Abstract
Background Poor self-management of heart failure (HF) has contributed to poor health outcomes.
Sensor-controlled digital games (SCDGs) integrates data from behavior-tracking sensors
to trigger progress, rewards, content, and positive feedback in a digital game to
motivate real-time behaviors.
Objectives To assess the usability of an SCDG prototype over a week of game-playing among 10
older adults with HF in their homes.
Methods During initial play, participants' SCDG experiences were observed in their homes
using a checklist based on the seven-item Serious Game User Evaluator (SeGUE) instrument.
After a week of game-playing, participants completed a survey guided by the Intrinsic
Motivation Inventory, to provide their perceptions of the SCDG's usability. Qualitative
analysis via semistructured interview-derived themes on experiences playing the SCDG,
perceptions regarding engaging with the SCDG, and any usability issues encountered.
Results Ten HF participants (50% women and 50% White) played the SCDG for an average of 6
out of 7 days. Nine found the SCDG to be interesting, satisfying, and easy to play.
The average step count over a week was 4,117 steps (range: 967–9,892). Average adherence
with weight monitoring was 5.9 days in a week. Qualitative analysis yielded outcomes
regarding attitudes toward SCDG, and barriers and facilitators that influenced participants'
engagement with the SCDG.
Conclusion To the best of the authors' knowledge, this usability and feasibility study is the
first to report an SCDG designed to improve HF self-management behaviors of older
adults in their homes. Future research should consider several issues, such as user
profiles, prior game-playing experiences, and network conditions most suitable for
connected health interventions for older adults living in the community.
Keywords
heart failure - digital game - connected sensors - older adults - self-management
