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Claborn KR, Conway F, Nydegger LA. Acceptability and Perceived Utility of Virtual Reality Among People Who Are Incarcerated Who Use Drugs. JOURNAL OF CORRECTIONAL HEALTH CARE 2024; 30:82-96. [PMID: 38386562 DOI: 10.1089/jchc.23.03.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
People who are incarcerated are at heightened risk of overdose upon community reentry. Virtual reality (VR) may provide an innovative tool for overdose prevention intervention in corrections facilities. This mixed methods study sought to understand incarcerated individuals' perspectives on VR for overdose prevention and explore physiological arousal associated with use of VR equipment. Study participants were 20 individuals, stratified by gender, with an opioid use disorder at a county jail. Qualitative interviews assessed acceptability and perceived utility of VR in the jail setting. Thematic analysis indicated high levels of acceptability and potential utility in the following areas: (a) mental health and substance use interventions, (b) community reentry skills training, and (c) communication and conflict resolution skills. Heart rate variability (HRV) data were collected continuously during the interview and during VR exposure to explore whether exposure to the VR environment provoked arousal. Physiological data analyses showed a significant decrease in heart rate (HR) [b = -3.14, t(18) = -3.85, p < .01] and no arousal as measured by root mean square of successive RR interval differences (RMSSD) [b = -0.06, t(18) = -1.06, p = .30] and high frequency-HRV (HF-HRV) [b = -0.21, t(18) = -1.71, p = .10]. This study demonstrated high acceptability and decreased HR response of VR among incarcerated people who use drugs.
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Affiliation(s)
- Kasey R Claborn
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
- Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Fiona Conway
- Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Liesl A Nydegger
- Bloomberg School of Public, Health Johns Hopkins University, Baltimore, Maryland, USA
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Aneni K, Fernandes CSF, Hoerner LA, Szapary C, Pendergrass Boomer TM, Fiellin LE. A Video Game Intervention to Prevent Opioid Misuse Among Older Adolescents: Development and Preimplementation Study. JMIR Serious Games 2023; 11:e46912. [PMID: 37921851 PMCID: PMC10656656 DOI: 10.2196/46912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/31/2023] [Accepted: 09/08/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Opioid misuse and mental disorders are highly comorbid conditions. The ongoing substance misuse and mental health crises among adolescents in the United States underscores the importance of widely scalable substance misuse preventive interventions that also address mental health risks. Serious video games offer an engaging, widely scalable method for delivering and implementing preventive interventions. However, there are no video game interventions that focus on preventing opioid misuse among older adolescents, and there are limited existing video game interventions that address mental health. OBJECTIVE This study aims to develop and conduct a formative evaluation of a video game intervention to prevent opioid misuse and promote mental health among adolescents aged 16-19 years (PlaySmart). We conducted formative work in preparation for a subsequent randomized controlled trial. METHODS We conducted development and formative evaluation of PlaySmart in 3 phases (development, playtesting, and preimplementation) through individual interviews and focus groups with multiple stakeholders (adolescents: n=103; school-based health care providers: n=51; and addiction treatment providers: n=6). PlaySmart content development was informed by the health belief model, the theory of planned behavior, and social cognitive theory. User-centered design principles informed the approach to development and play testing. The Exploration, Preparation, Implementation, and Sustainability framework informed preimplementation activities. Thematic analysis was used to identify themes from interviews and focus groups that informed PlaySmart game content and approaches to future implementation of PlaySmart. RESULTS We developed a novel video game PlaySmart for older adolescents that addresses the risk and protective factors for opioid misuse and mental health. Nine themes emerged from the focus groups that provided information regarding game content. Playtesting revealed areas of the game that required improvement, which were modified for the final game. Preimplementation focus groups identified potential barriers and facilitators for implementing PlaySmart in school settings. CONCLUSIONS PlaySmart offers a promising digital intervention to address the current opioid and mental health crises among adolescents in a scalable manner.
