Does Dynamic Tailoring of A Narrative-Driven Exergame Result in Higher User Engagement among Adolescents? Results from A Cluster-Randomized Controlled Trial.
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SUBMITTER: Schwarz A
PROVIDER: S-EPMC8305797 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundEvaluating engagement with an intervention is a key component of understanding its efficacy. With an increasing interest in developing behavioral interventions in the mobile health (mHealth) space, appropriate methods for evaluating engagement in this context are necessary. Data collected to evaluate mHealth interventions are often collected much more frequently than those for clinic-based interventions. Additionally, missing data on engagement is closely linked to level of engagement resulting in the potential for informative missingness. Thus, models that can accommodate intensively collected data and can account for informative missingness are required for unbiased inference when analyzing engagement with an mHealth intervention.ObjectiveThe objectives of this paper are to discuss the utility of the joint modeling approach in the analysis of longitudinal engagement data in mHealth research and to illustrate the application of this approach using data from an mHealth intervention designed to support illness management among people with schizophrenia.MethodsEngagement data from an evaluation of an mHealth intervention designed to support illness management among people with schizophrenia is analyzed. A joint model is applied to the longitudinal engagement outcome and time-to-dropout to allow unbiased inference on the engagement outcome. Results are compared to a naïve model that does not account for the relationship between dropout and engagement.ResultsThe joint model shows a strong relationship between engagement and reduced risk of dropout. Using the mHealth app 1 day more per week was associated with a 23% decreased risk of dropout (P<.001). The decline in engagement over time was steeper when the joint model was used in comparison with the naïve model.ConclusionsNaïve longitudinal models that do not account for informative missingness in mHealth data may produce biased results. Joint models provide a way to model intensively collected engagement outcomes while simultaneously accounting for the relationship between engagement and missing data in mHealth intervention research.
| S-EPMC5269557 | biostudies-literature
Project description:While opportunities for adolescents to drive their own learning are increasing, differences in motivations for and engagement in these opportunities are rarely investigated. The current study employed a sample of adolescents (N = 580, M age = 16.53) enrolled in GripTape, a 10-week self-driven learning program in which youth pursue topics of their choosing. Cluster analysis classified adolescents based on their personal (e.g., resilience, competence) and ecological (e.g., adult support, safe environments) assets, resulting in two distinguishable groups. A High Asset group scored more favorably on these indicators than a Lower Asset group. Between-cluster comparisons revealed that compared to the Lower Asset group, the High Asset group reported greater levels of motivation for self-driven learning (i.e., intrinsic, extrinsic, and competence demonstration), but not engagement (i.e., positive learning experience, commitment to learning topics and activities). Subsequent tests showed that extrinsic motivation and competence demonstration negatively correlates with youth commitment to learning topics and activities. These findings enrich the literature concerning adolescents' motivations for and engagement in self-driven learning, and how to support youth self-driven learning.Supplementary informationThe online version contains supplementary material available at 10.1007/s12144-021-02412-0.
| S-EPMC8783173 | biostudies-literature
Project description:BackgroundIn affective exergames, game difficulty is dynamically adjusted to match the user's physical and psychological state. Such an adjustment is commonly made based on a combination of performance measures (eg, in-game scores) and physiological measurements, which provide insight into the player's psychological state. However, although many prototypes of affective games have been presented and many studies have shown that physiological measurements allow more accurate classification of the player's psychological state than performance measures, few studies have examined whether dynamic difficulty adjustment (DDA) based on physiological measurements (which requires additional sensors) results in a better user experience than performance-based DDA or manual difficulty adjustment.ObjectiveThis study aims to compare five DDA methods in an affective exergame: manual (player-controlled), random, performance-based, personality-performance-based, and physiology-personality-performance-based (all-data).MethodsA total of 50 participants (N=50) were divided into five groups, corresponding to the five DDA methods. They played an exergame version of Pong for 18 minutes, starting at a medium difficulty; every 2 minutes, two game difficulty parameters (ball speed and paddle size) were adjusted using the participant's assigned DDA method. The DDA rules for the performance-based, personality-performance-based, and all-data groups were developed based on data from a previous open-loop study. Seven physiological responses were recorded throughout the sessions, and participants self-reported their preferred changes to difficulty every 2 minutes. After playing the game, participants reported their in-game experience using two questionnaires: the Intrinsic Motivation Inventory and the Flow Experience Measure.ResultsAlthough the all-data method resulted in the most accurate changes to ball speed and paddle size (defined as the percentage match between DDA choice and participants' preference), no significant differences between DDA methods were found on the Intrinsic Motivation Inventory and Flow Experience Measure. When the data from all four automated DDA methods were pooled together, the accuracy of changes in ball speed was significantly correlated with players' enjoyment (r=0.38) and pressure (r=0.43).ConclusionsAlthough our study is limited by the use of a between-subjects design and may not generalize to other exergame designs, the results do not currently support the inclusion of physiological measurements in affective exergames, as they did not result in an improved user experience. As the accuracy of difficulty changes is correlated with user experience, the results support the development of more effective DDA methods. However, they show that the inclusion of physiological measurements does not guarantee a better user experience even if it yields promising results in offline cross-validation.
