Gamification and Oral Health in Children and Adolescents: Scoping Review

Autores da FMUP

• Tiago Salgado De Magalhães Taveira Gomes

  Autor

Participantes de fora da FMUP

• Moreira, Rui
• Silveira, Augusta
• Sequeira, Teresa
• Durao, Nuno
• Lourenco, Jessica
• Cascais, Ines
• Cabral, Rita Maria

Unidades de investigação

• Medicina da Comunidade, Informação e Decisão em Saúde

Abstract

Background: Oral health is a determinant of overall well-being and quality of life. Individual behaviors, such as oral hygiene and dietary habits, play a central role in oral health. Motivation is a crucial factor in promoting behavior change, and gamification offers a means to boost health-related knowledge and encourage positive health behaviors. Objective: This study aims to evaluate the impact of gamification and its mechanisms on oral health care of children and adolescents. Methods: A systematic search covered multiple databases: PubMed/MEDLINE, PsycINFO, the Cochrane Library, ScienceDirect, and LILACS. Gray literature, conference proceedings, and WHOQOL internet resources were considered. Studies from January 2013 to December 2022 were included, except for PubMed/MEDLINE, which was searched until January 2023. A total of 15 studies were selected following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The eligibility criteria were peer-reviewed, full -text, and empirical research related to gamification in oral health care, reports of impact, and oral health care outcomes. The exclusion criteria encompassed duplicate articles; unavailable full texts; nonoriginal articles; and non-digital game-related, non-oral health-related, and protocol studies. Selected studies were scrutinized for gamification mechanisms and outcomes. Two main questions were raised: ``Does gamification in oral health care impact oral health?'' and ``Does oral health care gamification enhance health promotion and literacy?'' The PICO (Patient, Intervention, Comparison, Outcome) framework guided the scoping review. Results: Initially, 617 records were obtained from 5 databases and gray literature sources. After applying exclusion criteria, 15 records were selected. Sample size in the selected studies ranged from 34 to 190 children and adolescents. A substantial portion (11/15, 73%) of the studies discussed oral self-care apps supported by evidence-based oral health. The most clearly defined data in the apps were ``brushing time'' (11/11, 100%) and ``daily amount brushing'' (10/11, 91%). Most studies (11/15, 73%) mentioned oral health care behavior change techniques and included ``prompt intention formation'' (11/26, 42%), ``providing instructions'' (11/26, 42%), ``providing information on the behavior-health link'' (10/26, 38%), ``providing information on consequences `` (9/26, 35%), ``modeling or demonstrating behavior'' (9/26, 35%), ``providing feedback on performance'' (8/26, 31%), and ``providing contingent rewards'' (8/26, 31%). Furthermore, 80% (12/15) of the studies identified game design elements incorporating gamification features in oral hygiene applications. The most prevalent gamification features were ``ideological incentives'' (10/12, 83%) and ``goals'' (9/16, 56%), which were found in user -specific and challenge categories, respectively. Conclusions: Gamification in oral health care shows potential as an innovative approach to promote positive health behaviors. Most studies reported evidence -based oral health and incorporated oral health care behavior change techniques.

Keywords

• gamification; mechanisms of gamification; gamification components; intrinsic and extrinsic motivators; oral health care; health behavior; oral health care applications