Mahmoudi Ebrahim, Yejong Yoo Paul, Chandra Ananya, Cardoso Roberta, Denner Dos Santos Carlos, Majnemer Annette, Shikako Keiko
School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
JMIR Serious Games. 2024 Sep 6;12:e49029. doi: 10.2196/49029.
Children with disabilities face numerous challenges in accessing health services. Mobile health is an emerging field that could significantly reduce health inequities by providing more accessible services. Many mobile apps incorporate gamification elements such as feedback, points, and stories to increase engagement and motivation; however, little is known about how gamification has been incorporated in mobile apps for children with disabilities.
This scoping review aims to identify and synthesize the existing research evidence on the use of gamification in mobile apps for children with disabilities. Specifically, the objectives were to (1) identify the categories of these mobile apps (eg, treatment and educational) (2), describe the health-related outcomes they target, (3) assess the types and levels of gamification elements used within these apps, and (4) determine the reasons for incorporating gamification elements into mobile apps.
We searched MEDLINE, PsycINFO, CINAHL, Embase, the ACM Digital Library, and IEEE Xplore databases to identify papers published between 2008 and 2023. Original empirical research studies reporting on gamified mobile apps for children with disabilities that implemented at least 1 gamification strategy or tactic were included. Studies investigating serious games or full-fledged games were excluded.
A total of 38 studies reporting on 32 unique gamified mobile apps were included. Findings showed that gamified apps focus on communication skills and oral health in children with autism spectrum disorder while also addressing self-management and academic skills for other disability groups. Gamified mobile apps have demonstrated potential benefits across different populations and conditions; however, there were mixed results regarding their impact. The gamification strategies included fun and playfulness (23/32, 72%), feedback on performance (17/32, 53%), and reinforcement (17/32, 53%) in more than half of apps, whereas social connectivity was used as a gamification strategy in only 4 (12%) mobile apps. There were 2 main reasons for integrating gamification elements into mobile apps described in 16 (42%) studies: increasing user engagement and motivation and enhancing intervention effects.
This scoping review offers researchers a comprehensive review of the gamification elements currently used in mobile apps for the purposes of treatment, education, symptom management, and assessment for children with disabilities. In addition, it indicates that studies on certain disability groups and examinations of health-related outcomes have been neglected, highlighting the need for further investigations in these areas. Furthermore, research is needed to investigate the effectiveness of mobile-based gamification elements on health and health behavior outcomes, as well as the healthy development of children with disabilities.
残疾儿童在获得医疗服务方面面临诸多挑战。移动医疗是一个新兴领域，通过提供更易获得的服务可显著减少健康不平等现象。许多移动应用程序融入了游戏化元素，如反馈、积分和故事，以提高参与度和积极性；然而，对于游戏化如何融入残疾儿童移动应用程序，人们知之甚少。
本范围综述旨在识别和综合关于在残疾儿童移动应用程序中使用游戏化的现有研究证据。具体而言，目标是：（1）识别这些移动应用程序的类别（如治疗和教育类）；（2）描述它们所针对的与健康相关的结果；（3）评估这些应用程序中使用的游戏化元素的类型和水平；（4）确定将游戏化元素纳入移动应用程序的原因。
我们检索了MEDLINE、PsycINFO、CINAHL、Embase、ACM数字图书馆和IEEE Xplore数据库，以识别2008年至2023年期间发表的论文。纳入了报告至少实施了1种游戏化策略或战术的残疾儿童游戏化移动应用程序的原始实证研究。排除了调查严肃游戏或成熟游戏的研究。
共纳入了38项报告32款独特游戏化移动应用程序的研究。结果表明，游戏化应用程序侧重于自闭症谱系障碍儿童的沟通技能和口腔健康，同时也涉及其他残疾群体的自我管理和学术技能。游戏化移动应用程序在不同人群和情况下已显示出潜在益处；然而，其影响的结果不一。超过半数的应用程序中，游戏化策略包括趣味性和娱乐性（23/32，72%）、对表现的反馈（17/32，53%）和强化（17/32，53%），而社交连接仅在4款（12%）移动应用程序中被用作游戏化策略。16项（42%）研究中描述了将游戏化元素纳入移动应用程序的2个主要原因：提高用户参与度和积极性以及增强干预效果。
本范围综述为研究人员提供了对当前用于残疾儿童治疗、教育、症状管理和评估的移动应用程序中游戏化元素的全面综述。此外，它表明对某些残疾群体的研究以及对与健康相关结果的考察被忽视了，凸显了在这些领域进行进一步调查的必要性。此外，需要开展研究以调查基于移动的游戏化元素对健康和健康行为结果以及残疾儿童健康发展的有效性。
