Arbi Care: an innovative educational game to increase healthy behavior in diarrhea prevention among preschoolers
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The Indonesian Basic Health Survey (IBHS) shows that the number of children who have had diarrhea in Indonesia has increased over time, from 11% in 2002, to 13.7% in 2007, with the most recent survey results reporting 14% in 2012<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>.</p><p id="p0030" class="elsevierStylePara elsevierViewall">Preschoolers are the second largest group having diar-rhea<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. One nursing intervention in the treatment of diarrhea is to provide health education to children. However, nurses experience limitations to providing education to children due to high workload, a greater priority on other interventions, and a lack of educational media for children, especially media with content specifically about how to prevent diarrhea in preschoolers.</p><p id="p0035" class="elsevierStylePara elsevierViewall">The preschool period is a transition period from the dominance of parental control toward control by children themselves. In this phase, children learn independently from play<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>. As digital technology has developed, children have grown to like computer-based or electronic games. Educational games are a medium that aims to convey information in an entertaining way<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. Educational games are a fun medium for educating children in areas such as language skills, logical thinking, and interacting with the environment<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>. Games allow players to experiment with decision-making and problem solving under risk-free conditions and in an active learning environment<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. Video games are also recommended as an effective media to change behavior in children<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>.</p><p id="p0040" class="elsevierStylePara elsevierViewall">Various studies have explained that the causes of diarrhea are poor community hygiene and health practices<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7-9</span></a>. To prevent diarrhea it is necessary to teach healthy behaviors for children. Education to change children's behavior through a video game is based on social cognitive theory and the elaboration likelihood model of persuasion, including stages of attention, saving/retention, production, and motivation<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>. The first factor in the success of changing children's behavior through video games is children's interest in the educational game itself: they should be interested and willing to play the game repeatedly. Thus the first step for the developer of an educational game for preschoolers should be to discover the game characteristics favored by preschoolers themselves. This article presents the development process of an educational game to prevent diarrhea by increasing healthy behaviors of preschoolers.</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Method</span><p id="p0045" class="elsevierStylePara elsevierViewall">Research and development design was used in making this educational game, with four stages: define, design, develop, and disseminate<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>. The samples used in this study were preschoolers aged 3-6 years. In the define stage, researchers conducted a qualitative descriptive study to determine the game model favored by preschoolers. In the design stage, the researchers created the description of the game's story, which contains content that can be applied to the prevention of diarrhea by preschoolers. The researchers also cooperated with game developers to create the game prototype. In the develop stage, the researchers presented the product for validation by pediatric nursing media experts, specialists in health communication, and specialists in children's health promotion media. Expert inputs were used to make revisions to the game prototype, which was then tested with preschool children. There were 10 children aged 3-6 years involved in the trial phase of this product. Evaluation of the product as used by children was conducted using an observation sheet with indicators of ability to understand the game, interest in the game, and ability to learn from the game. In the disseminate phase, the researchers presented results through articles and a conference. Qualitative data obtained was processed through stages of data abstraction and data interpretation. Quantitative data obtained was processed according to the frequency distribution. Before being tested by preschoolers, the study received ethical clearance from the Faculty of Nursing, Universitas Indonesia.