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Affiliation(s)
- Kammarauche Aneni
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Claudia-Santi F Fernandes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Lily A Hoerner
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Claire Szapary
- Yale School of Public Health, New Haven, CT, United States
| | | | - Lynn E Fiellin
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
- Yale School of Public Health, New Haven, CT, United States
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Rosenthal A, Ebrahimi C, Wedemeyer F, Romanczuk-Seiferth N, Beck A. The Treatment of Substance Use Disorders: Recent Developments and New Perspectives. Neuropsychobiology 2022; 81:451-472. [PMID: 35724634 DOI: 10.1159/000525268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/28/2022] [Indexed: 11/19/2022]
Abstract
Substance-related disorders are complex psychiatric disorders that are characterized by continued consumption in spite of harmful consequences. Addiction affects various brain networks critically involved in learning, reward, and motivation, as well as inhibitory control. Currently applied therapeutic approaches aim at modification of behavior that ultimately leads to decrease of consumption or abstinence in individuals with substance use disorders. However, traditional treatment methods might benefit from recent neurobiological and cognitive neuroscientific research findings. Novel cognitive-behavioral approaches in the treatment of addictive behavior aim at enhancement of strategies to cope with stressful conditions as well as craving-inducing cues and target erroneous learning mechanisms, including cognitive bias modification, reconsolidation-based interventions, mindfulness-based interventions, virtual-reality-based cue exposure therapy as well as pharmacological augmentation strategies. This review discusses therapeutic strategies that target dysregulated neurocognitive processes associated with the development and maintenance of disordered substance use and may hold promise as effective treatments for substance-related disorders.
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Affiliation(s)
- Annika Rosenthal
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Ebrahimi
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friederike Wedemeyer
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anne Beck
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Health and Medical University, Campus Potsdam, Faculty of Health, Potsdam, Germany
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Martínez-Miranda J, Espinosa-Curiel IE. Serious games supporting the prevention and treatment of alcohol and drugs consumption in youth: a scoping review (Preprint). JMIR Serious Games 2022; 10:e39086. [PMID: 36006694 PMCID: PMC9459843 DOI: 10.2196/39086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/23/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The consumption of alcohol and drugs, particularly in adolescents and young adults, has increased worldwide in the last several years, representing a significant public health challenge. Serious games have the potential to support preventive and treatment interventions for substance use, facilitating the acquisition of relevant knowledge and the motivation for changes in attitudes and behaviors regarding substance consumption. Objective This scoping review aims to analyze a set of 7 relevant characteristics of current serious games designed to support the prevention and treatment of alcohol and drug consumption in adolescents and young adults—the substance addressed, the type of intervention, the theoretical basis, the computational techniques used, the mechanism for data security and privacy, the evaluation procedure followed, and the main results obtained. Methods The review was performed by following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Data were retrieved from January 2010 to May 2022, using PubMed, Scopus (Elsevier), IEEE Xplore, and ACM Digital as data sources. The eligibility criteria included studies that described serious games designed to support the prevention or treatment of alcohol and drug consumption, targeted a population aged between 12 and 30 years, and included an evaluation procedure. Authors (JMM and IEEC) individually screened the titles and abstracts, and then full articles were reviewed for a final inclusion decision. Results A total of 629 records were obtained, and 29 (4.6%) fulfilled the inclusion criteria. Most of the serious games (14/29, 48%) were focused on the prevention or treatment of alcohol use. The type of intervention that was the most supported was prevention (18/29, 62%), and most studies mentioned the theory, theoretical construct, or therapeutic technique used as a foundation (22/29, 76%). Most of the studies only provided information about the platform for execution (23/29, 79%), and few described the use of computational techniques, such as virtual reality or motion-based interaction (5/29, 17%). A small set of studies (10/29, 34%) explicitly mentioned how data security and privacy were addressed. Most of the reported evaluation protocols were pilot studies (11/29, 38%), followed by randomized controlled trials (10/29, 34%), and the reported results were positive in terms of acceptability, usability, and efficacy. However, more research is needed to assess long-term effects. Conclusions Given the increasing interest in the use of serious games as digital interventions to support the prevention or treatment of substance use, knowing their main features is highly important. This review highlights whether and how current serious games incorporate 7 key features that are useful to consider for the further development of the area.
