SBIR-STTR Award

Chronically ill children are an underserved, under-represented and disadvantaged population with regards to education. In addition to the child's medical illness, they are also at high risk for psychological problems. One of the most common psychological problem areas is educational difficulties or academic and learning problems due to regular school absences for medical reasons. Regular school absences put the child at an academic disadvantage. Also, complications from disease can result in learning disabilities or educational delays. We see an opportunity to leverage their disadvantage, a chronic and debilitating illness, into a potential educational advantage, providing motivation to learn about the systematic and scientific processes of their disease, which can spark an overall interest in math and science. Because of their chronic illness, the hospitalized children are a captive audience for informal and complex systems learning using the math and science behind their disease. We propose to develop a prototype digital game application that will consist of a small core set of models and activities that encourage children to ask questions and investigate the science behind their illness. These games will develop specific science, technology, engineering, and math (STEM) skills and provide an entry point to systems learning using the body as a model of a complex system. We anticipate that this core set of models will be adaptable to address the ways different diseases affect the body. In this way we can build upon what is personally meaningful to these children, increasing their motivation to engage and learn about STEM topics. Milestone 1: Prototype Game Development. Through paper and digital prototyping, with both the internal team and our intended audience, the game concept(s) (macro and micro) will be constructed, leveraging a proven software development process that provides both upfront direction and a process for iterative development. We will develop one body model and two small games built on that model Milestone 2: Evaluate the learning and motivation. Through observations, interviews, and conversation analysis we will evaluate the learning outcomes and changes to learning motivations through the use of the game. Milestone 3: Evaluate the potential for learning about systems thinking. Through observations and interviews we will seek to see where children and their families are making connections between the two games and possibly fitting what they know through the games to other content about their disease. Overview summary of Milestones: The objective of the current proposal is to develop a prototype of one core game model and two activities that can be incorporated into this game model. These activities will be based upon sickle cell anemia, and be tested with children with sickle cell anemia and their families. Our goal is to initially focus on one game model and one disease. Successful completion of this project will provide a platform technology that will be used to create a suite of games addressing how we can leverage different childhood illness for STEM and systems thinking learning.

Public Health Relevance Statement:


Public Health Relevance:
Children with chronic illnesses frequently miss school and may have limited opportunitie for informal learning, such as afterschool activities. Digital games may be an oppotunity to engage these young people outside of school. However, designing digital games that appeal to a wide range of children can be difficult, particularly when educational games are competing with entertainment games for their time. This project investigates leveraging the children's illness as a personally meaningful content area for educational games. These digital games will allow children to explore science and technology and serve as a platform for research on motivation to learn and technology adaptability in the field of learning sciences and educational technology.

Project Terms:
Address; Affect; Area; base; Child; Childhood; Chronic; Chronic Disease; Chronically Ill; Complex; design; Development; digital; Disadvantaged; Disease; Education; Educational Technology; Family; Goals; high risk; Hospitalized Child; interest; Interview; Learning; Learning Disabilities; mathematical sciences; Medical; Modeling; Motivation; Outcome; Paper; Population; Process; prototype; psychologic; public health relevance; Research; Schools; Science; Science, Technology, Engineering and Mathematics; Sickle Cell Anemia; skills; software development; System; Technology; Testing; Thinking, function; Time

