The effect of a bone-preserving board game program on the knowledge, attitudes and preventive behaviors of osteoporosis in older adults.

Osteoporosis predisposes to fractures, which affect the quality of life and can be life-threatening. However, the knowledge, attitudes and preventive behaviors of osteoporosis in older adults are insufficient. The aim of this paper was to develop and test the effect of a bone-preserving board game program among older adults. A convenience sample of 85 older adults recruited from two community activity centers in southern Taiwan were assigned to either an experimental group or a control group. The experimental group played a bone-preserving board game for 4 weeks, and the control group participated in routine community center activities. The generalized estimating equation showed significantly larger improvements in knowledge, attitudes, and preventive behaviors in the experimental group than in the control group. Board games designed for older adults can support public health education and help prevent osteoporosis. Our results provide a reference for educators, clinical practitioners and researchers.

Tutorless board game as an alternative to tabletop exercise for disaster response training: perception of interaction engagement and behavioral intention.

BACKGROUND: Although tabletop exercise is a commonly used method for disaster response training, it is labor-intensive, requires a tutor for facilitation and may not be ideal in a pandemic situation. Board game is a low-cost and portable alternative that can be utilized for this purpose. The purpose of this study was to compare the perception of interaction engagement and behavioral intention to use a newly developed board game with tabletop exercise for disaster training. METHODS: Using the Mechanics-Dynamics-Aesthetics' (MDA) framework, a new, tutorless educational board game known as the Simulated Disaster Management And Response Triage training ("SMARTriage") was first developed for disaster response training. Subsequently, the perceptions of 113 final year medical students on the "SMARTriage" board game was compared with that of tabletop exercise using a crossover design. RESULTS: Using Wilcoxon signed rank test, it was that found that tabletop exercise was generally rated significantly higher (with p < 0.05) in terms of perceived usefulness, perceived ease of use and behavioral intention compared to tutorless "SMARTriage" board game. However, in terms of attitude and interaction engagement, there was no significant difference between these two learning methods for most of the items. CONCLUSION: Although a clear preference for tutorless board game was not demonstrated, this study suggests that board game was not inferior to tabletop exercise in fostering interaction engagement suggesting that "SMARTriage" board game could potentially be used as an adjunct for teaching and learning activities.

Reducing older people's risk of fraud victimization through an anti-scam board game.

This study adopted an experimental design to evaluate the effectiveness of an anti-scam education program for older adults. Participants in the experimental group (n = 55) first participated in an anti-scam board game and then joined another board game featuring local tea restaurants two weeks later, whereas such order was reversed for the control group (n = 54). Compared with the control group, participants in the experimental group reported significant increases in their self-efficacy in fraud prevention and awareness of scam situations, and a significant decrease in perceived susceptibility to scams immediately and two weeks after the intervention, demonstrating the immediate and the short-term effects of the anti-scam education program in reducing fraud victimization risk of older adults.

Enterovirus board game for elementary school children: A pilot study.

OBJECTIVE: To evaluate the effect of an enterovirus board game on improving knowledge of enterovirus for elementary school children in Taiwan. DESIGN: A pilot study with a one-group pretest-posttest design. SAMPLE: Using convenience sampling, 27 children were recruited from a single elementary school in Taiwan in June 2020. MEASUREMENTS: Demographic data were collected and the children completed an enterovirus knowledge questionnaire. Statistical analyses included descriptive statistics, McNemar test, and Wilcoxon test. INTERVENTION: Each experimental group of four to five children participated in a 40-min enterovirus board game. RESULTS: After using the board game, the children had significantly higher mean scores for enterovirus knowledge. Specifically, the children had a higher proportion of correct answers for seven questions related to enterovirus after playing the game compared to before. CONCLUSIONS: Board games designed for elementary school-aged children can support public health education and help prevent outbreaks of infectious diseases such as enterovirus.

[Design and Application of Board Game Learning: An Example for Medical-Surgical Nursing Course].

