Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 16, 2023
Date Accepted: Jan 22, 2024
Effect of a mobile game-based intervention to enhance child safety: a randomized controlled trial
ABSTRACT
Background:
Evidence supports the effectiveness of serious games in health education, but little is known about their effects on the mental health of children in the general population.
Objective:
The aim of this study was to examine whether a mobile game-based safety education program can improve children’s safety and mental health outcomes.
Methods:
Safe City is a role-playing game for mobile devices designed to educate children in Hong Kong about safety. This randomized controlled trial included 340 children in grades 4 through 6. Intervention arm participants (n=170) were instructed to play the Safe City mobile game for 4 weeks, whereas control arm participants (n=170) received a safety booklet. All participants completed a survey on safety knowledge and behaviors and psychosocial problems at baseline (T1), 1 month post intervention (T2), and 3 months post intervention (T3). Cumulative game scores and mini-game performance were analyzed as a proxy for the extent of exposure to the game. Outcome data were analyzed using two-sample t tests to compare mean change from T1 to T2 and to T3 for intervention versus control arm participants. The association of game usage with outcome changes post intervention was analyzed using generalized additive models.
Results:
No significant differences were found in mean changes between the intervention and control arms. However, usage analyses showed that higher game scores were associated with improvements in safe behavior (p=0.034) and internalizing problems (p=0.010) at T3. Matching and Spot the Danger mini-game performance significantly predicted improvements in safety knowledge at T2 and T3.
Conclusions:
Playing the Safe City mobile game can lead to significant increases in safety knowledge and decreases in unsafe behavior and internalizing problems. These results support the mental health benefits of serious games and emphasize the potential of technology-based interventions to help children learn safety and avoid injuries. Clinical Trial: ClinicalTrials.gov (NCT04096196).
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