{"title":"Effects of Serious Games on Memory Improvement in Older Adults Without Obvious Cognitive Impairment: A Systematic Review and Meta-Analysis.","authors":"Yue Li, Shasha Li, Haibing Liu, Lijun Xu, Shufang Liao, Jianyi Bao, Yingxue Xi, Xiaofang Song","doi":"10.1089/g4h.2025.0015","DOIUrl":"https://doi.org/10.1089/g4h.2025.0015","url":null,"abstract":"<p><p>Serious games have been integrated into health care, but their effectiveness in enhancing memory among old adults is not yet unanimously determined. This study aimed to analyze the effect of serious games on memory improvement in older adults without obvious cognitive impairment. We searched six electronic databases. All eligible randomized controlled trials were assessed for risk of bias using the Cochrane Collaboration tool. The meta-analysis was conducted to calculate the effect size using the standardized mean difference (SMD) with 95% confidence interval (CI). A total of 18 studies were included in the systematic review and 16 were in the meta-analysis. Serious games had a significant effect on memory (SMD = 0.35, 95% CI: 0.22-0.47; <i>P</i> < 0.001). In subgroup analyses, serious games were categorized into two types: cognitive training games (SMD = 0.42, 95% CI: 0.26-0.58; <i>P</i> < 0.001) and exergames (SMD = 0.22, 95% CI: 0.01-0.43; <i>P</i> = 0.04). Memory was categorized into three types: visuospatial working memory (SMD = 0.77, 95% CI: 0.54-1.00; <i>P</i> < 0.001), verbal memory (SMD = 0.34, 95% CI: 0.08-0.61; <i>P</i> = 0.01), and working memory (SMD = 0.09, 95% CI: -0.09 to 0.27; <i>P</i> = 0.35). There were two types of control groups: the blank control (SMD = 0.35, 95% CI: 0.15-0.54; <i>P</i> < 0.001) and the active control (SMD = 0.35, 95% CI: 0.18-0.51; <i>P</i> < 0.001). Serious games can improve memory among older adults without obvious cognitive impairment, with varying effects on different memory types.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of Biofeedback-Based Serious Game for Pain Alleviation in Middle-Aged and Older Patients with Ovarian Cancer: A Randomized Controlled Trial.","authors":"Fangyuan Chang, Shuang Yang, Yuping Zhang, Changying Tian, Hongqing Xiang","doi":"10.1089/g4h.2024.0128","DOIUrl":"https://doi.org/10.1089/g4h.2024.0128","url":null,"abstract":"<p><p><b><i>Background:</i></b> Persistent pain affects many middle-aged and older patients with ovarian cancer. Serious games offer non-pharmacological relief, but their effectiveness and immersion monitoring in this population remain underexplored. <b><i>Objective:</i></b> To evaluate the efficacy of a biofeedback-driven serious game with dynamic difficulty in reducing pain and enhancing immersion. <b><i>Methods:</i></b> A two-arm, single-blinded randomized controlled trial was conducted with 52 participants randomized into an intervention group (biofeedback-driven dynamic-difficulty game) or a control group (fixed-difficulty game). Both groups engaged in a 15-minute gameplay session. The primary outcome was pain intensity, where the secondary outcomes were pain-related anxiety, immersion level, and user experience. <b><i>Results:</i></b> Both groups showed significant reductions in pain intensity and pain-related anxiety from baseline (<i>p</i> < 0.05). No significant between-group differences were observed in these outcomes. The intervention group, however, exhibited a significantly higher average immersion level compared to the control group (<i>p</i> < 0.01; d = 1.08; β = 0.11 [-0.38, 0.60]) . Participants in the intervention group also rated the game as more innovative, interesting, supportive, efficient, and exciting, though slightly more difficult to use. <b><i>Conclusion:</i></b> The biofeedback-based serious game effectively enhances immersion and may support pain and anxiety reduction in older ovarian cancer patients.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Effectiveness of Video-Based Game Exercise Therapy Applications in Pes Planus Rehabilitation: A Randomized Controlled Trial.","authors":"Ayşe Büşra Erten, Devrim Tarakçı, Yasemin Koç","doi":"10.1089/g4h.2024.0179","DOIUrl":"https://doi.org/10.1089/g4h.2024.0179","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aimed to evaluate the effectiveness of serious game, exergame, and structured exercises in pes planus rehabilitation. <b><i>Methods:</i></b> Sixty-nine individuals with pes planus were included in this study. Individuals were randomly divided into three groups: a structured exercise group (SEG), an exergame group (EGG), and a serious game group (SGG). The average