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Affiliation(s)
- Juan Martínez-Miranda
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Mexico
| | - Ismael Edrein Espinosa-Curiel
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Mexico
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Metcalf M, Rossie K, Stokes K, Tanner B. Health Care Professionals' Clinical Skills to Address Vaping and e-Cigarette Use by Patients: Needs and Interest Questionnaire Study. JMIR Form Res 2022; 6:e32242. [PMID: 35404264 PMCID: PMC9039806 DOI: 10.2196/32242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Widespread vaping and e-cigarette use is a relatively new phenomenon. Youth vaping peaked in 2019, with over 25% of high school students currently vaping. e-Cigarettes are used where smoking is not permitted or as an alternative smoking cessation treatment instead of Food and Drug Administration-approved options. Vaping and e-cigarette use has the potential to harm health, including causing adverse respiratory effects and nicotine addiction. Health care professionals need skills training to help their patients with this relatively new and evolving health problem. OBJECTIVE The aim of this study is to understand health care professionals' training needs in this subject area to determine the focus for web-based continuing education training. METHODS We reviewed the literature on clinical aspects of vaping and e-cigarette use. Using the results and our experience in substance use continuing education, we created a list of key clinical skills and surveyed health care professionals about their training needs. We also asked about their interest in a list of related topics. We recruited individuals who completed our web-based courses on substance use, members of health care professional-related groups, and experts who had published an article on the subject. Half of the 31 health care professionals who completed the survey were physicians and the remainder were primarily nurses, social workers, and counselors. Participants self-identified as nonexperts (n=25) and experts (n=6) on vaping. RESULTS Participants who were nonexperts on average agreed or strongly agreed that they needed training in each of 8 clinical skills (n=25; range 3.7-4.4 agreement out of 5). The top two skills were recommending treatments for patients (4.4 out of 5, SD 0.49) and evaluating and treating the health effects of vaping and e-cigarette use (4.4 out of 5, SD 0.50). Experts agreed on the importance of training for health care professionals in all skills but rated the need for training higher than nonexperts for each topic. Over half of the participating health care professionals (44%-80%) were interested in nearly all (9/10, 90%) vaping-related topics on a checklist. The topics participants were most interested in were the pros and cons of vaping versus smoking and the health effects of second- and third-hand vaping. Primary care physicians showed more interest in vaping-related topics than nonprimary care physicians (t13=2.17; P=.02). CONCLUSIONS This study confirmed gaps in health care professionals' vaping-related clinical skills identified in the literature by identifying a perceived need for training in related skills and health care professionals' interest in key topics related to vaping prevention and cessation. This study provides specific guidance on which clinical skills training is most needed and which topics are most interesting to health care professionals.
