טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
M.Sc Thesis
M.Sc StudentEfrat Maayan
SubjectCeliac Disease and Empowerment: Can Gamification Increase
Child's Empowerment Feeling and Adherence to
Gluten Free Diet?
DepartmentDepartment of Industrial Engineering and Management
Supervisor ASSOCIATE PROF. Avi Parush
Full Thesis textFull thesis text - English Version


Abstract

Young children recently diagnosed with celiac disease (CD) are immediately required to change their lives and strictly adhere to a gluten-free diet (GFD). The GFD requires major lifestyle changes that can be challenging and stressful, from both a child’s and parent’s perspective. To maintain lifelong dietary changes requires the ability to support all facets of change: psychosocial, physiological, emotional, socioeconomic, as well as sociocultural differences that influence both food intake and health-related quality of life. In this research we took the approach of educating and empowering children with CD through a mobile game application, to facilitate adherence and improve their feeling of empowerment, knowledge, GFD adherence and quality of life (QOL). Through a user-centered design process we implemented a city analogy where the children learn, through various games aimed at saving the city, to identify and distinguish between gluten-containing and gluten-free foods and to understand the basics of the GFD and CD pathophysiology. A total of 16 children, Hebrew speaking, aged 7-13 years old, with biopsy-confirmed CD diagnosis, and their parents, were recruited and randomized to an intervention group (n = 8) or a control group (n = 8). The study design was both between and within subject design. Pre and post-intervention data were collected in order to measure changes in the child's feeling of empowerment, CD knowledge, QOL, parent’s reaction to the CD, etc. Three-month follow-up data were collected from both groups. Results of the field experiment showed higher levels of empowerment feeling for the intervention group at follow-up: Mann-Whitney U=4 (p<.01), and knowledge level for both groups increased over time, with a sizable effect for the intervention group: Cohen’s d=0.858, and a small effect for the control group: Cohen’s d=0.196. The diagnosis of a child with CD can be traumatic to the child and his/her family. The changes required are both physical - adopting new dietary habits, and emotional. This research, along with many other similar projects for other chronic diseases, attempted to introduce a game as an instrument to alleviate such trauma. The uniqueness of this work is that it is one of the few that have attempted to introduce a game for children with CD to both educate and empower them through the gaming engagement and information. Technology and gamification are a fun and effective method to help children with CD, or other life changing diagnoses - to cope better and feel empowered. Despite the fact that more research is required, this research serves as a good proof of concept that a game can have an impact on the empowerment feeling of recently diagnosed children with CD.