JMIR Publications

ABSTRACT

Background:

Resilience is a person's mental ability to deal with challenging situations adaptively and is a crucial skill for managing stressful situations. Psychological resilience and finding ways to cope amidst a crisis is a highly relevant topic due to the recent coronavirus disease (COVID-19) pandemic, which enforced quarantine, social distancing measures, and schools' closing across the globe. Parents and children are currently living with increased stress due to COVID-19. We need to respond with immediate ways to strengthen children’s resilience. Internet-based Cognitive-Behavioral Therapy interventions (iCBT) for children's stress management overcome accessibility issues such as the inability to visit mental health experts due to COVID-19 movement restrictions. An interactive learning environment was created, based on the preventive program "Friends", to overcome accessibility issues associated with delivering CBT-based interventions in formal and informal education settings.

Objective:

The study aimed to examine the effectiveness of a web-based learning environment on resilience in: a) reducing the stress level and b) increasing emotion recognition and stress symptom management skills of 9-10 year-old children. It also aimed to evaluate the learning environment’s usability.

Methods:

A quasi-experimental pre-test post-test control group design was used. Twenty 4th graders of the experimental group interacted with the learning environment over six, weekly, 80-minute sessions. Twenty-one 4th graders acted as a control group. The main data sources were: a) a psychometric tool measuring children's stress levels, namely Spence Children's Anxiety Scale (SCAS-GR), b) three open-ended questions assessing emotion recognition and stress symptom management skills, and c) the System Usability Scale (SUS) to measure usability.

Results:

Results showed that in both groups, there was a small post-intervention decrease in stress levels, but it was not statistically significant, except in the case of the experimental group's obsessive-compulsive disorder. A paired samples t-test showed that students’ obsessive-compulsive disorder was reduced from M=1.06 (SD=0.68) to M=0.76 (SD=0.61) and this decrease was statistically significant (t(19) = 5.16, P = .010). The experimental group had a statistically significant increase in emotion recognition (t(19)=-6.99, P<.001), identification of somatic symptoms of stress (t(19)=-7.31, P<.001) and identification of stress management techniques (t(19)=-6.85, P<.001). The learning environment received a satisfactory usability score. The raw average SUS score was 76.75 (SD=8.28), which is in the 80% percentile rank, and would result in a grade of B.

Conclusions:

The study showed that interactive learning environments might deliver resilience interventions in an accessible and cost-effective way in formal education, potentially even in distance learning conditions imposed due to the COVID-19 pandemic. Interactive learning environments on resilience are also valuable tools for parents who can use them with their children at home, for informal learning, using mobile devices. As such, they could be a promising first-step, low-intensity intervention that children and youth can easily access.