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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IPROC</journal-id>
      <journal-id journal-id-type="nlm-ta">iproc</journal-id>
      <journal-title>Iproceedings</journal-title>
      <issn pub-type="epub">2369-6893</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">v8i1e41109</article-id>
      <article-id pub-id-type="pmid"/>
      <article-id pub-id-type="doi">10.2196/41109</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Abstract</subject>
        </subj-group>
        <subj-group subj-group-type="article-type">
          <subject>Abstract</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>The Heart Game: A New Tool for Digital Patient Education for Patients With Heart Failure</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Leung</surname>
            <given-names>Tiffany</given-names>
          </name>
        </contrib>
      </contrib-group>
      <contrib-group>
        <contrib id="contrib1" contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Hamborg</surname>
            <given-names>Lisbeth Gade</given-names>
          </name>
          <degrees>BSc, MSc</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <address>
            <institution>Laboratory for Welfare Technology- Digital Health &amp; Rehabilitation, Sport Sciences- Performance and Technology</institution>
            <institution>Department for Health Science and Technology</institution>
            <institution>Aalborg University</institution>
            <addr-line>Fredrik Bajers Vej 7D</addr-line>
            <addr-line>Aalborg</addr-line>
            <country>Denmark</country>
            <phone>45 50820076</phone>
            <email>Lghamborg@hotmail.com</email>
          </address>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0002-8576-7889</ext-link>
        </contrib>
        <contrib id="contrib2" contrib-type="author">
          <name name-style="western">
            <surname>Petersen</surname>
            <given-names>Rikke Jankuhn</given-names>
          </name>
          <degrees>BSc, MSc</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
        </contrib>
        <contrib id="contrib3" contrib-type="author">
          <name name-style="western">
            <surname>Spindler</surname>
            <given-names>Helle</given-names>
          </name>
          <degrees>MSc, PhD</degrees>
          <xref rid="aff2" ref-type="aff">2</xref>
        </contrib>
        <contrib id="contrib4" contrib-type="author">
          <name name-style="western">
            <surname>Dinesen</surname>
            <given-names>Birthe</given-names>
          </name>
          <degrees>PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution>Laboratory for Welfare Technology- Digital Health &amp; Rehabilitation, Sport Sciences- Performance and Technology</institution>
        <institution>Department for Health Science and Technology</institution>
        <institution>Aalborg University</institution>
        <addr-line>Aalborg</addr-line>
        <country>Denmark</country>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution>Department of Psychology and Behavioral Sciences</institution>
        <institution>Aarhus University</institution>
        <addr-line>Aarhus</addr-line>
        <country>Denmark</country>
      </aff>
      <author-notes>
        <corresp>Corresponding Author: Lisbeth Gade Hamborg <email>Lghamborg@hotmail.com</email></corresp>
      </author-notes>
      <pub-date pub-type="collection">
        <season>Jan-Dec</season>
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>23</day>
        <month>8</month>
        <year>2022</year>
      </pub-date>
      <volume>8</volume>
      <issue>1</issue>
      <elocation-id>e41109</elocation-id>
      <history>
        <date date-type="received">
          <day>15</day>
          <month>7</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>19</day>
          <month>8</month>
          <year>2022</year>
        </date>
      </history>
      <copyright-statement>©Lisbeth Gade Hamborg, Rikke Jankuhn Petersen, Helle Spindler, Birthe Dinesen. Originally published in Iproceedings (https://www.iproc.org), 23.08.2022.</copyright-statement>
      <copyright-year>2022</copyright-year>
      <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
        <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.</p>
      </license>
      <self-uri xlink:href="https://www.iproc.org/2022/1/e41109" xlink:type="simple"/>
      <abstract>
        <sec sec-type="background">
          <title>Background</title>
          <p>The COVID-19 pandemic has shown the need for new ways to perform remote patient education. Patients with heart failure are associated with a high readmission rate. Rehabilitation can prevent hospital readmissions, but there is poor participation in rehabilitation of patients with heart failure. Based on user-driven innovation in the Future Patient research project, we have developed the prototype of the digital Heart Game. The Heart Game is a new approach to digital patient education, where patients can access a digital board game via an app; through the board game, they can be presented with quizzes, activities, and reflection questions, all related to heart failure.</p>
        </sec>
        <sec sec-type="objective">
          <title>Objective</title>
          <p>The objective of our study was to assess the usability of the Heart Game prototype app.</p>
        </sec>
        <sec sec-type="methods">
          <title>Methods</title>
          <p>A total of 6 patients with heart failure were recruited. Think-aloud test, where participants were observed during play and sound and iPad screens were recorded, was conducted, followed by a questionnaire immediately after playing. Finally, an interview (n=6) was carried out. Qualitative data were analyzed in NVivo software (version 12.0).</p>
        </sec>
        <sec sec-type="results">
          <title>Results</title>
          <p>In total, 6 patients with heart failure (83% male; mean age 66 years) participated in the think-aloud tests. One participant did not complete the game. The game duration was from 9 minutes and 14 seconds to 16 minutes and 13 seconds. Findings from the think-aloud tests were shown in themes: digital games are a new world; practice makes perfect; the Heart Game is illogical; tasks are not generalizable, in understandable formulations, or entertaining; and the Heart Game is relevant, fun, and entertaining to play.</p>
        </sec>
        <sec sec-type="conclusions">
          <title>Conclusions</title>
          <p>The usability of the Heart Game shows opportunities for digital patient education. However, there are some challenges in the prototype with illogical game structures in the board game. Further test and development of the prototype needs to be performed.</p>
        </sec>
      </abstract>
      <kwd-group>
        <kwd>telehealth</kwd>
        <kwd>digital patient education</kwd>
        <kwd>heart failure</kwd>
        <kwd>game prototype</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <back>
    <app-group/>
    <fn-group>
      <fn fn-type="conflict">
        <p>None declared.</p>
      </fn>
    </fn-group>
  </back>
</article>
