A digital health game to prevent opioid misuse and promote mental health in adolescents in school-based health settings: Protocol for the PlaySmart game randomized controlled trial Journal Article


Authors: Pendergrass Boomer, T. M.; Hoerner, L. A.; Fernandes, C. S. F.; Maslar, A.; Aiudi, S.; Kyriakides, T. C.; Fiellin, L. E.
Article Title: A digital health game to prevent opioid misuse and promote mental health in adolescents in school-based health settings: Protocol for the PlaySmart game randomized controlled trial
Abstract: Adolescents who engage in non-opioid substance misuse and/or experience mental health symptoms are at greater risk of misusing opioids and/or developing opioid use disorder. Adolescence is a critical developmental period to both prevent the initiation of opioid misuse and target mental health. To date, there are no digital health games targeting both conditions. We describe the protocol for a randomized controlled trial designed to assess the efficacy of an original digital health game, PlaySmart. Five hundred and thirty-two adolescents aged 16–19 years old, who are at greater risk for initiating opioid misuse are recruited from 10 Connecticut school-based health sites. Participants are randomized to PlaySmart or a set of time/attention control videogames. Randomization was stratified by sex at birth and school grade. Participants play their assigned game or games for up to six weeks (300 minutes) and complete assessment questions over a 12-month period (baseline, post-gameplay, 3, 6, and 12 months). The primary outcome is perception of risk of harm of opioid misuse at 3 months. Secondary outcome measures specific to opioid misuse include intentions, self-efficacy, attitudes, knowledge, and perceived norms. Mental health outcomes include measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), help-seeking behaviors, stigma, measures of self-regulation, self-efficacy to seek professional help for mental health, and knowledge around coping skills. PlaySmart has the potential to significantly reduce the risk of initiation of opioid misuse, improve mental health outcomes, and given its high levels of engagement and accessibility, holds the promise for extensive reach, scale, and impact for adolescents. © 2023 Pendergrass Boomer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: adolescent; adult; controlled study; young adult; follow up; pain; randomized controlled trial; randomized controlled trials as topic; attitude to health; intervention study; adaptation, psychological; narcotic analgesic agent; infant, newborn; screening; newborn; cognition; health belief; health promotion; self concept; coping behavior; anxiety; randomization; informed consent; analgesics, opioid; opioid-related disorders; attention; decision making; mental health; stigma; psychological adjustment; sample size; drug misuse; opiate addiction; human experiment; randomized controlled trial (topic); exposure; risk perception; clinical outcome; help seeking behavior; humans; human; male; female; article; eligibility criteria; emotion regulation; patient health questionnaire 8; opioid misuse; clinical trial protocol; game; patient health questionnaire 2; generalized anxiety disorder-7; digital health game; social exposure
Journal Title: PLoS ONE
Volume: 18
Issue: 9
ISSN: 1932-6203
Publisher: Public Library of Science  
Date Published: 2023-09-08
Start Page: e0291298
Language: English
DOI: 10.1371/journal.pone.0291298
PUBMED: 37683047
PROVIDER: scopus
PMCID: PMC10490848
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Amber Maslar
    2 Maslar