JMIR Publications

ABSTRACT

Background:

COVID 2019 has spread worldwide and generated tremendous stress on human beings. Unfortunately, it is often hard for distressed individuals to access mental health services under conditions of restricted movement or even lockdown. In this research, we developed an online digital coloring game and tested its effectiveness as a more accessible and engaging instrument for maintaining subjective well-being(SWB) as well as for reducing anxiety during the pandemic.

Objective:

To develop an online digital intervention package on released coloring game and to test its effectiveness as a more accessible and engaging instrument for maintaining SWB and for reducing anxiety during the pandemic.

Methods:

An evidence-based coloring intervention package was developed and uploaded to an online coloring game. Global participants were randomized to color either four rounds of images characterized by awe, pink, nature, and blue or four rounds of irrelevant images. Assessments of subjective wellbeing (SWB), anxiety, and the perception that the activity was helpful in reducing anxiety were made one week before the intervention (T1), after completing pictures in each round (T2-T5), and after the intervention (T6). Independent t tests were used to examine the general intervention effect and the intervention effect of each round. One-way ANOVA was used to examine whether these outcome variables were influenced by the number of rounds completed.

Results:

1390 global players responded and completed at least one assessment. 164 participants in general intervention, 171 participants in the Awe round, 149 in Pink, 128 in Nature and 118 in Blue were included to analysis. The general intervention group showed a significantly larger increase in SWB than the general control group (P<0.001). Compared to the control group, the intervention group showed a larger increase in SWB in the Awe round (P=0.013) and an unexpected decrease in SWB in the Pink round (P=0.020). In Awe round, players colored four pictures showed nearly significant improvement in SWB (P=0.058) and significant effects in reducing anxiety (P=0.011) than those in the control group.

Conclusions:

This study introduced an online intervention base on released coloring game in maintaining SWB and reducing anxiety during the COVID-19 pandemic. It supported the effectiveness of online psychological interventions for mental health in the special period and validated the feasibility of developing an entertaining, accessible, cross-regional, and effective gamification intervention based on the existing products. The results have applied value in helping adults experience higher subjective well-being during periods of personal and social stress.