BACKGROUND: Influenza represents a critical public health challenge, disproportionately affecting at-risk populations, including older adults and those with chronic conditions, often compounded by socioeconomic factors. Innovative strategies, such as gamification, are essential for augmenting risk communication and community engagement efforts to address this threat.
OBJECTIVE: This study aims to introduce the \"Let\'s Control Flu\" (LCF) tool, a gamified, interactive platform aimed at simulating the impact of various public health policies (PHPs) on influenza vaccination coverage rates and health outcomes. The tool aligns with the World Health Organization\'s goal of achieving a 75% influenza vaccination rate by 2030, facilitating strategic decision-making to enhance vaccination uptake.
METHODS: The LCF tool integrates a selection of 13 PHPs from an initial set proposed in another study, targeting specific population groups to evaluate 7 key health outcomes. A prioritization mechanism accounts for societal resistance and the synergistic effects of PHPs, projecting the potential policy impacts from 2022 to 2031. This methodology enables users to assess how PHPs could influence public health strategies within distinct target groups.
RESULTS: The LCF project began in February 2021 and is scheduled to end in December 2024. The model creation phase and its application to the pilot country, Sweden, took place between May 2021 and May 2023, with subsequent application to other European countries. The pilot phase demonstrated the tool\'s potential, indicating a promising increase in the national influenza vaccination coverage rate, with uniform improvements across all targeted demographic groups. These initial findings highlight the tool\'s capacity to model the effects of PHPs on improving vaccination rates and mitigating the health impact of influenza.
CONCLUSIONS: By incorporating gamification into the analysis of PHPs, the LCF tool offers an innovative and accessible approach to supporting health decision makers and patient advocacy groups. It enhances the comprehension of policy impacts, promoting more effective influenza prevention and control strategies. This paper underscores the critical need for adaptable and engaging tools in PHP planning and implementation.
UNASSIGNED: RR1-10.2196/55613.

The recent emergence of innovative learning spaces, Future Classroom Lab (FCL), provides educators the use of physical learning spaces (to research, interact, exchange, develop, create, and present) and diverse technological tools to work according to active methodologies. Learners become more active in the learning process with the introduction of innovative learning environments that enable the application of interdisciplinary STEAM methodology and foster the development of 21st century competences. This study aims to uncover the probable link between application active and gamified STEAM educational interventions in the FCL and Pre-Service Teachers\' (PSTs) affective domain. The findings obtained showed statistically significant variations and, therefore, positive effects on the PSTs\' affective domain (self-efficacy, attitude, and emotion) after performing the intervention. The sample consisted of a total of 54 PSTs enrolled in the second year of Primary Education. Limited studies regarding the affective domain in the FCL were found, which restricted the comparison with prior research. This study has several implications, such as the introduction of innovative educational proposals to PSTs at the university level and, consequently, the implementation of similar interventions in elementary schools. This research intended to reveal how the different variables work as a support system for students\' learning process in mathematics and science disciplines.

BACKGROUND: Traffic crashes caused by adolescents are being assessed as particularly serious and a common concern of society as a whole. Improving traffic knowledge and skills is crucial in reducing adolescent traffic crashes.
OBJECTIVE: This study aimed to investigate the effects of a gamified e-learning platform on traffic knowledge and skills among adolescents (aged 15-18) in Vietnam.
METHODS: Using a pretest-posttest design, this quasi-experimental study, included 350 participants within the intervention group and 350 participants within the control group. All participants were selected from three high schools in Ho Chi Minh City in Vietnam. Intervention group participants got a gamified traffic safety learning experience with a gamified e-learning platform, while control group participants received general traffic safety education through conventional methods using short videos. The effect was measured via tests focusing on traffic knowledge and skills. Data were subsequently collected from both groups before (i.e., pretest) and immediately after (i.e., posttest 1) following the education. In addition, within the intervention group also a second posttest (i.e., posttest 2) was conducted six months after following the education.
RESULTS: A significant increase in scores on posttest 1 compared to the pretest was found in the intervention group but not in the control group. Also, among the intervention group, the scores in posttest 2 were significantly better than those in the pretest, however, there was no difference in scores between posttest 1 and posttest 2.
CONCLUSIONS: The results of this study indicated that the gamified e-learning platform cannot only improve participants\' knowledge of traffic safety but also help participants retain such knowledge for at least six months.
CONCLUSIONS: The study findings can reinforce the important role of traffic safety education in improving adolescent traffic knowledge and skills.

