Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study

BackgroundThe emergence of the novel coronavirus (COVID-19) has introduced additional pressures on an already fragile mental health care system due to a significant rise in depression, anxiety, and stress among Canadians. Although cognitive behavioral therapy (CBT) is known t...

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Main Authors: Nadia Minian, Anika Saiva, Allison Gayapersad, Rosa Dragonetti, Catherine Proulx, Patricia Debergue, Julia Lecce, Sarwar Hussain, Eric Desjardins, Peter Selby
Format: Article
Language:English
Published: JMIR Publications 2022-05-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2022/5/e36820
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author Nadia Minian
Anika Saiva
Allison Gayapersad
Rosa Dragonetti
Catherine Proulx
Patricia Debergue
Julia Lecce
Sarwar Hussain
Eric Desjardins
Peter Selby
author_facet Nadia Minian
Anika Saiva
Allison Gayapersad
Rosa Dragonetti
Catherine Proulx
Patricia Debergue
Julia Lecce
Sarwar Hussain
Eric Desjardins
Peter Selby
author_sort Nadia Minian
collection DOAJ
description BackgroundThe emergence of the novel coronavirus (COVID-19) has introduced additional pressures on an already fragile mental health care system due to a significant rise in depression, anxiety, and stress among Canadians. Although cognitive behavioral therapy (CBT) is known to be an efficacious treatment to reduce such mental health issues, few people have access to CBT in an engaging and sustainable manner. To address this gap, a collaboration between the Centre for Addiction and Mental Health (CAMH) and the National Research Council of Canada (NRC) developed CBT-based self-led, online, clinician-tested modules in the form of a video game, named Legend of Evelys, and evaluated its usability in the attenuation of a COVID-19–related increase in stress. ObjectiveWe here present the conceptualization and design of new self-care modules in the form of a video game, its implementation in a technological infrastructure, and inclusivity and privacy considerations that informed the development. A usability study of the modules was performed to assess the video game’s usability, user engagement, and user perceptions. MethodsThe development of the video game involved establishment of a technology infrastructure for secure implementation of the software for the modules and a clinician-led assessment of the clinical utility of these modules through two “whiteboard” sessions. The usability study was informed by a mixed methods sequential explanatory design to evaluate the intervention of the mobile app through two distinct phases: quantitative data collection using in-app analytics data and two surveys, followed by qualitative data collection by semistructured interviews. ResultsA total of 32 participants trialed the app for 2 weeks. They used the video game an average of six times and rated the game as “good” based on the Systems Usability Scale score. In terms of stress reduction, the study demonstrated a significant difference in the participants’ Perceived Stress Scale score at baseline (mean 22.14, SD 6.187) compared with that at the 2-week follow-up (mean 18.04, SD 6.083; t27=3.628, P=.001). Qualitative interviews helped participants identify numerous functionality issues and provided specific recommendations, most of which were successfully integrated into the video game for future release. ConclusionsThrough this collaboration, we have established that it is possible to incorporate CBT exercises into a video game and have these exercises adopted to address stress. While video games are a promising strategy to help people with their stress and anxiety, there is a further need to examine the real-world effectiveness of the Legend of Evelys in reducing anxiety.
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spelling doaj.art-329e91d0dd5d402b8e46f331979743fb2023-08-28T21:45:43ZengJMIR PublicationsJMIR Formative Research2561-326X2022-05-0165e3682010.2196/36820Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability StudyNadia Minianhttps://orcid.org/0000-0001-8179-3628Anika Saivahttps://orcid.org/0000-0003-0609-9497Allison Gayapersadhttps://orcid.org/0000-0002-8527-9869Rosa Dragonettihttps://orcid.org/0000-0002-8539-1762Catherine Proulxhttps://orcid.org/0000-0002-1776-2082Patricia Deberguehttps://orcid.org/0000-0002-6129-7149Julia Leccehttps://orcid.org/0000-0002-3677-541XSarwar Hussainhttps://orcid.org/0000-0002-5672-3617Eric Desjardinshttps://orcid.org/0000-0002-1839-7152Peter Selbyhttps://orcid.org/0000-0001-5401-2996 BackgroundThe emergence of the novel coronavirus (COVID-19) has introduced additional pressures on an already fragile mental health care system due to a significant rise in depression, anxiety, and stress among Canadians. Although cognitive behavioral therapy (CBT) is known to be an efficacious treatment to reduce such mental health issues, few people have access to CBT in an engaging and sustainable manner. To address this gap, a collaboration between the Centre for Addiction and Mental Health (CAMH) and the National Research Council of Canada (NRC) developed CBT-based self-led, online, clinician-tested modules in the form of a video game, named Legend of Evelys, and evaluated its usability in the attenuation of a COVID-19–related increase in stress. ObjectiveWe here present the conceptualization and design of new self-care modules in the form of a video game, its implementation in a technological infrastructure, and inclusivity and privacy considerations that informed the development. A usability study of the modules was performed to assess the video game’s usability, user engagement, and user perceptions. MethodsThe development of the video game involved establishment of a technology infrastructure for secure implementation of the software for the modules and a clinician-led assessment of the clinical utility of these modules through two “whiteboard” sessions. The usability study was informed by a mixed methods sequential explanatory design to evaluate the intervention of the mobile app through two distinct phases: quantitative data collection using in-app analytics data and two surveys, followed by qualitative data collection by semistructured interviews. ResultsA total of 32 participants trialed the app for 2 weeks. They used the video game an average of six times and rated the game as “good” based on the Systems Usability Scale score. In terms of stress reduction, the study demonstrated a significant difference in the participants’ Perceived Stress Scale score at baseline (mean 22.14, SD 6.187) compared with that at the 2-week follow-up (mean 18.04, SD 6.083; t27=3.628, P=.001). Qualitative interviews helped participants identify numerous functionality issues and provided specific recommendations, most of which were successfully integrated into the video game for future release. ConclusionsThrough this collaboration, we have established that it is possible to incorporate CBT exercises into a video game and have these exercises adopted to address stress. While video games are a promising strategy to help people with their stress and anxiety, there is a further need to examine the real-world effectiveness of the Legend of Evelys in reducing anxiety.https://formative.jmir.org/2022/5/e36820
spellingShingle Nadia Minian
Anika Saiva
Allison Gayapersad
Rosa Dragonetti
Catherine Proulx
Patricia Debergue
Julia Lecce
Sarwar Hussain
Eric Desjardins
Peter Selby
Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study
JMIR Formative Research
title Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study
title_full Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study
title_fullStr Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study
title_full_unstemmed Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study
title_short Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study
title_sort video game to attenuate pandemic related stress from an equity lens development and usability study
url https://formative.jmir.org/2022/5/e36820
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