JMIR Publications

ABSTRACT

Background:

During the COVID-19 pandemic, urban inhabitants have faced significant challenges in maintaining connections to nature, adhering to nutritional guidelines, and managing mental well-being.

Objective:

Recognizing the urgent need for innovative approaches, this study was designed to explore the potential benefits of a specific digital intervention – the rice farming simulation game "Sakuna: Of Rice and Ruin" on nature-relatedness, nutritional behaviors, and psychological well-being.

Methods:

A total of 66 adults, all without prior major psychiatric disorders and residing in an urban area, were recruited for the study. They were randomly assigned to two groups through block randomization: the immediate intervention group (IIG; n=34) and the waitlist group (WLG; n=32). Participants in the IIG were instructed to play the game at least 4 days a week for 3 weeks, with each session lasting from 30 minutes to 3 hours. Assessments were performed at baseline, week 1, and week 3. The Nature Relatedness (NR) and Nutrition Quotient (NQ) scales were employed to evaluate nature-relatedness and nutritional state, respectively. Meanwhile, psychological state was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF), Brief-Fear of Negative Evaluation Scale (BFNE), Social Avoidance and Distress Scale (SADS), Toronto Alexithymia Scale (TAS), State-Trait Anxiety Inventory (STAI), the Center for Epidemiologic Studies Depression Scale Revised (CESD-R), and the Korean Resilience Quotient (KRQ).

Results:

In the comparison between the IIG and the WLG, we discovered that both the total NR score and the self-subdomain score of the NR scale were statistically significantly increased in the IIG, demonstrating a significant time-group interaction. Regarding psychological state, we detected a meaningful increase in the total WHOQOL-BREF scores over time in the IIG compared to the WLG. Additionally, we analyzed changes in all subjects (n=66) from pre- to post-game intervention. There was a significant increase in the self and experience subdomains of NR, as well as the total NR score. We also observed a meaningful increase in the dietary behavior subdomain of NQ and the total NQ. Concerning psychological states, there was a substantial increase in both the total and all subdomains of WHOQOL-BREF. Additionally, we noted significant decreases (improvements) in BFNE, SADS, TAS, STAI, and CESD-R, along with a significant increase in the KRQ score.

Conclusions:

Our findings suggest that the rice-farming game intervention might have positive effects on nature-relatedness, nature-friendly dietary behaviors, quality of life, anxiety, depression, interpersonal relationships, and resilience among urban adults during the COVID-19 pandemic. The impact of pro-nature games in confined urban environments provides valuable evidence of how digital technologies can be used to enhance urban residents' affinity for nature and psychological well-being. This understanding could be extended in the future to other digital platforms, such as metaverses. Clinical Trial: Clinical Research Information Service (CRIS); KCT0007657