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Affiliation(s)
- Mary Metcalf
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Karen Rossie
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Katie Stokes
- Clinical Tools, Inc, Chapel Hill, NC, United States
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Wu X, Du J, Jiang H, Zhao M. Application of Digital Medicine in Addiction. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (SCIENCE) 2022; 27:144-152. [PMID: 34866856 PMCID: PMC8627382 DOI: 10.1007/s12204-021-2391-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/20/2021] [Indexed: 10/29/2022]
Affiliation(s)
- Xiaojun Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108 China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, 200031 China
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Priya H, Purohit B, Ravi P. Future scope of virtual reality and augmented reality in tobacco control. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_22_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Baghaei N, Chitale V, Hlasnik A, Stemmet L, Liang HN, Porter R. Virtual Reality for Supporting the Treatment of Depression and Anxiety: Scoping Review. JMIR Ment Health 2021; 8:e29681. [PMID: 34554097 PMCID: PMC8498902 DOI: 10.2196/29681] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Mental health conditions pose a major challenge to health care providers and society at large. The World Health Organization predicts that by 2030, mental health conditions will be the leading cause of disease burden worldwide. The current need for mental health care is overwhelming. In New Zealand, 1 in 6 adults has been diagnosed with common mental disorders, such as depression and anxiety disorders, according to a national survey. Cognitive behavioral therapy (CBT) has been shown to effectively help patients overcome a wide variety of mental health conditions. Virtual reality exposure therapy (VRET) might be one of the most exciting technologies emerging in the clinical setting for the treatment of anxiety and depression. OBJECTIVE This study aims to investigate the virtual reality (VR) technologies currently being used to help support the treatment of depression and anxiety. We also aim to investigate whether and how CBT is included as part of VRET and look at the VR technologies and interventions that have been used in recent studies on depression and anxiety. METHODS We performed a scoping review. To identify significant studies, we decided to use already aggregated sources from the Google Scholar database. Overall, the goal of our search strategy was to limit the number of initial results related to VR in mental health to only a relevant minimum. RESULTS Using our defined keywords, Google Scholar identified >17,300 articles. After applying all the inclusion and exclusion criteria, we identified a total of 369 articles for further processing. After manual evaluation, 34 articles were shortlisted; of the 34 articles, 9 (26%) reported the use of CBT with VR. All of the articles were published between 2017 and 2021. Out of the 9 studies, CBT was conducted within a VR environment in 5 (56%) studies, whereas in the remaining 4 (44%) studies, CBT was used as an addition to VRET. All 9 studies reported the use of CBT either in vivo or in a virtual environment to be effective in supporting the treatment of anxiety or depression. CONCLUSIONS Most studies demonstrated the use of VR to be effective for supporting the treatment of anxiety or depression in a range of settings and recommended its potential as a tool for use in a clinical environment. Even though standalone headsets are much easier to work with and more suitable for home use, the shift from tethered VR headsets to standalone headsets in the mental health environment was not observed. All studies that looked at the use of CBT either in vivo or in a virtual environment found it to be effective in supporting the treatment of anxiety or depression.
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Affiliation(s)
- Nilufar Baghaei
- Department of Natural and Computational Sciences, Massey University, Auckland, New Zealand
| | - Vibhav Chitale
- Department of Natural and Computational Sciences, Massey University, Auckland, New Zealand
| | - Andrej Hlasnik
- Otago Polytechnic Auckland International Campus, Auckland, New Zealand
| | - Lehan Stemmet
- Auckland Institute of Studies, Auckland, New Zealand
| | - Hai-Ning Liang
- Department of Computing, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Keijsers M, Vega-Corredor MC, Tomintz M, Hoermann S. Virtual Reality Technology Use in Cigarette Craving and Smoking Interventions (I "Virtually" Quit): Systematic Review. J Med Internet Res 2021; 23:e24307. [PMID: 34533471 PMCID: PMC8486991 DOI: 10.2196/24307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/22/2021] [Accepted: 06/21/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Over the last 2 decades, virtual reality technologies (VRTs) have been proposed as a way to enhance and improve smoking cessation therapy. OBJECTIVE This systematic review aims to evaluate and summarize the current knowledge on the application of VRT in various smoking cessation therapies, as well as to explore potential directions for future research and intervention development. METHODS A literature review of smoking interventions using VRT was conducted. RESULTS Not all intervention studies included an alternative therapy or a placebo condition against which the effectiveness of the intervention could be benchmarked, or a follow-up measure to ensure that the effects were lasting. Virtual reality (VR) cue exposure therapy was the most extensively studied intervention, but its effect on long-term smoking behavior was inconsistent. Behavioral therapies such as a VR approach-avoidance task or gamified interventions were less common but reported positive results. Notably, only 1 study combined Electronic Nicotine Delivery Devices with VRT. CONCLUSIONS The inclusion of a behavioral component, as is done in the VR approach-avoidance task and gamified interventions, may be an interesting avenue for future research on smoking interventions. As Electronic Nicotine Delivery Devices are still the subject of much controversy, their potential to support smoking cessation remains unclear. For future research, behavioral or multicomponent interventions are promising avenues of exploration. Future studies should improve their validity by comparing their intervention group with at least 1 alternative or placebo control group, as well as incorporating follow-up measures.
