Feasibility of a web-accessible game-based intervention aimed at improving help seeking and coping among sexual and gender minority youth: results from a randomized controlled trial

James E. Egan*, Stephanie L. Corey, Emmett R. Henderson, Kaleab Z. Abebe, William Louth-Marquez, Dorothy Espelage, Simon C. Hunter, Matthew DeLucas, Elizabeth Miller, Brooke A. Morrill, Kimberly Hieftje, Jordan M. Sang, Mark S. Friedman, Robert W.S. Coulter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To address the gap in interventions for improving sexual and gender minority youth (SGMY; e.g., lesbian, gay, bisexual, and transgender youth) health, we tested the feasibility of a game-based intervention for increasing help-seeking, productive coping skills, resource knowledge/use, and well-being. Methods: We conducted a 2-arm randomized controlled trial testing a theory-based, community-informed, Web-accessible computer role-playing game intervention. Control condition received a list of resources. Primary hypotheses were high levels of implementation success, game demand, and game acceptability. Results: We randomized 240 SGMYs aged 14-18 years into the intervention (n = 120) or control (n = 120) conditions. Participants completed baseline (100%), 1-month follow-up (T2; 73.3%), and 2-month follow-up (T3; 64.4%) surveys. Among intervention participants, 55.8% downloaded and played the game. Of those who played, 46.2% reported a desire to play it again, and 50.8% would recommend it. Game acceptability exceeded hypothesized benchmarks, wherein participants reported high positive affect (M = 2.36; 95% confidence interval [CI]: 2.13, 2.58), low negative affect (M = 2.75; 95% CI: 2.55, 2.95), low tension/annoyance (M = 3.18; 95% CI: 2.98, 3.39), and high competence (M = 2.23; 95% CI: 2.04, 2.43) while playing the game. In multivariable intent-to-treat analyses of 38 secondary/tertiary outcomes, intervention participants reported significantly larger reductions than control participants in cyberbullying victimization (T2 b = -.28; 95% CI: -.56, -.01), binge drinking frequency (T2 b = -.39; 95% CI: -.71, -.06), and marijuana use frequency (T3 b = -2.78; 95% CI: -4.49, -1.08). Conclusions: We successfully implemented a Web-accessible game trial with SGMY. The game-based intervention was feasible and acceptable to SGMY, and preliminary results show it improved several health-related behaviors. A larger scale trial is needed to test whether the game-based intervention can reduce health inequities for SGMY.
Original languageEnglish
Pages (from-to)604-614
Number of pages11
JournalJournal of Adolescent Health
Volume69
Issue number4
Early online date15 Jun 2021
DOIs
Publication statusPublished - 1 Oct 2021

Keywords

  • gamification
  • LBGT+
  • help seeking
  • coping
  • intervention
  • RCT
  • sexual and gender minority youth

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