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Multi-dimensional Intervention Support Architecture for Gamified eHealth and mHealth Products

Periodic Reporting for period 1 - iGame (Multi-dimensional Intervention Support Architecture for Gamified eHealth and mHealth Products)

Reporting period: 2019-01-01 to 2020-12-31

H2020-MSCA-RISE-2018 iGame project investigates evidence-based gamification techniques for eHealth and mHealth and develops a multi-dimensional intervention support architecture in order to improve the efficacy of gamified eHealth products (web-based health tools and health apps). The project will develop advanced game production techniques with ready-to-use toolkits to accelerate the innovation process for eHealth and mHealth products. This will help the digital industry (games, IoT and ICT) to innovate new products and services with science and technology underpinnings. The project builds inter-disciplinary and inter-sectorial collaborations between health behavioural change science, digital games, ICT and IoT technologies, and clinical evaluations to transfer knowledge, develop skills and market upscaling, meeting the extreme challenges and huge opportunities of large-scale cost-effective eHealth interventions.

Fundamental challenges faced with gamified eHealth interventions include the high development cost for digital SMEs in product innovation and the lack of clinical evaluation methods for its effectiveness assessment. This project investigates a Multi-dimensional Intervention Support Architecture for gamified eHealth and mHealth products. The results of the project will be manifested as gamification toolkits, an integrated ICT platform, and a clinical assessment handbook. The gamification framework will greatly accelerate the pace and scale of eHealth innovations, transform, and increase the quality and efficiency of gamified eHealth products.
The project started on 31st of January, 2019. The project consortium has made the following progress:

1) Research and Innovation Exchange and Staff Training: Project partners have performed twenty staff exchange secondment months before the global covid-19 pandemics started in January 2020. In total 12 researchers have received knowledge exchange training and have had opportunities to work with SME colleagues and academics in the partner countries. Two of the researchers are senior staff, 2 are mid-career and 8 are early-career researchers. All host organisations have provided full support to the exchange researchers, offering full access to research facilities, training workshops and opportunities for cultural exchanges. The general feedback of the research and innovation activities are very positive. As a result of the RISE project, an SME researcher in ITWare has started his PhD study at UMA, as part of the iGame secondments.

2) Scientific research and prototype development:
• A deep understanding of the link between effective clinical interventions in sedentary behaviour with behaviour change techniques (BCTs). A systematic review on behaviour change techniques and the effects associated with digital behaviour change interventions in sedentary behaviour in the clinical population has been conducted. The research outcome has investigated the most used BCTs. The prototype design and implementation have been based on the results of this investigation.
• A research paper on Assessment of the Quality of Mobile Applications (Apps) for Management of Low Back Pain Using the Mobile App Rating Scale (MARS) has been published. This work investigates the digital health interventions on the improvement of different behaviours and how to correctly assess the quality of the digital tools. This research result has informed the design of the iGame digital apps.
• Sensor design and data input process have been achieved. An activity recorder software using Python, which receives sensor data via Bluetooth and visualizes it via a live graph in a real-time manner. The software is capable of both receiving and visualizing sensor data in real-time. An open-source based algorithm to calculate several Energy Expenditure equations of different physical activities automatically.
• A user focus group has been set up ready for the experimental testing of the digital app developed by the iGame project.
• A database modelling and indexing-modelling database structure have been designed for Android and iOS app development.

3) Public Dissienination and Result Exploration:
• Presentations at 8 international conferences.
• Presentations at ICT Seminar in Tokyo in February 2019, and at the Digital Innovation Delegation in Tokyo in October 2019 and EU Interreg 2 SEAS and Channel programmes.

The project website has a record of secondments activities. Social media platforms Tweeter and LinkedIn have been used to disseminate the research and outcome of the project.
The expected results until the end of the project are to go beyond the current state of the art in a number of ways:
• Developing a multi-dimension eHealth gamification architecture integrated with BCTs theories (WP2&W3)

We have investigated some well-established behaviour techniques and clearly defined the link between behaviour change techniques and digital health intervention. We have developed a mapping between the 16 categories into gameplay elements and structures.

Design of health apps and analysis of commercial Apps have been carried out. And based on the study results, the practical elements of gamification have been designed. This study has established the interrelationships between the behaviour change theories and the game design structures, building the foundation for the proposed game design Toolkits informed by the best game design practices.

The pan-European action has allowed the iGame team to directly addresses the issue of lacking a multilevel (theoretical, technological, and practical) and integrated approach to offer the best chance of success for gamified eHealth interventions.

• Innovative advanced game development technology for cost-effective eHealth gamification
Based on the study of BCTs and the best game design practice, we have gained a deep understanding of the general requirements for gamification health apps. The next step will explore advanced AI algorithms to introduce new content continually to reduce the cost and time-intensive game development process for digital SMEs and small studios.
• Innovation in eHealth assessment and building digital industry innovation capacity.
We have conducted research on the assessment method on eHealth apps to develop a framework to assess the quality and the effectiveness of health apps. This study aims to ensure that apps have been checked by a rigorous process and adhere to the EU safety standard, but not implying efficacy. We have made a step forward in the quality assessment. The next step is to conduct real-life intervention studies that measure the effect on hard outcomes using a clinical validation process to assess its effectiveness. Effective clinical evaluation is a largely unexplored area, constituting a paradigm to a quality assessment of the determinants of eHealth promotion.

The proposed eHealth gamification Toolkits and the clinic validation Methodology integrated into a novel ICT Platform will further develop the field and will foster the new market to deliver advanced eHealth gamification in Europe and beyond. Building on the industry’s innovation capacity of ITWare, SensorID and ArtHaus, the innovation will allow IP exploitation and germinate path-breaking new products and services, improving eHealth intervention techniques through quality eHealth products using evidence-based criteria (SAS).