age of the participants was 21.02, and their body mass index was 21.91 kg/m<sup>2</sup>. Interventions were performed three times a week for 6 weeks. Navicular drop, plantar pressure analysis, femoral anteversion, balance, and muscle strength were evaluated pre- and post-treatment. A small effect size of 0.2 was applied for navicular drop, balance, and plantar pressure analysis, and a medium effect size of 0.5 for femoral anteversion and muscle strength analysis. <b><i>Results:</i></b> Navicular drop and muscle strength improved significantly in all groups (<i>P</i> < 0.05). The strength of the inverter, plantar flexor, and dorsiflexor muscles was found to be significantly greater in the SGG than in the other groups (<i>P</i> < 0.05). Balance showed significant improvement only in EGG and SGG (<i>P</i> < 0.05). The decrease in medial plantar pressure was found to be significant in both feet in SGG and only in the left foot in the SEG (<i>P</i> < 0.05). The subtalar angle improved significantly in both feet in the SGG and only in the right foot in the SEG (<i>P</i> < 0.05). No significant change was observed in the EGG (<i>P</i> > 0.05). Femoral anteversion did not change in any of the three groups (<i>P</i> > 0.05). <b><i>Conclusion:</i></b> Individuals with pes planus obtained more improvements in plantar pressure analysis, subtalar angle, and muscle strength after serious games rather than structured exercises and exergame. It was considered that serious game exercise programs would be used in pes planus.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virtual Reality Exercise with Autonomy Support Increases Positive Affect During Time Trial Exercise.","authors":"Andrew Ray Moore, Brooke An Shaohua Butler","doi":"10.1089/g4h.2024.0157","DOIUrl":"10.1089/g4h.2024.0157","url":null,"abstract":"<p><p><i><b>Background:</b></i> Being able to choose elements of an exercise session, known as autonomy support, improves motor performance and psychological responses. Virtual reality (VR) programs provide many options for embedding autonomy support in exercise sessions. The purpose of this study was to investigate the effects of autonomy support in a VR setting on physiological and psychological responses to self-regulated rowing exercise. <i><b>Methods:</b></i> Using a repeated-measures crossover design, healthy untrained men and women (<i>N</i> = 20, age = 23.0 ± 7.4) completed exercise sessions on a rowing ergometer coupled with a head-mounted immersive VR application. In the Choice condition, participants chose the virtual environment, and in the Control condition, the environment was assigned to the participant. Participants were instructed to complete 1500 m as quickly as possible in both conditions, while ratings of perceived exertion, affective valence, and heart rate were recorded throughout the trials. Finishing time and remembered pleasure were assessed at the end of each session. Repeated-measures analyses with an alpha level of 0.05 were used for all variables as appropriate, with Bonferroni adjustments applied for any post hoc tests. <i><b>Results:</b></i> There was a main effect of condition on affective valence which was higher in Choice (2.07 ± 1.67) than Control (1.64 ± 2.12, <i>P</i> = 0.03, <i>η</i><sup>2</sup> = 0.22). No other differences were detected between conditions for finishing time or the remaining variables. <i><b>Conclusion:</b></i> During self-regulated exercise accompanied by an immersive VR application, being able to choose the virtual environment oneself leads to a more positive affective state without compromising exercise effort, physiological strain, or performance.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"212-220"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of the Acute Effects of Virtual Reality Exergames and Core Stability Exercises on Cognitive Factors, Pain, and Fear Avoidance Beliefs in People with Chronic Nonspecific Low Back Pain.","authors":"Naghme Massah, Sedighe Kahrizi, Randy Neblett","doi":"10.1089/g4h.2024.0003","DOIUrl":"10.1089/g4h.2024.0003","url":null,"abstract":"<p><p><b><i>Objective:</i></b> In this study, we aimed to investigate and compare the acute effects of exergames (EXG) and core stability exercises (CSEs) on cognitive factors, pain, mood, and fear-avoidance beliefs (FAB) in individuals with chronic low back pain (CLBP). <b><i>Materials and Methods:</i></b> In a single-blinded clinical trial, 40 participants with CLBP were randomly assigned to either the EXG group or the CSEs group. The EXG group engaged in a single session of