A Digital Serious Game (Anticip’action) to Support Advance Care Planning Discussions in the General Population : Usability Study

Article Article scientifique Article A Digital Serious Game (Anticip’action) to Support Advance Care Planning Discussions in the General Population : Usability Study eng 2025-08-21 2025-08 author Campioni Dafne Eleonora 0009-0004-7574-6306 Institute for Ethics, History, and the Humanities, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 407819 author Ehrler Frédéric 0000-0001-9734-3242 Department of Medical Information Sciences, University Hospital of Geneva, Geneva, Switzerland. 509959 author Berger Antoine Gabriel Conrad 0000-0002-8447-0645 Department of Medical Information Sciences, University Hospital of Geneva, Geneva, Switzerland. 841311 author Clavien Christine 0000-0003-0968-144X Institute for Ethics, History, and the Humanities, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 833065 iEH2 (COETH) 1-23 e73378 10.2196/73378 40840871 2561-7605 PMC12411793 https://aging.jmir.org/2025/1/e73378 Background: In the context of an aging population and increasingly medicalized end-of-life practices, it is crucial to promote early discussions to help patients express their view on what is essential in their life as well as articulate their preferences regarding future medical treatments and end-of-life issues. An interprofessional research team at Geneva University and the Geneva University Hospitals has developed Anticip'action, a card game designed to help initiate and conduct advance care planning and end-of-life discussions. It is available for free in paper format in diverse languages and in a digital version in French. Objective: This study aims to assess the ergonomic quality of the digital version of the game with primary users. Methods: Overall, 10 users (women: n=5, 50%; men: n=5, 50%; mean age 41, SD 13.4 years; range 25-65 years; education: upper level; comfortable with smartphones) completed an online usability test. The test began with a rapid desirability test to capture initial impressions of the game's main screen without knowing what it is about. This was followed by a think-aloud procedure, including 26 tasks to perform all steps of the game. Posttest questionnaires were administered to collect participants' subjective perceptions of the usability (System Usability Scale), attractiveness (AttrakDiff), and relevance as well as overall endorsement of the game (Mobile Application Rating Scale). Open-ended questions were used to further explore usability issues. Usability problems were categorized and evaluated using standard evaluation grids. Content readability was assessed with Scolarius. Results: The rapid desirability test revealed an overall good or average impression. In 83.2% (208/250) of the cases, participants successfully completed the think-aloud tasks without assistance. Some of the tasks (4/25, 16%) revealed multiple usability issues requiring assistance. Analysis of the 23 failures and difficulties encountered revealed that 3 (13%) issues were due to suboptimal wording of the task instructions and that there were 9 (39%) major usability problems. All could be addressed through minor modifications. The Scolarius test indicated that the card titles were understandable at an elementary school level, while the explanations on the back of the cards required a high school reading level. Participants rated Anticip'action as good or excellent in usability (79 out of 100 on the System Usability Scale), attractiveness (1.57 on the -3 to +3 AttrakDiff scale), and relevance (4.1 out of 5 on section F of the Mobile Application Rating Scale). Participants provided overall positive qualitative feedback. Conclusions: The usability testing of the digital French version of Anticip'action produced positive results, with some areas for improvement identified. It can be recommended as a valuable resource for patients, families, and caregivers to prompt reflection, raise awareness, and support advance care planning conversations. Further tests should be conducted on wider population groups, including older patients and individuals less comfortable with digital solutions. Advance care planning Conversation tool End of life MHealth Mobile apps Mobile health Mobile phone Palliative care Serious game Usability Dewey 174.957 Dewey 616.0757 69 Institut Ethique Histoire Humanités 22A6 62 Département de radiologie et informatique médicale 227 false 1289 Ethique et science 1008 JMIR aging 8 0c4bdc06-4d0f-4f8d-87d5-2e837ea3906a Article (Published version) Public aging-2025-1-e73378.pdf 1920210 application/pdf CC BY-4.0 d5125b1b9d175355acbe9b97606bf37d02c1f6d27f7ff8dd091efd17dcdff562 6d0adc47-9797-4aee-96b8-c56684a9fa5c Supplemental data Public aging_v8i1e73378_app1.docx 88768 application/vnd.openxmlformats-officedocument.wordprocessingml.document CC BY-4.0 d0a4918d98bb3a6351cc21bd314aa061fa53998bf37171fe3866d74ac9bc06be openAccess Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut Ethique Histoire Humanités Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale

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