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Background: Finding innovative methods to enhance Tuberculosis treatment adherence in Malaysia is imperative, given the rising trend of non-adhere TB patients. Direct Observed Therapy (DOTS) has been used to ensure Tuberculosis (TB) drug compliance worldwide. However, due to its inconvenience, digitalizing this system into a virtual monitoring system via a mobile app can help deliver a more efficient tuberculosis management system. A gamified video-observed therapy is developed that connects three users the patient, supervisor, and administrator, allowing drug monitoring and patient loss to follow up with the patient tracking system. Thus, the objective of this study is to determine the impact of Gamified Real-time Video Observed Therapy (GRVOTS) mobile apps on patient medication adherence rates and motivation. Methods: 71 patients from 18 facilities participated in the 8-week single-arm intervention study. GRVOTS mobile apps were installed in their mobile apps, and patients were expected to fulfill tasks such as providing Video Direct Observe Therapy (VDOTS) daily as well as side effect reporting. At 3-time intervals of baseline,1-month, and 2-month intervals, the number of VDOT taken, the Malaysian Medication Adherence Assessment Tool (MyMAAT), and the Intrinsic Motivation Inventory (IMI) questionnaire were collected. One-sample t-test was conducted comparing the VDOT video adherence to the standard rate of 80%. RM ANOVA was used to analyze any significant differences in MyMAAT and IMI scores across three-time intervals. Results: This study involved 71 numbers of patients from 18 healthcare facilities who showed a significantly higher treatment adherence score of 90.87% than a standard score of 80% with a mean difference of 10.87(95% CI: 7.29,14.46; p < 0.001). The participants' MyMAAT and IMI scores significantly increased over 3-time intervals with the IMI Interest domain showing the highest mean difference 19.76 (95% CI: 16.37, 21.152: p < 0.001). Conclusions: By utilizing GRVOTS, a mobile application based on gamification and real-time features, we can enhance motivation and medication adherence among TB patients, while also addressing the limitations of physical DOTS. Trial registration: IRCT20230308057657N1, Registered on (15/03/23). [ABSTRACT FROM AUTHOR]

Background and Purpose: Gamification is a teaching and learning approach that is gaining popularity among teachers as a way to make classroom learning more enjoyable and engaging with the use of rewards to celebrate accomplishments. With the rise of online learning in Malaysian educational institutions, gamification is viewed as an interactive method of teaching and learning. Due to the fact that limited studies have been conducted to investigate the challenges in implementing gamification approaches among vocational instructors, it is the aim of this paper; therefore, to examine the challenges. Methodology: This study employed a quantitative research method. The respondents include 55 vocational lecturers from several vocational colleges in Malaysia. A set of questionnaires was used to examine the challenges faced by the lecturers in the implementation of gamification at their institutions. Four constructs were used to differentiate the differences of the challenges, which include support, access, competency, and applicability. Data collected from this study were analyzed using descriptive statistics (mean score and standard deviation) and inferential statistics (independent sample t-test) to identify the differences between gender. Findings: The findings of this study indicated that the majority of vocational lecturers have moderate challenges when implementing gamification approaches in their teaching and learning based on the findings related to the constructs. In addition, it was found that there were no significant gender differences in terms of the difficulties associated with implementing gamification approaches. This study also showed that most vocational lecturers have the potential to apply gamification in their teaching based on their high competencies with adequate support and enough access given to them. Contributions: The findings of the study can contribute to vocational lecturers to promote gamification approach during the learning process to increase students' motivation. [ABSTRACT FROM AUTHOR]

