An Internet-Based Psychological Intervention With a Serious Game to Improve Vitality, Psychological and Physical Condition, and Immune Function in Healthy Male Adults: Randomized Controlled Trial

Abstract

Background Recently, internet-based cognitive behavioral therapy (ICBT) and serious gaming interventions have been suggested to enhance accessibility to interventions and engagement in psychological interventions that aim to promote health outcomes. Few studies, however, have investigated their effectiveness in the context of simulated real-life challenges. Objective We aimed to examine the effectivity of a guided ICBT combined with a serious gaming intervention in improving self-reported psychophysiological and immunological health endpoints in response to psychophysiological and immune-related challenges. Methods Sixty-nine healthy men were randomly assigned to the intervention condition, receiving ICBT combined with serious gaming for 6 weeks, or the control condition, receiving no intervention. Self-reported vitality was the primary endpoint. Other self-reported psychophysiological and immunological endpoints were assessed following various challenges, including a bacillus Calmette-Guérin vaccination evoking pro-inflammatory responses, 1 and 4 weeks after the intervention period. Results Although the intervention did not affect vitality-associated parameters, self-reported sleep problems (P=.027) and bodily sensations (P=.042) were lower directly after the intervention compared with controls. Furthermore, wellbeing (P=.024) was higher in the intervention group after the psychophysiological challenges. Although no significant group differences were found for the psychophysiological and immunological endpoints, the data provided preliminary support for increased immunoglobulin antibody responses at the follow-up time points (P<.05). Differential chemokine endpoints between conditions were observed at the end of the test day. Conclusions The present study provides some support for improving health endpoints with an innovative ICBT intervention. Future research should replicate and further extend the present findings by consistently including challenges and a wide range of immune parameters into the study design. Trial Registration Nederlands Trial Register NTR5610; https://www.trialregister.nl/trial/5466

Effectiveness of gamified digital interventions in mental health prevention and health promotion among adults: A systematic review

“…Interestingly, Howells et al [35] reported signi cant improvements for positive affect but not negative affect. In turn, Schakel et al [30] could not identify any signi cant effects, neither for negative nor for positive affect (Table 3).…”

“…interventions with a duration of more than one month did not show non-signi cant results in mental health-related outcomes [26, 31,32]. However, Schakel et al [30] pointed out signi cant ndings regarding sleep problems and well-being but not quality of life and positive and negative affect, while the intervention duration was six weeks. In contrast, Collins et al [37] indicated within their ve days intervention signi cant improvements in energetic arousal and recovery.…”

“…Most studies examining well-being showed signi cant positive effects through game-based interventions. The general well-being signi cantly improved in ve studies [25,26,[28][29][30], while all studies examining psychological or mental well-being (n=5) found signi cant improvements [23,24,28,31,32]. Spiritual well-being (n=1) [28], interpersonal well-being (n=1) [24], community wellbeing (n=2) [24,28], and economic well-being (n=1) [24] showed also signi cant progresses through a game-based intervention.…”

“…Meanwhile, quality of life was signi cantly improved within two gami ed intervention [26,34]. However, one study did not show any signi cant improvements [30]. Personal growth (=1) [32], sleep problems (n=1) [30], emotional cognition (n=1) [23], frustration and irritability (n=1) [36], cognitive engagement (n=1) [22], cognitive and affective engagement (n=1) [22], energetic arousal (n=1) [37], recovery (n=1) [37], and positive and negative affect (n=2) [22,35], sometimes used as proxy for well-being, had a signi cant association with a gami ed intervention.…”

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Various interventions of serious games have been conducted not only for adolescents [ 31 ] and younger adults [ 32 ] but also for older adults [ 33 - 35 ]. They were applied to older adults in different ways, including video games, using devices such as Nintendo [ 36 , 37 ], and virtual reality serious games [ 38 ].…”