Gamification Concepts to Promote and Maintain Therapy Adherence in Children with Growth Hormone Deficiency

Growth hormone (GH) deficiency affects up to one in 4000 children and is usually treated with daily injections of GH whilst the child is still growing. With children typically diagnosed at around five years old, this can mean over 10 years of therapy, which can place a considerable burden on the child and the parent. Over three-quarters of children are estimated to be not fully compliant with therapy, which can compromise their chances of attaining their target height. In recent years, interactive mobile health (smart phone or tablet) interventions using game-like concepts, so called ‘gamification’, have increased in popularity and have demonstrated success in promoting positive self-management behaviour in children with chronic conditions, such as diabetes. The application of gamified interventions has the potential to support adherence to therapy and positive behaviour in children with GH deficiency in a number of ways: (1) By providing education in a format that the child understands and accepts (e.g., using behavioural constructs to facilitate explaining why adherence is important); (2) By providing a mechanism to reduce the anxiety and stress associated with administering the injection (e.g., diversion with a virtual pet); and (3) By providing feedback to encourage ongoing engagement (e.g., rewards, progression through levels).