Evaluating the Impact and Acceptability of a Pancreatic Cancer Awareness Serious Game: A Mixed Methods Study

Background:<br/>Pancreatic cancer has one of the lowest survival rates among cancers, primarily due to late-stage diagnosis and low public awareness of early symptoms. Public health campaigns often struggle to reach individuals with effective, memorable messaging. Serious games may offer an innovative, scalable approach to engaging the public in health education. This mixed methods study evaluated the acceptability, effectiveness, and perceived dissemination potential of a digital serious game promoting awareness of pancreatic cancer symptoms.<br/>Objective: <br/>To assess the short-term impact of a serious game on symptom awareness, help-seeking intention, and acceptability among UK adults using quantitative and qualitative methods.<br/>Methods: <br/>A convergent mixed methods design was used. The quantitative phase involved a pre–post evaluation with a convenience sample of 537 UK adults (70% female, mean age 41 years), who completed measures immediately before and after playing the game. Outcomes included awareness of pancreatic cancer symptoms (12-item knowledge test), self-reported intention to seek help, and acceptability ratings. The qualitative phase involved 30 participants who took part in four semi-structured focus groups after playing the game. Participants were purposively sampled to represent a range of ages and backgrounds. Focus group data were analyzed thematically using thematic analysis to explore user perspectives on the game’s content, impact, and dissemination potential.<br/>Results: <br/>Quantitative analysis demonstrated statistically significant improvements in awareness across all 12 pancreatic cancer symptoms (p &lt; .001). The mean number of symptoms correctly identified increased from 6.0 (SD 2.2) pre-intervention to 9.3 (SD 1.9) post-intervention. Participants also showed a significant increase in self-reported intention to seek help if experiencing relevant symptoms (pre: 71.9%; post: 89.8%, p &lt; .001). Acceptability ratings were high, with 94% of respondents stating the game was clear and 91% agreeing it was a good way to raise awareness.<br/>Thematic analysis of the qualitative data revealed three key themes. First, “It Could Work for Anything” captured participants’ views that the game format was broadly applicable beyond pancreatic cancer, with potential for use in other public health contexts due to its brevity and impact. Second, “I’d Actually Go See My Doctor Now” reflected how the game prompted increased awareness and personal reflection, with several participants reporting they would now be more inclined to seek medical advice if they experienced symptoms. Finally, “Put It Everywhere” highlighted creative suggestions for widespread dissemination, including integrating the game into sports event programs, television, radio, billboards, and magazines, often paired with QR codes to maximize accessibility and engagement.<br/>Conclusion: <br/>This mixed methods study found that the pancreatic cancer serious game significantly improved symptom awareness and help-seeking intentions. The game was rated as acceptable and engaging, with qualitative feedback underscoring its potential for broader public health applications and mass dissemination. These findings support further use of gamified health tools in cancer awareness efforts.<br/><br/><br/><br/>