Search Results (770)

The impact of oncological diseases extends far beyond the clinical patient, profoundly affecting the mental health of caregivers, family members, and volunteers who navigate complex emotional landscapes of grief, anxiety, and trauma. While the domain of digital health has seen a proliferation of serious games aimed at pediatric patient education and treatment adherence, the specific perspective of the “second-order patient”, the caregiver or survivor, remains significantly under-explored. The primary objective of this study is to systematically review the current state of interactive narratives in oncology, palliative care, and grief support, identifying research gaps to inform the broader design space of empathy-driven serious games. Following the PRISMA guidelines, 31 articles were selected from an initial query of 116 records. Interventions were categorized into Serious Games, Games, and Gamification. The analysis reveals a critical thematic transition: early interventions relied heavily on biological “battle” metaphors to empower patients, whereas the current literature advocates for “thanatosensitive” designs that foster empathy. However, a distinct research gap persists regarding narratives that explore post-loss meaning reconstruction and the hospital volunteer experience. Synthesizing these findings, this paper establishes an evidence-based theoretical framework demonstrating a significant opportunity for games that prioritize dialogue and emotional processing over traditional winning conditions. As a practical application of these findings, we also briefly outline the conceptualization of a prototype simulating a widower’s experience volunteering in a palliative ward, shifting the ludic focus from defeating a disease to navigating loss. Full article

Background: The purpose of this study was to compare the effects of two months of exergaming, conventional resistance exercise training, and no exercise on body composition and cardiometabolic risk factors in physically inactive older adults. Methods: For the preliminary study, twenty-four physically inactive adults aged 60–74 yrs. were allocated to an active video game training group (AVG n = 8), a conventional exercise group (CEG n = 7), or a non-exercising control group (CON n = 9). The AVG and CEG completed 24 supervised exercise training sessions over two months (three sessions per week) at self-selected, predominantly moderate-to-vigorous intensity, while the CON maintained usual daily activities. Body weight, skeletal muscle mass, body fat percentage, phase angle, and fasting blood biomarkers (glucose, total cholesterol, LDL, HDL, VLDL, and triglycerides) were assessed before and after the intervention. Results: No significant interactions were observed for body composition variables. Body weight decreased significantly following exercise training in both the AVG and CEG (p < 0.05). Significant interactions were found for total cholesterol (p = 0.001) and LDL cholesterol (p = 0.009). The AVG demonstrated significant reductions in fasting glucose, total cholesterol, and LDL cholesterol (p < 0.05), whereas the CEG showed a significant reduction only in total cholesterol. In contrast, the CON exhibited a significant increase in total cholesterol over the same period (p < 0.05). Conclusions: Two months of exergaming-based exercise training may lead to greater improvements in lipid-related cardiometabolic risk factors compared with conventional resistance exercise training in physically inactive older adults. These findings suggest that exergaming could be a promising exercise modality for supporting cardiometabolic health in aging populations. Full article

Background/Objectives: Periodontitis represents a significant global health burden, yet preventive health literacy remains critically low among emerging adults—a developmental stage where lifelong health behaviors crystallize. This study evaluated the effectiveness of the GUM (an acronym of Gum Understanding Mission) game, an interactive gamified digital tool incorporating AI-informed or manual feedback, for improving periodontitis literacy among tenth-semester Software Engineering students at the University of Guayaquil. Methods: In a controlled pre-test/post-test experiment, 50 participants were randomly assigned to either the GUM game intervention or a traditional lecture. Both groups completed identical knowledge assessments immediately before and after their respective 50-min instructional sessions. The GUM game featured adaptive questioning, immediate elaborated feedback, and comprehensive performance analytics, while the control group received instructor-led didactic instruction with a subsequent question-and-answer session. Results: The GUM group improved from a baseline of 21% to 94% correct responses, while the lecture group increased from 22% to 67% ($p<0.001$). Error reduction was 74% in the GUM group versus 45% in the control group. However, the study’s scope is currently limited to a single, digitally literate cohort, and knowledge retention over time was not assessed. Conclusions: These findings suggest that a self-directed, feedback-driven serious game can substantially outperform traditional methods in fostering periodontitis literacy within this population. Further research is needed across diverse populations with extended follow-up periods to assess knowledge retention and generalizability. Full article

