From Clinical Requirements to Game Mechanics: A Requirements Engineering Framework for Serious Games for Health

• Bruna M. Barbosa UFG
• Carlos Henrique R. Souza UFG
• Halleffy H. Reis Santos UFG
• Luciana O. Berretta UFG
• Sérgio T. Carvalho UFG

DOI: https://doi.org/10.5753/sbcas.2026.21474

Resumo

The development of Serious Games for Health (SGH) requires balancing clinical effectiveness with player engagement. However, the lack of structured development processes often leads teams to adopt ad hoc approaches, resulting in systems that fail to meet clinical objectives or technical quality standards. This methodological gap makes it difficult to translate complex clinical protocols into consistent and executable technical specifications. To address this challenge, this paper proposes a Requirements Engineering framework tailored to SGH development. The framework integrates established software engineering practices and process maturity principles inspired by the Capability Maturity Model Integration (CMMI). It structures a collaborative workflow involving healthcare professionals, software engineers, and end users, and employs a Requirements Traceability Matrix (RTM) to ensure traceability between clinical objectives and game mechanics. To evaluate the framework, we conducted a case study involving the development of a serious game for adults with Autism Spectrum Disorder (ASD). The results provide evidence that the proposed framework improves clinical–technical alignment and establishes a systematic and auditable process for translating clinical needs into implementable game requirements.

Referências

Abdul Aziz, N. U., Ibrahim, R., and Abdullah, F. (2024). Review of Game Features to Develop a Serious Game Model for Mental Health Awareness. In CIITE, pages 1–6, Sepang, Selangor, Malaysia. IEEE.

Ambros-Antemate, J. F., Beristain-Colorado, M. D. P., Vargas-Treviño, M., Gutiérrez-Gutiérrez, J., Hernández-Cruz, P. A., Gallegos-Velasco, I. B., and Moreno-Rodríguez, A. (2021). Software engineering frameworks used for serious games development in physical rehabilitation: Systematic review. JMIR Serious Games, 9(4):e25831.

Barbosa, B., Ribeiro, M. W., Berretta, L., and Carvalho, S. (2024). Diagnostea: a digital game as a tool for the diagnosis/therapy of autism spectrum disorder. In Anais do XXIII Simpósio Brasileiro de Jogos e Entretenimento Digital, pages 1707–1718, Porto Alegre, RS, Brasil. SBC.

Brooks, Jr, F. (1987). No silver bullet essence and accidents of software engineering. IEEE Computer, 20:10–19.

Carlier, S., Naessens, V., De Backere, F., and De Turck, F. (2023). A Software Engineering Framework for Reusable Design of Personalized Serious Games for Health: Development Study. JMIR Serious Games, 11:e40054.

Caserman, P., Hoffmann, K., Müller, P., Schaub, M., Straßburg, K., Wiemeyer, J., Bruder, R., and Göbel, S. (2020). Quality Criteria for Serious Games: Serious Part, Game Part, and Balance. JMIR Serious Games, 8(3):e19037.

Fang, D., Silva, E., and Reis, L. P. (2025). Designing Serious Games to Support Teachers’ Emotion Regulation: A Systematic Review. In SeGAH, pages 1–6, Manchester. IEEE.

Honorato, N., Santos, A., Delabrida, S., Freitas, A. R., and Oliveira, W. (2021). Strong: Desenvolvimento e avaliação de um jogo para auxiliar no tratamento do espectro do autismo. In Anais Estendidos do XX Simpósio Brasileiro de Jogos e Entretenimento Digital, pages 582–591, Porto Alegre, RS, Brasil. SBC.

Maxim, R. I. and Arnedo-Moreno, J. (2025). Identifying Key Principles and Commonalities in Digital Serious Game Design Frameworks: Scoping Review. JMIR Serious Games, 13:e54075.

Piedade, P., Neto, I., Pires, A. C., Prada, R., and Nicolau, H. (2023). PartiPlay: A Participatory Game Design Kit for Neurodiverse Classrooms. In ACM SIGACCESS, pages 1–5, New York NY USA. ACM.

Ramalho, B., Vicente, M., Escobar, H., Gama, S., Diniz, J., Charisis, V., Hajileontiadis, L., and Dias, S. (2024). Developing Sensorimotor Art Games for Psoriatic Arthritis using Agile Storyboarding and Game Co-Design Processes. In DSAI, pages 260–267, Abu Dhabi United Arab Emirates. ACM.

Ravers, D., Alexandrovsky, D., Naaris, M., Konings, M. J., Monbaliu, E., Hallez, H., and Gerling, K. (2025). RollAbility: A Case Study of Aligning the Design of Game-Based Wheelchair Skills Training with Clinical Protocols and Player Experience Goals. HCI, 9(6):756–785.

Robertson, M. C., Baranowski, T., Thompson, D., Basen-Engquist, K. M., Swartz, M. C., and Lyons, E. J. (2021). Using the Behaviour Change Wheel Program Planning Model to Design Games for Health: Development Study. JMIR Serious Games, 9(4):e29964.

Roungas, B. (2021). A Game Design Framework for Alleviating Negative Emotions of Cancer Patients. In IEEE 9th SeGAH, pages 1–8, Dubai, United Arab Emirates. IEEE.

Santos, P. A., Yasui, A. K., Cravo, A. M., Brandão, A. L., and Gois, J. P. (2021). Timing Game - Jogo sério para o estudo da percepção do tempo com Design Participativo: Protótipo e Game Design. In SBGames, pages 922–931, Brasil.

Souza, E. G. D., Classe, T. M. D., and Castro, R. M. D. (2023). CaSEJ: Game Design Canvas para Brainstorming de Jogos para Saúde. In SBGames, pages 1223–1234.

Trindade, A. B., Pereira, G. B., and Hounsell, M. D. S. (2022). Requisitos para Jogos Sérios Ativos em Chão Interativo para o Público Autista. In SBGames, pages 542–551, Brasil.

Ushaw, G., Eyre, J., and Morgan, G. (2017). A paradigm for the development of serious games for health as benefit delivery systems. In 5th SeGAH, pages 1–8, Australia.

Vasconcellos, M. and Carvalho, F. (2023). “gdd-sério”: uma proposta de game design document (gdd) para desenvolvimento de jogos sérios. In SBGames, pages 169–178.

Wiegers, K. and Beatty, J. (2013). Software Requirements. Microsoft Press, 3rd edition.

Yang, D.-J., Lu, M.-Y., Chen, C.-W., Liu, P.-C., and Hou, I.-C. (2022). Development of a Therapeutic Video Game With the MDA Framework to Decrease Anxiety in Preschool-Aged Children With Acute Lymphoblastic Leukemia: Mixed Methods Approach. JMIR Serious Games, 10(3):e37079.