Game for Health: Development of a modular eHealth resource for children and adolescents with chronic illness

Sample and data collection Children and young people with long term physical conditions, their parents and paediatricians were recruited by advertising via posters and flyers conveyed by clinicians at Starship Children’s Hospital in Auckland. Paediatricians at the same hospital were invited to participate via email. General practitioners were recruited through a colleague at the University of Auckland. Ethics Ethical approval for the study was obtained from the New Zealand Northern Region Ethics Committee (Ref 13/NTA/234/AM01). Written participant consent was obtained for those aged 16 or older. Written parental consent was obtained for those aged 15 and under. Focus Groups Most focus groups were undertaken by three of the authors (HT, VG and KS) at Starship Children’s Hospital in Auckland. The general practitioner focus group was conducted at a private residence in Auckland. All focus groups lasted between 90-120 minutes and were conducted in a similar manner using a semi-structured interview format starting with their general knowledge and later their specific use of eHealth interventions. They were then shown three demonstration or video clips of existing health games (Quest for the Code (Registered trademark), a physical health-related game designed for younger children), Re-Mission (Registered trademark), a physical health game designed for older children and SPARX (Registered trademark), a mental health game designed for young people) and asked their opinion about each. Finally, they were asked for ideas regarding potential new eHealth interventions that may be useful to them or their patients and factors that may influence use of or recommendation of such interventions. The interviewers included HT, a child psychiatrist and paediatrician, employed at Starship Children’s Hospital, KS, a research fellow at the University of Auckland and VS, a health psychology intern who was working in private practice. HT did not know any of the young people, children or parents prior to the focus groups, but did know the paediatricians. HT and KS knew one of the general practitioners who attended one of the clinician focus groups. Data Analysis All groups were digitally recorded and commentary was transcribed verbatim and analysed using a general inductive approach (GIA)28. Transcribed data was coded by HT using QSR NVivo 10 software. Statements of interest were identified as notes across transcripts, arranged into groups of nodes and these were reviewed to identify common themes and relationships pertaining to the research question. Approximately 30% of transcripts were cross-coded by KS for validation of the coding process. Any discrepancies were discussed by the coders until consensus was reached. Representative quotes were selected by HT and KS to illustrate each theme. Preliminary results were reviewed by a subset of participants and their feedback was incorporated before the analysis was finalised.