Accepted for/Published in: JMIR Serious Games
Date Submitted: Jun 27, 2025
Date Accepted: Apr 2, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Expanding Gamified Assessment of Cognitive Impulsivity through Co-design with People with Lived Experience of Eating Disorders and Mental Ill-Health: A mixed-methods study.
ABSTRACT
Background:
Cognitive impulsivity is associated with eating disorders and co-occurring mental ill-health and predict treatment engagement and outcomes. However, objective assessments of cognitive impulsivity are rarely perceived to be engaging or meaningful by individuals who complete them, limiting opportunities for research engagement and translation to clinical settings.
Objective:
In this study, we aimed to extend the reach and practical relevance of the Cognitive Impulsivity Suite (CIS), by adopting a collaborative co-design framework to enhance acceptance and engagement for users with eating disorders and commonly co-occurring mental ill-health.
Methods:
Data collection and analysis incorporated mixed methods, combining focus groups, evidence and experience guided expert production, qualitative ‘thinking aloud’ testing, and quantitative GUESS-18 evaluations. Data were analysed utilising reflexive thematic analysis, and descriptive and inferential statistics.
Results:
We co-designed guiding principles and ideas for aesthetics, story concepts, and game-play features, which closely aligned with leading theories of psychological well-being, clinical evidence concerning eating disorder recovery, and gamification frameworks. A mean GUESS-18 composite score of 45.9 (72.9%) demonstrated overall user satisfaction with the redeveloped games, while qualitative evaluations showed this was driven by personal accomplishment, simulated personal relationships, appealing visual and audio aesthetics, and psychological safety.
Conclusions:
Incorporating well-accepted objective cognitive assessment tools in routine clinical care will facilitate individualisation and prioritisation of interventions, and thus support treatment engagement and recovery for individuals experiencing disorders eating and common co-occurring mental health symptoms. Next steps will include verification of task psychometric properties and dissemination.
Citation
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Copyright
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