JMIR Publications

ABSTRACT

Background:

Resilience refers to the human ability to adapt to and cope with mental burdens, playing a vital role in maintaining and strengthening mental health. Digital psychological service offerings provide a resource-efficient and widely accessible alternative of comparable quality. However, long-term adherence to them and a quantitative measuring of their efficacy are common challenges.

Objective:

This work deals with the web application resiLIR for resilience training, which addresses the need for high user adherence by a human-computer interface in form of a serious game. Users attain the role of holidaymakers in a Mediterranean harbor city, engaging in sightseeing throughout the city. They are guided through the training program, visit locations in the city, which represent the training modules for the several resilience factors, and the process training units represented by various objects.

Methods:

The selection of a training module is initiated by choosing an accessible location on the city map. The path to the location of the selected training module includes a feedback inquiry regarding the previous module. Before entering the location, a user receives an introduction to the module. In the location view, a user accesses training units by clicking on accessible objects. The completion of a training unit returns a user to the location view with an updated accessibility status for any remaining unprocessed units. Once a module is completing by processing the scheduled units, a user begins the way back, which features a transfer unit for recapitulating the contents of the module. The training management involves the identification of suitable training contents and their provision to a user, the processing of user inputs for training units and verification of the completeness of these units based on the inputs. This management is realized as a rule-based system regulating the accessibility of training contents and their completion.

Results:

The effectiveness and feasibility of resiLIR were evaluated in two randomized controlled trials using a waitlist-control design, for the general population and for healthcare professionals. In the intervention groups, 43% and 44% completed all modules. Satisfaction was high (3.33 and 3.23 on a 1–4 scale). Preliminary analyses indicate short-term improvements in resilience and mental health. The web application has been publicly available since April 2024.

Conclusions:

resiLIR provides a service offering for resilience training, which adopts the concept of a serious game to enhance user adherence. Preliminary results suggest that resiLIR is a feasible and well-accepted digital training, which can improve resilience and mental health while users actively engage with the program and practice resilience skills. Adherence rates were comparable to other online interventions, and user satisfaction was high. Clinical Trial: This submission builds upon a RCT running under the ClinicalTrials.gov ID NCT05812716.