Scholars across disciplines are urging a rethinking of human–nature relationships beyond anthropocentrism, but these ideas remain difficult to convey to broader audiences and to implement in environmental management practices. This study analyses the design and performance of a serious game (used in 12 sessions with 99 participants in total) developed to encourage participants to reflect on modes of attention and relationships with non-humans in an everyday environment. The game draws on storytelling and art-based approaches to guide players through a thought experiment in which humans and non-humans can gradually communicate and coordinate. A series of game features have been designed to challenge players’ perception of ownership, stakeholders and agency beyond humans. In the sessions played, players initially competed against each other. The revelation, throughout the game, of non-humans’ presence in the landscape, and among the game’s characters themselves, led players to cooperate. Yet they mostly cooperated among human characters to address the needs of non-humans, but they rarely engaged directly with the non-human characters themselves through voluntary interactions. Engaging participants to act as, and interact with, non-humans through role-play allows questioning established interpretations and power dynamics in land or resource management. It offers an imaginative yet embodied experience for exploring what happens if non-humans are treated as active partners with whom we can directly communicate and coordinate to address environmental challenges. Full article

Serious video games are digital games designed for purposes beyond entertainment, typically to support education, training, health interventions, or behaviour change. They combine game mechanics with psychological and pedagogical principles, such as feedback, repetition, goal-setting, and scaffolding, to create interactive environments that facilitate learning, skill development, and sustained engagement. In many cases, they are built to simulate realistic tasks or decision contexts, allowing users to practise skills, test strategies, and learn from consequences in a low-risk setting. Within cyberpsychology, serious video games are particularly valuable because they provide structured digital contexts for examining how technology shapes cognition, emotion, motivation, and behaviour. They enable researchers and practitioners to observe how users respond to digital rewards, challenges, social features, and immersive environments, as well as how these features influence outcomes such as self-efficacy, persistence, attention, and emotion regulation. As a result, serious video games operate at the intersection of psychological theory, human–technology interaction, and applied digital intervention design. This entry provides an overview of their development, theoretical foundations, applications, effectiveness, and associated ethical considerations. Full article

International students at English-medium universities in Australia whose first language is not English often struggle with language learning due to challenges sustaining motivation and managing anxiety, while simultaneously needing to strengthen their English skills to succeed academically and fully engage in university life. Although serious games are increasingly used in second-language education, many are not explicitly grounded in established pedagogical strategy frameworks, and grammar-focused serious board games remain underrepresented. In response, this study designed a strategy-embedded serious board game (The Pyramid of Time) that integrates Oxford’s indirect Language Learning Strategies to support grammar-focused practice. Following a Design Thinking process informed by desk-based evidence and refined through two rounds of playtesting, the final prototype was evaluated in a single-session, between-subjects quasi-experiment with 64 international L2 English students studying in Australian English-medium universities, comparing a collaborative board-game condition with an individual textbook self-study condition. Outcomes were assessed using pre- and post-measures of grammar test performance, language learning motivation, and grammar-learning anxiety. The strategy-embedded, collaborative game-based condition showed larger short-term gains in grammar test performance and more favourable changes in motivation and anxiety than the individual textbook self-study condition. An exploratory bootstrapped mediation analysis was consistent with an indirect pattern in which anxiety reduction related to grammar gains primarily via increased motivation, although evidence was modest. Findings provide initial support for theory-informed, strategy-embedded game-based instruction as a promising approach for grammar-focused practice that also improves learners’ short-term motivational and affective experiences. These results should be interpreted in light of differences in instructional format, collaborative structure, and time-on-task across conditions. Full article

Advances in consumer virtual reality (VR) and artificial intelligence (AI) have accelerated the use of immersive virtual learning environments (iVLEs) for skills training. Learner engagement is a critical determinant of training effectiveness, which can be shaped by VR system features (e.g., visual, auditory, and tactile immersion) coupled with interaction mechanics and instructional design integrated with the instructional behaviors of virtual human assistants (VHAs). Although visual and behavioral fidelity in VHAs have been extensively studied, functional fidelity (i.e., the extent to which the iVLE and/or VHAs support cognitive, perceptual, and motor processes required to perform a task regardless of visual realism), and particularly the temporal alignment of instructional guidance with learners’ cognitive and motor demands, remains underexamined. This article highlights research on VHAs in iVLEs with a special emphasis on temporal functional fidelity as an emerging requirement for synchronizing instructional support with user workload and task phases. By consolidating existing findings and highlighting gaps in current empirical work, this article outlines key implications for the design and evaluation of VHAs and identifies directions for future research aimed at optimizing instructional timing in iVLEs. The goal is to inform principled VHA design and clarify how fidelity dimensions should be integrated to support effective, pedagogically grounded immersive learning experiences. Full article

