Abstract
INTRODUCTION
The Ebola outbreak in the Democratic Republic of Congo (DRC) has led to over 3300 confirmed cases and caused over 2250 deaths so far. Health promotion is a key component of the Ebola response, however, misconceptions about Ebola and the response are common. CHAMPIONS CONTRE EBOLA is a smartphone app for disseminating health promotion (HP) messages. It uses gamification to let people proactively identify adequate health behaviours. Players are asked simple questions about Ebola and asked to choose between two answers. For each correct answer, the player earns stars which unlocks avatars. Correct messages, consisting of a short text and two illustrations, and certificates showing successful game completion, can be shared on social media. The app, available in French, Swahili, and English, can be downloaded from Google Play or shared via Bluetooth. The game has been developed in a partnership between MSF and Pixel Impact.
METHODS
The first version of the app was tested in Bunia in October, 2019. 75 people in individual and group sessions gave feedback on the app’s messages and user interface. A second version, including a tutorial, improved coherency between stars, certificates, and avatars, and revised messages, was launched in January, 2020 in Bunia during MSF HP sessions. From these group sessions, 75 individuals, including medical team members, key community members, and other age and gender representative community members, agreed to test the application individually. Using a structured questionnaire, data were collected on app perception, understanding, and usability. An observer checklist was used by a supervisor to collect information on the technical reliability of the app during field use.
RESULTS
The app was positively perceived by 99% of respondents, for its capacity to facilitate knowledge improvement (51% of participants), to reach more people with health promotion messages (14%), to reinforce and affirm existing knowledge (14%), to support decision-making (16%), and as a user-friendly game (10%). The game’s design and pedagogical approach were appreciated and motivating for all participants, with 99% motivated to win stars, 97% appreciating the ability to choose avatars, and all participants agreeing with its utility to fight Ebola and likely acceptance by communities. Challenges were identified regarding usability, with 53% of people requiring assistance at the beginning of use, due to difficulty with game initiation (55% of those requiring assistance), fear regarding a new game (28%), and difficulty utilising the options in the game (18%). Additional factors were identified for improvement, including increased competitiveness and intuitiveness.
ETHICS
This innovation project did not involve human participants’ personal data; the MSF Ethics Framework for Innovation was used to help identify and mitigate potential harms.
CONCLUSION
CHAMPIONS CONTRE EBOLA generated a positive response and has potential as a complement to standard health promotion tools. It is designed to enable participants to engage actively in the learning process and to facilitate sharing of health messages within the community, rather than be passive recipients of health-care messages. Limitations include the lack of assessment of message retention and impact on behavior; further research would be needed to determine these effects. The app has been shared with other Ebola response actors and is available on Google Play.
Conflicts of interest
None declared.
