Title: Ramona, an educational and interactive Uruguayan ragdoll, empowering DMT1 children and adolescents self-management

Co-authors
B. Carrattini, C. Solari, M. Montero.
Asociación de Diabéticos del Uruguay, Montevideo, Uruguay.


Background
People of all ages learn best when involved in meaningful experiences. Learning takes place when the mind is able to put together information from all the senses and make a connection with past learning. Knowing that children and adolescents first choice for learning are games and ludic activities, makes it easier to use them for diabetes education, rather than in other traditional teaching-learning tools. Aim
To facilitate the acquisition of fundamental diabetes knowledge in an integrated way. Helping children and adolescents with type 1 diabetes to take their own and right choices. Method
Ramona is a child’s size ragdoll that allows children and adolescents to inject it. The game has a roulette wheel with different glycemic quotes and places to inject. Also have 2 types of cards; one with situations and another with different types of treatment. The objective is to help Ramona achieve her diabetes control by making the right choices. 
A diabetes educator who guides the players to accomplish their goals leads the game. 

Results
This game has been used in both diabetes educational camps and in the educational activities with children and adolescents of the Uruguayan Diabetes Association, making them have a global and integrated vision and being able to make appropriate diabetes management decisions. Everyone admitted that something new was learned during the game, which was clear to the game facilitator, since several questions and doubts arose during the playing time, and discussions were stimulated to make it possible for the player to reflect and, with mediation, solve their doubts. Children from 8 to 12 years old were able to learn to inject and rotate properly, differentiate insulin types and to take important treatment decisions. Adolescents between the ages of 13 and 18 learned to make their own decisions about self-injection, physical activities, healthy nutrition, self-monitoring and the correct analysis between them.

Discussion
knowing that diabetes integrated knowledge helps dmt1 to accomplish the metabolic goals, having a game that combines learning with having fun can help kids and adolescents to understand the complexity of their diabetes management. Playing the game during camp and sharing it not only with kids and adolescents but with doctors and parents had a positive learning impact in every one of them. As this is an interactional game, we suggest playing it in small groups, giving every person that is playing an opportunity to interact.

Ramona, an educational and interactive Uruguayian ragdoll, empowering DMT1 children and adolescents sellf managment