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Elementary school children's motivation and experience toward digital hand hygiene gamification : a mixed methods approach

Langener, Simon (2019) Elementary school children's motivation and experience toward digital hand hygiene gamification : a mixed methods approach.

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Abstract:Background: Primary prevention of infectious diseases within the community sector remains a challenge. The WHO recommends non-pharmaceutical interventions to prevent infection spread within the public sector, such as promotion of hand hygiene practices. Research indicates that young children are particularly susceptible within semi-closed settings like elementary schools. Existing handwashing interventions have shown to be effective but lack in long-term behavior change. Digital games have been increasingly acknowledged to promote healthy lifestyles. The enjoyable and engaging experience is expected to increase the intrinsic motivation, which is largely studied to be desirable in terms of health behavior change. Based on the concept of participatory development, this research aims to investigate how elementary school children can be motivated to engage in handwashing behavior, amongst others, by means digital gamification. Methods: Mixed-methods research was carried out by conducting semi-structured focus group interviews with children and teachers, primarily based on the Theory of Planned Behavior’s determinants resulting in behavior. Moreover, the intrinsic motivation was measured by adopting the German short-scale of intrinsic motivation (KIM), after introducing children to either a (A) common informative poster or (B) digital handwashing gamification prototype. Latter incorporates persuasive system design elements (PSD) from the PSD-model thought to increase the intrinsic motivation. After completion, user experience interviews focusing on the utilized PSD-strategies within the prototype have been conducted. Results: In total, seventeen children with a mean age of 8.4 years participated in focus group interviews. Furthermore, five teachers separately attended with a mean age of 44 years. Results show, that the children’s motivation toward handwashing is positively influenced by the willingness to stay healthy, fun, instructions and cues to action within the school context whereas an inadequate environment, inappropriate behavior of other, and laziness are reported to negatively influence motivation. On the other hand, the teacher’s concerns are outweighing the benefits when thinking of handwashing technology within the school setting, as they are suspecting misuse and disruption of classroom dynamics. However, in total sixteen elementary school children (mean age 8.2 years) completed a survey on intrinsic motivation which showed trends within means that should be further investigated, since all children indicated a positive attitude towards the prototype, especially toward the strategies modelling, simulation, and praise. Conclusion: The school environment and -context influences the motivation to engage in handwashing and should be considered thoroughly. Moreover, cues to action, fun and instructions as well as normative influences have been identified as potential strategies to motivate children, which can also be embedded in technology. However, based on this research it can be concluded, that persuasive and pervasive technology can be of added value when designing digital interventions to promote handwashing. Furthermore, user and stakeholder should be incorporated in the development process, as their needs and barriers are important to successfully design and implement interventions. Future research should investigate the potential of stimuli (e.g. smell and temperature), personalization as well as PSD-strategies and their combinational influence on the intrinsic motivation, in order to facilitate handwashing behavior by means of digital gamification.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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