41 Design of the persuasive game ‘Ademgenoot’ 2 by offering them a six-week challenge linked to an asthma-related personal goal (e.g., join friends on a skiing weekend). During this six-week period Ademgenoot visualizes inhaler use (maintenance and reliever inhaler) in a playful way to make the effect of the medication visible and to stimulate engagement with the game and thus use of their inhaler. Six weeks was chosen as this is generally the period in which individuals respond to ICS with an improvement in pulmonary function (42). At the end of the challenge, users should have gained insights into the effect of the daily use of their Figure 2 for a visual representation of the game). As such, Ademgenoot supports the intention, action, and evaluation of behaviour change. Table 1 Behavior change strategies and design and serious game requirements Behaviour change strategies Design requirements Serious game requirements Support intention Motivational interviewing Support self-efficacy. Patient education Education on differences between maintenance and reliever inhaler. Personal goal setting Set personal goal as driver for internal motivation. Commitment Commit to a try out period to experience effect and benefits and form a habit. Support action Feedback on behaviour Direct, real-time feedback to user on maintenance and reliever inhaler use. Visualize effect of inhaler use. Provide reward if desired behaviour is conducted. Be entertaining to engage with. Self-monitoring of behaviour Possibility to track and monitor maintenance and rescue inhaler use in a (semi)automatic way. Visualize medication use over time. Create overview of medication use over time. Self-monitoring of disease progression Tracking and monitoring asthma control. Be effortless. Sustain maintenance Evaluation moments Evaluation on behaviour and impact on daily asthma control. Link reliever usage to trigger moments.
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