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Affiliation(s)
- Merel Keijsers
- School of Product Design, College of Engineering, University of Canterbury, Christchurch, New Zealand
- HIT Lab NZ, College of Engineering, University of Canterbury, Christchurch, New Zealand
- John Cabot University, Rome, Italy
| | | | - Melanie Tomintz
- Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand
| | - Simon Hoermann
- School of Product Design, College of Engineering, University of Canterbury, Christchurch, New Zealand
- HIT Lab NZ, College of Engineering, University of Canterbury, Christchurch, New Zealand
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Tsamitros N, Sebold M, Gutwinski S, Beck A. Virtual Reality-Based Treatment Approaches in the Field of Substance Use Disorders. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00377-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Purpose
Substance use disorders (SUD) are burdening chronic conditions characterized by high relapse rates despite severe negative consequences. Substance-related cues that elicit craving by means of automatic physiological and behavioural responses have long been suggested to predict relapse. One major mechanism contributing to relapse behaviour are cue-induced behavioural approach tendencies towards the addictive agent. Recently, there has been an emerging interest in virtual reality (VR)-based approaches to assess and modify craving and its related responses. This review aims at elucidating (1) VR techniques applied in the field of SUD, (2) VR as an induction/assessment tool for biopsychological correlates of craving and (3) VR-based therapeutic approaches.
Findings
There is an emerging number of studies focusing on different substances of abuse incorporating VR in craving induction/assessment as well as therapy. Despite some limitations as missing of randomized controlled clinical trials with large samples and missing data on the long-term effects of VR treatment, the VR approach showed consistent results in eliciting and reducing craving across different substances.
Summary
This review suggests virtual reality as a promising tool for the assessment and treatment of craving among individuals with substance use disorders. Because of its ecological validity, VR unifies the benefits of a laboratory setting with the advantages of a realistic environment. Further studies with large samples and randomized controlled clinical trials using more homogenous VR techniques as well as assessment of objective biophysiological craving markers are required.
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Is Virtual Reality Cue Exposure a Promising Adjunctive Treatment for Alcohol Use Disorder? J Clin Med 2021; 10:jcm10132972. [PMID: 34279455 PMCID: PMC8268737 DOI: 10.3390/jcm10132972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 12/16/2022] Open
Abstract
This narrative review presents recent developments in virtual reality (VR)-based interventions for alcohol use disorders (AUDs). The latest advances in mental healthcare hail an imminent cyber revolution, ushering in novel treatment options, with immersive virtual technology at the very forefront of expected change. With an aim to (a) provide a background on VR use in mental healthcare of AUD patients, (b) summarize existing evidence on conventional approaches to the treatment of AUDs and a trending paradigm shift towards VR applications in their management, and (c) describe key issues and future directions in research on craving assessment and VR cue-induced therapy in AUDs, a search for experimental and meta-analytic evidence was performed in six databases: PubMed and EBSCO (Medline, ERIC, PsychINFO, Academic Search Ultimate, and Health Source: Nursing/Academic Edition). Pooled results were screened for eligibility, and relevant papers were selected for inclusion. The analysis revealed VR’s promising effects in the treatment of AUDs. Its remarkable potential to simulate cues underlying subsequent addictive behaviors makes its application in the assessment and treatment of AUDs an attractive alternative to researchers and clinicians alike. Nevertheless, more evidence is needed before virtual reality cue exposure therapy (VR-CET) can become a clinical standard of care.
