Using Games as Behavioral Change Interventions in Infection Prevention and Control


The uptake of improvement initiatives in infection prevention and control (IPC) has often proven challenging. Innovative interventions such as ‘serious games’ have been proposed in other areas to educate and help clinicians adopt optimal behaviors. A ‘serious game’ is defined as an ‘interactive computer application, with or without significant hardware component, that has a challenging goal, is fun to play and engaging, incorporates some scoring mechanism, and supplies the user with skills, knowledge or attitudes useful in reality. Serious games have already been used in clinical medicine, surgery and public health with successful results. Seemingly, game users enjoy interacting with games because they can fulfil psychological needs such as control, autonomy and a sense of achievement.

There is limited evidence about the application and evaluation of serious games in IPC. The purposes of the study by Castro-Sánchez, et al. (2016) were to synthesize research evidence on the use of serious games in IPC to support healthcare workers’ behavior change and best practice learning and to identify gaps across the formulation and evaluation of serious games in IPC.

A scoping study was conducted by Castro-Sánchezusing the methodological framework developed by Arksey and O’Malley. The researchers examined electronic databases (Ovid MEDLINE, Embase Classic + Embase, PsycINFO, Scopus, Cochrane, Google Scholar) in December 2015. Evidence from these studies was assessed against an analytic framework of intervention formulation and evaluation.

Nine hundred sixty five unique papers were initially identified, 23 included for full-text review, and four finally selected. Studies focused on intervention inception and development rather than implementation. Expert involvement in game design was reported in 2/4 studies. Potential game users were not included in needs assessment and game development. Outcome variables such as fidelity or sustainability were scarcely reported.

The researchers conclude that growing interest in serious games for health has not been coupled with adequate evaluation of processes, outcomes and contexts involved. Explanations about the mechanisms by which game components may facilitate behavior change are lacking, further hindering adoption.

Reference: Castro-Sánchez E, et al. Serious electronic games as behavioral change interventions in healthcare-associated infections and infection prevention and control: a scoping review of the literature and future directions. Antimicrobial Resistance & Infection Control. 2016;5:34

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