A Digital Gaming Intervention to Strengthen the Social Networks of Older Dutch Adults: Mixed Methods Process Evaluation of a Digitally Conducted Randomized Controlled Trial.
eHealth
gerontology
loneliness
mixed methods
mobile games
qualitative research
serious games
Journal
JMIR formative research
ISSN: 2561-326X
Titre abrégé: JMIR Form Res
Pays: Canada
ID NLM: 101726394
Informations de publication
Date de publication:
20 Oct 2023
20 Oct 2023
Historique:
received:
19
12
2022
accepted:
31
08
2023
revised:
19
05
2023
medline:
20
10
2023
pubmed:
20
10
2023
entrez:
20
10
2023
Statut:
epublish
Résumé
Digital loneliness interventions for older adults are promising, yet conclusive evidence is lacking due to a lack of randomized controlled trials (RCTs) and difficulties with recruitment. Process evaluation of performed RCTs is essential to inform future interventions. Still, it is rarely carried out, resulting in an overly optimistic view of the impact of eHealth interventions on loneliness in older adults and options to conduct such research entirely remotely. We describe a mixed methods process evaluation of a digitally conducted RCT assessing the effectiveness of a mobile social gaming app to facilitate meaningful social interactions in older adults. We analyzed the questionnaire and game data of the RCT participants to evaluate recruitment and onboarding, intervention adherence, and intervention acceptability. The RCT participants were allocated either to the main group of older adults (aged 65 years or older) or the side group (aged between 18 and 64 years). The side group used networking to play with the older adults. We also conducted 6 post-RCT evaluation interviews and 1 focus group with a total of 4 RCT participants and 5 welfare organization representatives that aided in RCT recruitment. In total, 371 people aged 18 years or older signed up for the RCT, of which 64% (238/371) were aged 65 years or older. Of the total sample, 20% (76/371) installed the app and signed informed consent, showing a large dropout during onboarding. The high number of questions was a relevant barrier for participants. Both questionnaire and gameplay adherence were low. Participants indicated that the games elicited contact and a feeling of togetherness and proposed challenging and competitive games with increasing difficulty levels. They suggested focusing on enjoying the games rather than administering questionnaires. Conducting a remote digital trial of a social gaming intervention for older adults is a great challenge. Remote recruitment and informed consent acquisition may often not result in sufficient participation. Personal engagement with fellow participants and researchers might be essential for adherence and enjoyment. Future digital gaming interventions should start with small-scale studies with in-person contact, repeated instructions, and fewer questionnaires.
Sections du résumé
BACKGROUND
BACKGROUND
Digital loneliness interventions for older adults are promising, yet conclusive evidence is lacking due to a lack of randomized controlled trials (RCTs) and difficulties with recruitment. Process evaluation of performed RCTs is essential to inform future interventions. Still, it is rarely carried out, resulting in an overly optimistic view of the impact of eHealth interventions on loneliness in older adults and options to conduct such research entirely remotely.
OBJECTIVE
OBJECTIVE
We describe a mixed methods process evaluation of a digitally conducted RCT assessing the effectiveness of a mobile social gaming app to facilitate meaningful social interactions in older adults.
METHODS
METHODS
We analyzed the questionnaire and game data of the RCT participants to evaluate recruitment and onboarding, intervention adherence, and intervention acceptability. The RCT participants were allocated either to the main group of older adults (aged 65 years or older) or the side group (aged between 18 and 64 years). The side group used networking to play with the older adults. We also conducted 6 post-RCT evaluation interviews and 1 focus group with a total of 4 RCT participants and 5 welfare organization representatives that aided in RCT recruitment.
RESULTS
RESULTS
In total, 371 people aged 18 years or older signed up for the RCT, of which 64% (238/371) were aged 65 years or older. Of the total sample, 20% (76/371) installed the app and signed informed consent, showing a large dropout during onboarding. The high number of questions was a relevant barrier for participants. Both questionnaire and gameplay adherence were low. Participants indicated that the games elicited contact and a feeling of togetherness and proposed challenging and competitive games with increasing difficulty levels. They suggested focusing on enjoying the games rather than administering questionnaires.
