The Adaptive GameSquad Xbox-Based Physical Activity and Health Coaching Intervention for Youth With Neurodevelopmental and Psychiatric Diagnoses: Pilot Feasibility Study

Editorial Perspective: Healthy body-Healthy mind? Does exercise benefit people with attention-deficit/hyperactivity disorder?

Attention-deficit/hyperactivity disorder (ADHD) stands out as one of the most prevalent neurodevelopmental disorders, significantly affecting daily functioning. However, finding a sustainable treatment strategy for ADHD remains a challenge. In this context, exercise emerges as a highly accessible behavioural intervention with lasting effects on ADHD. Historically, exercise has proven effective in inducing functional and structural adaptations in the brains of neurotypical populations, leading to improved cognition. Scientists working with individuals with ADHD have adapted approaches from research on neurotypical populations to understand the effects of exercise on reducing ADHD-related symptoms. To advance this research area further and enhance the therapeutic potential of exercise for managing ADHD symptoms, this editorial perspective offers the following recommendations: More research is required to better understand the neural markers of exercise interventions for ADHD and the inter-relation between changes in ADHD-related neural mechanisms and alterations in behavioural and cognitive symptomatology. Researchers should consider user perspectives and incorporate social support activities when developing exercise programmes for ADHD and Researchers should evaluate exercise as a stand-alone treatment approach using high-quality and well-designed clinical trials.

Promoting Physical and Mental Health among Children and Adolescents via Gamification-A Conceptual Systematic Review

The rapid growth in digital technology usage among children and adolescents has highlighted the need for novel approaches to promote their physical and mental health. This paper investigates the viability of gamification-the application of game mechanics to non-gaming contexts-as a potent instrument for health promotion and mental health support. This conceptual systematic review seeks to examine the various published articles promoting children and adolescents' physical and mental health through gamified techniques. These interventions can provide an interactive and engaging platform for encouraging physical activity, promoting healthy nutrition, enhancing emotional regulation, and promoting mental health. The significance of this topic stems from the pervasive use of electronic games, beginning at a young age, which makes them popular educational tools. For the review to be systematic and reproducible, the PsycINFO, Scopus, PubMed, and Elsevier databases were searched and the PRISMA method was utilized for the analysis. After analyzing the research data, empirical studies assessing the use of gamification in promoting adolescents' physical and mental health are discussed. In conclusion, gamification has demonstrated promise for promoting children's and adolescents' physical and mental health. It improves motivation, commitment, and adherence to healthy behaviors. However, additional research is required to evaluate gamification interventions' long-term effectiveness and sustainability in promoting health behaviors among this population.

Exergaming (physically active video gaming) for mental health service users in a community mental health care setting: an ethnographic observational feasibility study

BACKGROUND

People with severe and enduring mental illness experience health inequalities with premature mortality; lifestyle behaviours are known to be contributing factors with low levels of physical activity reported. Facilitating physical activity to help maintain or improve health for those who are disadvantaged is essential. Exergaming (gaming involving physical movement) is increasingly used to improve physical activity across the lifespan and for those with a range clinical conditions; this might offer a way to increase physical activity for those with severe mental illness. The aim of this study was to explore engagement of mental health service users with exergaming to increase physical activity in a community mental health care setting.

METHODS

An ethnographic observational feasibility study was undertaken through participant observation and semi-structured interviews. A gaming console was made available for 2 days per week for 12 months in a community mental health setting. A reflexive thematic analysis was performed on the data.

RESULTS

Twenty one mental health service users engaged with the intervention, with two thirds exergaming more than once. One participant completed the semi-structured interview. Key themes identified from the observational field notes were: support (peer and staff support); opportunity and accessibility; self-monitoring; and perceived benefits. Related themes that emerged from interview data were: benefits; motivators; barriers; and delivery of the intervention. Integrating these findings, we highlight social support; fun, enjoyment and confidence building; motivation and self-monitoring; and, accessibility and delivery in community mental health care context are key domains of interest for mental health care providers.

CONCLUSIONS

We provide evidence that exergaming engages people with SMI with physical activity. The value, acceptability and feasibility of open access exergaming in a community mental health service context is supported. Facilitating exergaming has the potential to increase physical activity for mental health service users leading to possible additional health benefits.

