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

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

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

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

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

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

Live Demo of the game by Nick

Co-Design of a Prostate Cancer Serious Game

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

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

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

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

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