Board games are currently widely used in various courses, including in the teaching of cardiopulmonary cerebral resuscitation for neonatal and infants. They are generally deemed as useful in teaching concepts such as empathy and interpersonal communication skills that are relatively difficult to understand. However, board games have rarely been used in medical-surgical nursing courses. The main reason for this may be because of many different systems in medical-surgical nursing courses complicate the process of designing relevant / useful scheme of board games. In general, college students have a weak conception of diseases because they have not yet entered clinical practice and their knowledge construction is based on traditional teaching methods. Using different teaching methods to construct knowledge may increase students` understanding of a disease and help them better understand content. In this article, the author uses different teaching strategies to increase students` knowledge. Concept mapping, board games, and human figures were designed to construct the knowledge of students in each system and to assist students to reintegrate disease knowledge in order to reinforce learning efficacy. This learning method may help improve students` understanding of textbook-based knowledge and enhance students` self-learning and future clinical practice.

Neural substrate of a cognitive intervention program using Go game: a positron emission tomography study.

BACKGROUND: Influence of cognitive intervention programs on brain activity has not been enough explored. AIMS: The aims of the present study were to clarify changes in brain activity from a cognitive intervention program utilizing the board game "Go" and to examine the relationship between brain activity and the acquisition of Go skills. METHODS: Eighteen community-dwelling older adults were randomly assigned either to an intervention group (IG), in which members attended 12 Go lessons either in groups or individually using tablet computers, or a control group (CG), in which members attended health education lectures unrelated to Go. Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET), cognitive assessments, and Go tests were performed before and after the intervention. RESULTS: The results showed different patterns of regional FDG uptake in both groups: regional cerebral glucose metabolism was significantly increased in the left middle temporal gyrus (MTG) and bilateral putamen (p < 0.01; cluster level) in the IG, and in the left superior frontal gyrus in the CG, (p < 0.01; cluster level). Furthermore, Go test scores were significantly improved in the IG (p < 0.05), and a significant association was observed between changes in Go test scores and glucose metabolism in the left MTG (p < 0.05). CONCLUSIONS AND DISCUSSION: This study indicates that a cognitive intervention program using Go may enhance brain activity. Further studies with larger populations and longer observation periods are needed to clarify the neural mechanisms underlying our Go intervention program.

Effectiveness of board game activities for reducing depression among older adults in adult day care centers of Taiwan: a quasi-experimental study.

Depression is common in older adults and is associated with an increased risk of cognitive impairment. To clarify the possible roles of board game use in psychosomatic health promotion, this study evaluated the effects of board game activities in reducing depression in older adults. This was a quasi-experimental study. Purposive sampling was used to select 150 participants aged 65 years and above with intact mental functions who were currently residing in adult day care centers. Seventy-five participants who participated in 12 sessions of selected board game activities were assigned to the experimental group, and 75 participants who adhered to their ordinary activities were allocated to the control group. Structured questionnaires were used for data collection. The board game activities showed promising effects on the depression levels of the investigated older adults living in adult day care centers. Therefore, one possible beneficial effect of board game activities may be reduced depression in older adults. The results of this study provide support for the mediating role of board game activities in the mental health of long-term care elders. Incorporating board game activities into social work may help to make it more diverse and innovative.

Effect of board game activities on cognitive function improvement among older adults in adult day care centers.

Stimulating leisure activities are considered as possible protective factors against dementia and cognitive decline in older adults, particularly due to the enhancement of cognitive reserve. This study tested the effectiveness of board game activities improving the cognitive function of older adults in adult day care centers. This was a quasi-experimental study. A purposive sampling strategy was used to select 82 subjects who were aged 65 and above with intact mental functions and currently residing in adult day care centers. 41 subjects who participated in a selection of 12 board game activities were assigned to the experimental group and 41 subjects who adhered to their ordinary activities were allocated to the control group. Structured questionnaires of the board game programs were used for data collection. The board game programs showed promising effects in the cognitive function of older adults living in adult day care centers. A possible beneficial effect of board game playing on the risk of dementia could be mediated by a less cognitive decline in older adults. Board game activities may benefit the cognitive function of older adults. Incorporating board game activities into social work care may help develop long-term care into a more diverse, unique and innovative direction.

[Applying Game-Based Learning in Nursing Education: Empathy Board Game Learning].

