Effectiveness, User Engagement and Experience, and Safety of a Mobile App (Lumi Nova) Delivering Exposure-Based Cognitive Behavioral Therapy Strategies to Manage Anxiety in Children via Immersive Gaming Technology: Preliminary Evaluation Study.
anxiety
app
children
cognitive behavioral therapy
digital intervention
exposure therapy
immersive gaming
mobile phone
smartphone
Journal
JMIR mental health
ISSN: 2368-7959
Titre abrégé: JMIR Ment Health
Pays: Canada
ID NLM: 101658926
Informations de publication
Date de publication:
24 Jan 2022
24 Jan 2022
Historique:
received:
22
03
2021
accepted:
18
10
2021
revised:
18
10
2021
entrez:
24
1
2022
pubmed:
25
1
2022
medline:
25
1
2022
Statut:
epublish
Résumé
Childhood anxiety disorders are a prevalent mental health problem that can be treated effectively with cognitive behavioral therapy, in which exposure is a key component; however, access to treatment is poor. Mobile-based apps on smartphones or tablets may facilitate the delivery of evidence-based therapy for child anxiety, thereby overcoming the access and engagement barriers of traditional treatment. Apps that deliver therapeutic content via immersive gaming technology could offer an effective, highly engaging, and flexible treatment proposition. In this paper, we aim to describe a preliminary multi-method evaluation of Lumi Nova, a mobile app intervention targeting mild to moderate anxiety problems in children aged 7-12 years using exposure therapy delivered via an immersive game. The primary objective is to evaluate the effectiveness, user engagement and experience, and safety of the beta version of Lumi Nova. Lumi Nova was co-designed with children, parents, teachers, clinicians, game industry experts, and academic partnerships. In total, 120 community-based children with mild to moderate anxiety and their guardians were enrolled to participate in an 8-week pilot study. The outcome measures captured the app's effectiveness (anxiety symptoms, child-identified goal-based outcomes, and functional impairment), user engagement (game play data and ease-of-use ratings), and safety (mood ratings and adverse events). The outcome measures before and after the intervention were available for 30 children (age: mean 9.8, SD 1.7 years; girls: 18/30, 60%; White: 24/30, 80%). Additional game play data were automatically generated for 67 children (age: mean 9.6, SD 1.53 years; girls: 35/67, 52%; White: 42/67, 63%). Postintervention open-response data from 53% (16/30) of guardians relating to the primary objectives were also examined. Playing Lumi Nova was effective in reducing anxiety symptom severity over the 8-week period of game play (t This preliminary study provides initial evidence that an immersive mobile game app may safely benefit children experiencing mild to moderate anxiety. It also demonstrates the value of the rigorous evaluation of digital interventions during the development process to rapidly improve readiness for full market launch.
Sections du résumé
BACKGROUND
BACKGROUND
Childhood anxiety disorders are a prevalent mental health problem that can be treated effectively with cognitive behavioral therapy, in which exposure is a key component; however, access to treatment is poor. Mobile-based apps on smartphones or tablets may facilitate the delivery of evidence-based therapy for child anxiety, thereby overcoming the access and engagement barriers of traditional treatment. Apps that deliver therapeutic content via immersive gaming technology could offer an effective, highly engaging, and flexible treatment proposition.
OBJECTIVE
OBJECTIVE
In this paper, we aim to describe a preliminary multi-method evaluation of Lumi Nova, a mobile app intervention targeting mild to moderate anxiety problems in children aged 7-12 years using exposure therapy delivered via an immersive game. The primary objective is to evaluate the effectiveness, user engagement and experience, and safety of the beta version of Lumi Nova.
METHODS
METHODS
Lumi Nova was co-designed with children, parents, teachers, clinicians, game industry experts, and academic partnerships. In total, 120 community-based children with mild to moderate anxiety and their guardians were enrolled to participate in an 8-week pilot study. The outcome measures captured the app's effectiveness (anxiety symptoms, child-identified goal-based outcomes, and functional impairment), user engagement (game play data and ease-of-use ratings), and safety (mood ratings and adverse events). The outcome measures before and after the intervention were available for 30 children (age: mean 9.8, SD 1.7 years; girls: 18/30, 60%; White: 24/30, 80%). Additional game play data were automatically generated for 67 children (age: mean 9.6, SD 1.53 years; girls: 35/67, 52%; White: 42/67, 63%). Postintervention open-response data from 53% (16/30) of guardians relating to the primary objectives were also examined.
RESULTS
RESULTS
Playing Lumi Nova was effective in reducing anxiety symptom severity over the 8-week period of game play (t
CONCLUSIONS
CONCLUSIONS
This preliminary study provides initial evidence that an immersive mobile game app may safely benefit children experiencing mild to moderate anxiety. It also demonstrates the value of the rigorous evaluation of digital interventions during the development process to rapidly improve readiness for full market launch.
Identifiants
pubmed: 35072644
pii: v9i1e29008
doi: 10.2196/29008
pmc: PMC8822420
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e29008Informations de copyright
©Joanna Lockwood, Laura Williams, Jennifer L Martin, Manjul Rathee, Claire Hill. Originally published in JMIR Mental Health (https://mental.jmir.org), 24.01.2022.