UNASSIGNED: This study investigates the interplay between the Technology Acceptance Model (TAM), self-regulation strategies, and academic self-efficacy, and their collective impact on academic performance and perceived learning among college students engaged in remote education.
UNASSIGNED: A sample of 872 university students from Southern China participated in this study. Structural Equation Modeling (SEM) was employed to analyze the theoretical relationships among the variables. The research focused on two primary areas: the connection between academic self-efficacy and gameful self-regulation strategies within the framework of TAM, and the influence of TAM\'s three dimensions on students\' perceived learning and academic performance.
UNASSIGNED: Findings highlight self-efficacy and gameful self-regulation strategies, in enhancing technology acceptance. Improved acceptance of technology is shown to positively affect academic performance and the perceived learning experience of students in classes using game-based online resources.
UNASSIGNED: The study emphasizes the significance of self-efficacy and gameful self-regulation strategies in shaping students\' perceptions and attitudes towards technology. These factors are found to be key determinants of both perceived learning and academic achievement in the context of game-based online resource classes.

BACKGROUND: Children with disabilities face numerous challenges in accessing health services. Mobile health is an emerging field that could significantly reduce health inequities by providing more accessible services. Many mobile apps incorporate gamification elements such as feedback, points, and stories to increase engagement and motivation; however, little is known about how gamification has been incorporated in mobile apps for children with disabilities.
OBJECTIVE: This scoping review aims to identify and synthesize the existing research evidence on the use of gamification in mobile apps for children with disabilities. Specifically, the objectives were to (1) identify the categories of these mobile apps (eg, treatment and educational) (2), describe the health-related outcomes they target, (3) assess the types and levels of gamification elements used within these apps, and (4) determine the reasons for incorporating gamification elements into mobile apps.
METHODS: We searched MEDLINE, PsycINFO, CINAHL, Embase, the ACM Digital Library, and IEEE Xplore databases to identify papers published between 2008 and 2023. Original empirical research studies reporting on gamified mobile apps for children with disabilities that implemented at least 1 gamification strategy or tactic were included. Studies investigating serious games or full-fledged games were excluded.
RESULTS: A total of 38 studies reporting on 32 unique gamified mobile apps were included. Findings showed that gamified apps focus on communication skills and oral health in children with autism spectrum disorder while also addressing self-management and academic skills for other disability groups. Gamified mobile apps have demonstrated potential benefits across different populations and conditions; however, there were mixed results regarding their impact. The gamification strategies included fun and playfulness (23/32, 72%), feedback on performance (17/32, 53%), and reinforcement (17/32, 53%) in more than half of apps, whereas social connectivity was used as a gamification strategy in only 4 (12%) mobile apps. There were 2 main reasons for integrating gamification elements into mobile apps described in 16 (42%) studies: increasing user engagement and motivation and enhancing intervention effects.
CONCLUSIONS: This scoping review offers researchers a comprehensive review of the gamification elements currently used in mobile apps for the purposes of treatment, education, symptom management, and assessment for children with disabilities. In addition, it indicates that studies on certain disability groups and examinations of health-related outcomes have been neglected, highlighting the need for further investigations in these areas. Furthermore, research is needed to investigate the effectiveness of mobile-based gamification elements on health and health behavior outcomes, as well as the healthy development of children with disabilities.

BACKGROUND: With the increased use of smartphones, mobile applications (apps) aimed at promoting healthy behaviors have experienced exponential growth.
OBJECTIVE: This study aimed to provide an overview of mobile apps that use gamification to motivate children to maintain optimal oral hygiene and to evaluate the quality of the oral hygiene apps for children (OHACs) available in the Turkish Google Play Store and the Apple Store.
METHODS: Between January 20 and February 2, 2024, OHACs were searched in the Turkish Google Play Store and the Apple Store. Seven apps were assessed using the Mobile Application Rating Scale (MARS) and evidence-based dentistry criteria (EBD). We used Microsoft Office Professional 2016 (Microsoft Excel 2016; Microsoft Corp, Redmond, WA, USA) and IBM SPSS Statistics version 29 for Windows (IBM Corp, Armonk, NY, USA) for all the data analyses and visualizations.
RESULTS: The best overall MARS scores were obtained for Diş Doktoru: Dentist (3.53 ± 0.15) and Diş Hekimi Oyunları: Dentist Game (3.72 ± 0.33). The worst overall MARS scores were obtained for Truthbrush (2.76 ± 0.06) and Mimizaur (2.85 ± 0.09). Hayvan Diş Hekimi: Animal Dentist, Diş Hekimi Oyunları, and the Brush Teeth Game: Kids Dentist included the most evidence-based content.
CONCLUSIONS: Most OHACs achieved moderate MARS scores for promoting oral hygiene habits among children. Improving the quality and educational content of OHACs could increase personal oral care motivation in children. More research is required to determine the long-term effects of the apps and whether they align with oral hygiene guidance.