Attending lectures and reading are two common approaches to acquiring knowledge, while repetitive practice is a common approach to acquiring skills. Nurturing proper attitudes in students is one of the greatest challenges for educators. Health professionals must incorporate empathy into their practice. Creative teaching strategies may offer a feasible approach to enhancing empathy-related competence. The present article focuses on analyzing current, empathy-related curriculums in nursing education in Taiwan, exploring the concepts of empathy and game-based learning, presenting the development of an empathy board game as a teaching aid, and, finally, evaluating the developed education application. Based on the learner-centered principle, this aid was designed with peer learning, allowing learners to influence the learning process, to simulate the various roles of clients, and to develop diverse interpersonal dialogues. The continuous learning loops were formed using the gamification mechanism and transformation, enabling students to connect and practice the three elements of empathy ability: emotion, cognition and expression. Via the game elements of competition, interaction, storytelling, real-time responses, concretizing feedback, integrated peer learning, and equality between teachers and students, students who play patient roles are able to perceive different levels of comfort, which encourages the development of insight into the meaning of empathy. Thereby, the goals of the empathy lesson is achievable within a creative game-based learning environment.

Don't Push Your Luck! Educational Family Board (Not Bored) Game for School-Age Children Living with Chronic Conditions.

PURPOSE: Children who are living with chronic conditions may be supported in self-care through enjoyable active learning and family social processes. This research focused on development and evaluation of "Don't Push Your Luck!", an educational board game designed to inspire family discussion about chronic conditions, and help affected children learn about self-care choices and consequences. DESIGN AND METHODS: Mixed-method research was conducted with families from one outpatient Cystic Fibrosis Clinic and four Hemophilia Treatment Centres in Canada and United States (N=72). In phase I, board game prototype and questionnaires were refined with affected boys, siblings, and parents living with hemophilia (n=11), compared with families living with cystic fibrosis (n=11). In phase II, final board game was evaluated with families living with hemophilia (n=50). Data collection included pre-post-game questionnaires on decision-making and Haemo-QoL Index©, and post-game enjoyment. Analysis included descriptive statistics, inferential statistics (non-parametric), and qualitative themes. RESULTS: Findings revealed this game was an enjoyable and effective resource to engage families in self-care discussions. Key themes included communication, being involved, knowing, decisions and consequences, and being connected. Qualitative and quantitative findings aligned. Statistical significance suggests the game enhanced family engagement to support decision-making skills, as parents identified that the game helped them talk about important topics, and children gained insight regarding family supports and self-care responsibility. CONCLUSIONS: This board game was an effective, developmentally appropriate family resource to facilitate engagement and conversation about everyday life experiences in preparation for self-care. PRACTICE IMPLICATIONS: There is promising potential to extend this educational family board game intervention with a greater range of school-age children and families living with chronic conditions.

Evaluating 'FREDA Challenge': a coproduced human rights board game in services for people with intellectual disabilities.

BACKGROUND: A serious board game called 'FREDA Challenge' was co-produced with people with intellectual disabilities (PWID) as a tool for human rights (HR) education and increase positive attitudes towards HR in healthcare settings. The current study evaluated 'FREDA Challenge' with PWID and their carers. METHOD: Eighteen PWID and 13 carers participated in a repeated measures design whereby changes in attitudes and knowledge of HR were measured. RESULTS: Analysis revealed statistically significant differences (P = 0.02) between PWID and carers in their knowledge of HR. The same was not evident for attitudes towards HR. The positive attitudes and knowledge in the PWID group significantly increased after playing the game (P ≤ 0.02), but not for the carers/professionals group. CONCLUSIONS: Findings suggest that playing the board game can positively change the attitudes and knowledge of PWID towards HR. The board game seems to elicit positive interpersonal dynamics between PWID and carers/professionals.

Bacttle: a microbiology educational board game for lay public and schools.

Inspired by the positive impact of serious games on science understanding and motivated by personal interests in scientific outreach, we developed "Bacttle," an easy-to-play microbiology board game with adaptive difficulty, targeting any player from 7 years old onward. Bacttle addresses both the lay public and teachers for use in classrooms as a way of introducing microbiology concepts. The layout of the game and its mechanism are the result of multiple rounds of trial, feedback, and re-design. The final version consists of a deck of cards, a 3D-printed board, and tokens (with a paper-based alternative), with all digital content open source. Players in Bacttle take on the character of a bacterial species. The aim for each species is to proliferate under the environmental conditions of the board and the interactions with the board and with other players, which vary as the play evolves. Players start with a given number of lives that will increase or decrease based on the traits they play for different environmental scenarios. Such bacterial traits come in the form of cards that can be deployed strategically. To assess the impact of the game on microbiological knowledge, we scored differences in the understanding of general concepts before and after playing the game. We assessed a total of 169 visitors at two different university open-day science fairs. Players were asked to fill out a brief survey before and after the game with questions targeting conceptual advances. Results show that Bacttle increases general microbiology knowledge on players as young as 5 years old and with the highest impact on those who have no a priori microbiology comprehension.

