Tuijnman Anouk, Kleinjan Marloes, Olthof Merlijn, Hoogendoorn Evert, Granic Isabela, Engels Rutger Cme
Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands.
Trimbos-institute, Utrecht, Netherlands.
JMIR Ment Health. 2022 Aug 17;9(8):e26615. doi: 10.2196/26615.
Depressive symptoms are highly prevalent among adolescents in Western countries. However, although treatment for depressive symptoms is available, many adolescents do not seek help when they need it. Important barriers to help-seeking among adolescents include low mental health literacy and high stigma. Therefore, we have developed a game-based school program, Moving Stories, which combines mental health literacy training for depression with contact with someone with lived experience both in the digital and nondigital world.
The aim of this study is to conduct a first test of the effectiveness of the newly developed game-based program, Moving Stories, using a cluster randomized controlled trial.
A total of 185 adolescents participated, divided over 10 classes from 4 schools. Half of the classes were randomly selected to follow the Moving Stories program, whereas the other half were in the control group, where no intervention was provided. The adolescents filled out digital questionnaires at 4 time points, with questions on mental health literacy, stigma, depressive symptoms, and the program itself (before the program, after the program, 3-month follow-up, and 6-month follow-up). Using R (R Foundation for Statistical Computing), we ran linear mixed-effects models for all continuous outcome variables and generalized linear mixed-effects models for all binary outcome variables.
Compared with the control group, participants in the Moving Stories group improved after the program in personal stigma (b=-0.53, 95% CI -1.02 to -0.03; t=-2.08; P=.04). Effects on personal stigma lasted over time (3-month follow-up: b=-0.57, 95% CI -1.11 to -0.03; t=-2.07; P=.04). Most adolescents in the Moving Stories group participated in the introduction (97/99, 98%) and contact session (93/99, 94%), played the game for 4 or 5 days (83/99, 83%), and indicated that they would recommend the game to their peers (90/98, 92%).
The results of this study show the potential of Moving Stories as a stigma reduction program. With changes in the program to improve its effects on mental health literacy, Moving Stories could be implemented in schools to improve help-seeking in adolescents and reduce the negative consequences and burden of depressive symptoms.
Dutch Trial Register NTR7033; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7033.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/11255.
抑郁症状在西方国家的青少年中极为普遍。然而，尽管有针对抑郁症状的治疗方法，但许多青少年在需要帮助时并不寻求帮助。青少年寻求帮助的重要障碍包括心理健康素养低和污名化程度高。因此，我们开发了一个基于游戏的学校项目“移动故事”，该项目将抑郁症的心理健康素养培训与在数字和非数字世界中与有实际生活经历的人接触相结合。
本研究的目的是使用整群随机对照试验对新开发的基于游戏的项目“移动故事”的有效性进行首次测试。
共有185名青少年参与，他们来自4所学校的10个班级。随机选择一半的班级参加“移动故事”项目，而另一半班级作为对照组，不接受任何干预。青少年在4个时间点填写数字问卷，问题涉及心理健康素养、污名化、抑郁症状以及项目本身（项目前、项目后、3个月随访和6个月随访）。我们使用R（R统计计算基金会）对所有连续结果变量运行线性混合效应模型，对所有二元结果变量运行广义线性混合效应模型。
与对照组相比，“移动故事”组的参与者在项目结束后个人污名化程度有所改善（b=-0.53，95%置信区间-1.02至-0.03；t=-2.08；P=.04）。对个人污名化的影响随时间持续（3个月随访：b=-0.57，95%置信区间-1.11至-0.03；t=-2.07；P=.04）。“移动故事”组的大多数青少年参加了介绍环节（97/99，98%）和接触环节（93/99，94%），玩游戏4或5天（83/99，83%），并表示他们会向同龄人推荐该游戏（90/98，92%）。
本研究结果表明“移动故事”作为一种减少污名化项目的潜力。随着项目的改进以提高其对心理健康素养的影响，“移动故事”可以在学校实施，以改善青少年寻求帮助的情况，并减少抑郁症状的负面后果和负担。
荷兰试验注册中心NTR7033；https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7033。国际注册报告识别码（IRRID）：RR2-10.2196/11255。
