JMIR Publications

ABSTRACT

Background:

o There is a strong need to identify effective interventions for improving mental health among adolescents with physical disabilities.

Objective:

This study had 3 purposes: 1) examine the effects of a home-based virtual reality (VR) multiplayer exergaming program on depression, socialization, and loneliness among 12 adolescents with physical disabilities; 2) quantify the acceptability of the program as measured by participant adherence, total play time, and exercise time; 3) describe behavioral mechanisms that affected participant engagement.

Methods:

Single group, pre to post design trial. The intervention was conducted at home. Participants were recruited from a Children’s Hospital. The intervention lasted 4 weeks and included 2 x 1-hour sessions per week of supervised peer-to-peer gaming. Participants used the Meta Quest 2 headset to meet peers and two coaches (a gaming coach and a mindfulness coach) in an online virtual private party. Aim 1 measures included the Children’s Depression Inventory 2 Short Form (CDI-S2) and the UCLA-20, a measure of social isolation and loneliness. Aim 2 was evaluated through the following feasibility metrics: participant adherence, the types of games played, friendship building and playtime, and program satisfaction and enjoyment.

Results:

12 people enrolled (mean age= 16.6 ± 1.8 years; 9 males/ 3 females) and 8 people completed the program. Mean attendance for the 8 participants was 72.2% (52 sessions / 72 total possible sessions). A trend was observed for improved CDI-S2 scores (mean pre score=7.25±4.2, mean post score=5.38±4.1; p-value=0.064; 95%CI=-0.15-3.9; effect size=0.77), but no difference was observed for UCLA-20 scores. Most participants (87.5% [n=7/8]) stated that they became friends with a peer in class; four (50%) reported they played with other people online. Participants reported high levels of enjoyment and satisfaction with how the program was implemented. Qualitative analysis resulted in four qualitative themes that explained behavioral mechanisms that determined engagement in the program.

Conclusions:

12 people enrolled (mean age= 16.6 ± 1.8 years; 9 males/ 3 females) and 8 people completed the program. Mean attendance for the 8 participants was 72.2% (52 sessions / 72 total possible sessions). A trend was observed for improved CDI-S2 scores (mean pre score=7.25±4.2, mean post score=5.38±4.1; p-value=0.064; 95%CI=-0.15-3.9; effect size=0.77), but no difference was observed for UCLA-20 scores. Most participants (87.5% [n=7/8]) stated that they became friends with a peer in class; four (50%) reported they played with other people online. Participants reported high levels of enjoyment and satisfaction with how the program was implemented. Qualitative analysis resulted in four qualitative themes that explained behavioral mechanisms that determined engagement in the program. Clinical Trial: NCT05259462