Playing Kioku Reduces Loneliness in Older Adults: A Pilot Study.

Introduction: Playing together increases social connectedness, and it may be a tool to reduce loneliness. Research into the mental health benefits of board games is underdeveloped. Objectives: The study aims to examine the effects of the Kioku board game on well-being outcomes. The Kioku board game was developed in order to enable small group interactions with a focus on encouraging participants to create stories through mutual attention and interaction. We hypothesized that following a weekly intervention for 12 weeks, players would report a decrease in loneliness and an increase in well-being, compared with nonplayers. Methods: During the summer of 2022, participants in groups of 4-5 players, chose a cube word and narrated a story. A sample of 151 older adults (Mean age = 75.05 ± 6.46 years) recruited from seven community activity centers in Israel was assigned by block randomization to an intervention (n = 72) or a control group (n = 79), awaiting 4-6 weeks for future participation. Loneliness (UCLA loneliness scale) and well-being (World Health Organization 5-item scale) were evaluated at baseline and at 12 weeks. Results: A two-way repeated measures analysis of covariance (ANCOVA) (Group × Time) controlling for age, country of origin, and marital status revealed significant interaction effects for loneliness [F(1, 146) = 178.04, n2 = 0.549, P < 0.001] and well-being [F(1, 146) = 69.14, n2 = 0.321, P < 0.001]. Loneliness decreased in the intervention group (mean difference: 0.62 points, P < 0.001), and increased in the control group (mean difference: 0.18 points, P = 0.001). Well-being increased in the intervention group (mean difference: 0.79 points, P < 0.001) and decreased in the control group (mean difference: 0.20 points, P < 0.001). Conclusions: Our findings support the effectiveness of the Kioku board game intervention for decreasing loneliness and promoting well-being in older adults, who might still be coping with the effects of the COVID-19 pandemic.

Trying a board game intervention on children with autism spectrum disorder in Macau: how do they react?

Limited special education and related services are available for children with autism spectrum disorder (ASD) in Macau, especially those who are educated in general education classrooms. No intervention study has been conducted on these children. This study was conducted to explore the relationship between a board game play intervention and board game play behaviors and social communication of children with ASD educated in general education classrooms in Macau. A repeated measures design was used and the results of this study showed the mean occurrence of unprompted board game play behaviors per session during intervention was not significantly different from that during pre- or post-intervention. The mean occurrence of social communication per session during intervention was significantly higher than that during pre- and post-intervention. These findings suggest a positive relationship existed between the board game intervention used in this study and social communication of children with ASD.

The Effect of a Reminiscence Therapy-Based Hybrid Board Game on Anxiety and Loneliness Levels in Older Adults: An Experimental Study.

Background: Anxiety and loneliness are prevalent psychological issues faced by older adults. To tackle these concerns, group reminiscence therapy has been widely recognized as an effective non-pharmacological form of intervention. Despite its proven efficacy, the implementation of this therapy normally requires professional guidance, limiting its accessibility to specialized institutions such as hospitals. Objective: In this study, the objective is to empirically validate the effectiveness of a reminiscence therapy-based hybrid board game, Journey of Memories, in reducing anxiety and loneliness among older adults. Method: We conducted a 12-day randomized controlled study. A total of 38 elderly participants aged between 61 and 75 were recruited. They were randomly assigned to an experimental group (consisting of 20 individuals) and a control group (consisting of 18 individuals). Participants in the experimental group were required to engage in three sessions of the Journey of Memories hybrid board game intervention, with a 5-day interval between each session. No intervention was administered to participants in the control group. Results: The results found that after 3 sessions of board game-based reminiscence therapy, 20 participants in the experimental group showed significant reductions in anxiety levels (the State Anxiety subscale of State-Trait Anxiety Inventory [STAI-S] average scores decreased from 43.83 to 41.05, P = 0.000, the Trait Anxiety subscale State-Trait Anxiety Inventory [STAI-T] average scores decreased from 46.72 to 43.61, P = 0.030) and loneliness levels (UCLA Loneliness Scale [UCLA] average scores decreased from 39.11 to 36.11, P = 0.002). In addition, participants reported high scores of usability (3.77/5) and user experience (4.08/5). Conclusion: These results demonstrate that the hybrid board game can effectively reduce older adults' feelings of anxiety and loneliness while providing a satisfactory user experience, motivating them to participate in group reminiscence therapy.

