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On Friday, August 31, 2018 at 12:00 pm Eastern Time, JMIR will be completing a server migration to improve site stability and user experience. We expect to be back online Friday, August 31, 2018 at 5:00 pm Eastern Time. Should any problems arise our technical team will be using the weekend to resolve them, and users will be able to access our site by Sunday, September 2, 2018 at 1:00pm Eastern Time.

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Journal Description

JMIR Serious Games (JSG, ISSN 2291-9279) is a sister journal of the Journal of Medical Internet Research (JMIR), one of the most cited journals in health informatics. In June 2018, JSG received an official inaugural journal impact factor of 2.226 (Journal Citation Reports 2017, Clarivate Analytics). This ranks JSG at the top of all gaming related academic journals, ahead of (for example) more established competitor journals such as the Games for Health Journal. 

JSG is a multidisciplinary journal devoted to computer/web/mobile/augmented and virtual reality applications that incorporate elements of gaming to solve serious problems such as health education/promotion, teaching and education, or social change.
The journal also considers commentary and research in the fields of video games violence and video games addiction.

JMIR Serious Games is indexed in Pubmed, PubMed Central, and in Clarivate/Thomson Reuters Science Citation Index Expanded (SCIE).

 

Recent Articles:

  • Source: Wikicommons; Copyright: Rama; URL: https://commons.wikimedia.org/wiki/File:CPR_training-03.jpg; License: Creative Commons Attribution + ShareAlike (CC-BY-SA).

    The Modification of Vital Signs According to Nursing Students’ Experiences Undergoing Cardiopulmonary Resuscitation Training via High-Fidelity Simulation:...

    Abstract:

    Background: High-fidelity simulation represents a primary tool in nursing education, especially when hands-on practical training is involved. Objective: We sought to determine the influence of high-fidelity clinical simulation, applied during cardiopulmonary resuscitation (CPR) training, on blood pressure, heart rate, stress, and anxiety levels in 2 groups of nursing students. One group had experience in health contexts, whereas the other group had none. Methods: We performed a quasi-experimental study. Data were collected between May and June 2015 and included measurements of all the resting values, before and after participation in CPR clinical simulations regarding the 2 groups of university students (ie, with and without experience). Results: An increase in vital signs was observed in students after participating in a clinical simulation scenario, especially the heart rate. In all students, increased stress and anxiety levels were observed before the first simulation case scenario. Also, in all study groups, a decrease in vital signs, stress levels, and anxiety was observed throughout the study. Conclusions: Participation in high-fidelity simulation experiences has both physiological and psychological effects on students.

  • Source: US Department of Defence (John J Kruzel); Copyright: US Department of Defence; URL: http://archive.defense.gov/news/newsarticle.aspx?id=51297; License: Public Domain (CC0).

    Video Games as a Potential Modality for Behavioral Health Services for Young Adult Veterans: Exploratory Analysis

    Abstract:

    Background: Improving the reach of behavioral health services to young adult veterans is a policy priority. Objective: The objective of our study was to explore differences in video game playing by behavioral health need for young adult veterans to identify potential conditions for which video games could be used as a modality for behavioral health services. Methods: We replicated analyses from two cross-sectional, community-based surveys of young adult veterans in the United States and examined the differences in time spent playing video games by whether participants screened positive for behavioral health issues and received the required behavioral health services. Results: Pooling data across studies, participants with a positive mental health screen for depression or posttraumatic stress disorder (PTSD) spent 4.74 more hours per week (95% CI 2.54-6.94) playing video games. Among participants with a positive screen for a substance use disorder, those who had received substance use services since discharge spent 0.75 more days per week (95% CI 0.28-1.21) playing video games than participants who had not received any substance use services since discharge. Conclusions: We identified the strongest evidence that participants with a positive PTSD or depression screen and participants with a positive screen for a substance use disorder who also received substance use services since their discharge from active duty spent more time playing video games. Future development and evaluation of video games as modalities for enhancing and increasing access to behavioral health services should be explored for this population.

  • Man wearing a virtual reality head-mounted device while walking in nature. Source: Pexels; Copyright: Bradley Hook; URL: https://www.pexels.com/photo/sea-landscape-nature-sky-123318/; License: Licensed by the authors.

