A Motion-Activated Video Game for Prevention of Substance Use Disorder Relapse in Youth: Pilot Randomized Controlled Trial

Abstract

Background Body motion-activated video games are a promising strategy for promoting engagement in and adherence to addiction treatment 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 aged 15-25 years were recruited from an inpatient drug treatment program and randomized to receive treatment as usual (control) or game play with treatment as usual (intervention). Assessments were conducted at baseline, prior to discharge, and at 4 and 8 weeks postdischarge. Results The provision of the game play intervention was found to be feasible in the inpatient setting. On an average, participants in the intervention group played for 36.6 minutes and on 3.6 different days. Participants in the intervention group mostly agreed that they would use the refusal skills taught by the game. Participants in the intervention group reported attending more outpatient counseling sessions than those in the control group (10.8 versus 4.8), but the difference was not significant ( P =.32). The game had no effect on drug use at 4 or 8 weeks postdischarge, with the exception of a benefit reported at the 4-week follow-up among participants receiving treatment for marijuana addiction ( P= .04). 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, but not outpatient treatment. With further development, such games hold promise as a tool for the treatment of youth substance use disorder. Trial Registration ClinicalTrials.gov NCT03957798; https://clinicaltrials.gov/show/NCT03957798 (Archived by WebCite at http://www.webcitation.org/78XU6ENB4)

Gaming My Way to Recovery: A Systematic Scoping Review of Digital Game Interventions for Young People's Mental Health Treatment and Promotion

“…SPARX , the game most studied ( 74 – 83 ), was played by youth at all three levels of illness severity (Steps 1, 2-3, 4) and Dojo ( 84 – 86 ) was played at Steps 2-3 and 4, which brings the total game count to 35 taking these repetitions into account. Other games tested in more than one study were: Recovery Warrior ( 87 , 88 ) (Step 4), SmartCAT ( 89 , 90 ) (Steps 2-3), Pesky gNATs ( 91 , 92 ) (Steps 2-3), and REThink ( 93 – 96 ) (Step 0). The remaining games were evaluated in single studies.…”

“…Seven games (9/49 studies: 18.4%) were played by youth with severe mental illness in residential institutions or inpatient/outpatient psychiatry units. They included four therapeutic games: The SIMS Life Stories TM ( 113 ) for trauma, SPARX ( 74 ) for depression, Muse ( 112 ) for trauma and RAGE-Control for anger management ( 102 ); two relapse prevention games: Arise ( 99 ) for substance use disorder and Recovery Warrior ( 87 , 88 ) for substance use disorder including opioid or marijuana use disorder, and a biofeedback game, Dojo ( 85 , 86 ), that was used as adjunct to therapy.…”

“…Processes (RQ1) involved a full range of methodologies: three RCTs ( 86 , 87 , 112 ), one open trial ( 74 ), two pre-post game assessments ( 85 , 88 ), one pilot survey ( 99 ), one qualitative study ( 113 ), and one single case study ( 102 ). Barriers to implementation included study design/research issues, e.g., lack of time and space in research settings, competing house/ward activities and illness acuity among participants ( 74 , 113 ).…”

“…Muse was enjoyed more and had a stronger treatment effect for male vs. female players ( 112 ). Moreover, study adherence, measured as program completion rates, was reported for seven studies that tested six games, as follows: Arise , 100% ( 99 ); Dojo , 90% ( 86 ), Recovery Warrior , 80% ( 87 ) and 66.7% ( 88 ); Muse , 77.7% ( 112 ), The SIMS Life Stories TM , 36.7% ( 113 ) and SPARX 10.0% ( 74 ). Regarding Sustainability , of the studies showing positive results, gains were not sustained at follow-up for Recovery Warrior ( 87 ), Muse ( 112 ) or for one study with Dojo ( 86 ).…”

Investigating the Use of a Serious Game to Improve Opioid Safety Awareness Among Adolescents: Quantitative Study

“…The game has been shown to improve adolescents' attitudes and change their behaviors [22]. Additionally, Recovery Warrior 2.0, a motion-activated video game prototype, which targets relapse prevention for adolescents, has preliminary data indicating that an SG for addiction recovery appears to be possible and appropriate for adolescents [24]. Although several interventions have shown promise in improving adolescents' health-related behaviors, there are limited studies that have examined the effect of an SG on adolescent's opioid-safety awareness [20].…”