</p></span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Results</span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0030">Define stage</span><p id="p0050" class="elsevierStylePara elsevierViewall">To obtain an interesting educational game for preschoolers, it is necessary to get information directly from the children themselves. Qualitative studies from this research obtained information about preschoolers' favored game characteristics, which are: <span class="elsevierStyleItalic">1)</span> a moving main character, attractive and containing elements of fantasy; <span class="elsevierStyleItalic">2)</span> a game model that contains varied activities, facilitates an adrenaline rush, has a reward, and contains educational elements, and <span class="elsevierStyleItalic">3)</span> use of primary colors, namely red, yellow, blue, and a combination of the three colors.</p></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Design stage</span><p id="p0055" class="elsevierStylePara elsevierViewall">This stage involved drafting the educational game to prevent diarrhea by increasing healthy behaviors of preschoolers, as follows:<ul class="elsevierStyleList" id="l0015"><li class="elsevierStyleListItem" id="u0025"><span class="elsevierStyleLabel">1.</span><p id="p0060" class="elsevierStylePara elsevierViewall">Based on information from the qualitative study, designers portrayed characteristics of the main characters, consisting of a girl and a boy intended to function as representatives of the players, so that the children would feel as if they were the ones engaged in the game. The intention is to make both positive and negative impacts of the character easily accepted by children's five senses<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>.</p><p id="p0065" class="elsevierStylePara elsevierViewall">The characters are depicted in ways such as the following:<ul class="elsevierStyleList" id="l0020"><li class="elsevierStyleListItem" id="u0030"><span class="elsevierStyleLabel">•</span><p id="p0070" class="elsevierStylePara elsevierViewall">Boy character: wearing a red shirt, blue pants, black hair, black eyes, and yellow sandals. The distinctive style of a boy will be illustrated with hands clenched, as if saying “yes!” This is based on observations of the typical style of most of the boys.</p></li><li class="elsevierStyleListItem" id="u0035"><span class="elsevierStyleLabel">•</span><p id="p0075" class="elsevierStylePara elsevierViewall">Girl character: wearing a pink shirt, purple skirt, using accessories in the hair (two hair ties), black eyes, and pink sandals. Girls seemed to lift one of their hands, showing a distinctive style; the authors observed that the majority of the children's current style was the “peace” symbol.</p></li></ul></p></li><li class="elsevierStyleListItem" id="u0040"><span class="elsevierStyleLabel">2.</span><p id="p0080" class="elsevierStylePara elsevierViewall">Healthy behaviors in the prevention of diarrhea draw from Ministry of Health guidelines (2012)<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>, but were selected based on which behaviors can be readily applied by preschoolers. These included hand washing with soap and the practice of clean eating with balanced nutrition. The game scenario requires players to meet the needs of children, including nutritional needs; the need for elimination, and the needs to play, rest, and sleep in a balanced manner. Here is an overview of the model of the educational game to prevent diarrhea through healthy behavior for preschoolers (<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>).</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0085" class="elsevierStylePara elsevierViewall">In addition to the core learning objectives of diarrhea prevention above, there are three mini games that are included to promote healthy behaviors that support diarrhea prevention in preschoolers. First mini game involves organic and inorganic waste sorting to encourage children to do the physical activity in everyday life, second mini game involves choosing healthy food, and the third mini game involves riding bicycle as the representative of importance physical activity as the way to prevent diarrhea. Including the variation of this mini game prevents boredom while children are playing the game. Preschoolers tend to be pleased with such diverse forms of activity and music in games<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>.</p></li><li class="elsevierStyleListItem" id="u0045"><span class="elsevierStyleLabel">3.</span><p id="p0090" class="elsevierStylePara elsevierViewall">With diarrhea prevention as the goal, an Android-based game application called Arbi Care was then developed through collaboration with game developers. During the making of the game prototype, meetings and intense communications were held each week with the game developers to ensure the product was made in accordance with the script prepared for diarrhea prevention educational purposes. The first prototype of the game took about three months to complete.