Covid-19 pandemic and its impact on increasing the risks of children's addiction to electronic games from a social work perspective

Digital Serious Games to Promote Behavior Change in Children With Chronic Diseases: Scoping Review and Development of a Self-Management Learning Framework

BACKGROUND

Digital serious games (SGs) have rapidly become a promising strategy for entertainment-based health education; however, developing SGs for children with chronic diseases remains a challenge.

OBJECTIVE

In this study, we attempted to provide an updated scope of understanding of the development and evaluation of SG educational tools and develop a framework for SG education development to promote self-management activities and behavior change in children with chronic diseases.

METHODS

This study consists of a knowledge base and an analytical base. This study followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. To build the knowledge base, 5 stages of research were developed, including refining the review question (stage 1), searching for studies (stage 2), selecting relevant studies (stage 3), charting the information (stage 4), and collating the results (stage 5). Eligible studies that developed SG prototypes and evaluated SG education for children with chronic diseases were searched for in PubMed, Embase, Google Scholar, and peer-reviewed journals. In the analytical base, the context-mechanism-output approach and game taxonomy were used to analyze relevant behavioral theories and essential game elements. Game taxonomy included social features, presentation, narrative and identity, rewards and punishment, and manipulation and control. A total of 2 researchers selected the domains for the included behavioral theories and game elements. The intended SG framework was finalized by assembling SG fragments. Those SG fragments were appropriately reintegrated to visualize a new SG framework.

RESULTS

This scoping review summarized data from 16 randomized controlled trials that evaluated SG education for children with chronic diseases and 14 studies on SG frameworks. It showed that self-determination theory was the most commonly used behavioral theory (9/30, 30%). Game elements included feedback, visual and audio designs, characters, narratives, rewards, challenges, competitions, goals, levels, rules, and tasks. In total, 3 phases of a digital SG framework are proposed in this review: requirements (phase 1), design and development (phase 2), and evaluation (phase 3). A total of 6 steps are described: exploring SG requirements (step 1), identifying target users (step 2), designing an SG prototype (step 3), building the SG prototype (step 4), evaluating the SG prototype (step 5), and marketing and monitoring the use of the SG prototype (step 6). Safety recommendations to use digital SG-based education for children in the post-COVID-19 era were also made.

CONCLUSIONS

This review summarizes the fundamental behavioral theories and game elements of the available literature to establish a new theory-driven step-by-step framework. It can support game designers, clinicians, and educators in designing, developing, and evaluating digital, SG-based educational tools to increase self-management activities and promote behavior change in children with chronic diseases.

A Narrative Review of the Factors Affecting the Mental Health of Adolescents and Young People During the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, led to a worldwide pandemic. There were unprecedented changes in the mental health of children, adolescents, and youth in the age group of 8-18 years as a result of COVID-19. The objective of this review is to identify direct and indirect factors that influenced these changes. We identified three main groups of factors that could have impacted the mental health of young people during the pandemic: (i) familial factors, (ii) social and educational factors, and (iii) positive variables. Our review suggests that the COVID-19 pandemic negatively impacted the mental health of children and adolescents through stressors like social isolation, parental unemployment and loss, and disrupted routines. As a result, sadness, hopelessness, depression, and generalized anxiety all increased significantly among adolescents during the pandemic, coupled with a simultaneous increase in substance use, suicide attempts, and violence. However, the pandemic also offered some positive variables such as reduced bullying, more family time, and improved relationships for those with adequate socioeconomic resources. The complex factors affecting the mental health of young people during the pandemic underscore the necessity for additional research to comprehend their individual effects. We advocate for collaborative youth-centered initiatives involving educational organizations, mental health experts, policymakers, healthcare systems, and other community stakeholders to effectively tackle these challenges.

