• Li Liu, Yao Wang, Tad Chun-Kwan Ho, Miranda Man-Yee Li, Eddie Wai-Sum Cheung, Rita Suk-Kuen Chow, Can Gu, and Helen Yue-Lai Chan.
• Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
• Palliat Med. 2024 Mar 1; 38 (3): 343351343-351.

BackgroundAdvance care planning can be challenging because discussing end-of-life care often has negative connotations. Gamification is a novel approach to encourage advance care planning conversations in Western culture.AimTo co-design a game with multiple stakeholders to promote advance care planning in Chinese communities.DesignA two-phase design guided by the Medical Research Council framework for developing complex interventions was adopted between May 2019 and August 2020. In phase I, a game prototype was developed based on literature review, expert consultation and end-user consultation. In Phase II, the game prototype was tested among end-users and refined according to their feedback and expertise of a multi-disciplinary team through an iterative process.Setting/ParticipantsExperts in the field of aged care, palliative care, life education and game development and Chinese community-dwelling adults aged 60 years or older.ResultsA board game called 'The Five Tastes Found in a Grocery Store' was developed. The game design was shaped by Bandura's Self-efficacy theory and feedback from experts and end-users. The participants generally found the gaming experience enjoyable and appreciated the opportunity to discuss end-of-life care openly.ConclusionsThis study is the first to develop an evidence-informed, theory-based, culturally sensitive game for promoting advance care planning in the Chinese community using a co-design approach.

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