exergames using the Xbox Kinect device, while the CSEs group completed a single session of common core stability exercises. Measurements of attention, working memory, pain intensity, mood states, and FAB were taken before and after each intervention. <b><i>Results:</i></b> The results showed that a single session of EXG was significantly more effective than CSEs in improving cognitive reaction time, pain intensity, FAB, and positive mood states (<i>P</i> ≤ 0.05). Additionally, participants reported lower perceived exertion due to exercising following EXG compared with CSEs. <b><i>Conclusion:</i></b> EXG may have potential therapeutic advantages over traditional exercise interventions for CLBP.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"233-241"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gamification and Language Learning to Enhance Cognition in Older Adults: A Systematic Literature Review.","authors":"Kimberly M W Y Tan","doi":"10.1089/g4h.2024.0025","DOIUrl":"10.1089/g4h.2024.0025","url":null,"abstract":"<p><p>In this systematic review, we explored the literature on both online gamification and language learning in older adults aged 50 and older. Studies describing either digital gamified cognitive training or language learning interventions and include objective outcomes relating to the cognition of the participants were highlighted as suitable to be included as part of the review. In accordance with the established studies, we analyzed the aim and outcomes of the two separate types of interventions, the study design used, the modalities utilized for the respective interventions, as well as the cognitive outcomes obtained. A focus on the Asian context is included to better understand the effects of such interventions on Asian older adults. Mixed findings have been noted in both online gamified and language learning trainings, especially for language learning. However, results lean toward improvements in the cognitive abilities of older adults following gamified interventions, especially gamified cognitive trainings.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"167-181"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariana Armando Lourenço, Tatiana de Paula Oliveira, Camila Souza Miranda, Matheus Silva d'Alencar, Thalita Gabriele Silva Santos, Judith E Deutsch, Maria Elisa Pimentel Piemonte
{"title":"Serious Game-Based Balance Training with Augmented Kinesthetic Feedback Enhances Aspects of Postural Control in Poststroke Patients: A Randomized Clinical Trial.","authors":"Mariana Armando Lourenço, Tatiana de Paula Oliveira, Camila Souza Miranda, Matheus Silva d'Alencar, Thalita Gabriele Silva Santos, Judith E Deutsch, Maria Elisa Pimentel Piemonte","doi":"10.1089/g4h.2023.0214","DOIUrl":"10.1089/g4h.2023.0214","url":null,"abstract":"<p><p><b><i>Background:</i></b> Poststroke hemiparesis presents with motor asymmetry and decreased postural control leading to functional limitations. Serious games (SG) for balance rehabilitation of people with stroke may improve motor recovery, and the visual and auditory feedback provided by the SGs helps to explain the therapeutic benefits. However, the contribution of SG combined with kinesthetic and verbal cues during balance training has not been investigated. The aim of this study is to compare the effects of two feedback conditions for an SG balance intervention, with or without the addition of kinesthetic and verbal cues, on balance performance of people with stroke. <b><i>Methods:</i></b> Thirty people with chronic poststroke hemiparesis and balance impairment participated in this randomized controlled trial and performed 14 individual SG training sessions combined with kinesthetic and verbal cues provided by the physical therapist or with SG's feedback only. Outcomes were assessed before training (pre), 1 week after the end of training (post), and 8 weeks after the end of training, which were adopted as the follow-up period, using the Balance Evaluation Systems Test, Lower Limb Subscale of Fugl-Meyer, six-minute walk test, and Stroke-Specific Quality of Life Scale. <b><i>Results:</i></b> The results showed that SG combined with kinesthetic and verbal cues improved outcomes relating to lower limb function and some balance domains (biomechanical constraints and limits of stability outcomes) better than with SG's feedback only. Both groups had similar significant improvement in quality of life and long-distance walking performance. <b><i>Conclusion:</i></b> This study is the first to directly compare two feedback conditions for SG-based balance intervention. The addition of kinesthetic and verbal cues during the SG balance improved aspects of postural control better than without this form of feedback.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"221-232"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robyn Gallagher, Lis Neubeck, Angus Davis, Julie Redfern, Helen M Parker, Karice Hyun, Clara Chow, David S Celermajer, Thomas Buckley, Tracy Schumacher, Geoffrey Tofler, Gemma Figtree
