Project currently in development:

Interactive Tablet Application: Diabetes Education for Low Health Literacy Populations

Diabeater Game Preview (Click to Play)

Background Information

Due to the chronic nature of diabetes, daily self-management of one’s medication and blood glucose levels is essential for a diabetic to manage their disease. However, a large impediment to diabetes management remains in those with low health literacy who, despite the wealth of information available, may still have limited understanding of the disease. The Affordable Care Act defines health literacy as “the degree to which an individual has the capacity to obtain, communicate, process, and understand health information and services in order to make appropriate health decisions.” Without proper education, patients with low health literacy have been shown to have less regulation over their glycemic control than patients with higher health literacy, and yet there are few interventions to resolve this barrier; therefore it is imperative that effective interventions provide education to low health literacy patients in diabetes management.

Games and applications that encourage their diabetic users to increase physical activity and think carefully about diet choices, as well as educate them in an easily understood manner, have great potential to improve diabetes self-management. This is especially true for low health literacy patients who would not benefit as much from simply reading about the subject. Therefore, this research will investigate the most appropriate methodology in creating an application for tablet devices that uses an interactive game to educate low health literacy patients in understanding and managing their diabetes. For the field of biomedical visualization, this research can serve as a model for taking complex medical material and breaking it down into visual, readily comprehendible information in the form of an interactive game specifically for low health literacy patients.

application character design page

Project Goals

This study will use current tablet technology to provide an interactive educational application that will supply audiovisual aids teaching diabetes self-management. The application will contain an interactive game that will teach and test the user’s understanding of self-management concepts such as information that diabetics might receive from their physicians, like BMI levels and glycemic control, and break it down into easily understood terms. The game will begin via creation of an avatar that has diabetes. Healthy choices will earn the player rewards while incorrect choices will prompt explanations via animations to reinforce self-management concepts, for example the importance of dieting, exercise, medication adherence, and blood glucose monitoring. Expected results for this project are the production of a working prototype of this interactive application on diabetes education. The prototype will be functional for tablet platforms in iOS, Android, and Windows. Content experts in diabetes education for low health literacy populations will evaluate the application for accuracy of content and potential approachability for low health literacy patients.




Date Started: January 2014
Committee Members: Dr. Ben Gerber, Denise Wurl, Donna Hughes, Swan Ly


The primary audience for this project will be low health literacy diabetics who can use and learn from this research’s application. This application will also be made approachable for younger diabetic patients who may still be in school but may also lack proper diabetes self-management education. Family members of the patients, caretakers, medical professionals, and professionals in the field of biomedical visualization may also learn from this project for ways of communicating and educating patients who may suffer from low health literacy. 


  • Adobe InDesign
  • Adobe Illustrator
  • Adobe Edge Animate
  • Adobe Audition
  • Adobe PhoneGap Build
  • Tablet device


After creating the assets for the application in Adobe Illustrator, those assets were brought into Adobe After Effects and Edge Animate for compositing. The first image above is an example of the workflow within After Effects while creating one of the animations and the second is the workflow in Edge Animate. The third image shows editing of audio in Adobe Audition where voiceover narration, sound effects, and music for the application were recorded and edited. 


The above images are designs of various settings within the game. The player is able to travel to different areas where they will learn various aspects of diabetes management, such as healthier options when eating out or exercises to do while at home.


This project contains a character design aspect in which the user will be able to create their own character with which to play the game. The above are pages of assets with which the user can customize their character. During the course of the game, the user will be able to earn points with which they can buy more in-game items to further customize their character. Points can be earned by completing in-game activities that improve your character's health and manage their diabetes. There will also be quiz questions to test the user's understanding of the information as well as animations to explain correct or incorrect answers.

The above are sketches of different concept designs of the application. These designs were constructed while keeping in mind the importance of conciseness and clarity, especially for low health literacy users. Calming colors were used along with sparse use of the text to direct the user with as little reading as possible. The third concept was chosen and revised for better clarity and ease of use.


concept map for the application