Aim/Purpose The main purpose of this study is to identify the factors affecting the continuance use intention of gamified m-learning applications by Higher Education Institution (HEI) learners in Malaysia. Background Mobile learning (m-learning) has been a popular choice among learners in HEIs due to its convenient 'on-the-go' concept. On the other hand, embedding gamification elements in m-learning applications help in increasing the users' interest in continuous use. Therefore, many HEIs have invested in producing their own m-learning products apart from utilizing existing m-learning applications that are widely available online. One of the challenges faced by HEIs is the low technology usage rates towards the 'in-house' developed applications, which affect the receptiveness of education stakeholders in investing or maintaining educational applications. Meanwhile, the lack of continuous usage had given a negative impact on their academic-related tasks and performance. Hence, it is important to understand the significant factors that influence learners' intentions in continuance usage of a gamified m-learning application. This will serve as an insight to the HEIs management regarding the needs and design that better suits their users' expectations. Methodology This study employed a correlational cross-sectional research design using an online survey. The participants of the final survey involved first-year students from one of the Malaysian public universities. For the final analysis, 269 responses were analysed using the partial least square-structural equation modelling (PLS-SEM) technique, which is a powerful multivariate analysis mechanism. The Expected Confirmation Model (ECM), which is a post-acceptance model, was extended with the pre-acceptance model named Extended Unified Theory of Acceptance and Use of Technology (UTAUT2), to form the research proposed model that describes the continuance intention in using a gamificationbased m-learning application. Contribution This research contributes to the body of knowledge and helps better understand users' continuance intention in the post-acceptance phase of the gamified m-learning application. It exposes information at the individual level, regarding the continuance intention of using an m-learning tool that is equipped with gamification elements. This will mostly benefit the educational resource developers in the HEIs in producing effective 'in-house' learning tools. Findings This research develops a theoretical enhancement of the Expectation Confirmation Model (ECM) that affects the HEIs' m-learning resource developers and management, dealing with IT-related behaviour. Moreover, a solid continuance usage intention conceptual model, which incorporated two important models, was also introduced. Out of all ten hypotheses, only two were not supported that are related to factors facilitating conditions and social influence. Those two factors negatively influence the HEI learners' continuance use intention. Meanwhile, the core factors for satisfaction, which are perceived usefulness and confirmation, were found to be significant. Lastly, satisfaction was proven to mediate the positive path between perceived usefulness and the continuance intention of using the gamified m-learning application. Recommendations for Practitioners This study offers insights into strategies that the HEIs' management should perform in securing continuance usage of the 'in-house' developed m-learning products. One of the strategies could be organising technology workshops that will prepare their educators in implementing the institutions' gamified teaching and learning tools. Another highlighted issue is regarding the need for faculties to design an effective approach to entice educators and learners towards applying new learning technologies. Recommendations for Researchers This study contributes to the micro-level analysis of the continuance use intention of gamification-based m-learning applications by fostering the understanding of the phenomenon at the individual level. It is recommended that other researchers extend the research model by incorporating other theories, as this study was only based on two models (i.e., ECM and UTAUT2). Additionally, a longitudinal study could be another approach that enables researchers to collect much richer data that includes a wide array of background characteristics or control variables. Another suggestion would be applying related factors that may contribute to the discovery of effective gamified m-learning application designs. Impact on Society The findings of the study show the importance of confirmation made by the applications' users towards usefulness and usage satisfaction. Confirmation and perceived usefulness also have an increasingly similar impact on users' satisfaction with the application and their subsequent continuance use intention. It is also revealed that easy-to-use products are commonly expected nowadays, as users might be reluctant to spend much time on them. On the other hand, for a specific gamification-based product, it is also expected by the users for it to be capable of giving an 'enjoyable' experience, hence motivating continuance usage. As a result, an effective gamified m-learning application or product will be able to be used by Malaysian HEI learners if the developers and stakeholders develop and evaluate the usage of their products with the consideration of the information provided by this research. Future Research Future studies could include respondents from other diploma programmes, resulting in an in-depth analysis. It is needed to support the generalizability of the findings in this study by considering larger populations from all different programmes. In addition, similar research can be done based on different circumstances; for instance, use of the gamified m-learning application during the incampus physical classes instead of virtual classes (online), which might influence the users' perception in terms of the social influence and facilitating condition. [ABSTRACT FROM AUTHOR]

Background: The success rate of tuberculosis (TB) treatment in Malaysia remains below the recommended World Health Organization target of 90% despite the implementation of directly observed therapy, short-course, a physical drug monitoring system, since 1994. With increasing numbers of patients with TB in Malaysia defaulting on treatment, exploring another method to improve TB treatment adherence is vital. The use of gamification and real-time elements via video-observed therapies in mobile apps is one such method expected to induce motivation toward TB treatment adherence. Objective: This study aimed to document the process of designing, developing, and validating the gamification, motivation, and real-time elements in the Gamified Real-time Video Observed Therapies (GRVOTS) mobile app. Methods: The modified nominal group technique via a panel of 11 experts was used to validate the presence of the gamification and motivation elements inside the app, which were assessed based on the percentage of agreement among the experts. Results: The GRVOTS mobile app, which can be used by patients, supervisors, and administrators, was successfully developed. For validation purposes, the gamification and motivation features of the app were validated as they achieved a total mean percentage of agreement of97.95% (SD 2.51%), which was significantly higher than the minimum agreement score of 70% (P<.001). Further, each component of gamification, motivation, and technology was also rated at 70% or more. Among the gamification elements, fun received the lowest scores, possibly because the nature of serious games does not prioritize the fun element and because the perception of fun varies by personality. The least popular element in motivation was relatedness, as stigma and discrimination hinder interaction features, such as leaderboards and chats, in the mobile app. Conclusions: It has been validated that the GRVOTS mobile app contains gamification and motivation elements, which are intended to encourage medication adherence to TB treatment. [ABSTRACT FROM AUTHOR]

The acceptance and use of the latest technology are an important due to various factors, especially when Covid-19 dynamics hit the world today. It is quite a difficulty for most people in Malaysia when this change occurs and have to go through it which is called "New Norms". They need to get used to doing work or study online because they are not allowed to attend any classes or events. Indirectly, they have to master almost all activities through online means. Therefore, this study aims to understand the underlying factors that influence user satisfaction on the implications of 3D Gamification in e- Learning. From the results of this study, we found that the results are as follows: (1) system quality, (2) service quality, (3) information quality, (4) perceived usability, (5) user satisfaction and (6) ease of use with the use of 3D gamification in e-Learning system. Data from 149 users have shown that satisfaction is influenced by the quality of service and the quality of information on the system. Surprisingly, service quality was found to be related to satisfaction. Lastly, the quality of information was found to influence user satisfaction rather than vice versa. Our findings support this implementation successfully make users easier to understand than the usual system used before. [ABSTRACT FROM AUTHOR]