous previous studies, the impact of shared book reading on grapheme awareness has not yet been investigated. Both methods resulted in positive effects on children's expressive vocabulary and grapheme awareness over a period of 6 months. Thus, early shared book reading may not only be considered to be a tool for promoting the development of expressive vocabulary, but also for implicit acquisition of grapheme awareness. The latter is considered an important precondition required for the explicit learning of grapheme-phoneme conversion rules (letter knowledge).

Evidence for a general auditory processing deficit in developmental dyslexia from a discrimination paradigm using speech versus nonspeech sounds matched in complexity.

PURPOSE: It is unknown whether phonological deficits are the primary cause of developmental dyslexia or whether they represent a secondary symptom resulting from impairments in processing basic acoustic parameters of speech. This might be due, in part, to methodological difficulties. Our aim was to overcome two of these difficulties: the comparability of stimulus material and task in speech versus nonspeech conditions. METHOD: In this study, the authors (a) assessed auditory processing of German vowel center stimuli, spectrally rotated versions of these stimuli, and bands of formants; (b) used the same task for linguistic and nonlinguistic conditions; and (c) varied systematically temporal and spectral parameters inherent in the German vowel system. Forty-two adolescents and adults with and without reading disabilities participated. RESULTS: Group differences were found for all linguistic and nonlinguistic conditions for both temporal and spectral parameters. Auditory deficits were identified in most but not all participants with dyslexia. These deficits were not restricted to speech stimuli-they were also found for nonspeech stimuli with equal and lower complexity compared with the vowel stimuli. Temporal deficits were not observed in isolation. CONCLUSION: These results support the existence of a general auditory processing impairment in developmental dyslexia.

Earlier timbre processing of instrumental tones compared to equally complex spectrally rotated sounds as revealed by the mismatch negativity.

Harmonically rich sounds have been shown to be processed more efficiently by the human brain compared to single sinusoidal tones. To control for stimulus complexity as a potentially confounding factor, tones and equally complex spectrally rotated sounds, have been used in the present study to investigate the role of the overtone series in sensory auditory processing in non-musicians. Timbre differences in instrumental tones with equal pitch elicited a MMN which was earlier compared to that elicited by the spectrally rotated sounds, indicating that harmonically rich tones are processed faster compared to non-musical sounds without an overtone series, even when pitch is not the relevant information.

Differences in sensory processing of German vowels and physically matched non-speech sounds as revealed by the mismatch negativity (MMN) of the human event-related brain potential (ERP).

We compared processing of speech and non-speech by means of the mismatch negativity (MMN). For this purpose, the MMN elicited by vowels was compared to those elicited by two non-speech stimulus types: spectrally rotated vowels, having the same stimulus complexity as the speech stimuli, and sounds based on the bands of formants of the vowels, representing non-speech stimuli of lower complexity as compared to the other stimulus types. This design allows controlling for effects of stimulus complexity when comparing neural correlates of processing speech to non-speech. Deviants within a modified multi-feature design differed either in duration or spectral property. Moreover, the difficulty to discriminate between the standard and the two deviants was controlled for each stimulus type by means of an additional active discrimination task. Vowels elicited a larger MMN compared to both non-speech stimulus types, supporting the concept of language-specific phoneme representations and the role of the participants' prior experience.