Elisa Choucair Hosken Arão A, Carlinda Arantes de Almeida Braga A, Yury Silva I, Monteiro dos Santos L, Fontenelle de Carvalho Costa H, Arielle Barros Reis R, César Arvelos Gomes M, Henrique Batista de Souza F. Vigilantes: an educational game proposal for health promotion. HPHR. 2021;39. DOI:10.54111/0001/MM2
Technology provides access to knowledge in a pressure-free environment where learning and leisure can work together in order to achieve health promotion through a game. This is the goal of Vigilantes, an application targeted on seven-year-old children and above and elementary teachers as well.
The application prototype was built using MIT App Inventor framework and this article is based on information compiled from books, websites, monographs, and periodicals available in the Scielo and PubMed database. In Vigilantes, the user has several missions and challenges with virtual rewards, in addition to extra bonuses meant to encourage the child to learn more about diseases and their preventions.
Games aiming at improving knowledge are a great source of information for children. Parents and teachers should have access to the content available to monitor and encourage the use of the app. Educational games can foster psychomotor, cognitive, behavioral, and social development thus contributing to the learning process. So as to motivate the user correctly, these games must be devised according to the target audience, using appropriate communication.
The Vigilantes game has been developed with a view to stimulating and disseminating healthy habits in a playful way. It makes room for useful discussion and change of habits that are harmful to health.
It is well known that the contemporary educational system has work gadgets such as computing systems and virtual equipment to optimize and stimulate the learning process. The pedagogic approach based on electronic games has become increasingly popular since the digital environment can combine playful aspects with specific content. It is possible, therefore, to infer that technology can be part of the daily life of children and teenagers, as a vehicle that offers a pleasant and pressure-free learning environment1-3.
Nowadays the world epidemic caused by the Coronavirus has affected economy, education, and health. In such a scenario, the Brazilian Ministry of Health has made some recommendations. So as to prevent being infected people should avoid touching mucous membranes, keep environments clean and well-ventilated, stay away from crowds and frequently wash their hands up to the wrists with soap and water or sanitize them with 70% alcohol gel4. Unfortunately, these recommendations are often neglected by many and some believe that Covid-19 prevention measures are exaggerated. To change such a belief and to contribute to a better knowledge of the situation it is propitious to use virtual methodology presented in the Vigilantes game. It will raise children’s awareness of the importance of following the recommendations given by the authorities.
By means of the proposition of engagement that games put on a specific audience, this work seeks to join together pleasure and social need for health education5,6. Thus, the purpose is to use a game to pass on information and provide education of the child involved. It is worth that health promotion goes beyond the user, bringing reflections of the virtual world to society.
The development methodology of this project consists of two aspects: the evaluation of the literature on the medical scientific bases of the concepts correlated to the proposed game and the construction process of the game, including its rules and the expected feedback according to its use.
The theoretical research process was conducted between 2019 to 2022, gathering information from books, websites, monographs, and periodicals, with a preference for documents written within 10 years. Periodic articles were obtained from the Scielo and PubMed online databases. For this search, descriptors in Portuguese, Spanish and English were used according to the Health Sciences Descriptors (DECs): Health Education, Early Childhood Education, Continuing Education, Health-Disease Process, Educational Technology, Experimental Games. Five hundred and fifty-one articles were found, six of which were duplicates. Twenty-one of five hundred and forty-five ones were chosen to be read in detail. Articles that did not mention the applicability of digital games to children in the abstract and that focused on the development of games for adults were excluded.
The CANVA application (app) was used to build the graphic design and the MIT App Inventor framework was selected to build the functional prototype. Vigilantes game will become available at both App Store and Play Store, encompassing both systems iOS and Android.
The software is a non-binding project produced for seven years old children and above. According to the monograph “Playing in early childhood education: The construction of habits and values for a transformative education proposal”, game is a very efficient way of stimulating intelligence.
Games demand impulse control and obedience to rules. Furthermore, the children get involved in fantasy and build a shortcut between the unconscious world where they would like to live and the real world where they need to live7. Thus, the learning and lessons acquired on games are consequently in accordance with the child’s reality.
From this shortcut between the fantasy world and the real world mentioned in the monograph, the Vigilantes game seeks to educate children about the prevention of diseases such as Dengue, Yellow Fever, Zika, Chikungunya, COVID-19, some types of cancer, and other preventable pathologies in an appropriate language for children. By raising awareness in children, the Vigilantes game will indirectly reach adults as well, once questioning grown-up´s behavior which they frequently do; children will make them reflect on their attitudes.
