Gamification for promoting advance care planning: A mixed-method systematic review and meta-analysis

Area of Science:

• Healthcare Technology
• Public Health
• Behavioral Science

Background:

• Gamification is increasingly used in healthcare to address sensitive topics and motivate behavior change.
• Games have been developed to facilitate discussions on end-of-life issues and promote advance care planning (ACP).

Purpose of the Study:

• To synthesize quantitative and qualitative evidence on the effectiveness and user experience of games for advance care planning.
• To provide a comprehensive understanding of the role of gamified interventions in ACP.

Main Methods:

• A mixed-methods systematic review and meta-analysis was conducted (PROSPERO ID: CRD42020163312).
• Searches were performed across multiple databases for qualitative, quantitative, and mixed-method studies.
• Joanna Briggs Institute Critical Appraisal tools were used for quality assessment, with data synthesized via meta-analysis or meta-aggregation.

Main Results:

• Eleven articles from ten studies were included; most quantitative components were low quality, while qualitative components were moderate.
• Meta-analysis indicated games for ACP effectively increase self-efficacy, readiness, knowledge, and ACP behaviors.
• Meta-aggregation revealed high acceptability, with participants finding the game experience fun and enjoyable.

Conclusions:

• Advance care planning games represent a promising intervention to boost ACP uptake.
• Further well-designed randomized controlled trials are necessary to evaluate the effectiveness of ACP games.