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12
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Derksen ME, van Strijp S, Kunst AE, Daams JG, Jaspers MWM, Fransen MP. Serious games for smoking prevention and cessation: A systematic review of game elements and game effects. J Am Med Inform Assoc 2021; 27:818-833. [PMID: 32330255 PMCID: PMC7309269 DOI: 10.1093/jamia/ocaa013] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/07/2020] [Accepted: 01/23/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Serious health games might have the potential to prevent tobacco smoking and its health consequences, depending on the inclusion of specific game elements. This review aimed to assess the composition of serious games and their effects on smoking initiation prevention and cessation and behavioral determinants. Materials and Methods We systematically searched MEDLINE, Embase, PsycINFO, and Web of Science for publications that evaluated serious games aimed at changing smoking behavior or behavioral determinants. A taxonomy by King et al was used to classify game elements. Results We identified 15 studies, evaluating 14 unique serious games. All games combined multiple game elements (mean 5.5; range, 3-10). Most frequently used were general and intermittent rewards, theme and genre features, and punishments. Six studies on smoking prevention together assessed 20 determinants and found statistically significant positive effects for 8 determinants (eg, attitude, knowledge, intention). Of 7 studies on smoking cessation, 5 found positive, statistically significant effects on smoking cessation or status. These studies found statistically significant positive effects for 6 of 12 determinants (eg, self-efficacy, attitude, intention). The majority of included studies had poor or fair methodological quality, lacked follow-up measures, and had fixed (as opposed to free, on-demand) play sessions. Conclusions Serious games included multiple types of game elements. The evidence from a number of studies suggests that games may have positive effects on smoking-related outcomes, particularly smoking cessation. However, as most studies had important methodological limitations, stronger designs are needed to demonstrate, quantify, and understand the effects of serious games.
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Affiliation(s)
- M E Derksen
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - S van Strijp
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - A E Kunst
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - J G Daams
- Medical Library, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M W M Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M P Fransen
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Aday JS, Davoli CC, Bloesch EK. Psychedelics and virtual reality: parallels and applications. Ther Adv Psychopharmacol 2020; 10:2045125320948356. [PMID: 32922734 PMCID: PMC7446267 DOI: 10.1177/2045125320948356] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/14/2020] [Indexed: 01/29/2023] Open
Abstract
Psychedelic drugs and virtual reality (VR) each have the capacity to disrupt the rigidity and limitations of typical conscious experience. This article delineates the parallels among psychedelic and VR states as well as their potential synergistic applications in clinical and recreational settings. Findings indicate that, individually, psychedelics and VR are used in analogous ways to alter sensory experience and evoke awe. They are also both used in tandem with traditional therapies to treat a variety of mood disorders; their shared capacity to transiently alter perspective and disrupt rigid patterns of mental experience may underly their analogous and transdiagnostic therapeutic uses. In terms of their combined applications, a number of recreational users currently utilize psychedelics and VR together to enhance their experience. We propose that VR may be a useful tool for preparing hallucinogen-naïve participants in clinical trials for the sensory distortions experienced in psychedelic states. Given the critical role of "setting" in psychedelic treatment outcomes, we also detail how VR could be used to optimize the environment in psychedelic sessions. Finally, we provide considerations for future studies and detail how advancements in psychedelic and VR research can inform one another. Collectively, this article outlines a number of connections between psychedelics and VR, and, more broadly, is representative of growing scientific interest into the interactions among technology, psychopharmacology, and mental health.
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Affiliation(s)
- Jacob S. Aday
- Department of Psychology, Central Michigan University, 101 Sloan Hall, Mount Pleasant, MI 48858, USA
| | | | - Emily K. Bloesch
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
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Goldfine C, Lai JT, Lucey E, Newcomb M, Carreiro S. Wearable and Wireless mHealth Technologies for Substance Use Disorder. CURRENT ADDICTION REPORTS 2020; 7:291-300. [PMID: 33738178 DOI: 10.1007/s40429-020-00318-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Purpose of review The goal of this scoping review is to evaluate the advances in wearable and other wireless mobile health (mHealth) technologies in the treatment of substance use disorders. Recent findings There are a variety of wireless technologies under investigation for the treatment of substance use disorder. Wearable sensors are the most commonly used technology. They can be used to decrease heavy substance use, mitigate factors related to relapse, and monitor for overdose. New technologies pose distinct advantages over traditional therapies by increasing geographic availability and continuously providing feedback and monitoring while remaining relatively non-invasive. Summary Wearable and novel technologies are important to the evolving landscape of substance use treatment. As technologies continue to develop and show efficacy, they should be incorporated into multifactorial treatment plans.