The Vigilantes game is a free app for mobile devices, and its features were grouped in a flowchart (Figure 1) to exemplify the activities offered by the digital platform.
Figure 1. Flowchart of the activities available in the app.
The Vigilantes game flowchart begins with the users signing in with their username and password. Once logged in, they must select their city so they can be directed to their corresponding village. Then, the users have access to their current status and various tasks are delegated, such as answering a quiz, fulfilling missions, or even registering complaints about sanitary irregularities in the virtual city hall.
The quiz is based on receiving periodic questions about topics related to the diseases explored in the game. As the user plays and achieves the goals, the difficulty level increases, which leads to the search for the necessary knowledge to complete the challenge and consequently obtain more coins – used in the game to purchase additional items for your character or your home. In the mission called ”Art against the enemy”, the user will be able to develop posters with educational information about the pathologies addressed in the game, with the option of sharing them on their social networks such as Instagram, Facebook, and Twitter. The greater the engagement of the publication, the larger the reward in coins for the player. A point to be highlighted in the game is the existence of a virtual city hall, that will be a reference for complaints of possible inadequacies, that could contribute to spread diseases, which may result in punishments or fines and consequent loss of coins.
For the visual representation of the game context, some screens are demonstrated in Figure 2.
Figure 2. Interface Screenshots
Figure 2.a: Initial app window
Figure 2.b: Account creation window
Figure 2.c: Initial window after user login
Figure 2.d: Social interaction task window.
Figure 2.e: Quiz window
Figure 2.f: Awards window
Figure 2.g: User village window
Figure 2.h: Virtual store window
Figure 2.i: Game window
The child residing in a specific region signs up for an RPG-style game- a Role-playing game – in which the digital experience can be, to a certain degree, transferred to reality once the players assume the role of their character and create their narratives. The user becomes part of a village with the name of the city where he resides and where he needs to take care of his house, character, and garden. To perform daily tasks, the user will need to cope with small challenges about various diseases such as those caused by arboviruses – their form of transmission, form of prevention, symptoms, and treatment. Also, he must learn about ways to prevent other common pathologies through adherence to vaccination policies or habit changes, for instance.
Each activity performed gives the user some coins that can be exchanged for improvements in his virtual house and garden. In addition, the Vigilantes app also allows the execution of extra tasks using the user’s social interaction. For this, the users can spread posters created by themselves with the content provided by the app, which guarantees the reliability of the publication about diseases on the user’s social networks.
Users are classified, so they become known in the virtual community for their work considering health promotion. The game is also a potential tool in early childhood education which can be used by teachers to propose discussions to the class and check the learning and the engagement through the ranking. In addition to that, the game can also provide tools to register the quantitative metrics of the users, their interests, and their improvement, by archiving data on cloud-based platforms. It will be possible to identify the number of students who are playing, the time they played, the range of choices in the game, the results of the quizzes, and the questions with their answers. This will encourage parents to talk and discuss the children’s issues, such as a difficult task or a lack of knowledge. Furthermore, it will measure if a specific topic is being well received by the users which will provide, if necessary, the possibility to reorganize the strategies.
According to the Statute of Children and Teenagers (a set of norms of the Brazilian legal system) it is the family, the community, the society, and the public power duty to ensure, with priority, the rights involving health, sports, freedom, cohabitation to family and community, professionalization, culture, and food. In this case, health (a fundamental right) is approached in the Vigilantes game since the players will be instructed on how to prevent some diseases and develop fundamental skills needed for life.
The Vigilantes game aims directly and indirectly to guarantee health to the population, helping to implement article 199 of the Brazilian Constitution of 1998 that states that health is a right of all and a duty of the State. This can be achieved through social and economic policies that reduce the risk of diseases and contribute to universal and equal access to actions and services for health promotion, protection, and recovery8.
Gee, J.P (2007) highlights that apps aimed at adding knowledge are necessary not only for children but also for schools, work, and families’ environments. The balance between pedagogical and recreational activities must be kept so that the targeted audience can clearly understand the information provided by the game. To achieve this goal, it is essential that the app includes activities that improve the user´s motivation by developing creativity, facing challenges, and even dealing with frustrations when unable to perform tasks on the platform9.
This balance of the complexity of the activities proposed for children must also encompass the individual ability to perform tasks as well as the neurological development. In this sense it is necessary the designation of the age group aimed by a particular app. Bearing this in mind and considering that the Vigilantes game requires the user’s ability to read, the age group discrimination for its usage was based on Brazilian legislation that provides the prioritization of literacy in the first year of elementary school, which occurs around the age of seven in the country10.
