Skip to main content
Top
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Pancreatic Cancer | Research

Co-design and evaluation of a digital serious game to promote public awareness about pancreatic cancer

Authors: Tara Anderson, Gillian Prue, Glenn McDowell, Patrick Stark, Christine Brown Wilson, Lisa Graham Wisener, Helen Kerr, Gemma Caughers, Katherine Rogers, Lana Cook, Stephanie Craig, Abdulelah Alanazi, Gary Mitchell

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

Pancreatic cancer, ranking seventh in global cancer-related deaths, poses a significant public health challenge with increasing incidence and mortality. Most cases are diagnosed at an advanced stage, resulting in low survival rates. Early diagnosis significantly impacts prognosis, making symptom awareness crucial. Symptoms are often subtle, leading to delayed help-seeking behaviour. Patients and their carers prioritise increased public awareness, indicating a need for innovative approaches to promote awareness of the disease.

Methods

This study employed a quasi-experimental pre-test/post-test design to assess the relationship between a serious game and pancreatic cancer awareness. Members of the public (N = 727) were recruited internationally, via social media and with signposting by relevant organisations. Participants completed measures of symptom awareness and help-seeking intentions before and after playing the game. The serious game, co-designed with experts by lived experience, patient advocates and healthcare professionals, presented participants with a human anatomy diagram, with each section linked to a question about pancreatic cancer.

Results

The serious game demonstrated a statistically significant improvement on pancreatic cancer awareness based on matched paired t-tests. Due to missing data, paired comparisons were only possible for 489 cases. Symptom awareness scores exhibited a statistically significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.43). Help-seeking intentions also markedly improved, showing a significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.10). Independent-samples t-tests were also conducted to determine if there were any group differences on pre- to post-test changes based on age, gender, and previous knowledge and/or experience of pancreatic cancer. Participants overwhelmingly endorsed the game’s usability and educational value, suggesting its potential as an effective tool for enhancing public awareness and proactive health-seeking behaviour.

