45 Design of the persuasive game ‘Ademgenoot’ 2 Figure 3. Paper prototype testing of the persuasive game ‘Ademgenoot’ with a participant. Based on the first prototype evaluation, several improvements were made to the prototype: a weekly report instead of every three days, icons instead of text in the trigger self-monitoring form, a more human-like character, a different colour pallet and design style to appear less child-like. Phase 3 and 4: prototype and evaluation – iteration 2 Four novel individuals with mild asthma participated in the WhatsApp prototyping and provided feedback during a semi- structured interview afterwards. Two participants indicated that they never until rarely used their maintenance inhaler, two participants occasionally used their maintenance inhaler. During the test period, one participant had multiple non- adherent days (i.e., received the grey and gloomy screens), while the other three were fully adherent during the test period. Usability and user-friendliness All participants understood the purpose of the game and found the game userfriendly and engaging. Participants appreciated the ease of registering trigger moments with the push-notification and the use of icons. “If I get such a pop-up in my screen, I open it and tap it [the trigger icon]. Easy”. Use of metaphors and narrative All participants enjoyed the narrative of Brad and indicated that it motivated them to use the app more often. Two out of the four participants mentioned that the character motivated them to use their maintenance inhaler daily. They emphasized with the character and felt responsible for his “wellbeing”, becoming concerned if Brad would fall into the water or drown. This was reinforced when they were presented with the grey and gloomy screens (i.e., the result of longer streaks of non-adherence) during
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