</p></li></ul></p></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">Develop stage</span><p id="p0095" class="elsevierStylePara elsevierViewall">After the Android-based game application to prevent diarrhea was completed, the next step was validation by experts that took part in expert seminars. These activities were conducted in order to obtain expert inputs to improve the game application prototype created. At this stage the researchers presented the product for validation by pediat-ric nursing media experts, specialists in health communication, and specialists in children's health promotion media. The product was presented with a simulation of how it is used, and then the experts provided a feasibility assessment of the product prototype and offered inputs for improvement. The Arbi Care prototype was considered feasible but needed revisions. The revised prototype was then tested by ten game players, namely children of preschool age, to determine the effectiveness of the game. The preschool game users obtained a mean score of 92%, indicating that Arbi Care, the Android-based game application to prevent diarrhea, can be used as educational media.</p></span></span><span id="s0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">Discussion</span><p id="p0100" class="elsevierStylePara elsevierViewall">The results of this study indicate that children are interested in playing the Arbi Care game provided, are capable of playing the game, and are able to understand the game's message. Baranowski et al (2008) suggested that the effectiveness of an educational game in changing healthy behavior in children is determined both by the extent that children are interested in the game and by the amount of time children persist in playing the game<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>. The longer the children play a game, the more educational information they can be exposed to.</p><p id="p0105" class="elsevierStylePara elsevierViewall">The Arbi Care game was developed in accordance with characteristics children favored in games, including varied activities, adrenaline stimulation, prizes or rewards, and educational elements. Children's favored activities in electronic games involved caring or nurturing, color matching, shooting, designing, and serving. Games stimulating adrenaline, e.g. through obstacles or racing, were also favored. When playing a game, children expect to receive a prize, which can be a trophy, something new in the game, or a score. The game model favored by preschoolers involved a varied game and contained educational elements.</p><p id="p0110" class="elsevierStylePara elsevierViewall">These results align with research by Nisa and Indrayana (2012), which identified board game design characteristics preferred by children aged 5-6 years<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>. They stated that the primary psychographic characteristics of preschoolers are: <span class="elsevierStyleItalic">1)</span> like to ask questions and are interested in what they do not know; <span class="elsevierStyleItalic">2)</span> like active movement; <span class="elsevierStyleItalic">3)</span> have a high sense of curiosity; <span class="elsevierStyleItalic">4)</span> have a good sense of imagination; <span class="elsevierStyleItalic">5)</span> always want to be involved in something; <span class="elsevierStyleItalic">6)</span> love to interact with peers; <span class="elsevierStyleItalic">7)</span> are interested in new things, and <span class="elsevierStyleItalic">8)</span> exhibit high creativity.</p><p id="p0115" class="elsevierStylePara elsevierViewall">Similar findings from Delima et al (2015) are also presented in research results that aimed to inform educational media design by identifying the needs of early childhood users<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>. Observations related to children in the fifth standard's interest in a multimedia application include: <span class="elsevierStyleItalic">1)</span> boys and girls interact with multimedia applications differently, in that girls are more interested in the visual display, while boys are more interested in assessing control, speed, and navigation; <span class="elsevierStyleItalic">2)</span> children preferred the game's main characters to be exciting, funny, and cheerful; <span class="elsevierStyleItalic">3)</span> children like flashy colors; <span class="elsevierStyleItalic">4)</span> challenge is a very important aspect of the game in order to arouse the curiosity of children and improve the child's interest in the game; <span class="elsevierStyleItalic">5)</span> words of appreciation and inspiration are very important in motivating children; <span class="elsevierStyleItalic">6)</span> forms of activity in the game should be varied to avoid children's boredom, and <span class="elsevierStyleItalic">7)</span> most children liked games to utilize music and sounds<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>.</p><p id="p0120" class="elsevierStylePara elsevierViewall">The game display is most interesting for the target player if it reflects favored characteristics. For example, preschoolers 3-5 years old characteristically engage in imaginative play with some fantasy and informal games<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>. This creates pleasant learning conditions for children and stimulates development of a child's mindset.