Digital Catalysts for Noncommunicable Disease Prevention Serious Games and Gamified Applications: Framework Design...

Unhealthy behaviors can cause so-called noncommunicable diseases (NCDs), which are on the rise. Notable examples include chronic respiratory diseases, diabetes, cardiovascular diseases, and various types of cancer. They are responsible for approximately 41 million deaths annually, which accounts for a staggering 74% of all global deaths. Major risk factors include physical inactivity, the use of tobacco, unhealthy diets, the harmful use of alcohol, and poor mental health, which can be classified as modifiable behavioral risk factors. Other factors include metabolic and environmental risk factors, such as air pollution. Many individuals struggle to make informed decisions about their health, which contributes to the risk factors mentioned earlier and, ultimately, can lead to the development of one or more NCD.

This research presents design and standardization considerations to enable the exchange of medical and game data to maximize their impact and usefulness. Serious games and gamified applications that strategically use behavior change techniques and educational content can help users change their behavior on a lasting basis, thereby reducing the aforementioned NCD risk factors. Still, each of them is currently independently designed and cannot interact with other applications.

We previously developed serious games and gamified applications to prevent NCDs. These served as the foundation of an interoperable framework for NCD prevention games and applications. On the basis of a comprehensive analysis, 6 key areas were identified, ultimately leading to a framework definition that was then evaluated against the already-developed games and applications.

This paper presented a novel interoperable framework to support the design and development of serious games and gamified applications that enable individuals to achieve sustainable behavior change and improve their overall health and well-being by defining 6 key areas, emphasizing interoperability, and exchanging meaningful medical and game data.

The framework presented in this study covers the major design and implementation aspects of NCD prevention games and applications in 6 key areas. Therefore, researchers should consider these guidelines when creating novel serious games and applications in those areas. The framework also intensively encourages the use of standards in the domain of medical informatics to ensure the semantic interoperability of patients' data produced. Thus, it promotes the exchange of meaningful data to improve patient care and anonymous data use for research.