GamerFit-ASD beta test: adapting an evidence-based exergaming and telehealth coaching intervention for autistic youth

Background

Health disparities faced by autistic youth are exacerbated by inadequate physical activity (PA) and sleep, whereas healthy PA and sleep may improve mood and function. Adaptive Game Squad (AGS) is an evidence-based telehealth coaching and exergaming intervention to improve PA and sleep for adolescents with diverse neurodevelopmental and psychiatric conditions. This study aimed to adapt AGS for autistic youth ages 10-15 years; beta-test the modified intervention for feasibility, accessibility, and engagement; and further refine the intervention for a larger planned demonstration pilot.

Methods

Interdisciplinary experts adapted AGS to create GamerFit-ASD, a 12-week intervention that included a progressive exergame schedule, Fitbit step-tracking, weekly health coaching, and health tip/exercise videos. For beta testing, the intervention was shortened to a 4-week trial with 5 parent/child dyads. Children completed exit surveys and parents and children were interviewed about intervention feasibility, accessibility, and engagement. Exit survey data were summarized with descriptive statistics. Qualitative data were analyzed using a modified grounded-theory approach.

Results

All participants (n = 5; ages 10-14 years) attended all 4 planned coaching sessions and completed an average of 9 of 12 planned exergame challenges for a weekly average of 50 min. All participants reported enjoying coaching sessions, 4 of 5 reported enjoying exergames, and 3 of 5 reported enjoying on-demand exercise videos. In interviews, children generally reported finding participation feasible, exergaming challenges active and fun, and coaches friendly and helpful. Parents reported high feasibility of supporting their children's involvement and valued child goal-setting and intervention flexibility; however, some found telehealth sessions overly scripted. Several adaptations to coaching scripts, coach training, and parent materials were made for the larger demonstration pilot, including changes to reduce scriptedness of coaching sessions, to provide parents with more information specific to autism, and to make video content more appropriate to children's needs/preferences.

Discussion

A telehealth coaching and exergaming intervention appears feasible, accessible, and engaging for autistic youth aged 10-15. Future studies with larger, more diverse samples, longer study durations and/or follow-up periods, and more rigorous study designs are needed to advance understanding of the appropriateness and effectiveness of this type of intervention for this population.

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

Nearly all young people use the internet daily. Many youth with mental health concerns, especially since the Covid-19 pandemic, are using this route to seek help, whether through digital mental health treatment, illness prevention tools, or supports for mental wellbeing. Videogames also have wide appeal among young people, including those who receive mental health services. This review identifies the literature on videogame interventions for young people, ages 12-29, and maps the data on game use by those with mental health and substance use problems, focusing on evidence for the capacity of games to support treatment in youth mental health services; how stakeholders are involved in developing or evaluating games; and any potential harms and ethical remedies identified. A systematic scoping review methodology was used to identify and assess relevant studies. A search of multiple databases identified a total of 8,733 articles. They were screened, and 49 studies testing 32 digital games retained. An adapted stepped care model, including four levels, or steps, based on illness manifestation and severity, was used as a conceptual framework for organizing target populations, mental health conditions and corresponding digital games, and study results. The 49 selected studies included: 10 studies (20.4%) on mental health promotion/prevention or education for undiagnosed youth (Step 0: 7 games); 6 studies (12.2%) on at-risk groups or suspected mental problems (Step 1: 5 games); 24 studies (49.0%) on mild to moderate mental conditions (Steps 2-3: 16 games); and 9 studies (18.4%) focused on severe and complex mental conditions (Step 4: 7 games). Two interventions were played by youth at more than one level of illness severity: the SPARX game (Steps 1, 2-3, 4) and Dojo (Steps 2-3 and 4), bringing the total game count to 35 with these repetitions. Findings support the potential integration of digital games in youth services based on study outcomes, user satisfaction, relatively high program retention rates and the potential usefulness of most games for mental health treatment or promotion/prevention. Most studies included stakeholder feedback, and involvement ratings were very high for seven games. Potential harms were not addressed in this body of research. This review provides an important initial repository and evaluation of videogames for use in clinical settings concerned with youth mental health.