A Gamified Real-time Video Observed Therapies (GRVOTS) Mobile App via the Modified Nominal Group Technique: Development and Validation Study

Siti Aishah Abas; Nurhuda Ismail; Yuslina Zakaria; Ismassabah Ismail; Nurul Hidayah Mat Zain; Siti Munira Yasin; Khalid Ibrahim; Asmah Razali; Mas Ahmad Sherzkawee Mohd Yusoff; Norliza Ahmad; Thilaka Chinnayah

doi:10.2196/43047

A Gamified Real-time Video Observed Therapies (GRVOTS) Mobile App via the Modified Nominal Group Technique: Development and Validation Study

JMIR Serious Games. 2023 Mar 7:11:e43047. doi: 10.2196/43047.

Authors

Affiliations

¹ Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh Campus, Sungai Buloh, Malaysia.
² Department of Pharmacology, Faculty of Pharmacy, Universiti Teknologi MARA Puncak Alam Campus, Puncak Alam, Malaysia.
³ Centre of Foundation Studies, Universiti Teknologi MARA Cawangan Selangor, Kampus Dengkil, Dengkil, Malaysia.
⁴ Faculty of Computer and Mathematical Science, Universiti Teknologi MARA Cawangan Melaka, Kampus Jasin, Jasin, Malaysia.
⁵ Tuberculosis and Leprosy Control Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia.
⁶ TB/Leprosy Disease Unit, Selangor State Health Department, Shah Alam, Malaysia.
⁷ TB/Leprosy Disease Unit, Negeri Sembilan State Health Department, Seremban, Malaysia.

^# Contributed equally.

PMID: 36881449
PMCID: PMC10031451
DOI: 10.2196/43047

Abstract

Background: The success rate of tuberculosis (TB) treatment in Malaysia remains below the recommended World Health Organization target of 90% despite the implementation of directly observed therapy, short-course, a physical drug monitoring system, since 1994. With increasing numbers of patients with TB in Malaysia defaulting on treatment, exploring another method to improve TB treatment adherence is vital. The use of gamification and real-time elements via video-observed therapies in mobile apps is one such method expected to induce motivation toward TB treatment adherence.

Objective: This study aimed to document the process of designing, developing, and validating the gamification, motivation, and real-time elements in the Gamified Real-time Video Observed Therapies (GRVOTS) mobile app.

Methods: The modified nominal group technique via a panel of 11 experts was used to validate the presence of the gamification and motivation elements inside the app, which were assessed based on the percentage of agreement among the experts.

Results: The GRVOTS mobile app, which can be used by patients, supervisors, and administrators, was successfully developed. For validation purposes, the gamification and motivation features of the app were validated as they achieved a total mean percentage of agreement of 97.95% (SD 2.51%), which was significantly higher than the minimum agreement score of 70% (P<.001). Further, each component of gamification, motivation, and technology was also rated at 70% or more. Among the gamification elements, fun received the lowest scores, possibly because the nature of serious games does not prioritize the fun element and because the perception of fun varies by personality. The least popular element in motivation was relatedness, as stigma and discrimination hinder interaction features, such as leaderboards and chats, in the mobile app.

Conclusions: It has been validated that the GRVOTS mobile app contains gamification and motivation elements, which are intended to encourage medication adherence to TB treatment.

Keywords: VDOT; directly observed therapy; gamification; mHealth; medication adherence; mobile app; mobile health; mobile health app; tuberculosis; video directly observed therapy; video-observed therapy.

©Siti Aishah Abas, Nurhuda Ismail, Yuslina Zakaria, Ismassabah Ismail, Nurul Hidayah Mat Zain, Siti Munira Yasin, Khalid Ibrahim, Asmah Razali, Mas Ahmad Sherzkawee Mohd Yusoff, Norliza Ahmad, Thilaka Chinnayah. Originally published in JMIR Serious Games (https://games.jmir.org), 07.03.2023.