Co-design of a Prostate Cancer Serious Game for African Men (Georgina Cosma, David Brown, Nicholas Shopland, Steven Battersby, Sarah Seymour-Smith Seymour-Smith, Matthew Archer, Masood Khan and Graham Pockley) Interactive Technologies and Games (ITAG) Conference 2015 Health, Disability and EducationDates: Thursday 22 October 2015 - Friday 23 October 2015 Location: The Council House, NG1 2DT

1. Co-Design of a Prostate Cancer Serious Game for
African Caribbean Men
Principal Investigator: David Brown
Georgina Cosma, Nicholas Shopland, Steven Battersby,
Sarah Seymour-Smith, A. Graham Pockley,
Rose Thompson, Masood Khan
And special thanks to:
Roydon Allen, Wayne Marston and Ken Campbell
School of Science and Technology, Nottingham Trent University
NG1 8NS Nottingham, United Kingdom

2. Introduction
• Over 40,000 men are diagnosed with prostate cancer every year and one in four
Black men will develop prostate cancer at some point in their lives
• Men are not seeking medical attention in a timely manner and this increases
mortality rates
• Barriers to timely intervention include unawareness of risk and symptoms of prostate
cancer, fear and potential consequences of treatments for prostate cancer, and
trust/mistrust of healthcare services
• After diagnosis men may experience severe psychological stress, and increased risk
of suicide
• There is a need to develop culturally sensitive interventions to enhance knowledge
and understanding of prostate cancer in African Caribbean men.
Co-Design of a Prostate Cancer Serious Game

3. Prostate Cancer Project
• Serious Game is part of a funded project titled: Towards a Better Understanding
of the Poor Prognostic Outcomes for Prostate Cancer in the African
Caribbean Community
• Project funded by the Nottingham City Clinical Commissioning Group
• Aim:
– Understanding Barriers for Early Presentation
– Patient Support and the Promotion of wellbeing and engagement
– Developing applications to promote relevant health behaviours in
undiagnosed and post-diagnosed men.
Co-Design of a Prostate Cancer Serious Game

4. Our Solution
• The game provides users with prostate cancer
information and evaluates their risk based on
their profile via game play
• There are several levels to capture user
responses, which adapt the flow of the game to
provide the most appropriate and personalised
feedback
• The feedback is designed to persuade
symptomatic men to seek medical advice
• Co-design is essential to help us consider design
issues including perceptions of prostate cancer,
risk factors, concerns about medical tests
Co-Design of a Prostate Cancer Serious Game

5. The importance of developing culturally
sensitive interventions
Rose Thompson
• Findings from our work with BME Cancer
Communities and FAB alerted us to the
importance of members of the
community being ‘the voice’ of health
promotion materials
• Most effective to achieve impact is to
have health advice that comes directly
from members of the community
“Previous research has outlined the
importance of designing culturally
sensitive interventions that enhance
knowledge and understanding in line
with cultural differences and healthcare
practices among different groups
(Consendine et al, 2006; Ream et al,
2010)”.
Co-Design of a Prostate Cancer Serious Game

6. Co-design of the game
• Study to explore why DRE is a
significant barrier to diagnosis within
UK African-Caribbean men (Sarah
Seymour Smith)
• The Game’s characters and narrative
were designed by Lisa Jackson using the
Patty Dumplin Characters (successfully
used for the British Heart Foundation,
Equation Project on Domestic Violence,
and Bright Ideas Project (children's
experiences of NHS)
• The rules behind the game (mechanic)
were developed by a group of prostate
cancer experts
• The content and information presented
to the users was carefully designed by a
group of experts in order to ensure that
it is suitable and appropriately framed
Co-Design of a Prostate Cancer Serious Game

7. Live Demo of the game by Nick
Co-Design of a Prostate Cancer Serious Game

8. Focus Group Evaluations
Experimental Design
• 29 African Caribbean men
• Experts and researchers evaluated
the game
• Game installed on 20 tablets,
participants placed in small focus
groups
• Asked to provide feedback and
suggestions for changes and
additional functionality
• Each focus group was co-ordinated
by one researcher who encouraged
discussion and recorded responses
Questions
• Would you use the game?
• What changes would you make?
(add other settings? More
characters? Voices louder or
quieter?)
• What would make it easier to use?
(is it easy to use the buttons to
control the game? is it easy to
start?)
• What would you like to add?
• Would you be more likely to see a
doctor after learning more about
symptoms?
Co-Design of a Prostate Cancer Serious Game

9. Feedback from the Focus Groups
Feedback
• Very useful in raising awareness of
prostate cancer
• Is more likely to be used by African
Caribbean men
• They are more likely to see their doctor if
they experienced symptoms
• Really liked the fact that the I-PSS
questionnaire is integrated in the game
• Addresses the concerns African Caribbean
men have about the DRE
Future Work
• How to keep healthy to prevent prostate cancer,
• How to keep healthy after surviving prostate cancer
• Provide guidance about the questions they need to
ask the doctor
• Information added about interpreting various test
results and provide personalised information about
this
• Numerical risk prediction functionality which takes
into consideration their family history, symptoms,
age, and ethnicity, and other relevant information to
make an informed risk prediction
• Experts emphasised the need to have an application
informing about prostate cancer symptoms, tests
and importantly how to interpret the results of these
tests which is suitable to the entire UK population
Co-Design of a Prostate Cancer Serious Game

10. Projects in Progress
• Develop cancer prediction tools in collaboration with the John
Van Geest cancer research centre and with clinicians
• The PC Game (used by the community) along with the staging
prediction tool (used by clinicians) could have a big impact.
• We intend to measure the impact of these interventions in a
NIHR Research for Patient Benefit grant application.
Co-Design of a Prostate Cancer Serious Game

11. Acknowledgements
• Director of BME Cancer Communities - Rose Thompson
• FAB Members – Roydon Allen, Wayne Marston and Ken Campbell
• mon0lisa Productions - Ms Lisa Jackson as Patty Dumpling
• Interactive Systems Research Group (ISRG) – NTU
• John Van Geest Cancer Research Centre and clinicians
• Professor Masood Khan Urologist –Urological Surgeon, University Hospitals
Leicester NHS Trust
Co-Design of a Prostate Cancer Serious Game

12. Thank you for listening.
Any questions?
Contact: Prof. David J. Brown & Dr. Georgina Cosma @
the
Interactive Systems Research Group
Computing and Technology Team
NTU, UK.
Tel: +44 115 848 8350
david.brown@ntu.ac.uk
Co-Design of a Prostate Cancer Serious Game