Poo Manager: Co-Designing a Serious Computer Game to Improve Constipation Management Awareness in Carers of People With Intellectual Disabilities

Approximately 2% of the population are people with intellectual disability (PwID). PwID are prone to multimorbidity, polypharmacy and premature mortality. Constipation is a prevalent and life-threatening issue for PwID fostered by iatrogenic harm, ignorance and stigma in family, and health and care settings. Despite its clinical significance, educational tools targeting caregivers’ knowledge of constipation prevention and management in PwID are scarce. Serious games (SGs) offer a novel and engaging platform to educate carers and reduce health stigma. Poo manager was collaboratively designed by a team of clinicians, academics, game developers and people with lived experience. The game involves navigating a care home, identifying constipation risk factors and selecting appropriate management strategies through evidence-based gameplay. A co-production workshop involving PwID, their carers and clinicians provided feedback on gameplay. Evaluation was conducted using validated measures to examine intervention acceptability, appropriateness and adoption feasibility. Over 60% found the SG enjoyable and believed it could improve constipation management knowledge. Scores demonstrated high acceptability, appropriateness and feasibility, though some concerns around game usability were noted. Poo manager is a promising SG intervention with strong potential to enhance constipation care for PwID. Further development and formal effectiveness evaluation are warranted to ensure impact on clinical outcomes.