Discussion

This study is the first to explore a serious game’s utility in pancreatic cancer awareness. Results suggest that such interventions can effectively increase public awareness and influence help-seeking intentions. The co-design process ensured content relevance, and participant satisfaction was high. Findings highlight the game’s potential as an accessible and convenient tool for diverse populations.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefPubMed Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefPubMed
2.
go back to reference Kan C, Liu N, Zhang K, Wu D, Liang Y, Cai W, et al. Global, Regional, and national burden of pancreatic cancer, 1990&ndash;2019: results from the global burden of disease study 2019. Ann Glob Health. 2023 May 25;89(1):33. Kan C, Liu N, Zhang K, Wu D, Liang Y, Cai W, et al. Global, Regional, and national burden of pancreatic cancer, 1990&ndash;2019: results from the global burden of disease study 2019. Ann Glob Health. 2023 May 25;89(1):33.
4.
go back to reference Partelli S, Sclafani F, Barbu ST, Beishon M, Bonomo P, Braz G, et al. European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): pancreatic Cancer. Cancer Treat Rev. 2021;99:102208.CrossRefPubMed Partelli S, Sclafani F, Barbu ST, Beishon M, Bonomo P, Braz G, et al. European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): pancreatic Cancer. Cancer Treat Rev. 2021;99:102208.CrossRefPubMed
7.
go back to reference Lee V, Cheng H, Li G, Saif MW. Quality of Life in Patients with Pancreatic Cancer. 2012. Lee V, Cheng H, Li G, Saif MW. Quality of Life in Patients with Pancreatic Cancer. 2012.
8.
go back to reference Bauer MR, Bright EE, MacDonald JJ, Cleary EH, Hines OJ, Stanton AL. Quality of life in patients with pancreatic Cancer and their caregivers: a systematic review. Pancreas. 2018;47(4):368–75.CrossRefPubMed Bauer MR, Bright EE, MacDonald JJ, Cleary EH, Hines OJ, Stanton AL. Quality of life in patients with pancreatic Cancer and their caregivers: a systematic review. Pancreas. 2018;47(4):368–75.CrossRefPubMed
9.
go back to reference Chung V, Sun V, Ruel N, Smith TJ, Ferrell BR. Improving Palliative Care and Quality of Life in Pancreatic Cancer patients. J Palliat Med. 2022;25(5):720–7.CrossRefPubMedPubMedCentral Chung V, Sun V, Ruel N, Smith TJ, Ferrell BR. Improving Palliative Care and Quality of Life in Pancreatic Cancer patients. J Palliat Med. 2022;25(5):720–7.CrossRefPubMedPubMedCentral
10.
go back to reference Clark KL, Loscalzo M, Trask PC, Zabora J, Philip EJ. Psychological distress in patients with pancreatic cancer-an understudied group: psychological distress in patients. Psychooncology. 2010;19(12):1313–20.CrossRefPubMed Clark KL, Loscalzo M, Trask PC, Zabora J, Philip EJ. Psychological distress in patients with pancreatic cancer-an understudied group: psychological distress in patients. Psychooncology. 2010;19(12):1313–20.CrossRefPubMed
12.
go back to reference Lewis ZK, Frost CJ, Venne VL. Pancreatic Cancer surveillance among high-risk populations: knowledge and intent. J Genet Couns. 2009;18(3):229–38.CrossRefPubMed Lewis ZK, Frost CJ, Venne VL. Pancreatic Cancer surveillance among high-risk populations: knowledge and intent. J Genet Couns. 2009;18(3):229–38.CrossRefPubMed
13.
go back to reference Mills K, Birt L, Emery JD, Hall N, Banks J, Johnson M, et al. Understanding symptom appraisal and help-seeking in people with symptoms suggestive of pancreatic cancer: a qualitative study. BMJ Open. 2017;7(9):e015682.CrossRefPubMedPubMedCentral Mills K, Birt L, Emery JD, Hall N, Banks J, Johnson M, et al. Understanding symptom appraisal and help-seeking in people with symptoms suggestive of pancreatic cancer: a qualitative study. BMJ Open. 2017;7(9):e015682.CrossRefPubMedPubMedCentral
14.
go back to reference Evans J, Chapple A, Salisbury H, Corrie P, Ziebland S. It can’t be very important because it comes and goes—patients’ accounts of intermittent symptoms preceding a pancreatic cancer diagnosis: a qualitative study: table 1. BMJ Open. 2014;4(2):e004215.CrossRefPubMedPubMedCentral Evans J, Chapple A, Salisbury H, Corrie P, Ziebland S. It can’t be very important because it comes and goes—patients’ accounts of intermittent symptoms preceding a pancreatic cancer diagnosis: a qualitative study: table 1. BMJ Open. 2014;4(2):e004215.CrossRefPubMedPubMedCentral
15.
go back to reference Saunders C, Gooden H, Robotin M, Mumford J. As the bell tolls: a foundation study on pancreatic cancer consumer’s research priorities. BMC Res Notes. 2009;2(1):179.CrossRefPubMedPubMedCentral Saunders C, Gooden H, Robotin M, Mumford J. As the bell tolls: a foundation study on pancreatic cancer consumer’s research priorities. BMC Res Notes. 2009;2(1):179.CrossRefPubMedPubMedCentral
16.
go back to reference Wouters P, Van Nimwegen C, Van Oostendorp H, Van Der Spek ED. A meta-analysis of the cognitive and motivational effects of serious games. J Educ Psychol. 2013;105(2):249–65.CrossRef Wouters P, Van Nimwegen C, Van Oostendorp H, Van Der Spek ED. A meta-analysis of the cognitive and motivational effects of serious games. J Educ Psychol. 2013;105(2):249–65.CrossRef
17.
go back to reference Zhonggen Y. A Meta-analysis of Use of Serious games in Education over a Decade. Int J Comput Games Technol. 2019;2019:1–8.CrossRef Zhonggen Y. A Meta-analysis of Use of Serious games in Education over a Decade. Int J Comput Games Technol. 2019;2019:1–8.CrossRef
18.