</p><p id="p0125" class="elsevierStylePara elsevierViewall">The developed game is educational—a type of media with a specific purpose not only of providing entertainment but of stimulating interactive learning that provides the opportunity for players to build knowledge and understanding independently<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. There are two general categories to distinguish games, namely mini games and complex games. Mini games are generally played for less than an hour at a time, have a specific content focus, and can be developed by a small team of two to three people. Complex games involve many levels and require various teams of designers, programmers, and artists<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>. The Arbi Care game developed in this study is categorized as a digital mini game.</p><p id="p0130" class="elsevierStylePara elsevierViewall">Developing an educational game for the preschool age group has great potential to impact child development. Preschool age children's growth and development reflects a period in which the majority of children have control over their body functions, are able to interact and cooperate with others, are using language to symbolize ideas, and demonstrate an increasing attention span and memory. In this period the psychosocial development of children is creating a sense of initiative. Therefore, preschool children are very enthusiastic to learn new things. Children play and learn to try to achieve success and satisfaction in doing activities. This is a very appropriate period to instill concepts of good behavior, including healthy behaviors; cultivation of the concept of good behavior during this period will lead to good behavior later in life<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>.</p></span><span id="s0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Conclusions</span><p id="p0135" class="elsevierStylePara elsevierViewall">This study shows that an educational game to prevent diarrhea can be effectively designed for preschoolers. The majority of children are expected to be able to apply the game Arbi Care's content to everyday life, as they become familiar with and begin to practice healthy behaviors that prevent diarrhea. In addition, Arbi Care can be used as an intervention medium for nurses providing education to children admitted with diarrhea. Further research is needed to look at the effectiveness of the educational game Arbi Care in increasing healthy behaviors and preventing diarrhea among preschoolers.</p><span id="s0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0055">Acknowledgment</span><p id="p0140" class="elsevierStylePara elsevierViewall">The authors would like to thank Hi Clay Studio our partner in developing this game, as well as the children and parents who participated in this research.</p></span></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:3 [ "identificador" => "xres1092643" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abs0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1035515" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "s0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "s0010" "titulo" => "Method" ] 4 => array:3 [ "identificador" => "s0015" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "s0020" "titulo" => "Define stage" ] 1 => array:2 [ "identificador" => "s0025" "titulo" => "Design stage" ] 2 => array:2 [ "identificador" => "s0030" "titulo" => "Develop stage" ] ] ] 5 => array:2 [ "identificador" => "s0035" "titulo" => "Discussion" ] 6 => array:3 [ "identificador" => "s0040" "titulo" => "Conclusions" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "s0045" "titulo" => "Acknowledgment" ] ] ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1035515" "palabras" => array:5 [ 0 => "Arbi Care" 1 => "Diarrhea" 2 => "Educational game" 3 => "Healthy behavior" 4 => "Preschool" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abs0005" class="elsevierStyleSection elsevierViewall"><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Innovation is needed to improve healthy behaviors of children in order to prevent diarrhea. Education through games is widely recommended as a way to change behavior in children. This study describes the process of developing an educational game to increase healthy behaviors of preschool children. This study used research and development design techniques with four stages, including: define, design, develop, and disseminate. Observation sheets were used to assess the effectiveness of the game in educating children. The process of developing this educational game included several phases: <span class="elsevierStyleItalic">1)</span> exploration of the characteristics of games favored by children; <span class="elsevierStyleItalic">2)</span> design of the intervention based on games preferred by children; <span class="elsevierStyleItalic">3)</span> validation of the game prototype by experts and testing of the game by preschool children, and <span class="elsevierStyleItalic">4)</span> revision of the game in order to obtain a game focused on diarrhea prevention that can be used as a behavioral health intervention. Results showed that in testing of the game by ten preschool were able to play and understand the message of the game 92% of the time. The results showed that the Arbi Care game can be used as a learning device to increase healthy behavior in preschool children.