Building a better society: The Vital role of Family's social values in creating a culture of giving in young Children's minds

This study aimed to investigate the role of families in instilling social values that enhance children's awareness of the culture of giving. A descriptive research design was used, and a sample survey method was employed, with 174 children participating. Results showed that the family's role in instilling social values was rated as moderate (weighted relative weight of 61.97%), with a total weight of 9705. The study also found that children face difficulties in adhering to the encouraging social values of volunteering. Specifically, the difficulties that children face were rated as moderate (weighted relative weight of 61.58%), with a total weight of 4822. One of the most important of these difficulties was the frequent family disputes between a child's parents that do not give them a way to practice volunteering. Besides, the families of some children are not interested in explaining the nature and mechanism of applying the encouraging social values of giving. Furthermore, the study revealed statistically significant differences in children's awareness of social values based on gender, age, educational stage, parents' educational level, and family cultural level. One of the study's key recommendations is to activate the role of families and educational institutions in organizing field visits for children to participate in voluntary and humanitarian programs. This would create constructive communication between children and vulnerable groups in society, such as orphans and the elderly, and deepen children's sense of the existence of these categories within society and the importance of providing support and assistance to them. Overall, this study highlighted the crucial role of families in instilling positive social values in children, which is essential for building a compassionate and committed future generation capable of giving back to society in various fields, particularly in human services.

Connections between Parental Phubbing and Electronic Media Use in Young Children: The Mediating Role of Parent-Child Conflict and Moderating Effect of Child Emotion Regulation

In this digital age, where parental attention is often diverted by digital engagement, the phenomenon of "parental phubbing," defined as parents ignoring their children in favor of mobile devices, is scrutinized for its potential impact on child development. This study, utilizing questionnaire data from 612 parents and Structural Equation Modeling (SEM) with moderated mediation, examines the potential association between parental phubbing and young children's electronic media use. The findings revealed a correlation between parental phubbing and increased electronic media use in children. Parent-child conflict, informed by instances of parental phubbing, was identified as a partial mediator in this relation. Notably, children's emotion regulation emerged as a moderating factor, with adept regulation linked to reduced adverse effects of parental phubbing and improved relational harmony. These findings underscore the importance of parental awareness of their digital behaviors and the benefits of fostering robust parent-child relationships and supporting children's emotional regulation to nurture well-adjusted "digital citizens" in the contemporary media landscape.

Problematic Gaming during COVID-19 Pandemic: A Systematic Review, Meta-Analysis, and Meta-Regression

The COVID-19 pandemic led to government measures enforcing isolation in order to mitigate the spread of the virus. Consequently, online activities, including gaming, increased during this challenging period. Thus, it was possible that problematic gaming (PG) patterns also increased. In this systematic review and meta-analysis, we estimated the prevalence of PG during the COVID-19 pandemic and examined differences among subpopulations. The evaluation of 38 studies revealed that the overall prevalence of PG during the COVID-19 pandemic was 3.6%. Furthermore, higher PG scores were found in undergraduate and gamer subpopulations, as well as in studies using the Gaming Addiction Scale. Finally, meta-regression analyses suggest that stricter government measures, as identified by the Government Stringency Index, may have contributed to a lower prevalence of PG behaviors. A potential explanation of this finding is that containment measures had a protective function with respect to emotional distress, and thus towards PG; alternatively, it could be that current measures for PG become less precise if an individual's functioning is already impaired due to other reasons, such as COVID-19 restrictions. Further theoretical, methodological, and practical implications of the findings are discussed.

Association between Electronic Media Use and Internalizing Problems: The Mediating Effect of Parent-Child Conflict and Moderating Effect of Children's Age

In today's digital world, children are exposed extensively to electronic media, making it an integral part of their daily lives. However, excessive use of electronic media during childhood has been associated with various internalizing problems. Moreover, parent-child conflict and children's age may be closely associated with children's problem behaviors. The current study employed a cross-sectional design and conducted a questionnaire survey of 711 parents to examine the association between children's electronic media use and their internalizing problems. Furthermore, this study probed the mediating role of parent-child conflict within this association and the moderating effect of children's age. The results of structural equation modeling showed a positive correlation between children's use of electronic media and their internalizing difficulties. Parent-child conflict served as a mediating factor in this association. Results also showed that the association between parent-child conflict and internalizing problems becomes more pronounced as children grow older. These findings imply that parents should encourage their children to develop healthy habits in using electronic media while fostering positive relationships. Parents should also be mindful of the psychological changes as children age and provide guidance to help them become proficient digital citizens.