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Affiliation(s)
- Charlotte Goldfine
- University of Massachusetts Medical School, Department of Emergency Medicine, Division of Medical Toxicology, Worcester, MA
| | - Jeffrey T Lai
- University of Massachusetts Medical School, Department of Emergency Medicine, Division of Medical Toxicology, Worcester, MA
| | - Evan Lucey
- University of Massachusetts Medical School, Department of Emergency Medicine, Division of Medical Toxicology, Worcester, MA
| | - Mark Newcomb
- University of Massachusetts Medical School, Department of Emergency Medicine, Division of Medical Toxicology, Worcester, MA
| | - Stephanie Carreiro
- University of Massachusetts Medical School, Department of Emergency Medicine, Division of Medical Toxicology, Worcester, MA
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15
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Appel L, Appel E, Bogler O, Wiseman M, Cohen L, Ein N, Abrams HB, Campos JL. Older Adults With Cognitive and/or Physical Impairments Can Benefit From Immersive Virtual Reality Experiences: A Feasibility Study. Front Med (Lausanne) 2020; 6:329. [PMID: 32010701 DOI: 10.3389/fmed.2019.00329/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/20/2019] [Indexed: 05/27/2023] Open
Abstract
Background: Older adults living in long term care, rehabilitation hospitals, and seniors' residences often experience reduced mobility, sometimes resulting in confinement indoors and isolation, which can introduce or aggravate symptoms of depression, anxiety, loneliness, and apathy. As Virtual Reality (VR) technologies become increasingly accessible and affordable, there is a unique opportunity to enable older adults to escape their restricted physical realities and be transported to both stimulating and calming places which may improve their general well-being. To date no robust evaluations of the use of immersive VR therapy [experienced through a head-mounted-display (HMD)] for older adults within these settings have been reported. VR-therapy may prove to be a safe, inexpensive, non-pharmacological means of managing depressive symptoms and providing engagement and enjoyment to this rapidly growing demographic. Objectives: Establish whether it is feasible to use immersive VR technology as therapy for older adults who have reduced sensory, mobility and/or impaired cognition. This includes evaluation of tolerability, comfort, and ease of use of the HMD, and of the potential for immersive VR to provide enjoyment/relaxation and reduce anxiety and depressive symptoms. Methods: Sixty-six older adults (mean age 80.5, SD = 10.5) with varying cognitive abilities (normal = 28, mild impairment = 17, moderate impairment = 12, severe impairment = 3, unknown cognitive score = 6), and/or physical impairments, entered a multi-site non-randomized interventional study in Toronto, Canada. Participants experienced 3 to 20 min of 360°-video footage of nature scenes displayed on Samsung GearVR HMD. Data was collected through pre/post-intervention surveys, standardized observations during intervention, and post-intervention semi-structured interviews addressing the VR experience. Results: All participants completed the study with no negative side-effects reported (e.g., No dizziness, disorientation, interference with hearing aids); the average time spent in VR was 8 min and 76% of participants viewed the entire experience at least once. Participants tolerated the HMD very well; most had positive feedback, feeling more relaxed and adventurous; 76% wanted to try VR again. Better image quality and increased narrative video content were suggested to improve the experience. Conclusion: It is feasible and safe to expose older adults with various levels of cognitive and physical impairments to immersive VR within these settings. Further research should evaluate the potential benefits of VR in different settings (e.g., home/community based) and explore better customization/optimization of the VR content and equipment for the targeted populations.
