Development of a serious video game to reduce uncertainty in the treatment choices of men with localized prostate cancer

Background: Localized prostate cancer (LPC) is an ideal model in which to test the impact of interactive computer games on decision-making. Patients diagnosed with LPC must choose among mutually exclusive treatments, each of which has similar survival outcomes, but different side-effects. LPC also provides an opportunity to study health games in older Americans—an understudied population.

Objective: Develop a theory-driven, evidence-based video game for treatment decision-making in localized prostate cancer that decreases social isolation and decisional conflict.

Methods: The game is designed to be a disruptive technology that changes the LPC treatment decision from a bewildering, isolating process into an empowering experience that allows men to “try out” the different treatments at home with their families. The game emphasizes shared decision-making and increases health knowledge. Design was guided by the results of an ethnographic study of LPC patients and ongoing feedback from a patient advisory board.

Results: The game design incorporates a mode of play that is familiar to the population, exposure to multiple treatments and side-effects in the short and long-term recovery periods, side-effects continually ranked by the user, printable results, and iterative play. By October, a randomized controlled study of the game's effect on isolation, decisional conflict, and uncertainty in men newly diagnosed with LPC will have been completed.

Discussion: This model addresses an underserved demographic in interactive health games. It demonstrates the value of ethnographic research and community involvement when designing games and the potential impact of this emerging medium.