Suicide Trends in Jordan in Correlation With the COVID-19 Pandemic: A Forensic Medicine Perspective

Background This study aimed to examine the suicide trends among Jordanians who died by suicide before and during the coronavirus disease 2019 (COVID-19) pandemic and assess their correlation with demographic data, including gender, age, marital status, and the method used for suicide, from a forensic medicine perspective. Methodology This was a retrospective, observational, autopsy-based study. Of the 731 medicolegal autopsies performed at the Al-Hussein New Hospital at Al Salt City between 2017 and 2022, 41 confirmed cases of suicide were identified. Results The study indicated that 75% of the subjects committed suicide during the COVID-19 pandemic period, of whom 13% were children. The average age of those who died by suicide was 32.1 (SD = 12.2) years. Overall, 58.5% were single, 61.0% unemployed, and 53.7% had a mental illness. Males were four times more likely to commit suicide than females. Hanging represented 60.61% of all male suicides, followed by firearms (27.27%); however, females used poisoning. Around 60% and 25% of the study subjects were in the age group of 21-40 years and 41 and more, respectively. The study also identified a statistically significant association between gender, age, and the time of suicide (during COVID-19). The findings of this study could not confirm any association between suicide and mental illness, marital status, and employment status. Conclusions The suicide rate in Jordan increased during the COVID-19 pandemic, and it is alarming that most of those who committed suicide were at a young age and in their productive years.

Increased adolescent game usage and health-related risk behaviors during the COVID-19 pandemic

This study examines adolescent game usage and corresponding health-related risk behaviors during a period of limited social interaction and activity due to the COVID-19 pandemic. Participants included 225 middle- and 225 high-school students in Seoul who completed a survey online from October 1 to 30, 2021. The study measured participants' game usage level and the health-related risk behavior index. Findings showed that participants who engaged in excessive gaming showed higher levels of health-related risk behaviors. A multivariate analysis of variance was conducted to compare the health-related risk behaviors of students in the general, potential, and high-risk groups on excessive gaming. Results indicated that female students in the high-risk group showed higher stress levels and fatigue (f = 5.549, p < .01, Cohen's d = 0.016) than the males of the same group. However, male students showed higher physical inactivity levels (f = 3.195, p > .05, Cohen's d = 0.009) than females. The post hoc test indicated clear sex distinctions among the general, potential, and high-risk groups on excessive gaming (p < .001). Among the high-risk game usage group, female students displayed a higher level of risk behaviors than males. Adolescent gaming addiction should be considered an emotional and behavioral disorder for which parental guidance and support are needed, and counseling experts and professionals must come together to provide a cure and reform program.

Internet and Video Games: Causes of Behavioral Disorders in Children and Teenagers

Even though video games have been present among children for many years, children are using them more continuously and in an abusive and indiscriminate way nowadays because of the "technological boom". It is affecting the behavior of children and adolescents. This is the reason why we are carrying out this systematic review. The main objective of this article is to investigate literature that directly connects the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people. The PRISMA statement was followed in the process of this article. We used SCOPUS, Web of Science and PubMed as databases, moreover, we searched studies with a scoping review. The results indisputably supported six out of seven of our hypotheses. We find that the excessive use of video games causes addiction to technology, aggressive behaviors, sleep disorders, and poor school performance. In addition, it hinders social relationships and the development of emotional intelligence. To conclude, it is necessary to correctly use video games in particular, and technologies in general, adapting their content to children's age, as well as the amount of time that they dedicate to use them.