CONCLUSIONS
CONCLUSIONS
Conducting a remote digital trial of a social gaming intervention for older adults is a great challenge. Remote recruitment and informed consent acquisition may often not result in sufficient participation. Personal engagement with fellow participants and researchers might be essential for adherence and enjoyment. Future digital gaming interventions should start with small-scale studies with in-person contact, repeated instructions, and fewer questionnaires.
Identifiants
pubmed: 37862093
pii: v7i1e45173
doi: 10.2196/45173
pmc: PMC10625069
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e45173Informations de copyright
©Jeroen Janssen, Bas Châtel, Nora Den Heijer, Rob Tieben, Menno Deen, Rense Corten, Geeske Peeters, Marcel Olde Rikkert. Originally published in JMIR Formative Research (https://formative.jmir.org), 20.10.2023.
Références
J Med Internet Res. 2016 Jan 28;18(1):e18
pubmed: 26822073
Appl Psychol Health Well Being. 2023 Feb;15(1):238-258
pubmed: 35621111
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
J Med Internet Res. 2012 Jun 22;14(3):e91
pubmed: 22743581
Int J Qual Stud Health Well-being. 2018 Dec;13(1):1474673
pubmed: 29869590
JMIR Form Res. 2023 Jan 27;7:e42172
pubmed: 36705962
Gerontologist. 2015 Oct;55(5):845-53
pubmed: 22899424
Lancet Reg Health West Pac. 2023 Jun;35:100528
pubmed: 35815240
J Med Internet Res. 2012 Nov 14;14(6):e152
pubmed: 23151820
J Gerontol Soc Work. 2023 Feb-Mar;66(2):274-290
pubmed: 35900001
JMIR Aging. 2019 Jul 24;2(2):e13638
pubmed: 31518268
Phys Ther. 2005 Oct;85(10):1008-119
pubmed: 16180950
Aging Ment Health. 2022 Jul;26(7):1327-1334
pubmed: 34215167
J Med Internet Res. 2013 Feb 12;15(2):e31
pubmed: 23403043
PLoS One. 2013 Dec 04;8(12):e81673
pubmed: 24324716
J Aging Stud. 2019 Jun;49:74-84
pubmed: 31229221
J Am Med Dir Assoc. 2011 Jun;12(5):331-6
pubmed: 21450245
J Med Internet Res. 2019 Oct 3;21(10):e14112
pubmed: 31584001
J Eval Clin Pract. 2015 Feb;21(1):97-102
pubmed: 25312557
Australas J Ageing. 2009 Sep;28(3):149-51
pubmed: 19845656
BMC Med Res Methodol. 2019 Aug 29;19(1):181
pubmed: 31464586
J Med Internet Res. 2022 Aug 4;24(8):e38015
pubmed: 35925655
PLoS One. 2015 Feb 23;10(2):e0116664
pubmed: 25706933
Healthcare (Basel). 2021 Mar 07;9(3):
pubmed: 33800099
J Med Internet Res. 2011 Aug 05;13(3):e52
pubmed: 21821503
PLoS One. 2013 Jul 05;8(7):e66844
pubmed: 23861749
BMC Public Health. 2020 Feb 14;20(1):129
pubmed: 32054474
Aging Ment Health. 2003 Mar;7(2):75-82
pubmed: 12745386
Aging Ment Health. 2021 Jul;25(7):1239-1245
pubmed: 32363903
JMIR Ment Health. 2022 Mar 7;9(3):e34221
pubmed: 35254273
Soc Sci Med. 2012 Mar;74(6):907-14
pubmed: 22326307
J Med Internet Res. 2015 Jul 22;17(7):e183
pubmed: 26202991
J Med Internet Res. 2021 Jun 4;23(6):e24712
pubmed: 34085942
JMIR Aging. 2022 Oct 24;5(4):e40125
pubmed: 36279155
J Am Geriatr Soc. 2013 Sep;61(9):1625-7
pubmed: 24028364
Health Soc Care Community. 2018 Mar;26(2):147-157
pubmed: 27413007
Int J Aging Hum Dev. 2002;55(3):233-69
pubmed: 12693547