Références
Psychol Assess. 2018 Oct;30(10):1342-1355
pubmed: 29902050
JMIR Serious Games. 2018 May 10;6(2):e9
pubmed: 29748165
Behav Res Ther. 1998 May;36(5):545-66
pubmed: 9648330
Cogn Behav Pract. 2016 May;23(2):184-193
pubmed: 27688681
J Clin Child Adolesc Psychol. 2014;43(4):566-78
pubmed: 23845036
Evid Based Ment Health. 2019 Aug;22(3):103-110
pubmed: 31315926
JMIR Mhealth Uhealth. 2019 Jan 18;7(1):e11941
pubmed: 30664463
J Child Psychol Psychiatry. 2020 Aug;61(8):928-940
pubmed: 32572961
Pediatrics. 2014 Sep;134(3):e716-22
pubmed: 25092934
BMC Psychiatry. 2020 Jun 11;20(1):293
pubmed: 32527236
J Clin Child Adolesc Psychol. 2016;45(2):91-113
pubmed: 26087438
J Anxiety Disord. 2013 Dec;27(8):772-80
pubmed: 23816349
NPJ Digit Med. 2020 Oct 15;3:133
pubmed: 33083568
Cochrane Database Syst Rev. 2015 Feb 18;(2):CD004690
pubmed: 25692403
Afr J Emerg Med. 2017 Sep;7(3):93-99
pubmed: 30456117
J Med Internet Res. 2020 Jun 23;22(6):e16317
pubmed: 32442160
J Am Acad Child Adolesc Psychiatry. 2014 Jan;53(1):21-33
pubmed: 24342383
J Med Internet Res. 2019 Dec 20;21(12):e15644
pubmed: 31859682
J Child Psychol Psychiatry. 2017 Apr;58(4):474-503
pubmed: 27943285
J Clin Child Adolesc Psychol. 2014;43(4):579-91
pubmed: 23915200
Front Psychiatry. 2019 Nov 13;10:759
pubmed: 31798468
J Psychopathol Behav Assess. 2018;40(4):655-668
pubmed: 30459485
J Child Psychol Psychiatry. 2021 May;62(5):584-605
pubmed: 33655534
J Affect Disord. 2018 Mar 1;228:248-253
pubmed: 29304469
Cogn Behav Pract. 2017 Nov;24(4):393-404
pubmed: 29056845
Internet Interv. 2018 Feb 19;12:1-10
pubmed: 30135763
J Clin Child Adolesc Psychol. 2019;48(sup1):S215-S226
pubmed: 28448176
Behav Res Ther. 2000 Aug;38(8):835-55
pubmed: 10937431
J Med Internet Res. 2017 May 25;19(5):e176
pubmed: 28546138
J Anxiety Disord. 2013 Mar;27(2):259-64
pubmed: 23549110
J Anxiety Disord. 2016 May;40:29-36
pubmed: 27085463
J Child Adolesc Psychopharmacol. 2016 Apr;26(3):246-51
pubmed: 26244903
Front Psychiatry. 2017 Jan 10;7:215
pubmed: 28119636
J Child Adolesc Psychopharmacol. 2004 Spring;14(1):105-14
pubmed: 15142397
Evid Based Ment Health. 2016 Aug;19(3):65-8
pubmed: 27402874
Child Care Health Dev. 2019 Jul;45(4):491-499
pubmed: 30990911
JMIR Ment Health. 2019 May 09;6(5):e12430
pubmed: 31094346
Behav Res Ther. 2015 Apr;67:1-18
pubmed: 25727678
J Med Internet Res. 2018 Jun 06;20(6):e199
pubmed: 29875089
Clin Child Fam Psychol Rev. 2014 Dec;17(4):319-39
pubmed: 25022818
Psychiatr Clin North Am. 2009 Sep;32(3):483-524
pubmed: 19716988
Behav Res Ther. 2015 Oct;73:83-9
pubmed: 26275761
Arch Gen Psychiatry. 2005 Jun;62(6):593-602
pubmed: 15939837
Clin Psychol Rev. 2013 Jul;33(5):698-711
pubmed: 23742782
BMC Pediatr. 2015 Dec 16;15:213
pubmed: 26675420
Eur Child Adolesc Psychiatry. 2018 Aug;27(8):1023-1031
pubmed: 29372331
J Med Internet Res. 2013 Nov 15;15(11):e247
pubmed: 24240579
Am J Prev Med. 2016 Nov;51(5):833-842
pubmed: 27745683
Child Adolesc Psychiatr Clin N Am. 2011 Apr;20(2):217-38
pubmed: 21440852
J Child Psychol Psychiatry. 2013 Jun;54(6):670-7
pubmed: 23330982
Behav Res Ther. 2014 Jul;58:10-23
pubmed: 24864005
Behav Ther. 2018 Mar;49(2):249-261
pubmed: 29530263
Eur Child Adolesc Psychiatry. 2020 May;29(5):649-664
pubmed: 31410579
PLoS One. 2015 Mar 18;10(3):e0119895
pubmed: 25786025
Front Psychiatry. 2016 Apr 18;7:65
pubmed: 27148094