Playing and Socializing—Adults’ Perceptions of the FIFA Digital Game

Gamers’ perceptions of using competitive digital games, especially concerning anxiety and socialization, have raised doubts about the benefits of playing such games. Since different studies highlight different results, this research aims to explore these differences by analyzing the perceptions of adults involved in playing a competitive digital game, in this case, FIFA, considering data that were collected during the COVID-19 pandemic period. The main question is ‘How do adults perceive anxiety, stress, and socialization when playing the FIFA digital game?’. The research comprises two studies involving volunteer participants: In the first part, which adopts a qualitative approach, the participants’ perceptions of what they think and feel when playing FIFA were analyzed and interpreted using text mining analysis. In the second, a quantitative study, FIFA users’ perceptions of the gaming experience were statistically analyzed. The results show that adult users tend to refer to positive perceived stress and socialization. The fact that participants identified manipulations and interference in the game and no longer allowed its use to influence their mood reveals that perceptions of attacks of rage were considered possible reactions to the use of the game, interpreted from the interface, and leading to the creation of knowledge.

COVID-19 pandemic impact on follow-up of child growth and development in Brazil

OBJECTIVES

This study investigated the impact of the COVID-19 pandemic on the primary health care (PHC) services to follow-up the child growth and development (CGD) in Brazil.

METHODS

A cross-sectional study was conducted using secondary data related visits to assess the growth and development of children up to five years between Apr-2017 to Mar-2021. Differences between monthly rate of visits (per thousand inhabitants up to five) during the pandemic (Apr-2020 to Mar-2021) and before (Apr-2017 to Mar-2020) were analyzed using paired t test and control diagrams (averages ± 1.96 standard deviation).

RESULTS

A total of 39,599,313 visits for monitoring CGD was studied. The average monthly rate of visits dropped from 61.34 (per thousand) before the pandemic to 39.70 in the first 12 months of the pandemic (p < 0.001). In all states, except Rio Grande do Sul, there was a significant reduction, with differences ranging from -14.21% in São Paulo to -59.66% in Ceará. The Northeast region was the most impacted, being lower than expected in all 12 first months of pandemic.

CONCLUSIONS

The number of visits to follow-up the CGD in PHC in Brazil decreased during the first year of the COVID-19 pandemic, varying over the months and between states and regions.

A systematic review of the impact of COVID-19 on the game addiction of children and adolescents

BACKGROUND

During the COVID-19 pandemic, it is reported that children and adolescents who are socially isolated experience high levels of stress and various mental health problems. At present, little research has been done to collect previous studies that focused on game addiction in children and adolescents during the COVID-19 pandemic. In this research, we aimed to investigate the prevalence of gaming disorder during COVID-19 in children and adolescents and the various factors experienced by children and adolescents that affected gaming disorder.

METHODS

We searched PubMed, Embase, PsycINFO, and Cochrane on 5 May 2021 to identify relevant literature. We extracted the prevalence estimates of game addiction from the studies to measure the global prevalence of game addiction. Then, we found the answers to the questions raised and synthesized them into several themes.

RESULTS

We identified 2,609 articles. Among them, studies that were not related to the topic, duplicated, and that did not meet the selection criteria were excluded, and 18 studies were selected. We rated most of the studies as moderate, and a few were low, and high. A majority of studies found an increase in game usage time and game addiction score during the COVID-19 pandemic. Some children and adolescents in emotional pain play games to communicate with their peers. Regarding parenting, violent parenting and the absence of parental supervision increase levels of game addiction in children. Gaming disorder was caused by the impact of COVID-19 in a vulnerable group with predisposing factors such as depression, anxiety, and attention-deficit/hyperactivity disorder. Adolescents and males scored higher on a game addiction scale, although we could not find any quantitative correlations due to the heterogeneous scales used for gaming addiction.

CONCLUSIONS

During the COVID-19 pandemic, isolated children and adolescents reported increased gaming hours as a result of coping with their psychological pain and avoiding social isolation. Their parents, who should provide proper supervision, also failed to provide appropriate support due to the stress caused by the pandemic. Mental health providers should educate children, adolescents, and their guardians on alternative ways to relieve stress and help parents effectively control their children's usage of games.