| S-EPMC8204235 | biostudies-literature
Project description:The process of transforming data into sounds for auditory display provides unique user experiences and new perspectives for analyzing and interpreting data. A research study for data transformation to sounds based on musical elements, called data-to-music sonification, reveals how musical characteristics can serve analytical purposes with enhanced user engagement. An existing user engagement scale has been applied to measure engagement levels in three conditions within melodic, rhythmic, and chordal contexts. This article reports findings from a user engagement study with musical traits and states the benefits and challenges of using musical characteristics in sonifications. The results can guide the design of future sonifications of multivariable data.
| S-EPMC10448511 | biostudies-literature
Project description:The study aimed to elucidate the influence of cognitive engagement comprised in an acute bout of exergame-based physical activity on executive functions (inhibition, cognitive flexibility) in adolescents. Therefore, the level of cognitive engagement and the intensity of physical activity were systematically varied across three experimental conditions. Sixty-five healthy male adolescents (13-16 years) were randomly assigned to one of three conditions: (a) physical activity with high levels of cognitive engagement during active video gaming, (b) physical activity with low levels of cognitive engagement during active video gaming, (c) sedentary with low levels of cognitive engagement during passive video watching. Manipulation checks, including subjective and objective operationalizations of cognitive engagement, were applied. Executive functions were assessed before and after each condition using the D-KEFS design fluency test. Results showed that cognitive engagement, operationalized by subjects' ratings and heart rate variability, differed between conditions. The physical activity condition with a high level of cognitive engagement resulted in significantly better performance in cognitive flexibility compared to conditions with low levels of cognitive engagement. Regarding benefits for executive functions in male adolescents, the results indicate that acute physical activity with high cognitive engagement could be more efficient than physical activity of the same intensity with low cognitive engagement. Even though further evidence is needed, these results extend previous research and suggest a methodological approach for measuring cognitive engagement.
| S-EPMC5193332 | biostudies-literature
Project description:The online healthcare community (OHC) has attained rapid development in recent years in which users are facilitated to exchange disease information and seek medical treatment. However, users’ motivation of participation in OHCs is still under investigation. Taking the perspective of user perceived value, this paper examined the impacts of different incentive levels including identity incentive, privilege incentive, and material incentive on user perceived value, user engagement, and user loyalty. To test the proposed hypotheses, the study adopted the methods of the between-subjects experiment and questionnaire. Based on the data analysis by ANOVA and structural equation model, the results show there are significant differences in the impacts of different incentive levels on users’ perceived value. Most of the incentive measures exert significant effects on simple user hedonic value and community identity value. Accordingly, the research findings suggest that affective support value and self-health management value demonstrate more importance for user engagement and user loyalty. Therefore, OHCs should try to improve users’ affective support value and self-health management value which are the ultimate aims of the OHCs. Our study sheds some light on profoundly understanding the design of incentive mechanism of OHC and contributes to the research of OHC services.