go back to reference Carter G, Brown Wilson C, Mitchell G. The effectiveness of a digital game to improve public perception of dementia: A pretest-posttest evaluation. Pan X, editor. PLOS ONE. 2021;16(10):e0257337. Carter G, Brown Wilson C, Mitchell G. The effectiveness of a digital game to improve public perception of dementia: A pretest-posttest evaluation. Pan X, editor. PLOS ONE. 2021;16(10):e0257337.
19.
go back to reference Cook B, Twidle P. Increasing Awareness of Alzheimer’s Disease through a Mobile Game. In: 2016 International Conference on Interactive Technologies and Games (ITAG) [Internet]. Notthingham, United Kingdom: IEEE; 2016 [cited 2023 Jul 14]. p. 55–60. Available from: http://ieeexplore.ieee.org/document/7782515/. Cook B, Twidle P. Increasing Awareness of Alzheimer’s Disease through a Mobile Game. In: 2016 International Conference on Interactive Technologies and Games (ITAG) [Internet]. Notthingham, United Kingdom: IEEE; 2016 [cited 2023 Jul 14]. p. 55–60. Available from: http://​ieeexplore.​ieee.​org/​document/​7782515/​.
20.
go back to reference Thomas TH, Bender C, Donovan HS, Murray PJ, Taylor S, Rosenzweig M et al. The feasibility, acceptability, and preliminary efficacy of a self-advocacy serious game for women with advanced breast or gynecologic cancer. Cancer. 2023;cncr.34887. Thomas TH, Bender C, Donovan HS, Murray PJ, Taylor S, Rosenzweig M et al. The feasibility, acceptability, and preliminary efficacy of a self-advocacy serious game for women with advanced breast or gynecologic cancer. Cancer. 2023;cncr.34887.
21.
go back to reference Kim HJ, Kim SM, Shin H, Jang JS, Kim YI, Han DH. A Mobile game for patients with breast Cancer for Chemotherapy Self-Management and Quality-of-life improvement: Randomized Controlled Trial. J Med Internet Res. 2018;20(10):e273.CrossRefPubMedPubMedCentral Kim HJ, Kim SM, Shin H, Jang JS, Kim YI, Han DH. A Mobile game for patients with breast Cancer for Chemotherapy Self-Management and Quality-of-life improvement: Randomized Controlled Trial. J Med Internet Res. 2018;20(10):e273.CrossRefPubMedPubMedCentral
22.
go back to reference Wochna Loerzel V, Clochesy J, Geddie P. Using Serious games to increase Prevention and Self-Management of Chemotherapy-Induced nausea and vomiting in older adults with Cancer. Oncol Nurs Forum. 2020;47(5):567–76.CrossRefPubMedPubMedCentral Wochna Loerzel V, Clochesy J, Geddie P. Using Serious games to increase Prevention and Self-Management of Chemotherapy-Induced nausea and vomiting in older adults with Cancer. Oncol Nurs Forum. 2020;47(5):567–76.CrossRefPubMedPubMedCentral
23.
go back to reference Mitchell G, Leonard L, Carter G, Santin O, Brown Wilson C. Evaluation of a ‘serious game’ on nursing student knowledge and uptake of influenza vaccination. Duplaga M, editor. PLOS ONE. 2021;16(1):e0245389. Mitchell G, Leonard L, Carter G, Santin O, Brown Wilson C. Evaluation of a ‘serious game’ on nursing student knowledge and uptake of influenza vaccination. Duplaga M, editor. PLOS ONE. 2021;16(1):e0245389.
24.
go back to reference Calik A, Cakmak B, Kapucu S, Inkaya B. The effectiveness of serious games designed for infection prevention and promotion of safe behaviors of senior nursing students during the COVID-19 pandemic. Am J Infect Control. 2022;50(12):1360–7.CrossRefPubMedPubMedCentral Calik A, Cakmak B, Kapucu S, Inkaya B. The effectiveness of serious games designed for infection prevention and promotion of safe behaviors of senior nursing students during the COVID-19 pandemic. Am J Infect Control. 2022;50(12):1360–7.CrossRefPubMedPubMedCentral
25.
go back to reference De Nooijer J, Lechner L, Candel M, De Vries H. Short- and long-term effects of tailored information versus general information on determinants and intentions related to early detection of cancer. Prev Med. 2004;38(6):694–703.CrossRefPubMed De Nooijer J, Lechner L, Candel M, De Vries H. Short- and long-term effects of tailored information versus general information on determinants and intentions related to early detection of cancer. Prev Med. 2004;38(6):694–703.CrossRefPubMed
26.
go back to reference Brooke J. SUS - A quick and dirty usability scale. 1996. Brooke J. SUS - A quick and dirty usability scale. 1996.
27.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;4(79):373–4. World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;4(79):373–4.
36.
go back to reference Mitchell G, Carter G, Brown Wilson C. Gaming for awareness. J Dement Care. 2021;29(1):16–7. Mitchell G, Carter G, Brown Wilson C. Gaming for awareness. J Dement Care. 2021;29(1):16–7.
37.
go back to reference DeSmet A, Van Ryckeghem D, Compernolle S, Baranowski T, Thompson D, Crombez G, et al. A meta-analysis of serious digital games for healthy lifestyle promotion. Prev Med. 2014;69:95–107.CrossRefPubMedPubMedCentral DeSmet A, Van Ryckeghem D, Compernolle S, Baranowski T, Thompson D, Crombez G, et al. A meta-analysis of serious digital games for healthy lifestyle promotion. Prev Med. 2014;69:95–107.CrossRefPubMedPubMedCentral
Metadata
Title
Co-design and evaluation of a digital serious game to promote public awareness about pancreatic cancer
Authors
Tara Anderson
Gillian Prue
Glenn McDowell
Patrick Stark
Christine Brown Wilson
Lisa Graham Wisener
Helen Kerr
Gemma Caughers
Katherine Rogers
Lana Cook
Stephanie Craig
Abdulelah Alanazi
Gary Mitchell
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18050-7

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue