Good Games Must Be Good Games: A Mixed-Methods Assessment of User Preferences to Improve Adherence and Engagement with Therapeutic Game Interventions in Adolescents (Preprint)

2018 ◽  
Author(s):  
Steven Barnes ◽  
Julie Prescott
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Game Design ◽  
Digital Health ◽  
User Preferences ◽  
Self Report ◽  
Mental Health Issue ◽  
Early Results ◽  
Therapeutic Game ◽  
The Impact

BACKGROUND Anxiety Disorders (AD) are a major mental health issue in adolescents. While numerous psychological interventions have proven effective in reducing AD, including Cognitive Behavioural Therapy (CBT), and Attention-Bias Modification (ABM), their efficacy is limited by both social and practical barriers (including cost, stigma, and availability), and AD symptomatology (e.g. avoidance-behaviours). As a result, less than 50% of adolescents with AD are estimated to seek treatment, with less than 20% of these ultimately receiving a scientifically validated intervention. Therapeutic games have emerged as an effective medium to promote access to, and engagement with, the therapeutic process. While early results are promising, the mechanisms underlying the ability of therapeutic games to engage this demographic are unclear, with some studies finding initial engagement and reduction in AD symptoms may not be sustainable over time. Despite the importance of player-preferences and participatory design in the development of traditional games for entertainment, little is currently known of adolescent player-preferences in digital health solutions, nor is user-centred design commonplace in this field. Addressing this area has the potential to maximise the impact and economy of gamified interventions, encouraging adherence and engagement over prolonged periods. OBJECTIVE The aim was to conduct an exploratory mixed-methods assessment of adolescents’ player-preferences in therapeutic games for AD. Feedback regarding five digital health games purported to be relaxing or informative about mental health was assessed to establish preferences in game-features and design-styles, and their impact on both player motivation and perceived game-impact. METHODS Sixteen adolescent participants (mean age=17.13, SD=.79) spent at least one hour engaging with at least one of the games and provided feedback via an open- and closed-ended version of a self-report questionnaire. RESULTS Compliance in feedback was high for the quantitative self-report (87.5%) and average for qualitative feedback (56.25%). Across both measures, adolescents generally reported therapeutic games to be an acceptable and engaging medium for delivery of health interventions. A significant preference for games incorporating a variety of tasks was noted (P = .016), and thematic analysis revealed a recurring focus on aesthetics (especially environment colour). Multiple regression analysis demonstrated a range of variables (engagement, functionality, aesthetics, and information) contributed to overall perceptions of game-quality and likeability (F6, 23 = 181.098, P <.001, R2 = .979), but that these variables did not predict perceptions of game impact on the health behaviour (F5, 24 = 4.295, P = .006, R2 = .472). CONCLUSIONS These findings suggest that while adolescents place value on the quality of health information provided in therapeutic games, AD therapeutic game design must also consider design variables, such as game-world aesthetics, game-functionality and game-mechanics, to promote sustained engagement and adherence in this demographic. Implications for further research and participatory therapeutic game design are discussed.

scholarly journals State of Mind Ireland-Higher Education: A Mixed-Methods Longitudinal Evaluation of a Positive Mental Health Intervention

2020 ◽  
Vol 17 (15) ◽  
pp. 5530
Author(s):  
Niamh O’Brien ◽  
Martin Lawlor ◽  
Fiona Chambers ◽  
Wesley O’Brien
Keyword(s):  
Mental Health ◽  
Higher Education ◽  
Mixed Methods ◽  
Mixed Methods Research ◽  
Positive Mental Health ◽  
Self Report ◽  
Education Student ◽  
State Of Mind ◽  
The Impact

Objective: This study evaluates the impact of the State of Mind Ireland-Higher Education (SOMI-HE) Mental Fitness intervention on student wellbeing, resilience, and physical activity (PA) participation. Design: A mixed-methods research design, comprising of a self-report questionnaire, and semi-structured focus group interviews at pre, post and follow-up phases were employed. Participants were a sample of 134 higher education students (29% male: 71% female; mean age range 18 to 25 years old). The quantitative outcome measures of wellbeing, resilience and PA data were analysed using SPSS version 26.0, (IBM, Armonk, NY, USA) with appropriate statistical analysis. Qualitative data were analysed using thematic analysis to capture the long-term outcomes and impact of the intervention. Results: The results indicate a significant intervention effect on participants’ wellbeing (t (120) = −4.27, p < 0.001), PA levels (t (126) = 3.91, p < 0.001) and motivational readiness for exercise change (χ2 (1, n = 131) = 6.9, p < 0.009 (2–sided). Qualitative findings suggest a sustained long-term increase in PA and resilience skills for positive mental health, and reduced stigma and barriers to positive mental health. Conclusion: The findings demonstrate the effectiveness of the SOMI-HE evidence-based intervention, and beneficial outcomes of a salutary approach to higher education student mental health.

scholarly journals Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Impact Evaluation ◽  
Digital Health ◽  
Youth Mental Health ◽  
Model Of Care ◽  
Health Service Provision ◽  
Industrial Grade ◽  
The Impact

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

scholarly journals Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024230 ◽  
Author(s):  
Stephen Rocks ◽  
Melissa Stepney ◽  
Margaret Glogowska ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Resource Utilisation ◽  
South East England ◽  
The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

scholarly journals Cultivating the compassionate self against depression: An exploration of processes of change

2017 ◽  
Vol 41 (S1) ◽  
pp. S356-S356 ◽  
Author(s):  
M. Matos ◽  
J. Duarte ◽  
C. Duarte ◽  
J. Pinto-Gouveia ◽  
P. Gilbert
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Longitudinal Design ◽  
Self Report ◽  
Processes Of Change ◽  
Post Intervention ◽  
Mediation Analyses ◽  
Self Compassion ◽  
Compassion Focused Therapy ◽  
The Impact

IntroductionCompassion and self-compassion can be protective factors against mental health difficulties, in particular depression. The cultivation of the compassionate self, associated with a range of practices such as slow and deeper breathing, compassionate voice tones and facial expressions, and compassionate focusing, is central to compassion focused therapy (Gilbert, 2010). However, no study has examined the processes of change that mediate the impact of compassionate self-cultivation practices on depressive symptoms.AimsThe aim of this study is to investigate the impact of a brief compassionate self training (CST) intervention on depressive symptoms, and explore the psychological processes that mediate the change at post intervention.MethodsUsing a longitudinal design, participants (general population and college students) were randomly assigned to one of two conditions: Compassionate self training (n = 56) and wait-list control (n = 37). Participants in the CST condition were instructed to practice CST exercises for 15 minutes everyday or in moments of stress during two weeks. Self-report measures of depression, self-criticism, shame and compassion, were completed at pre and post in both conditions.ResultsResults showed that, at post-intervention, participants in the CST condition decreased depression, self-criticism and shame, and increased self-compassion and openness to receive compassion from others. Mediation analyses revealed that changes in depression from pre to post intervention were mediated by decreases in self-criticism and shame, and increases in self-compassion and openness to the compassion from others.ConclusionsThese findings support the efficacy of compassionate self training components on lessening depressive symptoms and promoting mental health.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Contribution of the co.LAB Framework to the Collaborative Design of Serious Games: Mixed-Methods Validation Study (Preprint)

2021 ◽  
Author(s):  
Dominique Jaccard ◽  
Laurent Suppan ◽  
Félicia Bielser
Keyword(s):  
Mixed Methods ◽  
Game Design ◽  
Serious Games ◽  
Positive Impact ◽  
Serious Game ◽  
Multidisciplinary Design ◽  
Design Teams ◽  
Design And Development ◽  
Significant Difference ◽  
The Impact

BACKGROUND Multidisciplinary collaboration is essential to the successful development of serious games, albeit difficult to achieve. The co.LAB serious game design framework was created to support collaboration within serious game multidisciplinary design teams. Its use has not yet been validated in a naturalistic context. OBJECTIVE The objective of this study was to perform a first assessment of the impact of the co.LAB framework on collaboration within multidisciplinary teams during serious game design and development. METHODS This was a mixed-methods study based on two serious game design projects in which the co.LAB framework was used. The first phase was qualitative and carried out using a general inductive approach. To this end, all members of the first serious game project team who used the co.LAB framework were invited to take part in a focus group session (N=6). Results inferred from qualitative data were then used to define a quantitative instrument (questionnaire) which was designed according to the Checklist for Reporting Results of Internet E-Surveys. Members of both project teams (N=11) were then asked to answer the questionnaire. Quantitative results were reported as median [Q1;Q3] and appropriate non-parametric tests used to assess for between group differences. Finally, results gathered through the qualitative and quantitative phases were integrated. RESULTS In both phases, the participation rate was 100%. Verbatim transcripts were classified into 4 high level themes: influence on collaborative dimensions; impact on project course, monitoring and efficiency; qualitative perceptions of the framework; and influence of team composition on the use of the framework. Accordingly, the web-based questionnaire was then developed according to Burhardt's seven dimensions of collaboration. In both projects, the co.LAB framework had a positive impact on most dimensions of collaboration during the multidisciplinary design and development of serious games. When all collaborative dimensions were aggregated, the overall impact of the framework was rated on a scale from "-42" to "+42" (very negative to very positive). The overall score was 23 [20;27], with no significant difference between groups (P=.58). Most respondents also believed that all serious game design teams should include a member possessing a significant expertise in serious game design frameworks to guide the development process. CONCLUSIONS The co.LAB framework has a positive impact on collaboration within serious game development teams. However, expert guidance seems necessary to maximize development efficiency. Whether such guidance can be provided by means of a collaborative web platform remains to be determined.

Impact of Perceived Social Support on Mental Health, Quality of Life, and Disability in Post–9/11 U.S. Military Veterans

2020 ◽  
pp. 0095327X2091992
Author(s):  
Eric Proescher ◽  
Darrin M. Aase ◽  
Holly M. Passi ◽  
Justin E. Greenstein ◽  
Christopher Schroth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Social Support ◽  
Support Group ◽  
Psychosocial Functioning ◽  
Perceived Social Support ◽  
Self Report ◽  
Post Traumatic Stress ◽  
The Impact

This study examined the impact of perceived social support on mental health and psychosocial functioning in combat veterans after military deployment, including veterans with post-traumatic stress disorder (PTSD) and veterans with comorbid PTSD and alcohol use disorder. Veterans ( n = 139; female = 23) completed self-report and clinician-administered measures of social support, mental and physical health, functional impairment, and quality of life. The cohort was divided into high, medium, and low perceived social support based on averages of the total score from the Multidimensional Scale of Perceived Social Support. Relative to the low perceived social support group, the high perceived social support group reported fewer symptoms of PTSD, anxiety, and depression. The high perceived social support group also reported a more diverse and embedded social network, less disability, and better quality of life. Of note, the high and low perceived social support groups did not differ on age, gender, education, race ethnicity, or combat trauma exposure. These findings highlight that perceived social support may play an important role in the treatment of postwar veterans as they transition back to civilian life.

scholarly journals The Psychological Wellbeing of Palestinian Children Living among Israeli Settlements in Hebron Old City

2021 ◽  
Vol 3 (28) ◽  
pp. 30-45
Author(s):  
Amer Shehadeh ◽  
Keyword(s):  
Mental Health ◽  
Political Conflict ◽  
Self Report ◽  
Psychological Wellbeing ◽  
Palestinian Territories ◽  
Care And Support ◽  
Health Differences ◽  
Reaction Index ◽  
Palestinian Children ◽  
The Impact

For more than ten decades, the Palestinian Occupied Territories are marked by a protracted political conflict. During this conflict, more than 300 settlements have been built inside West Bank, Gaza, and East Jerusalem “Occupied Palestinian Territories”, since that time the conflict between Palestinian and Israeli occupation forces is still ongoing. One of the most important results of this occupation and conflict is the suffering of Palestinian living among these Israeli settlements. Therefore, this study aimed at gaining insight into the impact of living within this situation on children and adolescents’ psychological wellbeing. 357 8-18 years old Palestinian children took part; Two self-report questionnaires: the UCLA-PTSD-Reaction Index, investigating symptoms of posttraumatic stress, and the Strengths and Difficulties Questionnaires, looking at overall psychological problems, were filed by children themselves, mothers, and teachers. Descriptive analyses investigated mental health differences between both variables, gender, and age, and the mental health outcomes. This study shows the important impact of being lived among Israeli settlements on the psychological wellbeing of Palestinian, above, girls, younger adolescents, also reported higher scores on both questionnaires, the study urges for more psychological care and support for family members – in particular children.

scholarly journals Psychological distress and resilience in a sample of Adolescents and Young Adults with cancer during the COVID-19 pandemic

2021 ◽  
Author(s):  
Clare Jacobson ◽  
Rebecca Mulholland ◽  
Nicola Miller ◽  
Laura Baker ◽  
Daniel Glazer ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Cancer Treatment ◽  
Online Survey ◽  
Protective Factor ◽  
Care Delivery ◽  
Self Report ◽  
Patient Health ◽  
The Uk ◽  
The Impact

AbstractBACKGROUNDAdolescents and young people (AYA) with cancer are at greater risk of psychological distress which can impact treatment. COVID-19 has resulted in changes to cancer care delivery and AYA have been disproportionately affected by economic and educational effects of COVID-19, potentially impacting on mental health. Understanding the impact of COVID-19 on AYA with cancer is important to inform care.METHODSOnline survey of 16-24 year olds receiving cancer treatment at 8 cancer centres in the UK in December 2020. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships and used the 8-item Patient Health Questionnaire(PHQ-8), 7-item Generalised Anxiety Disorder Scale(GAD) and the 2-item Connor-Davidson Resilience Scale(CD-RISC).RESULTS112 AYA participated (17.8% of total eligible). 62.8% were female, 67.3% were 21-24 years. 83% were white. 59.8% had previously experienced mental health difficulties. 67.9% received cancer treatment during the pandemic and 33.9% were diagnosed during the pandemic. 78.6% reported COVID-19 having a significant impact on their life, 55.4% on their key relationship and 39.3% on their treatment. 79% reported experiencing some degree of increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% for GADS-7. Self-report of impact on life was associated with greater anxiety during COVID-19 and moderate-severe PHQ-8 score (OR 3.64, 95% CI 2.52 to 19.40, p <0.01; OR 5.23, 95%CI 1.65 to 16.56, p < 0.01). Impact on relationships was associated with greater anxiety and moderate-severe GADS-7and PHQ-8 score (OR 2.89, 95% CI 1.11 to 7.54, p = 0,03; OR 3.54, 95% CI 2.32 to 15.17, p<0.01; OR 2.42, 95% CI 1.11 to 5.25, p =0.03). Greater CD-RISC score was associated with lower risk of anxiety and mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95%CI 0.41 to 0.81, p <0.01; OR 0.55 95% CI 0.4 to 0.72, p <0.01; OR 0.52, 95% CI 0.38 to 0.69, p <0.01)CONCLUSIONSWe found high levels of psychological distress in AYA with cancer, which is important knowledge for clinical teams working with this age group. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a potential protective factor.

scholarly journals The Impact of COVID-19 on the Mental Health of Autistic Adults in the UK: A Mixed-Methods Study

2021 ◽  
Author(s):  
Rebecca Bundy ◽  
William Mandy ◽  
Laura Crane ◽  
Hannah Belcher ◽  
Laura Bourne ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Online Survey ◽  
Negative Impact ◽  
Self Regulation ◽  
Health Impact ◽  
Mixed Methods Study ◽  
Autistic People ◽  
Autistic Adults ◽  
The Impact

The COVID-19 pandemic has been associated with mental health declines in the general population. Those with pre-existing vulnerabilities are known to be at particular risk. This may include autistic people, who have high levels of mental and physical health problems. Yet little is currently known about the impact of the pandemic on autistic people. Using an online survey, this mixed-methods study gathered data from 133 autistic adults in the United Kingdom (UK), about their experiences of the pandemic in relation to their mental health. Results indicated that the mental health impact of the pandemic on autistic adults was variable. A sizeable minority reported improvements in their mental health associated with COVID-19 restrictions. By contrast, most participants described an overall negative impact their levels of depression, anxiety and stress. Analysis of qualitative data using thematic analysis highlighted four themes that contributed to mental health changes in autistic adults: (i) adjusting to changes to the social world, (ii) living with uncertainty, (iii) disruptions to self-regulation, and (iv) barriers to fulfilling basic needs. Based on these findings, we discuss recommendations about how to support autistic people; both as the pandemic persists and once normality ensues.

scholarly journals LO67: Alcohol-related emergency department visits by youth aged 12-24: demographics and resource utilization at Kingston Health Sciences Centre

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S32-S32
Author(s):  
H. Murray ◽  
L. Erlikhman ◽  
T. Graham ◽  
M. Walker
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Resource Use ◽  
Standard Form ◽  
Emergency Department Visits ◽  
Acute Intoxication ◽  
Mental Health Issue ◽  
Male Predominance ◽  
Ed Visits ◽  
The Impact

Introduction: Recent evidence shows an increase in alcohol-related emergency department (ED) visits among youth. We sought to quantify the impact of ED visits (type and frequency, patient characteristics and resource use) related to alcohol in our centre. Methods: This was a chart review of patients aged 12-24 with alcohol-related ED visits between Sept 2013-Aug 2017. The National Ambulatory Care Reporting System (NACRS) database was searched for visits alcohol related ICD-10 codes. The Canadian Hospital Injury Reporting and Prevention Program (CHIRPP) database was also searched using the keyword alcohol. Duplicate visits were removed. Visits were excluded if patients had a history of psychosis, were held in the ED for psychiatric assessment, were homeless, were inmates from a correctional institute, if alcohol use was not mentioned and for complaints of sexual assault/intimate partner violence. Data was abstracted by two reviewers using a standard form with predetermined variables. Differences were resolved with third party adjudication. Interrater reliability of the reviewers was assessed with Kappa scores through duplicate review of 10% of randomly selected charts. A further 10% were assessed by a 3rd reviewer for extraction accuracy. Results: 3,256 ED visits were identified with 777 removed via predefined exclusion criteria. 2,479 visits were reviewed with a male predominance (54.3%). More than half of all patients (50.9%) arrived via ambulance. Assigned CTAS levels were Resuscitation: 1% Emergent: 9.9% Urgent: 48.2% Less Urgent: 35.7% Non-Urgent: 4.2% (missing 1%). The median LOS was 2.9 hrs (IQR 1.8-4.6). All visits were subclassified into mutually exclusive categories: injury (51.8%), acute intoxication (45.1%) and mental health issue (3.2%). Males were more likely to present with injury (62.4% vs 42.6%, p < 0.01). Females were more likely to present with acute intoxication (53.3% vs 46.7%, p <0.01) and mental health issues (59.5% vs 40.5%, P = 0.01). ED resource use was notable: 483 (19.4%) had imaging tests and 1216 (49.1%) had some medical intervention (blood test, fluids or medication). 57 (2.3%) patients were admitted and there was one death from an alcohol related MVC. Conclusion: Alcohol-related ED visits by youth are common in our centre and utilize substantial prehospital and in-hospital resources. Identification of effective harm reduction strategies should be a research priority.

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