Development of a Playful Scale of Child Health Literacy Integrated into a Digital Game about Childhood Cancer

ABSTRACT

Introduction:  Health literacy enables children to understand and use health-related information. Employing educational strategies tailored to them makes it easier to grasp complex health concepts and helps coping with the disease.

Objective:  Process of development of a playful pediatric health literacy scale integrated into a digital game designed for children diagnosed with cancer, focusing on acute lymphoid leukemia.

Method:  Methodological study conducted from November 2024 to May 2025, consisting of five main stages: defining the theoretical domains of the scale, adapting language for a young audience, integrating evaluative elements into the game's narrative, creating a question bank, and planning validation. The scale was embedded in a digital educational game structured in chapters and minigames, with playful questions at the end to assess health literacy domains.

Results:  Four main domains were established: (1) Knowledge about cancer; (2) Treatment and side effects; (3) Self-care and healthy habits; and (4) Emotions and support. Twelve objective questions were developed and integrated into the game "Star Pirates". Health literacy is assessed interactively through the game's story and the choices children make during their experience.

Conclusion:  Embedding the scale in a digital game offers an innovative strategy to promote and evaluate health literacy in children with cancer, contributing to more humane, understandable, and participatory care.

Key words:
Health Literacy; Health Education; Educational Technology; Child; Precursor Cell Lymphoblastic Leukemia-Lymphoma