Paraskeva Nicole, Haywood Sharon, Anquandah Jason, White Paul, Budhraja Mahira, Diedrichs Phillippa C, Williamson Heidi
Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
Department of Engineering, Design and Mathematics, University of the West of England, Bristol, United Kingdom.
J Med Internet Res. 2025 Jul 31;27:e66625. doi: 10.2196/66625.
Body dissatisfaction is a global public health issue negatively impacting young people's mental and physical well-being, underscoring an urgent need to develop early interventions. Emerging evidence suggests that microinterventions are acceptable and effective in delivering mental health interventions. Given the popularity of video games among young people, gaming holds great promise for body image microinterventions. As such, we developed Super U Story, a stand-alone, self-paced, narrative-based adventure video game for the popular gaming platform Roblox grounded in the Tripartite Influence Model of body dissatisfaction and basic tenets of positive body image.
This trial evaluated the effectiveness of playing a purpose-built Roblox video game once on US children and adolescents' state and trait body image and related outcomes. Gameplay was capped at 30 minutes.
Overall, 1059 US-based girls and boys (n=460, 43.4% girls) aged 9 to 13 years (mean age 10.9, SD 1.36 years) from diverse ethnic, socioeconomic, and geographic backgrounds were recruited online via a research agency into a 3-arm, online, parallel randomized controlled trial. Participants were assigned to an intervention group, active control group (a Roblox game called Rainbow Friends 2 Story [Color Story]), or attention control group (web-based word search). Participants completed self-report assessments at baseline (1 week before the intervention and before randomization), immediately before and after intervention testing, and 1 week after the intervention. Outcomes included state measures of body satisfaction (primary outcome), mood, and body functionality and trait measures of body esteem, body appreciation, internalization of appearance ideals, and social media literacy. Data were evaluated using repeated-measure analysis of covariance controlling for baseline. Engagement and acceptability data were collected.
Intervention participants showed improved state body satisfaction (F=5.20; P=.02; η=0.01) relative to the active control but not in comparison to the attention control. State mood, state body functionality, internalization of appearance ideals, and social media literacy showed no effects. Relative to the intervention group, the active control showed improved trait body esteem (F=5.40; P=.02; η=0.01) and body appreciation (F=6.08; P=.01; η=0.01). Exploratory analyses found that age and gender did not moderate the effects. We were unable to examine dose-response effects. Acceptability scores were good. Self-report engagement data suggested that participants experienced a highly variable and often low-dose exposure.
This large-scale, fully powered trial is the first to assess the effectiveness of a Roblox-based body image intervention, demonstrating the potential for disseminating microinterventions to children and adolescents on large and popular commercial platforms. Overall, playing Super U Story did not cause harm; however, evidence is lacking to suggest that it improved body image. Learnings are discussed, including psychoeducation as an intervention technique, "chocolate-covered broccoli" phenomena (ie, losing players who recognize thinly disguised educational messages), and measuring intervention engagement.
ClinicalTrials.gov NCT05669053; https://clinicaltrials.gov/study/NCT05669053.
身体不满是一个全球性的公共卫生问题，对年轻人的身心健康产生负面影响，这凸显了开发早期干预措施的迫切需求。新出现的证据表明，微干预在提供心理健康干预方面是可接受且有效的。鉴于电子游戏在年轻人中很受欢迎，游戏在身体形象微干预方面具有巨大潜力。因此，我们开发了《超级U故事》，这是一款基于身体不满的三方影响模型和积极身体形象的基本理念，为热门游戏平台Roblox打造的独立、自定进度、基于叙事的冒险电子游戏。
本试验评估玩一款专门设计的Roblox电子游戏一次对美国儿童和青少年的状态和特质身体形象及相关结果的有效性。游戏时长限制为30分钟。
总体而言，通过一家研究机构在网上招募了1059名来自不同种族、社会经济和地理背景的9至13岁美国女孩和男孩（n = 460，43.4%为女孩）（平均年龄10.9岁，标准差1.36岁），将其纳入一项三臂、在线、平行随机对照试验。参与者被分配到干预组、积极对照组（一款名为《彩虹朋友2故事》[色彩故事]的Roblox游戏）或注意力对照组（基于网络的单词搜索）。参与者在基线（干预前1周且在随机分组前）、干预测试前后以及干预后1周完成自我报告评估。结果包括身体满意度的状态指标（主要结果）、情绪、身体功能，以及身体自尊、身体欣赏、外表理想内化和社交媒体素养的特质指标。使用控制基线的重复测量协方差分析对数据进行评估。收集了参与度和可接受性数据。
与积极对照组相比，干预组参与者的状态身体满意度有所改善（F = 5.20；P = 0.02；η = 0.01），但与注意力对照组相比没有改善。状态情绪、状态身体功能、外表理想内化和社交媒体素养没有受到影响。与干预组相比，积极对照组的特质身体自尊（F = 5.40；P = 0.02；η = 0.01）和身体欣赏（F = 6.08；P = 0.01；η = 0.01）有所改善。探索性分析发现年龄和性别并未调节这些影响。我们无法检验剂量反应效应。可接受性得分良好。自我报告的参与度数据表明参与者经历的接触高度可变且通常剂量较低。
这项大规模、有充分效力的试验是首个评估基于Roblox的身体形象干预有效性的试验，证明了在大型热门商业平台上向儿童和青少年传播微干预的潜力。总体而言，玩《超级U故事》没有造成伤害；然而，缺乏证据表明它改善了身体形象。讨论了相关经验教训，包括将心理教育作为一种干预技术、“巧克力包裹西兰花”现象（即失去那些能识别出伪装得很薄的教育信息的玩家）以及测量干预参与度。
ClinicalTrials.gov NCT05669053；https://clinicaltrials.gov/study/NCT05669053