Serious games and negotiation simulations such as the Phosphorus Negotiation Game (P-Game) are increasingly used to support sustainability-oriented education. To broaden accessibility, a smartphone-based version of the face-to-face P-Game was developed and is presented here. A comparative design integrating quantitative pre–post survey measures with analysis of open-ended responses was employed to examine self-reported knowledge gains and learning experiences among participants who completed the P-Game in face-to-face workshops and those who played the virtual version. Both formats were associated with significant increases in participants’ perceived understanding of phosphorus science and negotiation science/practice. Self-reported knowledge of phosphorus science increased by 92.3% (global face-to-face), 70.7% (Hungarian face-to-face), and 88.4% (online), with comparable gains observed in negotiation science and practice across groups. Qualitative findings complemented these results, indicating that while learning gains were broadly similar, the modes differed in experiential emphasis: face-to-face delivery elicited performance-oriented and socially embedded reflections, whereas the online format was more frequently described in terms of structured participation and reflective processing. User satisfaction with the virtual P-Game was high, reflected by a System Usability Scale (SUS) score above 80. Overall, the findings suggest that the virtual P-Game represents a viable and accessible complement to traditional face-to-face implementation, maintaining educational impact while extending reach. Further research with larger and more diverse participant samples is recommended to strengthen generalizability and explore long-term learning outcomes in sustainability contexts. Full article

Background: The impact of screen time is having serious adverse effects on people’s lives. Unfortunately, early childhood is the most vulnerable stage in the lifespan, and most children are using television, computers, parents’ and mothers’ mobile phones, or tablets, for longer than recommended. For this reason, the interest of the education community in proposing programs for reducing screen time has grown, which could be of interest for families and professionals in early childhood development and care for children adhering to a healthy lifestyle. For this reason, the objective of this study is to compile programs including families that have tried to reduce preschool-aged children’s time in front of screens. Method: The search strategy is designed based on the PICOS framework. A review was conducted in three databases (PubMed, Web of Science, and ProQuest Central) on 11 October 2024, following the PRISMA guidelines. The systematic review is registered in PROSPERO. Results: A total of 287 articles were initially found, and 15 met all inclusion criteria. Conclusions: The results reveal that programs based on training parents in addition to performing games with children have positive effects for reducing screen time in children up to six years old, even in a specific population. Full article

This work investigates whether open-weight large language models can automatically generate runnable and educationally faithful serious games in a constrained, text-only interactive-fiction (IF) setting. The target games are station-based single-player serious games for knowledge assessment, implemented as IF in a structured, machine-readable text format, and used here as a first step towards later ambient scenarios. A fully automated pipeline called SINE (Serious Interactive Narrative Engine) is evaluated with four prompting strategies, grammar-guided decoding, deterministic validation, and a repair agent. Across a staged evaluation with 240 seeds and increasing complexity, finalist configurations reach success rates between roughly 68% and 86% on the joint criterion of compilation, playability, and learning-goal fidelity. Repair iterations proved central to robustness, whereas grammar masking on top of reasoning prompts did not consistently improve outcomes. The study provides a reproducible benchmark setup, open artifacts, and a constrained generation pipeline as a basis for later extensions toward broader serious game scenarios. Full article

Digital serious games are increasingly recognised as valuable tools for fostering student engagement and supporting active learning processes in formal educational contexts. Within the field of heritage education, however, empirical evidence concerning teacher-created games and their pedagogical effects remains limited. This study examines the educational impact of a digital serious game designed by teachers using RPG Maker MV to support the teaching of Social Sciences and local cultural heritage. The game, Misterios de Olivenza, integrates historical, geographical, and cultural content related to the municipality of Olivenza (Extremadura, Spain) through exploratory gameplay and problem-based activities. The research involved 86 primary education students aged 10–13 and employed a validated questionnaire to analyse gameplay experience, motivation, and self-perceived learning, with attention to age and gender differences. Results indicate high levels of enjoyment, motivation, and perceived learning, with no statistically significant differences by gender and limited age-related variation. A moderate positive correlation was identified between motivation and self-perception of learning, suggesting that engagement plays a key role in students’ educational experience. The findings highlight the pedagogical potential of teacher-created serious games for heritage education, while underscoring the importance of careful curricular integration and adequate scaffolding to maximise educational effectiveness. Full article

