Personalizing sensor-controlled digital gaming to self-management needs of older adults with heart failure: A qualitative study

Authors: RADHAKRISHNAN, KAVITA - University Of Texas; BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC); O'HAIR, MATTHEW - Good Life Games, Llc; FOURNIER, CATHERINE - University Of Texas; SPRANGER, CATHY - Ascension Seton Medical Center Austin; KIM, MIYONG - University Of Texas

Submitted to: The Games for Health Journal: Research, Development, and Clinical Applications
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/20/2020
Publication Date: 3/6/2020
Citation: Radhakrishnan, K., Baranowski, T., O'Hair, M., Fournier, C.A., Spranger, C.B., Kim, M.T. 2020. Personalizing sensor-controlled digital gaming to self-management needs of older adults with heart failure: A qualitative study. The Games for Health Journal: Research, Development, and Clinical Applications. 9:4. https://doi.org/10.1089/g4h.2019.0222.
DOI: https://doi.org/10.1089/g4h.2019.0222

Interpretive Summary: While heart failure has become an increasingly common condition requiring careful monitoring of weight, physical activity and medication adherence, few patients with heart failure do so. This qualitative study reports heart failure patient (n=15) perspectives on a sensory-controlled videogame designed to help heart failure patients self-monitor their behaviors. The idea of a sensory-controlled videogame to motivate heart failure patients to self-monitor their behavior was highly acceptable (80%). Participants made numerous suggestions on how best to design a videogame intended to meet their needs. The investigators proceeded to use these suggestions in the design of a sensory-controlled videogame.

Technical Abstract: In older persons with heart failure (HF), an inability to self-manage their disease condition can result in poor health outcomes and quality of life. With the rise in smartphone use and digital game playing among older adults, digital tools such as sensor-controlled digital games (SCDGs) can offer accessible health-promoting tools that are enjoyable and easy to use. However, designing SCDGs that are compelling and aligned with their life values and self-management needs can be challenging. This article describes a qualitative study with older adults with HF who were recruited from a cardiac rehabilitation laboratory in central Texas to identify their perceptions and expectations regarding a SCDG for HF self-management. A low-fidelity prototype that demonstrated the features of a SCDG was used to obtain the participants' perceptions about the value of SCDGs for HF self-management with respect to content, customization, flexibility, and usability through qualitative interviews. We interviewed 15 patients with HF (53% women; age range, 53-90 years; 60% white). The concept of SCDGs for HF self-management was highly acceptable (80%). Participants provided suggestions for game characters, progress in the game, and game notifications and incentives. Perceived benefits included helping users track their behaviors and establish routines, become informed on strategies to manage HF, and empower themselves to take charge of their health. The study's findings will guide personalization of SCDG development to motivate patient engagement in HF self-management behaviors.