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Affiliation(s)
- Lora Appel
- Faculty of Health, School of Health Policy and Management, York University, Toronto, ON, Canada
- OpenLab, University Health Network, Toronto, ON, Canada
| | - Eva Appel
- OpenLab, University Health Network, Toronto, ON, Canada
| | - Orly Bogler
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Leedan Cohen
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Natalie Ein
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Howard B Abrams
- OpenLab, University Health Network, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer L Campos
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
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16
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Appel L, Appel E, Bogler O, Wiseman M, Cohen L, Ein N, Abrams HB, Campos JL. Older Adults With Cognitive and/or Physical Impairments Can Benefit From Immersive Virtual Reality Experiences: A Feasibility Study. Front Med (Lausanne) 2020; 6:329. [PMID: 32010701 PMCID: PMC6974513 DOI: 10.3389/fmed.2019.00329] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/20/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Older adults living in long term care, rehabilitation hospitals, and seniors' residences often experience reduced mobility, sometimes resulting in confinement indoors and isolation, which can introduce or aggravate symptoms of depression, anxiety, loneliness, and apathy. As Virtual Reality (VR) technologies become increasingly accessible and affordable, there is a unique opportunity to enable older adults to escape their restricted physical realities and be transported to both stimulating and calming places which may improve their general well-being. To date no robust evaluations of the use of immersive VR therapy [experienced through a head-mounted-display (HMD)] for older adults within these settings have been reported. VR-therapy may prove to be a safe, inexpensive, non-pharmacological means of managing depressive symptoms and providing engagement and enjoyment to this rapidly growing demographic. Objectives: Establish whether it is feasible to use immersive VR technology as therapy for older adults who have reduced sensory, mobility and/or impaired cognition. This includes evaluation of tolerability, comfort, and ease of use of the HMD, and of the potential for immersive VR to provide enjoyment/relaxation and reduce anxiety and depressive symptoms. Methods: Sixty-six older adults (mean age 80.5, SD = 10.5) with varying cognitive abilities (normal = 28, mild impairment = 17, moderate impairment = 12, severe impairment = 3, unknown cognitive score = 6), and/or physical impairments, entered a multi-site non-randomized interventional study in Toronto, Canada. Participants experienced 3 to 20 min of 360°-video footage of nature scenes displayed on Samsung GearVR HMD. Data was collected through pre/post-intervention surveys, standardized observations during intervention, and post-intervention semi-structured interviews addressing the VR experience. Results: All participants completed the study with no negative side-effects reported (e.g., No dizziness, disorientation, interference with hearing aids); the average time spent in VR was 8 min and 76% of participants viewed the entire experience at least once. Participants tolerated the HMD very well; most had positive feedback, feeling more relaxed and adventurous; 76% wanted to try VR again. Better image quality and increased narrative video content were suggested to improve the experience. Conclusion: It is feasible and safe to expose older adults with various levels of cognitive and physical impairments to immersive VR within these settings. Further research should evaluate the potential benefits of VR in different settings (e.g., home/community based) and explore better customization/optimization of the VR content and equipment for the targeted populations.
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Affiliation(s)
- Lora Appel
- Faculty of Health, School of Health Policy and Management, York University, Toronto, ON, Canada.,OpenLab, University Health Network, Toronto, ON, Canada
| | - Eva Appel
- OpenLab, University Health Network, Toronto, ON, Canada
| | - Orly Bogler
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Leedan Cohen
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Natalie Ein
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Howard B Abrams
- OpenLab, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer L Campos
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
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17
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Slater P, Hasson F, Gillen P, Gallen A, Parlour R. Virtual simulation training: Imaged experience of dementia. Int J Older People Nurs 2019; 14:e12243. [DOI: 10.1111/opn.12243] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/21/2019] [Accepted: 04/15/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Paul Slater
- Institute of Nursing and Health Research Ulster University Belfast UK
| | - Felicity Hasson
- Institute of Nursing and Health Research Ulster University Belfast UK
| | - Patricia Gillen
- Institute of Nursing and Health Research Ulster University Belfast UK
| | - Anne Gallen
- Nursing/Midwifery Planning & Development at Health Service Executive, North West Ballyshannon Ireland
| | - Randal Parlour
- Nursing/Midwifery Planning & Development at Health Service Executive, North West Ballyshannon Ireland
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