Community Health Workers (CHWs) play a critical role in delivering primary healthcare services in low-resource settings, yet sustaining their training and performance remains a persistent challenge. Prior research has explored digital and game-based approaches for CHW training. However, limited work has synthesized longitudinal design insights into generalizable guidelines for interactive health interventions. Building on a four-year design-based research program involving multiple game-based refresher training systems, including quiz-based mobile apps, physical and augmented reality games, card-based games, and location-based games, we examine which design guidelines support sustained engagement, learning transfer, and contextual appropriateness in CHW training. We conducted a mixed-methods analysis across deployments with Accredited Social Health Activists and Anganwadi Workers in India, including interviews, field observations, and usage logs. Through thematic synthesis, we derive eight design guidelines addressing contextual realism, adaptive learning, hybrid interaction, social motivation, explainability, professional identity, and ethical considerations. Our findings contribute actionable design knowledge for researchers and practitioners developing interactive health interventions in low-resource healthcare contexts.

翻译：社区卫生工作者（CHWs）在低资源环境中提供初级医疗服务方面发挥着关键作用，但维持他们的培训和绩效仍然是一个长期挑战。先前的研究已探索了数字化和游戏化方法用于CHW培训，然而，将纵向设计洞察综合为可推广的交互式健康干预指南的成果有限。基于一项为期四年的设计研究计划（涵盖多种游戏化复训系统，包括基于测验的手机应用、实体与增强现实游戏、纸牌游戏以及基于位置的游戏），我们考察了哪些设计指南能够支持CHW培训中的持续参与、学习迁移及情境适应性。我们对印度认证社会健康活动家和安加瓦迪工作者开展了混合方法分析（涵盖访谈、实地观察及使用日志）。通过主题综合，我们推导出八项设计指南，涵盖情境真实性、自适应学习、混合交互、社会动机、可解释性、职业身份与伦理考量。我们的研究结果为在低资源医疗健康环境中开发交互式健康干预措施的研究人员与实践者提供了可操作的设计知识。