*1.1. The PERGAMON Platform*

The PERGAMON platform that we present here is a gamification platform that integrates educational gaming and coaching. It gamifies self-care-related activities so users are rewarded for making progress in the game world. The virtual coach can keep track of users' daily BGM, physical activity, food intake and send reminders and motivational messages when the user forgets to follow recommendations agreed upon with their healthcare professional. The coaching system can reward behaviours that correspond to personalized goals. The platform provides a secure way for message exchange and data sharing between patients, their peers and their caregivers.

The platform integrates game elements and virtual coaching with a well designed system of main game and mini games based on an ontology of tasks, sub-goals and goals. Moreover, contrary to many systems medical content and coaching messages are tailored and personalized.

The aim is to see how gamification and digital coaching can be integrated into the continuous care of patients with chronic conditions, with the aim to integrate the findings in existing Patient Web Portals that support care of patients with T1D. Involving young patients with T1D and their caregivers in the development process was part of the development and research process. Young people and adolescents in particular have different requirements for medical devices than adults [48]. They also have different preferences for types of games and gamification methods [49].

In this research we investigate if the PERGAMON framework does support the specification and implementation of a pervasive serious gaming and coaching system for specific target groups. We demonstrated the answer by developing the system for young children with diabetes in a clinical setting. Next to this question, this research tries to investigate if patients do like the PERGAMON platform, how they use the different functions and the games of the platform, and if the integration of the components motivate educative game play as well as self-management of diabetes (in particular adherence to blood glucose monitor use).

After we discuss design principles and the design of the PERGAMON gamification platform, we present preliminary pilot study results obtained with experiences with the platform "in the wild", that is, with young patients with T1D under supervision of paediatricians and diabetes nurses in a Dutch hospital. The aim of the evaluation was to see whether patients had problems using the system and how they assessed the games and the coaching. Such usability and experience evaluations are a prerequisite for future evaluations that measure the impact of the platform in terms of medical outcomes.