OBJECTIVE: Many strategies are employed in pharmacy education to maintain student engagement through active learning. Gamification, such as the choose-your-own-adventure activity (CYOAA), is one such method. The purpose of this study was to assess improvement in clinical knowledge and retention after implementation of CYOAA.
METHODS: Two CYOAA were designed and implemented within second-year pharmacy courses. One activity was on venous thromboembolism (VTE) and the other on chronic obstructive pulmonary disease (COPD). Students completed a six question pre- and post-quiz for both activities mapped to core learning objectives and four similar, but more difficult questions on corresponding exams. After the CYOAA, students completed a reflection and perceptions survey.
RESULTS: Seventy-five students completed the VTE CYOAA and 77 completed COPD. Over the three timepoints there was a significant decrease in mean assessment scores on the VTE activity (68% to 65% to 40%; p<0.001) versus a significant and sustained increase in mean assessment scores on COPD (62% to 83% to 85%; p<0.001). Of the 36 and 33 students that completed the post-survey, the majority agreed or strongly agreed that they preferred CYOAA to traditional cases and that the activities improved their knowledge, critical thinking skills, and confidence in clinical decision making.
CONCLUSIONS: There was a mixed result in mean assessment scores with an increase seen with the COPD CYOAA and a decrease with VTE, as well as positive perceptions for both VTE and COPD, indicating that this classroom innovation is well liked and may improve knowledge outcomes.

Maintaining a diverse gene pool is important in the captive management of zoo populations, especially in endangered species such as the pink pigeon (Nesoenas mayeri). However, due to the limited number of breeding individuals and relaxed natural selection, the loss of variation and accumulation of harmful variants is inevitable. Inbreeding results in a loss of fitness (i.e., inbreeding depression), principally because related parents are more likely to transmit a copy of the same recessive deleterious genetic variant to their offspring. Genomics-informed captive breeding can manage harmful variants by artificial selection, reducing the genetic load by avoiding the inheritance of two copies of the same harmful variant. To explain this concept in an interactive way to zoo visitors, we developed a sonification game to represent the fitness impacts of harmful variants by detuning notes in a familiar musical melody (i.e., Beethoven\'s Für Elise). Conceptually, zoo visitors play a game aiming to create the most optimal pink pigeon offspring in terms of inbreeding depression. They select virtual crosses between pink pigeon individuals and listen for the detuning of the melody, which represents the realised load of the resultant offspring. Here we present the sonification algorithm and the results of an online survey to see whether participants could identify the most and least optimal offspring from three potential pink pigeon offspring. Of our 98 respondents, 85 (86.7%) correctly identified the least optimal offspring, 73 (74.5%) correctly identified the most optimal, and 62 (63.3%) identified both the most and least optimal offspring using only the sonification.

The concept of gamification, originally rooted in digital media and game design, has increasingly emerged as a pivotal element in psychology and engagement strategies. Its application spans diverse domains within healthcare, offering innovative solutions to transform patient care through behavior modification and heightened engagement. This contemporary perspective explores theoretical frameworks and provides a critical interdisciplinary examination of current advancements in gamification for mental health and health psychology, identifying existing knowledge gaps and projecting future trends and research directions within these contexts. Based on this, concise criteria for designing, implementing, and evaluating gamification in healthcare, aligned with acknowledged best practices to promote ethical, fair, and trustworthy systems, are outlined, establishing a robust theoretical framework to design gamified interventions and scientifically evaluate their impact.

BACKGROUND: In the Netherlands, neighborhood sport coaches (NSCs) play an important role as intermediaries in promoting physical activity (PA) in the neighborhood. Gamification is the use of game elements in nongame contexts; it can be implemented with or without technology and holds promise for promoting PA. NSCs infrequently make use of this option.
OBJECTIVE: This study aims to understand barriers to, and facilitators of, using gamification to promote PA, as perceived by NSCs.
METHODS: A total of 25 semistructured interviews were conducted with NSCs in the Netherlands. The interviews were audiotaped, transcribed, and analyzed by means of thematic analysis using ATLAS.ti (version 22; ATLAS.ti Scientific Software Development GmbH) software. The deductive coding was informed by the capability, opportunity, motivation, behavior model and the theoretical domains framework, complemented by inductive coding.
RESULTS: Barriers and facilitators identified as factors influencing the implementation of gamification were related to 7 themes. NSCs required technical, creative, and promotion skills; knowledge about existing gamification tools; and social support from their employer and professional network. Financial costs were identified as a barrier to the successful implementation of gamification. Lack of clarity regarding stakeholders\' responsibility to implement gamification could further hamper implementation. In general, NSCs were positive about investing time in implementing gamification and expected positive effects from implementing it.
CONCLUSIONS: To overcome identified barriers, a clear overview of tools, best practices, and available subsidies must be created, a gamification network must be established, the responsibility of NSCs must be clarified, and guidance must be offered on the promotion of gamification.