Mueller Sonja, Soriano Delphine, Boscor Andrei, Saville Naomi M, Arjyal Abriti, Baral Sushil, Fordham Maureen, Hearn Gareth, Kayastha Rachya, Kostkova Patty
Institute for Risk and Disaster Reduction, University College London, London, United Kingdom.
Institute for Risk and Disaster Reduction Centre for Digital Public Health in Emergencies (dPHE), University College London, London, United Kingdom.
Front Public Health. 2020 Dec 11;8:584375. doi: 10.3389/fpubh.2020.584375. eCollection 2020.
Serious games, conveying educational knowledge rather than merely entertainment, are a rapidly expanding research domain for cutting-edge educational technology. Digital interventions like serious games are great opportunities to overcome challenges in low-and-middle-income countries that limit access to health information, such as social barriers like low-literacy and gender. MANTRA: Increasing maternal and child health resilience before, during and after disasters using mobile technology in Nepal takes on these challenges with a novel digital health intervention; a serious mobile game aimed at vulnerable low-literacy female audiences in rural Nepal. The serious game teaches 28 learning objectives of danger signs in geohazards, maternal, and neonatal health to improve knowledge and self-assessment of common conditions and risks to inform healthcare-seeking behavior. Evaluations consisted of recruiting 35 end users to participate in a pre-test assessment, playing the game, post-test assessment, and focus groups to elicit qualitative feedback. Assessments analyzed knowledge gain in two ways; by learning objective with McNemar tests for each learning objective, and by participant scores with paired -tests of overall scores and by module. Results of assessments of knowledge gain by learning objective (McNemar tests) indicate participants had sufficient prior knowledge to correctly interpret and respond to 26% of pictograms (coded AA), which is a desirable result although without the possibility of improvement through the intervention. The geohazard module had greatest impact as 16% of responses showed knowledge gain (coded BA). The two most successful learning objectives showing statistically significant positive change were evidence of rockfalls and small cracks in the ground ( = < 0.05). Assessment of knowledge gain by participant scores (paired -tests) showed the 35 participants averaged a 7.7 point improvement ( < 0.001) in the assessment (28 learning objectives). Average change in knowledge of subdivided module scores (each module normalized to 100 points for comparison) was greatest in the geohazard module (9.5 points, < 0.001), then maternal health (7.4 points, = 0.0067), and neonatal health (6.0 points, = 0.013). This evaluation demonstrated that carefully designed digital health interventions with pictograms co-authored by experts and users can teach complex health and geohazard situations. Significant knowledge gain was demonstrated for several learning objectives while those with non-significant or negative change will be re-designed to effectively convey information.
严肃游戏传递的是教育知识而非仅仅是娱乐，对于前沿教育技术来说，它是一个正在迅速扩展的研究领域。像严肃游戏这样的数字干预措施是克服中低收入国家面临的挑战的绝佳机会，这些挑战限制了人们获取健康信息，比如低识字率和性别等社会障碍。尼泊尔的“MANTRA：利用移动技术增强灾害前、中、后母婴健康复原力”通过一种新颖的数字健康干预措施应对了这些挑战；这是一款针对尼泊尔农村识字率低的弱势女性受众的严肃手机游戏。这款严肃游戏教授了关于地质灾害、孕产妇和新生儿健康方面危险信号的28个学习目标，以提高对常见状况和风险的认识及自我评估能力，从而为寻求医疗行为提供信息。评估包括招募35名最终用户参与预测试评估、玩游戏、后测试评估以及焦点小组讨论以获取定性反馈。评估从两种方式分析知识增益；通过对每个学习目标用麦克尼马尔检验按学习目标进行分析，以及通过对参与者总分和按模块进行配对检验的分数进行分析。按学习目标（麦克尼马尔检验）进行的知识增益评估结果表明，参与者有足够的先验知识来正确解读和回应26%的象形图（编码为AA），这是一个理想的结果，尽管不可能通过干预得到改善。地质灾害模块的影响最大，因为16%的回答显示有知识增益（编码为BA）。显示出具有统计学显著正向变化的两个最成功的学习目标是落石和地面小裂缝的迹象（P = < 0.05）。按参与者分数（配对检验）进行的知识增益评估表明，35名参与者在评估（28个学习目标）中的平均分提高了7.7分（P < 0.001）。细分模块分数（每个模块归一化为100分以便比较）的知识平均变化在地质灾害模块中最大（9.5分，P < 0.001），其次是孕产妇健康（7.4分，P = 0.0067），新生儿健康（6.0分，P = 0.013）。这项评估表明，由专家和用户共同创作的带有象形图的精心设计的数字健康干预措施可以教授复杂的健康和地质灾害情况。几个学习目标显示出显著的知识增益，而那些没有显著变化或有负向变化的将被重新设计以有效传达信息。
