Friends, Family, and Food: Interactive Virtual Environments for Children with Food Allergies

描述（由申请人提供）：儿童食物过敏（FA）被认为是一种严重的公共卫生问题，影响了大约4- 8%的儿童，其症状影响多个器官系统，包括皮肤、呼吸道和胃肠道。食物引起的过敏反应是一种快速的、可能危及生命的反应，在更严重的情况下可能发生。尽管疾病管理的巨大负担和相关的负面生活质量影响，很少有资源存在，以促进有效的策略管理FA。此外，针对这一人群的大多数资源强调信息传播和教育，无论是面对面的还是通过网络的，而且通常侧重于父母，很少为受影响的儿童设计资源。该SBIR/STTR第一和第二阶段的中心目标是为患有FA的学龄儿童开发一种吸引人的、基于互动游戏的干预措施，以增加知识，提高自我效能来管理疾病，并最终降低负面结果的风险。针对儿童各种儿科疾病的基于软件的干预措施在可获得性和可及性方面有所增加。可在多种平台（计算机、移动设备）上使用的交互式、基于游戏的方法在提供高度吸引人的心理教育和基于技能的实践方面，比传统干预具有明显的优势。这个第二阶段的应用程序建立在朋友，家庭和食品应用程序（F3A-App）的非常有前途的原型之上，通过我们第一阶段团队的成功和协同合作制作。F3A- App由四个相关部分组成：(a)一个互动的，基于游戏的应用程序，是该计划的核心；(b)互动环境中的体验场景（例如，学校食堂的小插图），针对社会背景下的知识和行为技能练习；(c)两个引人入胜的多层次游戏，以培养食物避免技能（标签学习）；喜欢它或失去它！)和症状评估（反应行动！），以及(d)多层奖励系统，使用基于代币经济的强化来增强动机和参与度（SeaLife Spectacular）。初步原型的可行性和有效性测试表明，F3A-App非常受FA家长和儿童的欢迎，促进了儿童的知识获取，并提高了FA管理关键领域的自我效能感。定性报告表明，F3A-App还加强了家长和孩子之间关于FA管理的沟通。在这个二期项目中，我们建议制作一个完整的F3A-App版本，包括添加的内容和增强的功能，在小样本中试用新版本（n= 40），并在随机临床试验中评估最终产品（n=100）。这种干预将在互动性、易用性、父母接受度和卫生保健专业人员的推广方面超越现有的以儿童为中心的软件程序。我们设想f3a应用程序将作为一个模板，为患有其他需要自我管理的慢性疾病（如哮喘、糖尿病和乳糜泻）的儿童提供基于互动游戏的干预。在一个电脑、智能手机和平板电脑技术日益普及和日常使用的时代，商业机会的承诺是重要的。

DESCRIPTION (provided by applicant): Pediatric Food Allergy (FA) is recognized as a serious public health concern that affects approximately 4-8 percent of children, with symptoms affecting multiple organ systems, including skin, the respiratory tract, and the GI tract. Food-induced anaphylaxis, which is a rapid, potentially life-threatening reaction, can occur in more serious cases. Despite the substantial burden of disease management and associated negative quality of life effects, very few resources exist to promote effective strategies for managing FA. Moreover, most resources targeting this population emphasize information dissemination and education, either in-person or via the web, and typically focus on parents, with few resources designed for affected children. The central goal of Phases I and II of this SBIR/STTR is to develop an engaging, interactive game-based intervention for school-aged children with FA that will increase knowledge, improve self-efficacy to manage the disease, and ultimately reduce risk of negative outcomes. Software-based interventions targeting children for various pediatric conditions have increased in availability and accessibility. Interactive, game-based approaches available on multiple platforms (computer, mobile devices) offer distinct advantages over traditional interventions in providing highly engaging formats of psychoeducation and skills-based practice. This Phase II application builds on the highly promising prototype of the Friends, Family, and Food App (F3A-App), produced through the successful and synergistic collaboration of our Phase I team. The F3A- App consists of four related parts: (a) an interactive, game-based application that is the core of the program, (b) the experiential scenarios in interactive environments (e.g., school cafeteria vignette) that target knowledge and behavioral skills practice in social contexts, (c) two engaging multi-level games to build skills i food avoidance (Label Learning: Like it or Lose it!) and symptom assessment (Reaction Action!), and (d) a multi- tiered reward system that uses token economy-based reinforcement to enhance motivation and engagement (SeaLife Spectacular). Feasibility and efficacy testing of our initial prototype indicated the F3A-App was very well-received by parents and children with FA, facilitated child knowledge acquisition, and increased FA self- efficacy in key areas of FA management. Qualitative reports indicated the F3A-App also enhanced communication between parents and children regarding FA management. In this Phase II project, we propose to produce a fully-developed version of the F3A-App, including added content and enhanced features, to pilot the new version in a small sample (n = 40), and to evaluate the final product in a randomized clinical trial (n=100). This intervention will surpass existing approaches for child-focused software programs in interactivity, ease of use, acceptance by parents, and promotion by health care professionals. We envision that the F3A-App will serve as a template for interactive game-based interventions for children with other chronic conditions requiring self-management, such as asthma, diabetes, and celiac disease. The promise of commercial opportunity is significant in an era in which there is an increasingly widespread access to and everyday use of computers, smart phones, and tablet technologies.