virtual games for diabetic children - ilami conference 9-june-2014
DESCRIPTION
Makomba virtual world for diabetic children developed by Compedia and Schneider Children's Hospital.TRANSCRIPT
Interactive Games for Increasing Compliance of Chronic Patients
A Virtual World for Children with Diabetes
Ofer AtzmonBusiness Development Advisor, [email protected]
Moran Shemesh-Iron - Psychologist, Schneider Medical Center
Nessia Nagelberg - Rehabilitative Psychologist, Schneider Medical Center
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Agenda
• The Development Team• Diabetes Type I – The Implications• The Advantages of Games• The Game Environment• The Clinical Trial• Outcomes and Conclusions
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The Development Team
• Schneider Children’s Medical Center • Clinical and psychological knowledge • Clinical tests
• Compedia• Co-finance• Gamification and gaming technologies• Software development
• Intel Israel • Financial support• Contribute laptops
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About Schneider Medical Center
The Institute of Endocrinology & Diabetes, National Center for Childhood Diabetes
• One of the largest type 1 diabetes clinics in the world
• 17,000 out-patients a year, 1,700 patients with type 1 diabetes
• Multidisciplinary team approach which includes: physicians, nurses, dietitians, psychologists and social workers
• Psycho-social team includes 6 psychologists and social workers
• Median HbA1C is lower then international average
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• Schneider’s median HbA1C is 7.8% (2011)• International median: 8.2%• Recommended median: 7.5%
About Compedia • Twenty-five years experience in gaming and gamification
• Focus on education and healthcare
• 35+ languages, 50+ markets, 10M units sold
• High level of R&D; dozens of awards
• Cross platform: PC, MAC, iPhone, iPad, Android
• R&D cooperation with leading corporations, research
centers and universities
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Areas of Compedia’s Activity• Educational & digital learning systems
• Engagement & reward systems
• Learning management systems
• Adaptive learning and content development
• Sensors integrated systems
• Virtual learning environments and simulations
• Augmented reality (AR) platform for training and applications
• eHealth software systems:
• For children with diabetes
• For children with autism
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Type 1 Diabetics: The Problem
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• 1 in 400 children has type 1 diabetes
• Will double in the next 20 years
• No known cure
• The pancreas does not produce enough insulin, a hormone that regulates blood sugar
• Require daily management of insulin for glycemic balance
• Self-management, education and training are critical for improving outcomes and quality of life
• Intensive insulin therapy reduces the risk of cardiovascular disease
• National burden of disease (USA, 2012): $245 billion
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A Novel Solution: Games for Health
8
• Games for health are a growing area of interest
• Inform and teach patients and families about proper care
• Turn a routine unpleasant process into fun
• Improve knowledge and adherence
• Save costs, improve outcomes
• Learning by trial and error, without “paying” for mistakes
• Gamification could revolutionize healthcare industry
• Particularly effective for children
The Makomba Environment
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• Life-simulating virtual environment
• Specific diabetes learning
• Variety of fun games and learning activities
• Multiuser activities & safe social networking
Makomba: The Movie
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https://www.youtube.com/watch?v=rKbdJQ-mDdg
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The Avatar
• Each child has his own Avatar (character) which has diabetes
• The child customizes his Avatar
• The child has to take care of his Avatar’s diabetes while performing daily activities
• The Avatar’s blood glucose levels change during the day
Data Collection
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• Integration of blood glucometer – including data upload
• Monitoring and management tools for caregivers
• Helping the therapists to monitor, control and treat
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Fun Learning Activities• Many fun games distracting children’s attention away
from their condition
• Disease related knowledge games
• Data on user progress is uploaded to the web
• Personalized and adjusted to each patient
Social Interaction
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• Multi-user activities
• Group sharing and morel support
• Safe and secure private network
• Social support group
Encouraging involvement
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• Rewards (virtual and tangible)
• Designing a personal home
• Hall of Fame
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Advantages of the System
• Overcoming psychological resistance
• Real engaging environment
• Support & motivation via social networking & multiuser activities
• Enabling rules-based recommendations and alerts
• Collecting data helps therapists to treat and control
• Caregivers’ system for monitoring & mission assignment
• Integration of a blood glucometer
• Cross platform
Testing the Impact• 30 children assigned to study and control group in 2:1 ratio
• Children in the study group were provided with Makomba installed on an Intel® Classmate PC for a 3 months period
• Inclusion Criteria: Type 1 diabetes diagnosed at least one year prior to study entry, ages 7-11 years
• Treatment either with CSII (pump) or MDI (injections), HbA1c > 8.0%
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Study Outcomes
• Playing time:
• Average playing time was 15 ± 8.6 hours/3 months (range from 1.2 - 32.1 hours)
• 50% of the children played > 13 hours
• Clinical/Psychological outcomes:
• Playing Makomba improved Quality of Life of the study group
• Study group doubled their Diabetes Knowledge
• Study group showed a higher effect size in metabolic control compared with the control group
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Quality of Life Results• Improvement in quality of life (PedsQL) in study group
was found to be significant compared to control group
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0
20
40
60
80
100
120
physical emotional Social school psychosocial Total
study control
P<.01 P<.01 P<.01 P<.01
Knowledge Test & Results
• Measures basic diabetes knowledge
• Multiple-choice questions
• % of children who responded correctly to all questions:
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Study Group (N=17) Control Group (N=10)
Base line 17.6% 20%
After 3 months 52.9% 20%
Median HbA1C Results
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8.25
8.3
8.35
8.4
8.45
8.5
8.55
8.6
8.65
8.7
8.75
study control
base line after 3 months
Cohen’s d= 0.75
Cohen’s d= 0.2
Cohen's d : Effect Size Index is calculated by dividing the difference in medians for the two groups by the SD
Conclusions
• Living with diabetes in the fantasy world improves management of diabetes in the real world
• Virtual games have significant potential to improve compliance, knowledge and clinical outcomes
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Future Developments
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• Integration with glucometers and insulin pumps systems
• Integration with eHealth systems for homecare
• Target additional users groups and ages
• Expand scope of clinical trials
• Develop virtual games for other chronic conditions
Summary – Lessons Learned
• Makomba virtual system aims at improving compliance and metabolic control for children with diabetes
• Main advantages:
• Overcoming psychological resistance
• Learning via Life-simulating environment
• Social networking
• Engagement system
• Integration of a blood glucometer
• Monitoring and intervention tools for caregivers
• Promising potential for additional healthcare segments
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Thank you תודה רבה
Ofer AtzmonBusiness Development [email protected]
Additional information and video:www.Makomba.nethttp://www.youtube.com/watch?v=rKbdJQ-mDdg
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