However, the ability to read and interpret texts is subject to some particularities that make it possible for some children to be able to read at different ages. The Brazilian Ministry of Education itself understands that the literacy cycle, even if it starts at age six, can end only at age eight, the period referring to elementary school11. Due to this, the proposition of a target audience for the use of the app must be understood as a recommendation in a broad way and may include children under seven years of age who are literate, or those who need the help of a guardian for the interpretation and execution of the tasks proposed in the game.
The teacher has a fundamental role in the cognitive and neurological development process of the student. The educator must be more than a provider of information and also assume the role of an agent in the knowledge construction process, helping the student to overcome challenges proposed in each learning phase, whether it is necessary to use an app or not12.
Mattar (2010) states that conventional education is a reproduction of just words and more words and, therefore, the acquisition of knowledge by students is naturally low. Sometimes they attend classes without didactic interaction between teacher and student, and they cannot make a connection with their own reality, because what is being transmitted often makes little or no sense to them13. Within this context, schools that use the virtual environment in early childhood education in an accessible way end up offering the possibility for children to improve their reasoning, getting them to solve problems themselves and not just memorize the solutions, as sometimes occurs in traditional teaching14. Such considerations demand from a successful educational app adequate functionality, usability, reliability, and efficiency to cite some characteristics15.
Educational games can work on psychomotor, cognitive, behavioral, and social development and lead to the construction of knowledge16. According to 2019 research about 24.3 million children and teenagers aged between nine and seventeen years old are active users of the internet in Brazil, corresponding to approximately 86% of the total number of people belonging to this age group17. Based on this prerogative the implementation of public policies to increase access to educational apps becomes crucial18.
Knowing the benefits that the use of educational games promotes in education, the Brazilian Institute of Smart, Human and Sustainable Cities prepared a ranking of advantages related to the use of this virtual pedagogical tool19. Within this scale, the three main benefits mentioned regarding the use of educational games were: greater student dedication to studying, greater content retention, and increased promotion of social interactions. All these factors reveal that educational apps promote not only the child’s neurocognitive development, but also greater social interaction20.
Thus, the Vigilantes app, through its open access to the population, will provide the opportunity for children to be entertained with interactive games making them conscious of the importance of practicing prophylactic and disease-fighting measures. In this way, the game aims to raise awareness and display information related to health, as a way of helping to combat persistent diseases.
The children’s educational process is often a challenge from multiple perspectives since parents, school, teachers, and students need to be involved to strengthen the quality of education. This project aims to contribute to children’s knowledge by creating awareness about various public health issues. Given the challenges of attracting the target audience the Vigilantes game proves to be a helpful proposition to achieve this goal.
The current generation’s interest in technological resources contributes to virtual research through playful activities enhancing the dissemination of critical knowledge in an amusing and intuitive way. Moreover, it is presumed that the user will help spread useful information to close friends and adults.
Last but not least, it is expected that parents monitored their children and observed their positive reactions will encourage others to use the app. In this way, it is possible to absorb information that is sometimes neglected, creating a sense of responsibility that will bring gains to the entire community.
The author(s) have no relevant financial disclosures or conflicts of interest.
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Ana Elisa Choucair Hosken Arão is a medicine student in Centro Universitário de Belo Horizonte at Brazil. Her research areas include health and medicine based on evidences.
Anna Carlinda Arantes de Almeida Braga is a medicine student in Centro Universitário de Belo Horizonte at Brazil. Her research areas include health and ophthalmology.
Igor Yury Silva is a medicine student in Centro Universitário de Belo Horizonte at Brazil. His research areas include health and psychiatry.
Luiza Monteiro dos Santos is a medicine student in Centro Universitário de Belo Horizonte at Brazil. Her research areas include health, gynecology and obstetrics .
Helena Fontenelle de Carvalho Costa is a medicine student in Centro Universitário de Belo Horizonte at Brazil. Her research areas include health and infectology.
Raíssa Arielle Barros Reis is a medicine student in Centro Universitário de Belo Horizonte at Brazil. Her research areas include health and general surgery.
Matheus Cézar Arvelos Gomes is a medicine student in Centro Universitário de Belo Horizonte at Brazil. His research areas include health and general surgery.
Dr. Flávio Henrique Batista de Souza is a professor in the interdisciplinary at Centro Universitário de Belo Horizonte at Brazil. His research areas include artificial intelligence applications and mobile applications aimed at health. He received his formal training at Universidade Federal de Minas Gerais.