| S-EPMC9100646 | biostudies-literature
Project description:ObjectiveTo discuss the pathogenesis of severe coronavirus disease 2019 (COVID-19) infection and the pharmacological effects of glucocorticoids (GCs) toward this infection. To review randomized controlled trials (RCTs) using GCs to treat patients with severe COVID-19, and investigate whether GC timing, dosage, or duration affect clinical outcomes. Finally. to discuss the use of biological markers, respiratory parameters, and radiological evidence to select patients for improved GC therapeutic precision.BackgroundCOVID-19 has become an unprecedented global challenge. As GCs have been used as key immunomodulators to treat inflammation-related diseases, they may play key roles in limiting disease progression by modulating immune responses, cytokine production, and endothelial function in patients with severe COVID-19, who often experience excessive cytokine production and endothelial and renin-angiotensin system (RAS) dysfunction. Current clinical trials have partially proven this efficacy, but GC timing, dosage, and duration vary greatly, with no unifying consensus, thereby creating confusion.MethodsPublications through March 2021 were retrieved from the Web of Science and PubMed. Results from cited references in published articles were also included.ConclusionsGCs play key roles in treating severe COVID-19 infections. Pharmacologically, GCs could modulate immune cells, reduce cytokine and chemokine, and improve endothelial functions in patients with severe COVID-19. Benefits of GCs have been observed in multiple clinical trials, but the timing, dosage and duration vary across studies. Tapering as an option is not widely accepted. However, early initiation of treatment, a tailored dosage with appropriate tapering may be of particular importance, but evidence is inconclusive and more investigations are needed. Biological markers, respiratory parameters, and radiological evidence could also help select patients for specific tailored treatments.
| S-EPMC8421952 | biostudies-literature
Project description:The use of mobile health applications (apps) especially in the area of lifestyle behaviors has increased, thus providing unprecedented opportunities to develop health programs that can engage people in real-time and in the real-world. Yet, relatively little is known about which factors relate to the engagement of commercially available apps for health behaviors. This exploratory study examined behavioral engagement with a weight loss app, Lose It! and characterized higher versus lower engaged groups. Cross-sectional, anonymized data from Lose It! were analyzed (n = 12,427,196). This dataset was randomly split into 24 subsamples and three were used for this study (total n = 1,011,008). Classification and regression tree methods were used to identify subgroups of user engagement with one subsample, and descriptive analyses were conducted to examine other group characteristics associated with engagement. Data mining validation methods were conducted with two separate subsamples. On average, users engaged with the app for 29 days. Six unique subgroups were identified, and engagement for each subgroup varied, ranging from 3.5 to 172 days. Highly engaged subgroups were primarily distinguished by the customization of diet and exercise. Those less engaged were distinguished by weigh-ins and the customization of diet. Results were replicated in further analyses. Commercially-developed apps can reach large segments of the population, and data from these apps can provide insights into important app features that may aid in user engagement. Getting users to engage with a mobile health app is critical to the success of apps and interventions that are focused on health behavior change.
| S-EPMC5526821 | biostudies-other
Project description: Not available
| S-EPMC8323184 | biostudies-literature
Project description:Over the years, the various mediums available for storytelling have progressively expanded, from spoken to written word, then to film, and now to Virtual Reality (VR) and Augmented Reality (AR). In 2016, the cutting-edge Head-Mounted Display (HMD) AR Microsoft HoloLens was released. However, though it has been several years, the quality of the user experience with narration using HMD-based AR technology has been rarely discussed. The present study explored interactive narrative in HMD-based AR regarding different user interfaces and their influence on users' presence, narrative engagement and reflection. Inspired by an existing exhibition at the National Holocaust Centre and Museum in the U.K., a HoloLens narrative application, entitled The AR Journey, was developed by the authors using two different interaction methods, Natural User Interface (NUI) and Graphical User Interface (GUI), which were used to perform an empirical study. As revealed from the results of the between-subject design experiment, NUI exhibited statistically significant advantages in creating presence for users without 3D Role Playing Game (RPG) experience, and GUI was superior in creating presence and increasing narrative engagement for users with 3D RPG experience. As indicated by the results of the interviews, the overall narrative experience in HMD-based AR was acceptable, and the branching narrative design was engaging. However, HoloLens hardware issues, as well as virtuality and reality mismatch, adversely affected user experience. Design guidelines were proposed according to the qualitative results.Supplementary informationThe online version contains supplementary material available at 10.1007/s11042-021-11723-0.
| S-EPMC8717307 | biostudies-literature