Use of gamification as a strategy to modify the health of pregnant women and nursling children in a poor community in Curitiba

Canguru de Boa

Abstract

Introduction: Pregnancy and the consequent arrival of a new child are periods of extreme importance in the life of a family. To minimize risks and ensure a good evolution of the pregnancy, periodic follow-up is necessary, with a well-established routine of exams and medical consultations. In a health unit that serves a vulnerable population in the city of Curitiba, Paraná (PR), pregnant women do not always attend scheduled appointments or perform the requested laboratory tests. Childcare follow-up is also hampered by these absences. Method: As a way of trying to face this problem, a computer application was created that carried out automated interactions with pregnant women and mothers of infants assisted in this unit. The main objective was to evaluate the difficulties in its development and use. The application sent messages to the participant’s WhatsApp whenever a new milestone was reached, be it the advancement of gestational age or the reminder for an appointment. It also sent encouraging messages for the positive actions carried out, such as attending pre-scheduled consultations and remaining in the program. Such messages were part of a gamification process — the use of techniques common to games in non-game situations —, with rewards through virtual scores (emojis) according to achieved goals. Results: The application was active for 9 months, with 28 pregnant women and mothers of infants being monitored. Despite some difficulties related to obtaining data from the pre-existing electronic medical record system, as well as the manual work involved in feeding the application, it worked as planned. The participants interacted with the system, sent responses showing positive emotions when receiving an encouraging message, in addition to asking various questions to the system. Half of the participants answered the final evaluation questionnaire, all with favorable responses to its use. Conclusions: The use of gamification through interaction via WhatsApp is functional and feasible. However, it is concluded that the ideal would be for a software of this nature to be developed as a module of the electronic medical record that already exists and is in use in health care units. Although this integration is a bold proposal and there are countless other urgent needs, improving adherence to prenatal care is a worldwide demand, and any measure that can try to prevent deaths of both women and children is always commendable. Future research is needed, with control groups, to verify whether the gamification process can effectively improve adherence as well as the health outcomes of future pregnancies.