Accepted for/Published in: JMIR Mental Health
Date Submitted: Mar 14, 2023
Date Accepted: Jun 20, 2023
The Impact of a Gamified Mobile Mental Health App (eQuoo) on Resilience and Mental Health in a Student Population: A Large-Scale Randomised Controlled Trial
ABSTRACT
Background:
With many digital (mental) health interventions (DHI) failing to engage clients for enough time to demonstrate substantive changes to their wellbeing and with only 2% of all digital solutions on App Stores having undergone randomised controlled trials, the rising demand for mental health prevention and early intervention care is not being met. Young adults in particular struggle to find digital wellbeing apps that suit their needs.
Objective:
The present study explored the effects of eQuoo—an evidence-based mental health game which teaches psychological skills through gamification—on resilience, depression, anxiety, and attrition in student population.
Methods:
In total, 1,166 student participants from 180 universities in the United Kingdom participated a 5-week, three-armed randomised controlled trial. The three groups consisted of eQuoo, a treatment as usual evidence-based cognitive behavioural health app called Sanvello, and a no-intervention waitlist. The Rugged Resilience Scale, the GAD7, and the PHQ8 were administered to all participants at baseline and going forward every 7 days until completion.
Results:
A repeated measures analysis of variance (ANOVA) revealed statistically significant increases in resilience in the test group compared with both control groups over 5 weeks. The app also significantly decreased anxiety and depression. With 65% adherence, eQuoo retained 42% more participants than the control groups.
Conclusions:
eQuoo shows that gamifying prevention and early digital health interventions are effective, scalable, and low-cost solutions for the support of young adults that is available on all leading mobile platforms. Meeting the client where they currently were had a powerful positive impact on the viability of a promising platform. Clinical Trial: German Clinical Trials Register (DRKS) Number: DRKS00027638
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