This proposal seeks to create the Hemonauts suite of interactive digital media (IDM) to serve chronically ill, frequently hospitalized students in grades five through eight and their support networks to (i) Increase STEM content knowledge through gameplay; (ii) Increase knowledge of and intent to persist in STEM careers; and (iii) Increase disease literacy to improve patient self-advocacy, treatment compliance, and to promote healthy lifestyle choices. Chronically ill children are at risk of falling behind in school due to frequent absences and disease implications, potentially resulting in additional psychological complications and long term setbacks. While there are several health-based apps on the market that promote disease management, there is a lack of serious STEM games offered to children with the chronic diseases of Sickle Cell Disease (SCD), Asthma, and Diabetes. Hemonauts leverages these diseases as an entry point to exploit the target population's innate interest in anatomy and physiology, leading to not only a greater understanding of patients' diseases but also an increase in STEM content knowledge through newly designed, adaptive math and science challenges and virtual interactions with STEM professionals (e.g., scientists, doctors, roboticists, etc.). Through previous Phase I SBIR funding (R43OD021310), we created and tested a prototype game involving three activities to engage children in challenges related to SCD. Chronically ill student players expressed that the game was captivating and highly needed; however, they did not demonstrate increases in STEM content knowledge and expressed an alarmingly low level of disease literacy. For these reasons, our Phase II grant will lead to the creation of a series of games with supplemental, remedial education materials: a digital graphic and text and/or audio, depending on findings from our research with SCD games, that will strengthen users' abilities to correctly answer challenge questions, complete systems biology missions, and report findings to STEM professionals. Assessing how students, patients, and their families interact with remedial materials in the context of the game, and how usage relates to advancement through the game, will contribute to the growing body of STEM game literature and will answer our research question: What is the optimal mode of delivery for STEM educational content within IDM to promote increases in content knowledge and intent to persist in STEM? Once we understand how players learn STEM and disease-based concepts within IDM, we will apply and extend this knowledge to children with Asthma and Diabetes. This suite of Hemonauts IDM will be piloted with patients receiving in-hospital treatment, their parents, and siblings. Family members can explore diseases via graphic novels and videos and complete STEM missions that simulate real world disease challenges. As additional components, we will offer the Hemonauts games and supplemental materials in both English and Spanish and develop in-app functions to track patient symptoms and appointments, connect with support groups, and communicate non-emergency information to healthcare providers.

Public Health Relevance Statement:
Project Narrative This project seeks to understand how players learn STEM and disease-based concepts within the context of IDM. Through research and iterative design, we will determine which mode of content delivery: (a) graphic and text, (b) graphic and audio, or (c) graphic, text, and audio, leads to the intended outcomes of increased STEM content knowledge, increased knowledge of and intent to persist in STEM careers, and increased disease literacy to improve patient self-advocacy, treatment compliance, and to promote healthy lifestyle choices. The Hemonauts games will focus on three common illnesses - Sickle Cell Disease, Asthma, and Diabetes – to support children who frequently miss school due to hospitalizations and their families through fun, disease- based gameplay, opportunities to learn more about disease physiology, and an all-in-one product to track symptoms, plan appointments, and interact with their doctors. !

NIH Spending Category:
Behavioral and Social Science; Clinical Research; Hematology; Pediatric; Rare Diseases; Sickle Cell Disease

Project Terms:
Academy; Advocacy; Advocate; Anatomy; Appointment; Asthma; Award; base; Child; Child health care; Child Support; Childhood; Chronic Disease; Chronically Ill; Clinical; Cognitive; compliance behavior; Data; design; Diabetes Mellitus; digital; digital media; Disease; Disease Management; dosage; Educational Materials; elementary school; experience; fall risk; Family; Family member; Feedback; fifth grade; Funding; Future Teacher; Grant; Health; Health Personnel; healthy lifestyle; Hospitalization; Hospitals; improved; Institutes; interest; Interview; iterative design; Knowledge; Language; Learning; Letters; literacy; Literature; Marketing; mathematical sciences; Medical; medical schools; member; Mission; Notification; novel; Outcome; Parents; Patients; Phase; Physiology; prototype; psychologic; recruit; Remedial Teaching; remediation; Reporting; Research; Research Design; Schools; Scientist; Series; seventh grade; Siblings; Sickle Cell Anemia; Small Business Innovation Research Grant; STEM career; STEM game; Students; Support Groups; support network; Surveys; Symptoms; Systems Biology; Target Populations; Technology; Testing; Text; TimeLine; tool; Universities; Update; virtual