"CARBGAME" (CARd & Board GAmes in Medical Education) as an innovative gamification tool for learning clinical enzymology in biochemistry for first year medical students.

Gamification is emerging as an active learning innovation in medical education to enhance student engagement and promote life-long learning in a unique and collaborative environment. Clinical enzymology in biochemistry is one of the core topics in the medical curriculum. However, students face challenges in comprehension and retention of information. Hence, CARd & Board GAmes in Medical Education (CARBGAME) was introduced and evaluated for its effectiveness in enhancing learning, application, and retention of knowledge in clinical enzymology via gamification context. This mixed-method study involved 150 first-year undergraduate medical students. Before the game, students completed a pre-test in clinical enzymology. Later they were divided into 25 small groups to compete in the board game designed for enzymology in biochemistry. The students took turns throwing the dice and answering the questions on the game board to continue moving forward. The first team to reach 100 and solve the case-based question was deemed the winner. Following the board game, the students took up the post-test to compare the educational impact of the innovation. Also, the subsequent internal assessment scores were compared with previous batch who were not implemented with this intervention. Then students evaluated the effectiveness of CARBGAME-Clinical Enzymology using a 32-item questionnaire on 5-point Likert scale. The feedback obtained on a 10-point rating scale and for qualitative analysis, students' and faculty perceptions were recorded in small groups. CARBGAME received overwhelmingly positive feedback from both students and faculty. It was perceived well by students for being fun, relevant, consistent, motivating, collaborative, and promoting experiential learning. The game's low-stakes approach, effective feedback, and sense of accomplishment were highly appreciated, making it a valuable tool for education. A significant improvement in knowledge was recorded, from a mean score of 8.37 ± 1.126 on a 20-point scoring scale before the game to 16.53 ± 1.219 after with a p-value of 0.0001. The comparison of the internal assessment scores between the intervention and non-intervention group of students also showed a significant improvement among those implemented with CARBGAME (p < 0.0001). The CARBGAME innovation has achieved the intended outcome of promoting active learning and enhanced performance in clinical enzymology. Highly positive responses from faculty and students also indicate the exigent need to introduce innovative components like games into curricula to achieve student engagement and promote a meaningful learning experience.

Livogena: The Ikteros Curse-A Jaundice Narrative Card and Board Game for Medical Students.

Introduction: Jaundice is a common condition that requires integrating knowledge of biochemistry, physiology, pathology, and general medicine. However, medical students face difficulty in learning with passive teaching methods. To enhance their learning, an educational story game that promotes active learning and assessment with immediate feedback was implemented. Methods: This jaundice game was named Livogena: The Ikteros Curse-denoting the liver as the principal organ and jaundice (icterus) as a problem. One hundred fifty first-year medical students were divided into small groups to play using a game board and cards. The players moved ahead on the game board by providing the correct answer and completing the activities. The first team to reach the end was the winner. Perceptions and feedback questionnaires were distributed to students at the end of the game. Individual views about the game were recorded for qualitative analysis. Also, to analyze the effectiveness of this intervention, pre- and posttests on jaundice were conducted. Results: Livogena: The Ikteros Curse resulted in a highly significant improvement in students' knowledge and application skills in jaundice, from 5.5 (SD = 2.4) in the pretest to 11.2 (SD = 7.6) in the posttest for 20 marks (p < .001). Students perceived and rated the game exceptionally positively. Discussion: This educational game significantly increased learners' understanding of the concepts of jaundice. Highly positive perceptions from students further affirm this to be a creative innovation to enhance their learning and application of knowledge in an active and team-based learning environment.

Enhancing student engagement with introductory microbiology and immunology topics using a novel board game.

