A mixed-methods evaluation of a co-designed Chinese Dementia Game for dementia awareness in Singapore

Abstract Background Dementia-related stigma and misconceptions can affect help-seeking, family communication, social inclusion and public responses to people living with dementia. In multilingual and multicultural contexts such as Singapore, public dementia education needs to be accessible, culturally responsive and relevant to specific language communities. However, there is limited evidence evaluating culturally responsive, co-designed serious games developed specifically for Mandarin-speaking Chinese communities in Singapore. This study does not claim novelty in the use of serious games for dementia education; rather, it evaluates a co-designed, Mandarin-language and culturally responsive adaptation of a digital Dementia Game for Chinese-speaking communities in Singapore, as a public dementia awareness and health communication intervention. Methods A mixed-methods evaluation was conducted in Singapore. An explanatory sequential design used an uncontrolled pre-test/post-test design. Participants completed the Mandarin version of the 19-item Approaches to Dementia Questionnaire before and immediately after gameplay. Wilcoxon signed-rank tests examined changes in total and subscale scores. The qualitative component comprised two online focus groups with participants who had played the game. Data were analysed thematically and integrated with quantitative findings. Results Sixty-five matched pre-test/post-test responses were included. Median total ADQ scores increased from 66.00 to 73.00. Significant improvements were also observed in the Hope subscale, from 22.00 to 27.00, z = -5.41, p < .001, and Recognition of Personhood, from 43.00 to 47.00, z = -5.59, p < .001. Seven participants took part in focus groups. Four themes were generated: initial understanding and perceptions of dementia; outcomes and learning experiences from the game; user-led refinements; and promoting the game for wider dementia awareness. Qualitative findings suggested that the game helped clarify misconceptions, support person-centred reflection and prompt consideration of more empathetic responses, although fear about dementia remained for some participants. Conclusions The Chinese Dementia Game shows preliminary promise as a culturally responsive digital knowledge translation intervention for dementia public education in Singapore. Further controlled and longitudinal research with larger and more diverse samples is needed.