    Head-Mounted Virtual Reality and Mental Health: Critical Review of Current Research

    Abstract:

    Background: eHealth interventions are becoming increasingly used in public health, with virtual reality (VR) being one of the most exciting recent developments. VR consists of a three-dimensional, computer-generated environment viewed through a head-mounted display. This medium has provided new possibilities to adapt problematic behaviors that affect mental health. VR is no longer unaffordable for individuals, and with mobile phone technology being able to track movements and project images through mobile head-mounted devices, VR is now a mobile tool that can be used at work, home, or on the move. Objective: In line with recent advances in technology, in this review, we aimed to critically assess the current state of research surrounding mental health. Methods: We compiled a table of 82 studies that made use of head-mounted devices in their interventions. Results: Our review demonstrated that VR is effective in provoking realistic reactions to feared stimuli, particularly for anxiety; moreover, it proved that the immersive nature of VR is an ideal fit for the management of pain. However, the lack of studies surrounding depression and stress highlight the literature gaps that still exist. Conclusions: Virtual environments that promote positive stimuli combined with health knowledge could prove to be a valuable tool for public health and mental health. The current state of research highlights the importance of the nature and content of VR interventions for improved mental health. While future research should look to incorporate more mobile forms of VR, a more rigorous reporting of VR and computer hardware and software may help us understand the relationship (if any) between increased specifications and the efficacy of treatment.

  • The user's character riding te Hokioi, a giant eagle, within the SPARX program. Source: Image created by the Authors; Copyright: The Authors; URL: http://games.jmir.org/2018/3/e13/; License: Licensed by the authors.

    Indigenous Adolescents’ Perception of an eMental Health Program (SPARX): Exploratory Qualitative Assessment

    Abstract:

    Background: Depression is a major health issue for indigenous adolescents, yet there is little research conducted about the efficacy and development of psychological interventions for these populations. In New Zealand there is little known about taitamariki (Māori adolescent) opinions regarding the development and effectiveness of psychological interventions, let alone computerized cognitive behavioral therapy. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computerized intervention developed in New Zealand to treat mild-to-moderate depression in young people. Users are engaged in a virtual 3D environment where they must complete missions to progress to the next level. In each level there are challenges and puzzles to completeIt was designed to appeal to all young people in New Zealand and incorporates several images and concepts that are specifically Māori. Objective: The aim was to conduct an exploratory qualitative study of Māori adolescents’ opinions about the SPARX program. This is a follow-up to an earlier study where taitamariki opinions were gathered to inform the design of a computerized cognitive behavior therapy program. Methods: Taitamariki were interviewed using a semistructured interview once they had completed work with the SPARX resource. Six participants agreed to complete the interview; the interviews ranged from 10 to 30 minutes. Results: Taitamariki participating in the interviews found SPARX to be helpful. The Māori designs from the SPARX game were appropriate and useful, and the ability to customize the SPARX characters with Māori designs was beneficial and appeared to enhance cultural identity. These helped young people to feel engaged with SPARX which, in turn, assisted with the acquisition of relaxation and cognitive restructuring skills. Overall, using SPARX led to improved mood and increased levels of hope for the participants. In some instances, SPARX was used by wider whānau (Māori word for family) members with reported beneficial effect. Conclusions: Overall, this small group of Māori adolescents reported that cultural designs made it easier for them to engage with SPARX, which, in turn, led to an improvement in their mood and gave them hope. Further research is needed about how SPARX could be best used to support the families of these young people.

  • Web-Based Immersive Patient Simulator ALICE (montage). Source: The Authors / Placeit.net; Copyright: JMIR Publications; URL: http://games.jmir.org/2018/3/e10693/; License: Creative Commons Attribution (CC-BY).

    Web-Based Immersive Patient Simulator as a Curricular Tool for Objective Structured Clinical Examination Preparation in Surgery: Development and Evaluation

    Abstract:

    Background: Objective Structured Clinical Examination is a standard method of testing declarative and process knowledge in clinical core competencies. It is desirable that students undergo Objective Structured Clinical Examination training before participating in the exam. However, establishing Objective Structured Clinical Examination training is resource intensive and therefore there is often limited practice time. Web-based immersive patient simulators such as ALICE (Artificial Learning Interface of Clinical Education) can possibly fill this gap as they allow for the training of complex medical procedures at the user’s individual pace and with an adaptable number of repetitions at home. ALICE has previously been shown to positively influence knowledge gain and motivation. Objective: Therefore, the aim of this study was to develop a Web-based curriculum that teaches declarative and process knowledge and prepares students for a real Objective Structured Clinical Examination station. Furthermore, we wanted to test the influence of ALICE on knowledge gain and student motivation. Methods: A specific curriculum was developed in order to implement the relevant medical content of 2 surgical Objective Structured Clinical Examination stations into the ALICE simulator framework. A total of 160 medical students were included in the study, where 100 students had access to ALICE and their performance was compared to 60 students in a control group. The simulator performance was validated on different levels and students’ knowledge gain and motivation were tested at different points during the study. Results: The curriculum was developed according to the Kern cycle. Four virtual clinical cases were implemented with different teaching methods (structured feedback, keynote speech, group discussion, and debriefing by a real instructor) in order to consolidate declarative and process knowledge. Working with ALICE had significant impact on declarative knowledge gain and Objective Structured Clinical Examination performance. Simulator validation was positive for face, content, construct, and predictive validity. Students showed high levels of motivation and enjoyed working with ALICE. Conclusions: ALICE offers Web-based training for Objective Structured Clinical Examination preparation and can be used as a selective didactic intervention as it has positive effect on knowledge gain and student motivation.

  • Adults playing tabletop board game at gaming convention. Source: Flickr; Copyright: dooley; URL: https://www.flickr.com/photos/dooleynoted/21607509202; License: Creative Commons Attribution (CC-BY).

    Physical Wellness Among Gaming Adults: Cross-Sectional Study

    Abstract:

    Background: Video and hobby gaming are immensely popular among adults; however, associations between gaming and health have primarily been investigated in children and adolescents. Furthermore, most research has focused on electronic gaming, despite traditional hobby gaming gaining prominence. Objective: To determine whether the number of platforms used, platform preference, and gaming time are associated with obesity, physical activity, sedentary behavior, and cardiovascular risk factors in an adult gaming population. Methods: We conducted a cross-sectional analysis using data obtained from 292 participants who attended a large Midwestern gaming convention. We collected data using a computer-based questionnaire that comprised questions on gaming behavior, demographics, physical activity (using the International Physical Activity Questionnaire), and health characteristics. In addition, we used multivariable-adjusted linear and logistic regression to model health outcomes as a function of the number of platforms used, platform preference, and weekday and weekend gaming time quartile. Results: After adjusting for covariates, we observed a significant linear trend for increasing odds of being obese and higher weekend sitting time by the number of platforms used (P=.03 for both). The platform preference and weekend gaming time quartile exhibited significant associations with odds of meeting physical activity recommendations (P=.047 and P=.03, respectively). In addition, we observed higher odds of being obese among those reporting that they sat most or all of the time while gaming [odds ratio (OR) 2.69 (95% CI 1.14-6.31) and OR 2.71 (95% CI 1.06-6.93), respectively]. Conclusions: In adult gamers, the number of platforms used, which platforms they prefer to play on, and the amount of time spent gaming on weekends could have significant implications for their odds of being obese and meeting physical activity recommendations.

  • The <italic>Inspired</italic> game (montage). Source: The Authors / Placeit.net; Copyright: JMIR Publications; URL: http://games.jmir.org/2018/2/e11/; License: Creative Commons Attribution (CC-BY).

    A Mobile Game to Support Smoking Cessation: Prototype Assessment

    Abstract:

    Background: Cigarette smoking results in an estimated seven million deaths annually. Almost half of all smokers attempt to quit each year, yet only approximately 6% are successful. Although there are multiple effective interventions that can increase these odds, substantial room remains for improvement. One effective approach to helping smokers quit is contingency management, where quitting is incentivized with the delivery of monetary rewards in exchange for objective evidence (eg, exhaled carbon monoxide levels) of abstinence. Objective: We assessed the feasibility and promise of Inspired, a contingency management mobile app for smoking cessation that uses game-based rewards to incentivize abstinence from smoking instead of the monetary (or material) rewards typically used. We sought participant feedback and limited objective data on: the features and design of Inspired, interest in using Inspired when it becomes available, the likelihood of Inspired being an effective cessation aid, and the rank order preference of Inspired relative to other familiar smoking cessation aids. Methods: Twenty-eight treatment-seeking smokers participated in this study. Participants attended a single one-hour session in which they received an overview of the goals of the Inspired mobile game, practiced submitting breath carbon monoxide (CO) samples, and played representative levels of the game. Participants were then told that they could play an extra level, or they could stop, complete an outcome survey, receive payment, and be dismissed. A sign-up sheet requesting personal contact information was available for those who wished to be notified when the full version of Inspired becomes available. Results: Using binary criteria for endorsement, participants indicated that, assuming it was currently available and fully developed, they would be more likely to use Inspired than: any other smoking cessation aid (21/28, 75%), the nicotine patch (23/28, 82%), a drug designed to reduce smoking cravings (23/28, 82%), or a program involving attendance in training sessions or support group meetings (27/28, 96%). In the questionnaire, participants indicated that both the Inspired program (26/28, 93%) and the Inspired game would be “Fun” (28/28, 100%), and 71% (20/28) reported that the program would help them personally quit smoking. Fifty-eight percent of participants (15/26) chose to continue playing the game rather than immediately collecting payment for participation and leaving. Eighty-two percent of participants (23/28) signed up to be notified when the full version of Inspired becomes available. Conclusions: This was the first study to evaluate a game-based contingency management app that uses game-based virtual goods as rewards for smoking abstinence. The outcomes suggest that the completed app has potential to be an effective smoking cessation aid that would be widely adopted by smokers wishing to quit.

  • Source: The Authors / Placeit.net; Copyright: JMIR Publications; URL: http://games.jmir.org/2018/2/e10/; License: Creative Commons Attribution (CC-BY).

    Training Working Memory in Adolescents Using Serious Game Elements: Pilot Randomized Controlled Trial

    Abstract:

    Background: Working memory capacity has been found to be impaired in adolescents with various psychological problems, such as addictive behaviors. Training of working memory capacity can lead to significant behavioral improvements, but it is usually long and tedious, taxing participants’ motivation to train. Objective: This study aimed to evaluate whether adding game elements to the training could help improve adolescents’ motivation to train while improving cognition. Methods: A total of 84 high school students were allocated to a working memory capacity training, a gamified working memory capacity training, or a placebo condition. Working memory capacity, motivation to train, and drinking habits were assessed before and after training. Results: Self-reported evaluations did not show a self-reported preference for the game, but participants in the gamified working memory capacity training condition did train significantly longer. The game successfully increased motivation to train, but this effect faded over time. Working memory capacity increased equally in all conditions but did not lead to significantly lower drinking, which may be due to low drinking levels at baseline. Conclusions: We recommend that future studies attempt to prolong this motivational effect, as it appeared to fade over time.

  • VANESSA encounter. Source: Image created by the Authors; Copyright: The Authors; URL: http://games.jmir.org/2018/2/e8/; License: Creative Commons Attribution + Noncommercial + ShareAlike (CC-BY-NC-SA).

    Virtual Antenatal Encounter and Standardized Simulation Assessment (VANESSA): Pilot Study

    Abstract:

    Background: Prenatal counseling at the limits of newborn viability involves sensitive interactions between neonatal providers and families. Empathetic discussions are currently learned through practice in times of high stress. Decision aids may help improve provider communication but have not been universally adopted. Virtual standardized patients are increasingly recognized as a modality for education, but prenatal counseling simulations have not been described. To be valuable as a tool, a virtual patient would need to accurately portray emotions and elicit a realistic response from the provider. Objective: To determine if neonatal providers can accurately identify a standardized virtual prenatal patient’s emotional states and examine the frequency of empathic responses to statements made by the patient. Methods: A panel of Neonatologists, Simulation Specialists, and Ethicists developed a dialogue and identified empathic responses. Virtual Antenatal Encounter and Standardized Simulation Assessment (VANESSA), a screen-based simulation of a woman at 23 weeks gestation, was capable of displaying anger, fear, sadness, and happiness through animations. Twenty-four neonatal providers, including a subgroup with an ethics interest, were asked to identify VANESSA’s emotions 28 times, respond to statements, and answer open-ended questions. The emotions were displayed in different formats: without dialogue, with text dialogue, and with audio dialogue. Participants completed a post-encounter survey describing demographics and experience. Data were reported using descriptive statistics. Qualitative data from open ended questions (eg, “What would you do?”) were examined using thematic analysis. Results: Half of our participants had over 10 years of clinical experience. Most participants reported using medical research (18/23, 78%) and mortality calculators (17/23, 74%). Only the ethics-interested subgroup (10/23, 43%) listed counseling literature (7/10, 70%). Of 672 attempts, participants accurately identified VANESSA’s emotions 77.8% (523/672) of the time, and most (14/23, 61%) reported that they were confident in identifying these emotions. The ethics interest group was more likely to choose empathic responses (P=.002). Participants rated VANESSA as easy to use (22/23, 96%) and reported that she had realistic dialogue (15/23, 65%). Conclusions: This pilot study shows that a prenatal counseling simulation is feasible and can yield useful data on prenatal counseling communication. Our participants showed a high rate of emotion recognition and empathy in their responses.

