Phase I SBIR proposals will be accepted. Fast-Track proposals will not be accepted. Phase I clinical trials will not be accepted. Number of anticipated awards: 1 Budget (total costs): Phase I: up to $243,500 for up to 6 months; Phase II of up to $1,000,000 and a Phase II duration of up to 2 years PROPOSALS THAT EXCEED THE BUDGET OR PROJECT DURATION LISTED ABOVE MAY NOT BE FUNDED. Background Hand hygiene is one of the simplest, most effective interventions to limit the spread of communicable disease such as gastrointestinal or respiratory illness. As part of the response to the COVID-19 pandemic, a range of non-pharmaceutical interventions are being promoted as key prevention strategies. This includes frequent handwashing with soap and water and frequent use of hand sanitizers. Engagement in frequent handwashing is being promoted among multiple populations as part of the coronavirus response. Polling conducted over the course of the coronavirus response has indicated that the general public is engaging in handwashing behavior and perceive handwashing to be an effective strategy for coronavirus prevention. A range of factors can influence whether an individual engages in handwashing. This can include knowledge of the benefits, perceptions of risk for illness, access to supplies or infrastructure to engage in handwashing, norms, and hygiene related habits. Interventions to promote community handwashing behavior have targeted these drivers through social marketing or health communication campaigns, or educational interventions. Several of these interventions have been focused on promoting handwashing behavior among youth and children. Children and youth have been prioritized for interventions aimed at promoting handwashing behavior because children often engage in inadequate hygiene related behaviors and are often in congregate settings where there is potential to spread infection easily. Additionally, if children are educated early about the importance of handwashing, and this behavior becomes a life-long habit, it could result in future health benefits. To date, however, few interventions focused on promoting handwashing behavior have utilized “gamification” as an approach. Gamification has been used broadly in public health to promote a range of health promotion behaviors in both adults and children. Games can make learning about a health behavior more fun, can keep individuals more engaged with a health promoting behavior, and can allow for behavioral monitoring and feedback that can further reinforce the behavior into routine activities. Games have been used, for example, to promote exercise behavior among children. Games work by going beyond increasing knowledge, and incorporate strategies to incentivize health promotion behavior, provide opportunities for feedback, can allow for monitoring, and can utilize video and animation to provide real-time feedback on behaviors. Developing an innovative, interactive, phone-based game to promote handwashing behavior could be used as an innovative strategy to promote handwashing behavior among children and to help sustain frequent handwashing behavior over the lifespan. Project Goals The purpose of this project is to develop an interactive, phone-based game to promote handwashing behavior among children. Phase I Activities and Expected Deliverables It is expected that the development of a complete, functional, prototype of the video game would be accomplished during this project period. This would include the game story line, the graphics, the scientific content, and all other functionalities to make the game compelling and fun for the user. As part of the development of the functional prototype, aspects of human- centered design strategies will be used to assess and improve the usability of the game. Impact As handwashing is one of the key non-pharmaceutical interventions being promoted during the coronavirus response, it is critical to identify innovative strategies to promote this behavior and to encourage sustained engagement in these behaviors. The impact of this game could result in increases in handwashing behavior which could result in decreases in infection of not just respiratory illness associated with coronavirus, but also for a wider range of other communicable diseases. Commercialization Potential Educational games for children are widely promoted through phone-based app stores and educational games for children are also available through a range of toy companies. As more and more children are using tablets as part of their school-work activities, this educational game could be marketed toward school districts to be included on these tablets and incorporate the game into routine activities children complete on their school tablets. The game could also be marketed toward a range of parent groups, such as PTAs, as an educational tool parents can utilize within the home to promote handwashing behavior among children. As many of the games developed to promote healthy behaviors among children allow for real-time monitoring by an administrator, this functionality would be of interest to parents and educators who can monitor child engagement with the materials as well as monitor their completed handwashing behavior. The game could also be marketed to pediatrician offices which could load it on waiting room tablets allowing children to utilize the game to learn about proper handwashing behavior, and could give pediatricians real-time feedback to follow-up on information learned from the game to provide directed health education to both parents and children about handwashing.