Children and teenagers who receive a solid organ transplant (such as a kidney, liver, or heart) must take medications every day to keep their new organ healthy. Taking these medications correctly and on time is one of the most important parts of staying well after a transplant, but it can be hard for young patients to understand why this matters and to keep up with their routines. Doctors and nurses usually teach patients about their transplant through conversations, which may not always be engaging or easy for kids to remember.
This study looks at a new way to help young transplant patients learn about their condition and their medications: an educational game played on a tablet. The purpose of the study is to find out what patients think of the game and how well it works for them. Researchers want to know whether young patients find the game acceptable and enjoyable, whether it is easy to use, whether it makes them feel motivated and capable, and how engaged they feel while playing.
To do this, patients will play the tablet game and then share their experiences. After playing, they will take part in a small group interview where they talk about what they liked, what was confusing, and whether the game helped them understand their transplant and medications. They will also fill out short questionnaires about how easy the game was to use and how engaging it felt.
The researchers' hypothesis is that pediatric solid organ transplant patients will find the educational tablet-based game acceptable, easy to use, and engaging, and that it will be a welcome and helpful tool for learning about their transplant care. The findings will help guide whether this kind of game could be used to support transplant education for children and teens.
Pediatric solid organ transplant recipient (e.g., liver, kidney, heart)
Age 7-14 years
Currently admitted to Lucile Packard Children's Hospital
Able to understand and interact with a tablet-based game in English
Significant cognitive impairment or developmental condition limiting ability to participate in gameplay or surveys
Acute medical instability
Severe visual, hearing, or motor impairment preventing interaction with the game
Non-English speaking participant
Single group
Mystic Wizard
BehavioralMystic Wizards is a tablet-based serious game intervention designed to support medication understanding, self-efficacy, and health engagement among pediatric solid organ transplant recipients. The game uses a narrative fantasy framework in which players assume the role of a young wizard entrusted with a "Legacy Flame" representing their transplanted organ. Daily medications are represented as "potions" required to maintain the strength and stability of the Flame. The intervention includes short narrative sequences, interactive mini-games, visual feedback systems, and avatar customization features designed to reinforce medication routines and promote empowerment in a developmentally appropriate manner. Participants complete a single gameplay session lasting approximately 10-12 minutes on a tablet device during their inpatient hospitalization, followed by brief surveys and a semi-structured interview.
Determine the acceptability the tablet-based game among solid transplant patient.
Semi-structured focus group interviews conducted in person immediately after intervention. Six core questions plus probing prompts assessing attitudes, opinions, and perceptions of the intervention experience
Evaluate the usability of the tablet-based game among solid transplant patient using System Usability Scale (SUS)
The system usability scale (SUS) is a simple, ten-item attitude Likert scale giving a subjective assessments of usability. The measure is scored on a scale from 0 to 100 with 100 indicating higher usability.
To assess participants' intrinsic motivation and psychological needs satisfaction (autonomy, competence, relatedness, presence) while using the intervention using Player Experience of Needs Satisfaction (PENS).
The PENS scale is a validated, 21-item psychometric questionnaire used to assess participants' psychological experiences during gameplay. Higher scores correlate with greater psychological satisfaction and long-term treatment adherence.
To assess participants' overall engagement with the digital intervention (focused attention, perceived usability, aesthetic appeal, reward) using User Engagement Scale (UES) - Short.
User engagement will be measured by User Engagement Scale (UES) - Short. This scale consists of 12 items that participants will respond to, reflecting their feelings and interactions with the application or platform. Each item is rated on a Likert scale ranging from 1 to 5, where 1 indicates "strongly disagree" and 5 indicates "strongly agree."
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