JMIR Publications

ABSTRACT

Background:

The rapid advancement in media technology has radically changed the way we learn and interact with one another. Games, with its engaging and interactive approach, hold promise in the delivery of skills and knowledge. This has potential in child and adolescent mental health work, where the lack of insight and motivation for therapy are major barriers to treatment. However, research on the use of serious games in mental health interventions for children and adolescents is still in its infancy.

Objective:

The present study adds to this area through the development and evaluation of RegnaTales, a series of six mobile applications designed to help children and adolescents manage anger. We examined the usability and playability of RegnaTales, as well as children’s aggression levels before and after game play.

Methods:

Seventy-two children aged six to twelve were recruited for the study, of which 35 have a clinical diagnosis of disruptive behavior disorders (DBD) while 37 were typically developing children (TD).Each child played the assigned RegnaTales application for approximately 50 minutes before completing the Playability and Usability Questionnaire. The Reactive-Proactive Aggression Questionnaire was completed before and after game play.

Results:

Overall results showed high levels of enjoyment and playability. TD experienced significantly more fun on mobile game applications 1-4 as compared to children with DBD, t(46) = 2.49, P= .02. On mobile applications 5 and 6, there was no significant difference in the Experience Fun scores between TD and DBD, t(22) = -0.48, P = .63.There was no significant difference in the overall Perceived Playability scores between TD and children with DBD on mobile game applications 1-4,t(46) = 0.96, P = .34 and mobile applications 5 and 6, t(22) = -1.09, P = .29. Overall, more than 50% indicated that they would like to play the applications again. Importantly, children felt that they acquired skills in anger management, were motivated to use them in their daily lives and felt confident that the skills would help them better manage their anger. Paired sample t-tests demonstrated that children with DBD reported lower reactive aggression, t(32) = 4.85, P< .001, and overall aggression, t(32) = 4.50, P< .001, after using the RegnaTales applications. Similarly, TD also endorsed lower reactive aggression, t(36) = 4.06, P< 0.01, and overall aggression, t(36) = 2.62, P = .01, after game play.

Conclusions:

The current study provided preliminary positive findings primarily in the domains of playability and usability of RegnaTales as a serious game. Coupled with future research to further determine its efficacy in managing anger issues, RegnaTales could be a potential intervention for clinical as well as non-clinical populations.