  • Source: Image created by the Authors; Copyright: The Authors; URL: http://games.jmir.org/2018/2/e9/; License: Creative Commons Attribution + NoDerivatives (CC-BY-ND).

    Using Mobile Health Gamification to Facilitate Cognitive Behavioral Therapy Skills Practice in Child Anxiety Treatment: Open Clinical Trial

    Abstract:

    Background: Cognitive behavioral therapy is an efficacious treatment for child anxiety disorders. Although efficacious, many children (40%-50%) do not show a significant reduction in symptoms or full recovery from primary anxiety diagnoses. One possibility is that they are unwilling to learn and practice cognitive behavioral therapy skills beyond therapy sessions. This can occur for a variety of reasons, including a lack of motivation, forgetfulness, and a lack of cognitive behavioral therapy skills understanding. Mobile health (mHealth) gamification provides a potential solution to improve cognitive behavioral therapy efficacy by delivering more engaging and interactive strategies to facilitate cognitive behavioral therapy skills practice in everyday lives (in vivo). Objective: The goal of this project was to redesign an existing mHealth system called SmartCAT (Smartphone-enhanced Child Anxiety Treatment) so as to increase user engagement, retention, and learning facilitation by integrating gamification techniques and interactive features. Furthermore, this project assessed the effectiveness of gamification in improving user engagement and retention throughout posttreatment. Methods: We redesigned and implemented the SmartCAT system consisting of a smartphone app for children and an integrated clinician portal. The gamified app contains (1) a series of interactive games and activities to reinforce skill understanding, (2) an in vivo skills coach that cues the participant to use cognitive behavioral therapy skills during real-world emotional experiences, (3) a home challenge module to encourage home-based exposure tasks, (4) a digital reward system that contains digital points and trophies, and (5) a therapist-patient messaging interface. Therapists used a secure Web-based portal connected to the app to set up required activities for each session, receive or send messages, manage participant rewards and challenges, and view data and figures summarizing the app usage. The system was implemented as an adjunctive component to brief cognitive behavioral therapy in an open clinical trial. To evaluate the effectiveness of gamification, we compared the app usage data at posttreatment with the earlier version of SmartCAT without gamification. Results: Gamified SmartCAT was used frequently throughout treatment. On average, patients spent 35.59 min on the app (SD 64.18) completing 13.00 activities between each therapy session (SD 12.61). At the 0.10 significance level, the app usage of the gamified system (median 68.00) was higher than that of the earlier, nongamified SmartCAT version (median 37.00, U=76.00, P<.01). The amount of time spent on the gamified system (median 173.15) was significantly different from that of the earlier version (median 120.73, U=173.00, P=.06). Conclusions: The gamified system showed good acceptability, usefulness, and engagement among anxious children receiving brief cognitive behavioral therapy treatment. Integrating an mHealth gamification platform within treatment for anxious children seems to increase involvement in shorter treatment. Further study is needed to evaluate increase in involvement in full-length treatment.

  • Take Control player silhouettes. Source: Image created by the Authors; Copyright: The Authors; URL: http://games.jmir.org/2018/2/e7/; License: Licensed by JMIR.

