Health literacy refers to a person’s ability to access, understand, and use information and services to promote and maintain good health and wellbeing. Childhood is an optimal period for developing health literacy, as it empowers children and adolescents and supports their agency, participation, autonomy, and freedom in health-related matters. Low health literacy is associated with poorer health outcomes, inefficient use of healthcare services, and increased strain on health systems. Supporting health literacy in children is particularly challenging because children have limited capacity to process complex written or verbal information.

Serious games offer a promising and scalable approach to strengthening health literacy among younger populations. By combining evidence-based pedagogy with high levels of engagement, games can present health concepts in an accessible and motivating format. Educational games designed to prepare children for medical procedures or to teach them about health conditions allow children to explore information at their own pace in a familiar and supportive environment.

This presentation explores our experience of co-designing an interactive serious game with and for preschool children undergoing anesthesia for medical procedures in two Nordic countries. The game explains what to expect and teaches coping strategies. The development process included workshops with children, interviews with parents and healthcare professionals, and collaboration within an interprofessional team. Usability was evaluated with children and parents using observations and questionnaires, and a trial is currently underway to assess the game’s effectiveness in reducing anxiety in clinical settings. Pilot testing showed positive results, which will be presented alongside preliminary findings from the ongoing trial.

The cultural relevance of the game was also successfully tested in two hospitals in Nepal, supporting the idea that experiences of anesthesia are globally shared and that the game has international applicability and scalability. Based on our experience, we are confident and enthusiastic about the potential of serious games to improve children’s health literacy, knowledge, and self-efficacy in both sickness and health. When designed to be culturally appropriate and freely accessible, such games can convey essential health information, promote health-supportive behaviors, and contribute to improved health services globally.