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San Francisco Injury Center (SFIC) »  Development and Evaluation of an Interactive Injury Prevention Video Game for School Aged Children

Development and Evaluation of an Interactive Injury Prevention Video Game for School Aged Children

Principal Investigator: M Margaret Knudson MD

Brief Summary of Project: Injury is the number one cause of death and disability in children in the United States and an increasingly important public health problem worldwide. In addition to physical trauma, injuries can also result in prolonged psychological disorders in children. Once thought of as being "accidents", it is now recognized that most pediatric injuries are preventable. Unfortunately, injury prevention efforts are currently scare, fragmented, poorly funded, and rarely tested for their effectiveness in changed behavior and decreasing injury rates. The causes of injury in children vary by age as do the methods that can be utilized to prevent then. While injury control efforts for infants and small children are focused on parents, school-aged children are learning to think independently and thus can be influenced by efforts aimed at teaching "self-care" behaviors. Pedestrian crashes are a common cause of injury in school-aged children. Among the 5,000 pedestrian deaths and 64,000 non-fatal pedestrian injuries that occur annually in the United States, approximately 20% occur in children aged 5-9 years. To that end, we have developed a unique, interactive video game for early elementary school children focused on pedestrian safety. The purpose of this research is to evaluate the effectiveness of this game in promoting pedestrian safety knowledge transfer and behavior changes compared to more traditional didactic teaching methods.

Specific Aims:
1. To design an interactive video game for elementary school children that will incorporate crticial safety lessons into game play in a challenging way.
2. To evaluate the influence of the game on the acquisition, retention, and practice of safety knowledge and behaviors.


Studies and Results: Ace's Adventure Game is a high-quality, market-ready interactive computer-based video game which focuses on elementary school-aged pedestrian safety. The game, which was designed by members of the San Francisco Injury Center, was developed by REALTIME Associates in Los Angeles, an independent game-making company. In order to test the "translation" of game-based lessons into performance, a life-size simulated Safety Street was designed by a Hollywood company to resemble the game and to test the child's behavior as he/she walks through the street. The "testing" stations on the street replicate the same safety lessons that are contained in the game. In order to evaluate the ability of the game to impart pedestrian safety knowledge, we have designed the following study:
1. After obtaining consent from both the child and the parents, students in Grade 1 and 2 will first be tested on the Safety Street for baseline pedestrian safety "knowledge". Thus, each student will serve as his/her own control.
2. Participating students will then be randomly assigned to receiving pedestrian safety lessons in a didactic fashion (a member of the research team providing didactic information along with teachings materials like color books etc) versus spending time playing Ace's Adventure game.
3. After the two sessions, each child will again be tested on the Safety Street and the pre and post scores will be compared.

Video game pic

1. To date, we have beta-tested both the Safety Street and Ace's Adventure Game among 200 children in the Los Angeles school district.
2. Based on our beta-testing, we have redesigned both the game and the street for ease of play, clarify, and to make the street more closely resemble the game.
3. The game has been translated into Spanish and a second character (a "girl" figure) has been added for female players.
4. 5 dedicated computers/controllers have been purchased to facilitate visits to schools.
5. A research coordinator at Children's Hospital has been hired for this project.
6. IRB approval has been obtained from both UCSF and USC.

Significance: Even in this early, beta-testing stage of development, this project has attracted enormous interest from pediatric trauma surgeons, prevention advocates, and parents! We have had a large number of volunteers who want to assist in the testing stations. There has also been some interest from game-developers and the entertainment industry. Dr. Martin Eichelberger, the Chief of Surgery at Children's Hospital Washington and the founder of SAFEKIDS has joined our research team and will assist us in promoting this unique concept of using game-play for prevention.

Future: Beginning in May 2011, we will engage the cooperation of 10 elementary schools (approximately 1200 students) for the formal testing of the game versus the didactic teaching sessions. At the end of the year, we will analyze the data and prepare an abstract of our results for submission to the American Association for the Surgery of Trauma. The overall goal is to demonstrate the "proof of concept" that video games can be used to impart important safety knowledge and thus revolutionize our approach to pediatric injury prevention.

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