Interactive game could reduce heart attack deaths by teaching rapid response to symptoms

October 31, 2000

An experimental interactive game could save lives by teaching potential heart attack victims to react swiftly at the first sign of a heart attack, according to a paper being presented at a convention of the Institute for Operations Research and the Management Sciences (INFORMS®).

The paper, The Use of Virtual Worlds and Animated Personas to Improve Health Care Knowledge & Self-Care Behavior: The HEART-SENSE Game, is by Barry G. Silverman and John Holmes of the University of Pennsylvania. They will speak in San Antonio's Henry B. Gonzalez Convention Center on Monday, Nov. 6.

The paper introduces an interactive computer game that teaches potential heart attack victims to respond quickly to early warning signs of a heart attack by acknowledging the possibility of a heart attack and immediately calling 911.

Studies suggest that computer-based patient education improves many dimensions of health and health care, including prevention, compliance, and patient choices about treatment options. To assist with developing such training devices, this game pioneers a generic simulator consistent with patient behavior change theory, and it includes re-programmable virtual personas that can be applied to other health topics in addition to heart attack domains.

NIH Funding

The paper and related research was conducted with financial support from the National Institute of Health's National Heart Attack Alert Program and the National Library of Medicine.

The HEART-SENSE GAME is a multi-media interactive, computer-based health promotion program designed to improve health knowledge and influence behavior among individuals thought to be at risk of acute myocardial infarction.

The HEART-SENSE game has targeted "delay in calling 911" as opposed to a more general goal such as 'improved heart health." Behavior theorists contend that the most effective interventions are those directed at a single behavior rather than at multiple behaviors.

HEART-SENSE consists of three basic modules that engage, train, and rehearse the individual at risk. Actors portraying patients, emergency medical technicians, and physicians speak to the users. In all the modules, a heart-shaped character accompanies participants.

"The character - we call her Bea - helps keep it simple," explains Prof. Silverman. "She furnishes cues, offers companionship, and provides a bit of entertainment."

Facing Harsh Threat

By helping virtual people diagnose their symptoms and convincing them to call 911 without delay, users learn to take better care of themselves.

HEART SENSE begins with an upsetting sequence that is watched by the user. The scenario depicts a man who ignores heart attack symptoms, collapses, and must be rushed by ambulance to the emergency room, where it is too late to revive him.

HEART SENSE continues with interactive modules that use quizzes and conversations with virtual people to help the user prevent members of a virtual community from succumbing to a fatal heart attack.

The virtual cases will ultimately contain many people having various types of heart attacks or false symptoms. Each case will contain hundreds of scenarios, diagnoses, and possible interventions.

If users can't save a virtual character, they are encouraged to use the back key to choose the healthier option. A set of pretests was used to begin evaluating HEART-SENSE. It involved two types of evaluation activities, advisory groups and user tests. The advisory groups included two focus groups. The focus groups were medical faculty and clinicians at the University of Pennsylvania Health System. One group comprised six cardiologists and the other consisted of six general practitioners.

HEART SENSE is expected to be tested in clinical trials in 2001 after which it will be made available to the public.
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The theme of the INFORMS convention is "Integrating Theory and Application 2000." The convention will include sessions on topics applied to numerous fields, including commuter transit, e-commerce, health care, information technology, energy, transportation, marketing, telecommunications, and sports. More than 1,500 papers are scheduled to be delivered. The General Chair of the convention is Dr. Way Kuo, Texas A&M University. Additional information about the conference is at http://www.informs.org/Conf/SanAntonio2000/ and http://www.informs.org/Press.

The Institute for Operations Research and the Management Sciences (INFORMS®) is an international scientific society with 10,000 members, including Nobel Prize laureates, dedicated to applying scientific methods to help improve decision-making, management, and operations. Members of INFORMS work in business, government, and academia. They are represented in fields as diverse as airlines, health care, law enforcement, the military, the stock market, and telecommunications. The INFORMS website is at http://www.informs.org.

Institute for Operations Research and the Management Sciences

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