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Abstract
Objectives To determine the feasibility and acceptability of ‘ACTing Minds’, a novel single-player adventure video game based on acceptance and commitment therapy (ACT).
Design A single-arm, mixed-methods repeated measures feasibility study.
Setting Intervention and questionnaires were completed at home by participants. Semistructured interviews were also conducted at home via the Zoom platform.
Participants Thirty-six participants were recruited into the study, 29 completed all phases of the feasibility design. Eligibility criteria required participants to be over the age of 18 and self-reporting experiencing ongoing depression, anxiety or stress.
Intervention Participants completed a single session of the ‘ACTing Minds’ video game, lasting approximately 1 hour, designed to educate users on key principles from ACT.
Primary outcome measures Participant recruitment and retention, questionnaire completion, long-term intervention adherence and acceptability of the intervention. Reflexive thematic analysis was conducted on semistructured interviews run immediately postintervention and 3 weeks later.
Secondary outcome measures Measures of depression, anxiety, stress, psychological flexibility, social connectedness and well-being were assessed at baseline, immediately following intervention completion, and after a 3-week follow-up period. We used a standardised battery of questionnaires.
Primary results Twenty-nine participants completed the study. A reflexive thematic analysis indicated that participants responded positively to the intervention and the study at all stages. Themes reflect participants’ desire for an engaging therapeutic experience, use of game for exploring emotions, as well as their perspectives on how they had applied their learning to the real world.
Secondary results Quantitative results indicated small to large effect sizes associated with decreases in depression (ηp2 = 0.011), anxiety (ηp2 = 0.096) and stress (ηp2 = 0.108), and increases in psychological flexibility (ηp2 = 0.060), social connectedness (ηp2 = 0.021), well-being (ηp2 = 0.011) and participation in usual activities (ηp2 = .307).
Conclusions Implementation of the ‘ACTing Minds’ intervention is warranted, based on both qualitative and quantitative outcomes.
Trial registration number NCT04566042 ClinicalTrials.gov
- MENTAL HEALTH
- Health Education
- Depression & mood disorders
Data availability statement
Data are available in a public, open access repository. Data are available on the open science framework which is linked to within the paper.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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Data availability statement
Data are available in a public, open access repository. Data are available on the open science framework which is linked to within the paper.
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Footnotes
Contributors DJE and AHK designed the original protocol, whilst TCG updated and revised the protocol design. TCG wrote the first draft of the paper and conducted all of the quantitative and qualitative results. DJE and AHK provided substantial revisions on all drafts and advised TCG throughout the development of this manuscript. DJE designed and developed the game development. TCG acts as the guarantor for this study as first author, responsible for the overall content.
Funding Funding for the development of this game came from European development funds via the commercial entity of Swansea University called AgorIP (Reference: 229-0256-0046) awarded to DJE.
Competing interests The game ACTing Minds was developed using European development funds via the commercial entity of Swansea University (AgorIP) and awarded to DJE with the intention to develop this game for commercial purposes (as a game app for the Apple and Google Play stores). DJE was involved in the design of the protocol but did not recruit participants, collect any data, and did not conduct the analysis on the data. TCG and AHK have no involvement in any commercial aspects of the game.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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