</p></span>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "t0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Learning objective \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Game model \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Emphasize the importance of hand washing with soap at two critical points, namely:<ul class="elsevierStyleList" id="l0005"><li class="elsevierStyleListItem" id="u0005"><span class="elsevierStyleLabel">•</span><p id="p0005" class="elsevierStylePara elsevierViewall">Before eating</p></li><li class="elsevierStyleListItem" id="u0010"><span class="elsevierStyleLabel">•</span><p id="p0010" class="elsevierStylePara elsevierViewall">After using the toilet</p></li></ul> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">When a child says “I'm hungry”, the player must click on the dining table. However, the choice to eat cannot be selected if the child has not clicked on the sinks to wash hands first. The same thing happens when players meet the needs of children for toilet elimination. Players cannot get out of the toilet before clicking on a sink to wash hands after toileting. When clicking on the sink to wash hands, the player will be asked to order the steps of proper hand washing \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Demonstrate the practice of clean eating, namely:<ul class="elsevierStyleList" id="l0010"><li class="elsevierStyleListItem" id="u0015"><span class="elsevierStyleLabel">•</span><p id="p0015" class="elsevierStylePara elsevierViewall">Wash any cutlery that has fallen before reusing</p></li><li class="elsevierStyleListItem" id="u0020"><span class="elsevierStyleLabel">•</span><p id="p0020" class="elsevierStylePara elsevierViewall">Choose healthy foods and beverages</p></li></ul> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">When children are eating, the spoon suddenly falls, and a short tutorial video emerges on the proper behavior when cutlery falls<br>There is a mini game in which the player is asked to choose which one is the healthy food and beverage. For each healthy food chosen, the player will receive a star score \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">When clicking on the dining table, the player will be asked to select the menu. Players must fulfill the four components of balanced nutrition, namely carbohydrates, proteins, fruits, and vegetables, in the diet that is selected \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Teach how to choose a diet with balanced nutrition \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1868599.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Overview model of educational game to prevent diarrhea through healthy behaviour for preschoolers</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bs0010" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 0 | 4 |
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| 2024 February | 20 | 3 | 23 |
| 2024 January | 23 | 2 | 25 |
| 2023 December | 17 | 5 | 22 |
| 2023 November | 16 | 4 | 20 |
| 2023 October | 18 | 5 | 23 |
| 2023 September | 19 | 1 | 20 |
| 2023 August | 18 | 3 | 21 |
| 2023 July | 10 | 1 | 11 |
| 2023 June | 25 | 3 | 28 |
| 2023 May | 31 | 0 | 31 |
| 2023 April | 52 | 6 | 58 |
| 2023 March | 19 | 6 | 25 |
| 2023 February | 21 | 7 | 28 |
| 2023 January | 35 | 24 | 59 |
| 2022 December | 24 | 7 | 31 |
| 2022 November | 47 | 8 | 55 |
| 2022 October | 38 | 8 | 46 |
| 2022 September | 26 | 17 | 43 |
| 2022 August | 25 | 14 | 39 |
| 2022 July | 30 | 10 | 40 |
| 2022 June | 35 | 10 | 45 |
| 2022 May | 44 | 8 | 52 |
| 2022 April | 82 | 11 | 93 |
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| 2022 January | 58 | 5 | 63 |
| 2021 December | 37 | 15 | 52 |
| 2021 November | 46 | 19 | 65 |
| 2021 October | 22 | 18 | 40 |
| 2021 September | 23 | 18 | 41 |
| 2021 August | 26 | 13 | 39 |
| 2021 July | 17 | 8 | 25 |
| 2021 June | 14 | 6 | 20 |
| 2021 May | 32 | 10 | 42 |
| 2021 April | 78 | 40 | 118 |
| 2021 March | 28 | 9 | 37 |
| 2021 February | 21 | 10 | 31 |
| 2021 January | 37 | 20 | 57 |
| 2020 December | 25 | 9 | 34 |
| 2020 November | 22 | 9 | 31 |
| 2020 October | 8 | 6 | 14 |
| 2020 September | 30 | 11 | 41 |
| 2020 August | 23 | 6 | 29 |
| 2020 July | 19 | 4 | 23 |
| 2020 June | 13 | 4 | 17 |
| 2020 May | 15 | 16 | 31 |
| 2020 April | 18 | 7 | 25 |
| 2020 March | 27 | 8 | 35 |
| 2020 February | 32 | 9 | 41 |
| 2020 January | 15 | 8 | 23 |
| 2019 December | 24 | 19 | 43 |
| 2019 November | 11 | 11 | 22 |
| 2019 October | 18 | 17 | 35 |
| 2019 September | 26 | 7 | 33 |
| 2019 August | 5 | 4 | 9 |
| 2019 July | 20 | 17 | 37 |
| 2019 June | 9 | 12 | 21 |
| 2019 May | 18 | 31 | 49 |
| 2019 April | 6 | 3 | 9 |
| 2019 March | 11 | 0 | 11 |
| 2018 December | 2 | 1 | 3 |
| 2018 September | 1 | 0 | 1 |
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