This dissertation describes the development of a conceptual framework for designing videogames to help children with type 1 diabetes manage their condition. The study involved surveys and focus groups with children to understand their needs, preferences, and behaviors regarding diabetes management and videogames. A central concept of "A game made for me" emerged to guide the framework. The framework proposes a six-phase videogame aligned with health behavior change theories and tailored to the needs identified, such as improving disease knowledge and self-care skills. The conceptual framework contributes to discussions on applying behavioral theories to interactive technology design and supports future diabetes videogame development.

1. SPARAPANI, V. C. “A game made for me”: conceptual framework for the
development of videogames for children with type 1 diabetes mellitus. 2015. 299 p.
Doctoral Dissertation – University of São Paulo at Ribeirão Preto College of Nursing,
Ribeirão Preto, 2015.
Type 1 diabetes mellitus is a chronic illness that mainly affects the child-juvenile
population, and its incidence has increased all over the world. These children face
different challenges to achieve the appropriate management of the disease. Non-
compliance with the treatment and the lack of structured interventions for these clients
entail the need to develop new educational strategies that are creative, interactive and
based on the valuation of their needs and preferences. In that context, videogames have
emerged as educational strategies capable of incorporating these needs and promoting
positive change in inappropriate behaviors. Although the literature appoints the potential
use of videogames to support the management of chronic illnesses, there is growing
concern with the best way to develop these strategies. The integration of theoretical and
methodological principles is recommended, but hardly described and explored in
research. This study aims to develop a conceptual framework to support the
development of videogames for children with type 1 diabetes mellitus. A
methodological study was undertaken that describes the steps for the development of
this conceptual framework, in view of the Health Behavior Change Theories and the
User-Centered Design approach as theoretical and methodological frameworks,
respectively. A descriptive and cross-sectional quantitative study was developed to
survey the profile of children and adolescents with type 1 diabetes mellitus, who attend
a public hospital in the interior of the State of São Paulo, so as to get to know the future
videogame users more properly. Next, two cycles of focus groups were held, totaling 11
groups, in which 21 children between 7 and 12 years participated. These data were
subject to deductive and inductive content analysis and a central category was
elaborated named “A game made for me”. We identified preferences regarding the use
of videogames, as well as the learning needs related to the knowledge on the disease and
to the self-care tasks and, thus, these children’s inappropriate behaviors. The children
listed their preferences for the design of a videogame aimed at them, focused on the
previously identified results. Next, we relate the results obtained with the determinants
of health behavior changes theories and we describe, for each of them, their influences
on the children’s behavior. Finally, the conceptual framework was developed through
the steps developed earlier, based on the Health Behavior Changes Theories and their
determinants. The conceptual framework proposed a videogame that consists of six
phases, each of which addresses one stage of behavior change and specific
determinants, aligned with the needs and preferences identified among the participating
children. We present the applicability of this framework in view of each phase proposed.
The results of this study contribute to advance in the discussions on how the behavioral
theories and their determinants should be related to the design of interactive
technologies. In addition, this study supports future studies aimed at developing
videogames for children with diabetes, to serve as agents of change and, at the same
time, be creative and funny.
Key words: Pediatric Nursing. Child. Type 1 Diabetes Mellitus. Video games. Healthy
Behaviors.