JMIR Publications

ABSTRACT

Background:

Childhood anxiety disorders are a prevalent mental health problem that can be treated effectively with cognitive behaviour therapy (CBT) in which exposure is a key component, however access to treatment is poor. Mobile-based applications (apps) on smartphones/tablets may facilitate the delivery of evidenced-based therapy for child anxiety, overcoming access and engagement barriers of traditional treatment. Applications that deliver therapeutic content via immersive gaming technology could offer an effective, highly engaging and flexible treatment proposition.

Objective:

We describe a preliminary evaluation of Lumi Nova, a mobile app intervention targeting mild to moderate anxiety problems in children aged 7-12 years using exposure therapy delivered via an immersive game. The primary objective is to evaluate the effectiveness, acceptability and safety of the beta version of Lumi Nova.

Methods:

Lumi Nova was co-designed with children, parents, teachers, clinicians, games industry experts and academic partnerships. One hundred and twenty children with mild to moderate anxiety and their guardians were enrolled to take part in an 8-week pilot study. Pre and post intervention outcome measures on effectiveness (anxiety symptoms, child-identified Goal Based Outcomes and functional impairment), usability (game play data and player ratings) and safety (mood ratings and adverse events) were available for 30 children. Additional gameplay data was automatically generated for sixty-seven children over approximately 8 weeks of game play. Open response data from guardians relating to the primary objectives were also examined.

Results:

Playing Lumi Nova was effective in reducing anxiety symptom severity over the 8-week period of gameplay (P=.009) and making progress towards treatment goals, but there were no improvements in relation to functional impairment. Children found it easy to play the game and they engaged safely with the therapeutic content. However, positive effects were small and there were limitations with the gameplay data.

Conclusions:

This preliminary study provides initial evidence that an immersive mobile app game may safely benefit children experiencing mild to moderate difficulties with anxiety. It also demonstrates the value of rigorous evaluation of digital interventions during the development process to rapidly improve in readiness for full market launch.