    Virtual Reality Cue Refusal Video Game for Alcohol and Cigarette Recovery Support: Summative Study

    Abstract:

    Background: New technologies such as virtual reality, augmented reality, and video games hold promise to support and enhance individuals in addiction treatment and recovery. Quitting or decreasing cigarette or alcohol use can lead to significant health improvements for individuals, decreasing heart disease risk and cancer risks (for both nicotine and alcohol use), among others. However, remaining in recovery from use is a significant challenge for most individuals. Objective: We developed and assessed the Take Control game, a partially immersive Kinect for Windows platform game that allows users to counter substance cues through active movements (hitting, kicking, etc). Methods: Formative analysis during phase I and phase II guided development. We conducted a small wait-list control trial using a quasi-random sampling technique (systematic) with 61 participants in recovery from addiction to alcohol or tobacco. Participants used the game 3 times and reported on substance use, cravings, satisfaction with the game experience, self-efficacy related to recovery, and side effects from exposure to a virtual reality intervention and substance cues. Results: Participants found the game engaging and fun and felt playing the game would support recovery efforts. On average, reported substance use decreased for participants during the intervention period. Participants in recovery for alcohol use saw more benefit than those in recovery for tobacco use, with a statistically significant increase in self-efficacy, attitude, and behavior during the intervention. Side effects from the use of a virtual reality intervention were minor and decreased over time; cravings and side effects also decreased during the study. Conclusions: The preliminary results suggest the intervention holds promise as an adjunct to standard treatment for those in recovery, particularly from alcohol use.

  • Focus group discussing user requirements. Source: Wikipedia; Copyright: Lekomun; URL: https://upload.wikimedia.org/wikipedia/commons/e/e9/%D0%98%D1%81%D0%B0%D0%BA%D0%BE%D0%B2_%D0%B1%D1%8E%D1%80%D0%BE.jpg; License: Creative Commons Attribution + ShareAlike (CC-BY-SA).

    Gamified Cognitive Control Training for Remitted Depressed Individuals: User Requirements Analysis

    Abstract:

    Background: The high incidence and relapse rates of major depressive disorder demand novel treatment options. Standard treatments (psychotherapy, medication) usually do not target cognitive control impairments, although these seem to play a crucial role in achieving stable remission. The urgent need for treatment combined with poor availability of adequate psychological interventions has instigated a shift toward internet interventions. Numerous computerized programs have been developed that can be presented online and offline. However, their uptake and adherence are oftentimes low. Objective: The aim of this study was to perform a user requirements analysis for an internet-based training targeting cognitive control. This training focuses on ameliorating cognitive control impairments, as these are still present during remission and can be a risk factor for relapse. To facilitate uptake of and adherence to this intervention, a qualitative user requirements analysis was conducted to map mandatory and desirable requirements. Methods: We conducted a user requirements analysis through a focus group with 5 remitted depressed individuals and individual interviews with 6 mental health care professionals. All qualitative data were transcribed and examined using a thematic analytic approach. Results: Results showed mandatory requirements for the remitted sample in terms of training configuration, technological and personal factors, and desirable requirements regarding knowledge and enjoyment. Furthermore, knowledge and therapeutic benefits were key requirements for therapists. Conclusions: The identified requirements provide useful information to be integrated in interventions targeting cognitive control in depression.

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  • Acceptability of a Plasticity Focused Serious Game Intervention for PTSD: A User Requirements Analysis

    Date Submitted: Aug 10, 2018

    Open Peer Review Period: Aug 19, 2018 - Oct 14, 2018

    Background: Trauma-focussed CBT (TF-CBT) is a first line treatment for post-traumatic stress disorder PTSD. Despite a solid evidence base, TF-CBT response and attrition rates vary considerably. Plasti...

    Background: Trauma-focussed CBT (TF-CBT) is a first line treatment for post-traumatic stress disorder PTSD. Despite a solid evidence base, TF-CBT response and attrition rates vary considerably. Plasticity focused interventions, including the use of serious games, have the potential to improve TF-CBT response and treatment retention. Objective: The aim of this study was assess the acceptability of a smartphone delivered plasticity focused serious game to improve response to TF-CBT for PTSD; and to carry out a user requirements analysis should development of a prototype be warranted. Methods: We conducted two one-to-one interviews (n = 2);one focus group involving service users who had received a diagnosis of PTSD (n = 3); and one focus group involving psychological trauma service clinicians (n = 4). Results: We found that the concept of a plasticity focused smartphone intervention for PTSD is acceptable to patients and clinicians. Service users and clinicians both believed that usage should be guided by a therapist, and both contributed useful input regarding the audiovisual aspects of the proposed serious game. It was accepted that the game would not be suitable for all patients, and that clinicians would need to appropriately prescribe usage of the game. Conclusions: Our findings highlight the acceptability of the proposed serious game and clarify the user requirements for such an intervention. It is the intention of the authors to carry out a user experience evaluation using a prototype serious game in a clinical population.