In introductory microbiology courses for non-biology majors, it can be difficult to ensure that students gain a functional understanding of the interplay between the host immune system and an invading infectious agent. Immune Battle is a board game that allows students to explore pathogen evolution and the immune system's response to incursions in a captivating way, leveraging battleship and worker placement styles of gameplay. Students play in teams as either a pathogenic microbe attempting to reproduce and transmit itself to new hosts or as the immune system trying to defend the host from infection. Immune Battle seeks to mimic real-world interactions between immune cells and microbes using board game mechanics. For example, students will quickly find that adaptive immune system actions are better at fighting off microbial incursions than innate immune actions but require more time to activate. In this way, Immune Battle reinforces student's understanding of the immune system and pathogenic virulence in an exciting and interactive way that keeps them thinking about host defenses long after the end of the class period or exam. This board game is well suited for advanced high school courses and introductory college-level courses that have only limited time to cover the immune system and microbiology. Documents containing the necessary components of the board game (not including a six-sided die) are included in the supplemental materials, so educators can print out their own copies and use this board game in their classes with no cost to themselves or their students.

Effectiveness of a nursing board games in psychiatric nursing course for undergraduate nursing students: An experimental design.

AIM: To examine the effectiveness of a psychiatric nursing board game in an undergraduate psychiatric nursing course. BACKGROUND: Didactic teaching fails to assist students in deepening their understanding of abstract concepts in psychiatric nursing. The game-based learning of professional courses can address the demands of digital-age students, which may improve their learning outcomes. DESIGN: A parallel two-arm experimental design was adopted in a nursing college in southern Taiwan. METHODS: The participants were fourth-year students enroled in a college nursing programme in southern Taiwan. Simple random sampling was used to divide the class into intervention and control groups. The former participated in an eight-week game-based intervention course, while the latter continued to receive traditional instruction. In addition to collecting the students' demographic data, three structural questionnaires were developed to examine the variation in students' nursing knowledge and attitudes toward psychiatric nursing, as well as their learning satisfaction before and after the intervention. RESULTS: There were a total of 106 participants, with 53 in each group. After the intervention, the two groups were significantly different in terms of their psychiatric nursing knowledge, attitudes and self-reported learning satisfaction. The intervention group's scores were significantly higher than those of the control group across all three dimensions. This suggests the positive effects of the board game intervention on students' learning outcomes. CONCLUSION: The research outcome can be applied in formative and undergraduate nursing education in teaching psychiatric nursing globally. The game-based learning materials developed can be used to train psychiatric nursing teachers. Future studies should recruit a larger sample and increase the follow-up time for assessing students' learning outcomes, as well as examine the similarities and differences in the learning outcomes of students from different educational systems.

Comparing the effectiveness of board game-based and drill-based education programs in improving Taiwanese nurses' fire safety knowledge, attitudes, and behavior: A quasi-experimental study.

BACKGROUND: Fire education is currently dominated by drill-based programs, however only a limited number of participants may take part in fire drills. This gap could be addressed by the development of innovative board game-based educational programs. OBJECTIVE: This study sought to compare the effectiveness of board game-based and drill-based fire safety education programs in improving nurses' fire safety knowledge, attitudes, and behavior. METHODS: In this quasi-experimental study, 122 nurses were purposively sampled from a hospital in southern Taiwan. The participants were divided into two groups based on their willingness. Sixty-two nurses in the game-based group took part in an hour-long educational board game for fire safety; and 60 in the drill-based group took part in an hour-long fire drill organized by the hospital. The participants' pre- (T0) and post-intervention (T1) questionnaire scores on fire safety knowledge, attitudes, and behavior were recorded. The statistical methods included descriptive statistics and t-tests. RESULTS: After the interventions, both groups had improved safety knowledge, attitudes, and behavior. However, from T0 to T1, only fire safety knowledge was significantly higher in the game-based group than in the drill-based group, and there were no significant differences in fire safety attitudes and behavior between the two groups. CONCLUSIONS: A board game-based fire education program is similar to a tabletop exercise, and drill-based programs more accurately reflect actual circumstances. Both methods can be applied based on the educational objectives and actual educational settings. The results of this study may function as a reference for designing clinical, educational, and academic interventions for fire safety in healthcare settings.