Content Validation of Gamified-Real-Time Video Observed Therapy (GRVOTS) Mobile Application Study via Modified Group Technique

Siti Aishah Abas, Nurhuda Ismail , Yuslina Zakaria ,Siti Munira Yasin , Khalid Ibrahim , Asmah Razali , Mas Ahmad Sherzkawi , Norliza Ahmad and Thilaka Chinnayah

Abstract:

Background

The number of Tuberculosis (TB)  patient increases everyday and according to a model projection by (Ismail N. et al.,2013), the observed and projected TB cases in Malaysia, will reach up to 300,000 cases in 2030.  In Malaysia, Direct Observed Therapy Short Course (DOTS) has been implemented since 1994 however the treatment success rate still remains at, below the recommended WHO target of 90%.  With the increasing trend of TB Defaulter in Malaysia despite DOTS implementation, exploring another method to improve TB treatment adherence is vital. Therefore, the use gamification- reality elements via Video Observed Therapy (VOTS) in the mobile apps is expected to induce motivation toward TB treatment adherence. This study aims to document the process of designing, developing, and validating the gamification-motivation-reality element in the GRVOTS mobile apps. Design/ Method: According to the literature review, gamification elements can motivate TB patients. The modified nominal group technique (NGT) via expert panel of 14 people were used to validate the presence of gamification-motivation element inside the apps. The participants of the serial NGT session were divided into three main groups, including the IT expert team, the TB administrator team, and the on-site healthcare worker. They were asked to assess the gamification-motivation element in the apps based on the percentage value of agreement, where a value of more than 70% is interpreted as acceptable and confirming to the element's existence. Result The GRVOTS mobile apps, that can be used by three different users — patients, supervisors, and administrators — was successfully developed. For the validation study purpose, this apps have also been verified as the gamification-motivation features inside it have been rated over 70% through the agreement results via the NGT study. For the gamification element, the fun received the lowest values maybe due to many factors including  perception of fun vary by different  personalities  as well as the nature of  serious game  which do not prioritize the fun element. As for the motivation factors,  the least voted element is relatedness which usually associated with  feature of leader boards or chat which is not favoured in this apps as majority our tuberculosis patients refuse to disclose their condition and communicate with other patient due to the stigma associated with the tuberculosis itself. Conclusion It has been validated that the GRVOTS mobile apps contain a gamification-motivation element, which is intended to encourage medication adherence for DOTS amongst the TB patients