University of East Anglia, Norwich, United Kingdom.
Norfolk and Suffolk NHS Foundation Trust, Norwich, United Kingdom.
JMIR Ment Health. 2024 Oct 22;11:e52866. doi: 10.2196/52866.
Anxiety disorders are among the most common mental health conditions in childhood, but most children with anxiety disorders do not access evidence-based interventions. The delivery of therapeutic interventions via digital technologies has been proposed to significantly increase timely access to evidence-based treatment. Lumi Nova (BfB Labs Limited) is a digital therapeutic intervention designed to deliver evidence-based anxiety treatment for those aged 7-12 years through a mobile app incorporating immersive gaming technology.
We aimed to evaluate the real-world impact of providing access to Lumi Nova through UK National Health Service-funded mental health services.
We analyzed precollected anonymized data routinely captured through the implementation of Lumi Nova from children aged 7-12 years, who lived in the United Kingdom and had the opportunity to use the intervention for at least 1 week over an 18-month period. Engagement indices included whether the game key was activated, number of unique sessions, time spent engaging, and number of "challenges" completed. Clinical outcomes were assessed using the Goal-Based Outcomes measure and Child Outcome Rating Scale. Demographic data were analyzed to assess the health equality implications of Lumi Nova.
Of 1029 eligible families invited to use Lumi Nova, 644 (62.5%) activated their game key, of whom 374 (58.1%) completed at least one in-game graded exposure challenge. The median number of unique sessions was 6 (IQR 3-12) and the median time spent engaging with the intervention was 42 (IQR 15-79) minutes. For the subset of young people with paired outcomes, there were statistically significant small to medium improvements in goal-based outcome scores (n=224; t223=5.78, P<.001; d=0.37, 95% CI 0.25-0.52) and Child Outcome Rating Scale scores (n=123; t122=5.10, P<.001; d=0.46, 95% CI 0.27-0.65) between the first and last data points. Two in 5 young people's scores reflected a change that would be considered reliable. Analysis of demographic characteristics tentatively suggested that children from ethnic minority backgrounds and those living in the most deprived neighbourhoods may be less likely to access Lumi Nova, but children from socioeconomically deprived areas were more likely to successfully complete a challenge once they accessed the intervention (P=.02). However, the level of missing data and small number of children in some demographic groups limited meaningful statistical comparisons.
This study provides initial evidence that Lumi Nova may be associated with improved outcomes for those aged 7-12 years seeking anxiety treatment in real-world settings. However, the lack of a control comparator group and information about concurrent treatments accessed by the young people, in addition to substantial attrition, limited the analysis that could be conducted and confidence in the conclusions drawn.
焦虑症是儿童中最常见的心理健康问题之一，但大多数患有焦虑症的儿童无法获得基于证据的干预措施。通过数字技术提供治疗干预措施被提议可以大大增加及时获得基于证据的治疗的机会。Lumi Nova（BfB Labs Limited）是一种数字治疗干预措施，旨在通过一款整合沉浸式游戏技术的移动应用程序，为 7-12 岁的人群提供基于证据的焦虑治疗。
我们旨在评估通过英国国民保健服务资助的心理健康服务提供 Lumi Nova 访问权限的实际影响。
我们分析了在 18 个月期间，通过 Lumi Nova 实施过程中常规收集的、来自 7-12 岁儿童的匿名预采集数据。参与指数包括游戏密钥是否激活、独特会话次数、参与时间和完成的“挑战”次数。临床结果使用基于目标的结果测量和儿童结果评定量表进行评估。对人口统计学数据进行分析，以评估 Lumi Nova 对健康公平的影响。
在 1029 名符合条件的受邀使用 Lumi Nova 的家庭中，有 644 个（62.5%）激活了他们的游戏密钥，其中 374 个（58.1%）完成了至少一个游戏内分级暴露挑战。独特会话的中位数为 6（IQR 3-12），参与干预的中位数时间为 42（IQR 15-79）分钟。对于有配对结果的年轻人子集，在基于目标的结果评分（n=224；t223=5.78，P<.001；d=0.37，95%CI 0.25-0.52）和儿童结果评定量表评分（n=123；t122=5.10，P<.001；d=0.46，95%CI 0.27-0.65）方面均有统计学上显著的小到中等改善。在第一个和最后一个数据点之间，五分之二年轻人的分数反映了一个被认为可靠的变化。对人口统计学特征的分析初步表明，少数民族背景的儿童和居住在最贫困社区的儿童可能不太容易获得 Lumi Nova，但来自社会经济贫困地区的儿童一旦接触到干预措施，更有可能成功完成挑战（P=.02）。然而，数据缺失程度高以及一些人口统计学群体中的儿童人数较少，限制了有意义的统计比较。
本研究初步表明，在现实环境中，Lumi Nova 可能与寻求焦虑治疗的 7-12 岁儿童的改善结果相关。然而，由于缺乏对照组和年轻人同时接受的治疗信息，以及大量的患者流失，限制了可以进行的分析，并降低了结论的可信度。