Stunting remains a major public health challenge in Indonesia, with a national prevalence of 21.6% in 2022. Rural regions such as Madura face heightened vulnerability due to cultural dietary taboos, gendered caregiving structures, intergenerational authority, and digital disparities that shape household nutrition decision-making. This formative qualitative study explores stakeholders’ perceptions to inform the conceptual development of gender-sensitive serious games for nutrition communication in rural Indonesia. Using an exploratory design, 42 informants, including mothers of children under five, brides-to-be, health cadres, midwives, religious and community leaders, and local digital actors, were recruited across rural Madura. Thematic analysis examined trust-based communication patterns, gender dynamics, perceptions of artificial intelligence (AI), and contextual conditions influencing digital health acceptance. Findings indicate that acceptance of gender-sensitive serious games depends on cultural alignment, institutional endorsement, perceived credibility, and usability in low-resource settings. Participants consistently positioned serious games and AI-supported features as complementary communication layers rather than replacements for health workers. Game-based tools were considered potentially relevant when designed to support intergenerational co-play, integrate local narratives and religious values, and function in low-connectivity environments. Rather than evaluating an implemented intervention, this study proposes a conceptual design framework grounded in feminist communication perspectives, serious games scholarship, and technology acceptance theory. The findings provide context-sensitive insights to guide future prototype development and pilot testing within hybrid, community-based nutrition communication systems. Full article

Background: Interpersonal emotion regulation (iER) is the process of managing others’ emotions and is critical during early adolescence, when social awareness and peer dependence increase. Little is known about how sex and gender role orientation shape adolescents’ iER. This study examined whether early adolescents differ in their use of person-focused (acceptance) versus problem-focused (positive engagement) strategies and whether these differences depend on context and measurement method. Methods: Data were collected from 322 adolescents (141 girls, 181 boys; aged 10–14 years, M = 12.47, SD = 1.55). The cross-sectional online study used a multi-method design comprising open-ended visual vignettes, a standardised questionnaire, and a serious game task. Participants also completed a validated gender-role self-concept measure assessing femininity and masculinity. Analyses were conducted using Poisson and logistic regressions with sex, femininity, and masculinity as predictors. Results: Across tasks, adolescents preferred problem-focused over person-focused strategies. Girls and those higher in femininity reported or generated more acceptance-based strategies, whereas boys and those higher in masculinity favoured positive engagement. These effects were evident in reflective measures (vignettes and questionnaire) but not in the interactive game, where sex and gender differences were absent. Conclusions: Findings suggest that gendered socialisation processes shape how adolescents regulate others’ emotions, particularly when behaviour is consciously reported. However, in ecologically valid contexts, these differences diminish, indicating shared capacities for adaptive interpersonal regulation across genders. Full article

Cultural heritage, in all its tangible and intangible expressions, is undergoing a process of renewal driven by the integration of digital technologies and participatory approaches. This study presents a pilot project developed within the SAMOTHRACE Fundation, focused on the design of a Serious Game dedicated to the Norman Castle of Aci Castello in Sicily. The project explores how game-based learning and interactive storytelling can enhance visitor engagement, accessibility, and understanding of small-scale heritage sites that are often excluded from major cultural circuits. Using Unity and Blender, the prototype combines historical research, 3D reconstruction, and narrative interaction to transform the castle into an immersive educational environment. This initial phase also served as the basis for an academic thesis, laying the methodological groundwork for future expansion and evaluation. The results of this pilot provide preliminary quantitative evidence that serious games can support cultural communication strategies, foster emotional engagement, and stimulate curiosity toward minor heritage sites, while remaining compatible with the constraints of modest institutions. Ultimately, the project illustrates how even modest institutions can leverage digital innovation to revitalize their heritage assets, promote inclusive participation, and explore new models of interactive archaeology and community-centered cultural engagement. Full article

There is a growing need for accessible and engaging rehabilitation tools for individuals with neurodevelopmental disorders such as Cerebral palsy (CP), Down syndrome (DS), and Autism spectrum disorder (ASD). Serious games offer a promising approach, yet few are tailor-made to meet the therapeutic demands of these populations. A tailor-made, non-immersive virtual reality (VR) serious games framework featuring a basketball task was developed, with therapist-controlled modules for customization and monitoring. Twenty-eight participants (CP: 14; DS: 7; ASD: 7) completed the game across eight sessions, grouped into three practice phases: an initial session, an early adaptation phase, and a consolidated practice phase. Performance metrics included accuracy, reaction time, and number of victories. All groups improved performance across phases, with accuracy increasing significantly in central (p = 0.005) and total positions (p = 0.007). The number of victories also increased from the initial to the early adaptation phase (p = 0.019) and from the initial to the consolidated practice phase (p = 0.008). Participants with ASD showed significantly higher accuracy than the DS group, while CP and DS participants showed a temporary increase in reaction time during the early adaptation phase, followed by a reduction in the consolidated phase, suggesting task adaptation. These findings support the feasibility and short-term effectiveness of a modular, tailor-made serious games platform for telerehabilitation. Full article