A Virtual Environment based Serious Game to Support Health Education

ICST Transactions on Ambient Systems Research Article A Virtual Environment based Serious Game to Support Health Education Tiago Gomes1 , Tiago Abade1 , José Creissac Campos1 , Michael D. Harrison2 , José Luís Silva3,∗ 1 Departamento de Informática/Universidade do Minho & HASLab/INESC TEC, Braga, Portugal 2 Newcastle University & Queen Mary University of London, UK 3 Madeira-ITI, Universidade da Madeira, Funchal, Portugal Abstract APEX was developed as a framework for ubiquitous computing (ubicomp) prototyping through virtual environments. In this paper the framework is used as a platform for developing a serious game designed to instruct and to inform. The paper describes the Asthma game, a game aimed at raising awareness among children of asthma triggers in the home. It is designed to stimulate a healthier life-style for those with asthma and respiratory problems. The game was developed as the gamification of a checklist for the home environment of asthma patients. Received on 01 December 2013; accepted on 03 February 2014; published on 04 March 2014 Keywords: Human Factors, Design, Health Education, Serious Games, Asthma, Virtual Environments Copyright © 2014 Tiago Gomes et al., licensed to ICST. This is an open access article distributed under the terms of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/), which permits unlimited use, distribution and reproduction in any medium so long as the original work is properly cited. doi:10.4108/amsys.1.3.e5 1. Introduction Serious games support playing to learn. Games can be used to promote training, education, health, public policies and strategic communication as well as to provide pleasure [1–3]. This paper is concerned with the possibility of promoting health education through computer-based serious games. The paper describes a first person game that addresses the problems faced by children with asthma. Asthma is a chronic disease and specific procedures prevent the emergence of crises. The goal of the game is to convey knowledge about these procedures, focusing children at elementary school level. The game was designed as the gamification [4] of a checklist used to evaluate the living conditions of asthma sufferers. First person games typically involve control of an avatar that is placed inside a 3D virtual world. The paper illustrates the use of a framework called APEX, that is designed to prototype ubicomp environments [5], to support the rapid development of serious games. Ubicomp environments provide personalized services to users within physical spaces through the integration of environmental information using sensors. APEX ∗ Corresponding author. Email: EAI European Alliance for Innovation supports the creation of virtual environments (using a 3-D application server) and the definition of behaviors within them, and can be used to develop games within these environments. The paper extends work originally presented in [6], providing a more detailed description of the rationale behind the game’s design. It also describes an evaluation of the first version of the game and proposals for design improvement. 2. Related work A substantial research literature is concerned with exploring how best to design serious games for health education and training. An extensive review of the general area of video games in health care can be found in [7]. This review spans education and training to therapeutic applications of games. The more specific topic of immersive 3-D environments in healthcare education is also reviewed in [8]. 3-D application servers, that can be used to develop the kind of immersive 3-D game that is the focus of the paper, have also been explored in other work. Boulos provides an overview of the use of Second Life [9]. Two of their conclusions are: (1) that educators need to think out of the box when using this type of environment, 1 ICST Transactions on Ambient Systems 07 2013 - 03 2014 | Volume 01 | Issue 3 | e5 Tiago Gomes et al. The platform supports different types of evaluation of the prototypes using these components. The models of the behavioral component can be analyzed. The developed prototype can be used to evaluate user experience experimentally. This paper describes how APEX was used to create a virtual environment that incorporates a serious game (cf. [11]). The aim of the proposed game is to convey information about asthma and how best to prevent asthma attacks. 4. Asthma Figure 1. APEX Architecture avoiding a replication of the class room context inside the virtual environment, and (2) that research is still needed to make 3-D virtual worlds more accessible and to improve the efficiency and effectiveness of their use for learning and teaching. The present paper addresses these two issues. Gamification provides a means of making environments more engaging than a simple replication of the physical world. APEX provides a flexible means to develop such games. 3. The APEX framework APEX (rApid Prototyping for user EXperience) [5] is a framework for the rapid prototyping of ubicomp environments, enabling their simulation and analysis in the early stages of development. The platform consists of a number of components providing support for prototyping at different levels. There are four main components (see logical architecture in Figure 1). (1) The behavioral component (top left in the figure) is responsible for managing the behavior of the prototype. It is based on CPN Tools1 and uses Coloured Petri Nets (CPN) [10] to describe the behavior of the virtual environment in response to user actions and context changes. (2) The virtual environment component (top right) is responsible for managing the physical appearance and layout of the prototype. It is based on OpenSimulator2 , a multi-platform and multi-user virtual environment simulator. (3) The communication/execution component (top middle) and (4) the physical component (bottom middle) are responsible for coordinating the communication between all components and for communication with external devices, respectively. These components form an OpenSimulator module. Asthma is a chronic inflammatory disease of the respiratory tract characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. The most common symptoms include wheezing, coughing and shortness of breath [12]. Asthma attacks can arise for a number of reasons. The most common reasons are drug intake while eating or taking medication, and inhaling substances such as pollen, smoke, animal dander or dust. Many of the substances that cause asthma attacks derive from the presence of mites. These substances are often present in the home. Upholstery, curtains and clothes often harbor large communities of mites. There are several procedures that prevent the causes of asthma attacks, but these procedures are not always known by asthma sufferers. Parents, and especially children, need support to identify what (...truncated)