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A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer: A Randomized Trial
Abstract
OBJECTIVE. Suboptimal adherence to self-administered medications is a common problem. The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia, lymphoma, and soft-tissue sarcoma. METHODS. A randomized trial with baseline and 1- and 3-month assessments was conducted from 2004 to 2005 at 34 medical centers in the United States, Canada, and Australia. A total of 375 male and female patients who were 13 to 29 years old, had an initial or relapse diagnosis of a malignancy, and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were randomly assigned to the intervention or control group. The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults. Outcome measures included adherence, self-efficacy, knowledge, control, stress, and quality of life. For patients who were prescribed prophylactic antibiotics, adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices (n = 200). Adherence to 6-mercaptopurine was assessed through serum metabolite assays (n = 54). RESULTS. Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group. Self-efficacy and knowledge also increased in the intervention group compared with the control group. The intervention did not affect self-report measures of adherence, stress, control, or quality of life. CONCLUSIONS. The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy. The findings support current efforts to develop effective video-game interventions for education and training in health care.
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“Serious gaming (ie, [digital] games used for purposes other than purely entertainment) is a novel and promising approach to support the treatment of clinical symptoms and improvement of adaptive functioning among diverse patient groups [31-35].”
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“Serious games are games whose primary purpose is not entertainment, enjoyment, or fun [15], but rather the achievement of educational goals in various fields through elements of entertainment and competition [16]–[19].”
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Metadata
- Authors
- Kato, P. M., Cole, S. W., Bradlyn, A. S., & Pollock, B. H.
- Affiliations
- Stanford Health Care (US)
- HopeLab (US)
- West Virginia University (US)
- The University of Texas at San Antonio Health Science Center (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2008-08-01
- Volume
- 122
- Issue
- 2
- Pages
- e305-e317
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2163083471
- Cited by
- 802
- References
- 71
- Citations by year
- 2026: 14 · 2025: 26 · 2024: 26 · 2023: 39 · 2022: 41 · 2021: 44 · 2020: 51 · 2019: 44 · 2018: 61 · 2017: 46 · 2016: 75 · 2015: 95 · 2014: 62 · 2013: 55 · 2012: 48
- FWCI
- 17.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hopelab Foundation
- National Cancer Institute (CA-054174, P30CA054174, CA95861, CA 098543, U10CA098543, U10CA095861)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- video game intervention, medication adherence, adolescent and young adult cancer, self-efficacy, health knowledge, trimethoprim-sulfamethoxazole, 6-mercaptopurine, antibiotic prophylaxis, acute leukemia, lymphoma, soft tissue sarcoma, stress, quality of life, health education
- MeSH terms
- Adaptation, Physiological, Adaptation, Psychological, Adolescent, Adult, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Neoplasms, Patient Compliance, Patient Education as Topic, Probability, Quality of Life, Reference Values, Health Behavior, Poisson Distribution, Video Games, Self Efficacy
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