  • A territorial diagnosis tool which uses serious games to address health and environmental inequalities: Equit’Game

    Date Submitted: Aug 2, 2018

    Open Peer Review Period: Aug 6, 2018 - Oct 1, 2018

    Background: The territorial diagnosis is prerequisite for local actions concerning public health and the reduction of social, environmental and health-related inequalities. To orient local programs or...

    Background: The territorial diagnosis is prerequisite for local actions concerning public health and the reduction of social, environmental and health-related inequalities. To orient local programs or initiatives targeting health inequalities, the policy maker need simulation territorial diagnosis tools. Yet, very few platforms have been developed for the purpose of guiding public authorities as they seek to reduce these social inequalities. Objective: Our study aimed to describe the design and methods of the development process of the territorial diagnosis tool based on serious game named “Equit’Game” which put learners at the heart of the territorial diagnosis process, asking them to review the current health, environmental and socioeconomic state of their territory. Methods: The realistic situations employed in our serious game should encourage players, in a fun and playful manner, to (1) appropriate the data of their own terirtory, (2) apply their methodological knowledge in a practical way, (3) reflect on the most pertinent statistical and/or spatial tools for their situation and, (4) ultimately, to acquire new knowledge and skills in the use of territorial diagnosis tools with a spatial dynamic. Results: Equit’Game was deployed over the course of a week’s training and structured into 4 levels: Level 1: ‘Dataminer’ (identifying relevant information to respond to the question); Level 2: ‘Analyst’ (selecting the appropriate method of analysis), Level 3: ‘Atlas’ (mapping the data), Level 4: ‘Cluster’ (extraction of statistical and spatial information). Equit’Game has also been designed as a sort of ‘virtual campus, creating a fun learning environment in which each door represents a level. Users can access Equit’Game via a platform compatible with tablets, PCs and smartphones. Conclusions: Equit’Game was developed to help learners the techniques of territorial diagnosis, with the aim of creating an “innovative tool for public health” capable of conveying educational messages and providing a structure for training.

  • Feasibility of a Motion-Activated Videogame for Substance Use Disorder Relapse Prevention in Youth: A Pilot Randomized Trial

    Date Submitted: Jul 27, 2018

    Open Peer Review Period: Jul 31, 2018 - Sep 25, 2018

    Background: Body motion-activated video games are a promising strategy for promoting addiction treatment engagement and adherence among youth. Objective: This pilot randomized trial (N=80) investigate...

    Background: Body motion-activated video games are a promising strategy for promoting addiction treatment engagement and adherence among youth. Objective: This pilot randomized trial (N=80) investigated the feasibility of a body-motion activated video game prototype, Recovery Warrior 2.0, targeting relapse prevention in the context of a community inpatient care program for youth. Methods: Participants ages 15-25 were recruited from an inpatient drug treatment program and randomized to treatment as usual (TAU) or to game play + TAU. Assessments were conducted at baseline, prior to discharge, and at 4-and 8-weeks post discharge. Results: The provision of the game play intervention was found to be feasible in the inpatient setting. On average, participants in the intervention group played for 36.6 minutes and played on 3.6 different days. Participants in the intervention group mostly agreed that they would use the refusal skills taught by the game. Those in the intervention group reported attending more outpatient counseling sessions than the control group (10.8 versus 4.8, respectively), but differences were not significant. The game had no effect on drug use at 4-weeks or 8-weeks post discharge, with the exception of a benefit reported at 4-week follow up to participants in treatment for marijuana addiction (p<.05). Conclusions: Preliminary evidence indicates that a motion activated video game for addiction recovery appears to be feasible and acceptable for youth within the context of inpatient treatment. With further development, such games hold promise as a tool for youth substance use disorder treatment.

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