Type I Diabetes Self-management With Game-Based Interventions for Pediatric and Adolescent Patients.

Type 1 diabetes is a disease with a peak diagnosis between the ages of 10 and 14 and carries with it required intensive lifestyle changes. Disease self-management is essential for adequate metabolic control to prevent acute and long-term complications. Yet common methods of diabetes self-management education, such as lectures or pamphlets, lead to low knowledge, engagement, and clinical outcomes. Game-based learning has led to increased motivation, engagement, and productivity overall with substantial increases in self-management of chronic diseases in children. The purpose of this article is to review and synthesize literature on the impact on self-management knowledge, behavior, and engagement of the game-based interventions of serious games and gamification for children and adolescents with type 1 diabetes. Nine studies were reviewed. Results showed statistically significant differences in knowledge, behavior, and engagement in response to the game-based interventions. Knowledge outcomes were found most significant in serious game interventions, while behavioral outcomes were predominantly found in gamification/serious game combination interventions. Findings also reveal there was inconsistent use of theories for game development and moderate to low quality of evidence across studies. While the nine studies reviewed strongly demonstrate the potential of game-based tools to significantly improve type 1 diabetes self-management care, further studies with expanded and more rigorous study parameters are recommended before an outright change in practice may be applied. The potential impact of the clinical nurse leader in the use and research of game-based interventions is also discussed.

Lessons learned from multisite implementation and evaluation of Project SHARE, a teen health information literacy, empowerment, and leadership program.

BACKGROUND: This case study describes the implementation and evaluation of a multisite teen health information outreach program. The objectives of the program were to increase health knowledge, health information literacy, interest in health careers, community engagement, and leadership skills of teens in disadvantaged communities. CASE PRESENTATION: Teens at six sites across the country participated in a multi-week curriculum that focused on various aspects of health literacy, information literacy, and leadership. Lesson topics addressed personal health, social determinants of health, information quality, and communication and advocacy skills. Program evaluation included both quantitative and qualitative components and focused on multiple knowledge and skills outcome variables. Results suggested that while teens at all sites showed improvement, particularly with respect to engagement and interest in the topics, the degree of gains in knowledge and information literacy measures varied significantly from site to site. CONCLUSION: On-site implementation planning, cohesive integration of added activities, and emphasis on retention can contribute to implementation and evaluation effectiveness. This work also underscores the limitation of a purely quantitative approach to capturing the impact of health information and stresses the importance of supplementing numerical scores and statistics with qualitative data.