Feeding the Flame, One Day at a Time: Design and Acceptability of a Serious Game to Support Medication Adherence and Education for Pediatric Solid Organ Transplant Patients (Mystic Wizard)

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.

Study Overview

• Status: Not yet recruiting
• Conditions: Solid Organ Transplant
• Intervention / Treatment: Behavioral: Mystic Wizard

• Study Type: Interventional
• Enrollment (Estimated): 15
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Thomas Caruso, MD, PhD; Phone Number: 650-723-5728; Email: tjcaruso@stanford.edu
• Study Contact Backup: Name: Amrita Narang, MD; Phone Number: (650) 721-2250; Email: anarang@stanford.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Between age 7-14
• History of solid organ transplantation
• Current admission in inpatient unit
• Able to understand and interact with a tablet-based game in English

Exclusion Criteria:

• Legal guardian not present to obtain consent
• Child with a significant neurological condition, or major developmental disability
• Child with active infection of the face or hand
• History of severe motion sickness
• Severe visual or motor impairment limiting gameplay participation
• Acute medical instability
• Major surgery within the last 48 hours
• Inability to understand English

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Solid organ transplant recipient

Behavioral: Mystic Wizard; Mystic 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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	Immediately after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluate the usability of the tablet-based game among solid transplant patient using System Usability Scale (SUS)	Usability of the tablet-based game will be assessed using Usability and Acceptability Scale (UAS), which is a 8 item 5-point Likert scale ranging from "Strongly Disagree" to "Strongly Agree with 40 indicating highest usability of the tool.	Immediately after intervention
To assess participants' intrinsic motivation and psychological needs satisfaction (autonomy, competence, relatedness, presence) while using the intervention	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	Immediately after intervention
To assess participants' overall engagement with the digital intervention	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	Immediately after intervention

Collaborators and Investigators

• Sponsor: Stanford University
• Investigators: Principal Investigator: Thomas Caruso, MD, PhD, Stanford University

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): June 30, 2027
• Study Completion (Estimated): June 30, 2027

Study Registration Dates

• First Submitted: May 19, 2026
• First Submitted That Met QC Criteria: May 19, 2026
• First Posted (Actual): May 27, 2026

Study Record Updates

• Last Update Posted (Actual): July 9, 2026
• Last Update Submitted That Met QC Criteria: July 7, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Education
• Other Study ID Numbers: 87110

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No