{"title":"A Self-Administered Gamified Mobile Application for Secondary Prevention of Heart Disease in Patients Following a Cardiac Event (MyHeartMate): Process Evaluation from a Randomized Controlled Trial.","authors":"Robyn Gallagher, Lis Neubeck, Angus Davis, Julie Redfern, Helen M Parker, Karice Hyun, Clara Chow, David S Celermajer, Thomas Buckley, Tracy Schumacher, Geoffrey Tofler, Gemma Figtree","doi":"10.1089/g4h.2024.0174","DOIUrl":"10.1089/g4h.2024.0174","url":null,"abstract":"<p><p><i><b>Objective:</b></i> This study reports the process evaluation of a randomized controlled trial of the MyHeartMate app for patients with coronary heart disease (CHD). <i><b>Materials and Methods:</b></i> Data were collected on engagement in the intervention group from the app platform logs and self-reported usage and via interviews for perspectives of usefulness and acceptability. Participants' (<i>n</i> = 194) data logs showed 80.4% entered baseline data. Tracking (≥30 days) occurred for body mass index (23.2%), blood pressure (BP) (21.1%), and exercise (23.7%). Missions completed on ≥4 days were 47.5% for healthy eating and 30.9% for exercise; 50.5% used the word game. One quarter (26.8%) was classified as \"engaged\" (tracked exercise and/or BP ≥5 times and completed ≥18 missions in the first 30 days). There were no differences between participants who were \"engaged\" or not in baseline characteristics or 6-month outcomes, although engaged users were more likely to meet 4/5 recommended risk factor guideline levels (30.8% vs. 17.6%, <i>P</i> = 0.03). <i><b>Results:</b></i> Participants perceived tracking, prompts, and rewards as useful for recovery and risk factor-related lifestyle change, and games were enjoyed. Engagement decreased with time. Acceptability was limited when app processes were difficult to understand, not personalized enough and/or the overall game concept was disliked. <i><b>Conclusions:</b></i> Insight into user's perceptions and use of gamified app components is essential to address barriers to uptake and optimize potential health benefits. The target audience for a serious game app for CHD remains uncertain.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"204-211"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heather Leutwyler, Erin Hubbard, Theo Bussell, Dennys Balestra, Bruce Cooper, Richard B Souza, Gary Humfleet
{"title":"A Pilot Randomized Controlled Trial of a Multicomponent Smoking Cessation Intervention for Adults with Serious Mental Illness.","authors":"Heather Leutwyler, Erin Hubbard, Theo Bussell, Dennys Balestra, Bruce Cooper, Richard B Souza, Gary Humfleet","doi":"10.1089/g4h.2023.0160","DOIUrl":"10.1089/g4h.2023.0160","url":null,"abstract":"<p><p><b><i>Background:</i></b> Combined behavioral- and pharmacological-based tobacco cessation interventions are effective for adults with serious mental illness; yet, they continue to smoke at alarming rates. <b><i>Materials and Methods:</i></b> A pilot two-arm randomized controlled trial of the program consisted of 50 minutes of game-based groups 3×/week, for 12 weeks alongside counseling and pharmacotherapy. The intervention group engaged in game-based group physical activity (PA), while the control group engaged in sedentary games. <b><i>Results:</i></b> Multilevel regression analyses were used to examine the primary aims. Mean number of cigarettes smoked per week (cig/wk) for the sample (<i>n</i> = 48) at enrollment was 56.3 cigarettes. The linear change was significant at 2.9 fewer cig/wk. The average psychiatric symptom score at enrollment for the PA group was 41.5 points with a significant predicted linear decrease in scores. <b><i>Conclusion:</i></b> Both study groups showed a significant reduction in cig/wk. The combination of counseling and pharmacotherapy offered in groups may have aided with cessation and cigarette reduction while also providing a benefit to mental health.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"242-250"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lihong Ou, Angela Chia-Chen Chen, Elizabeth Reifsnider, Michael Todd, Ashish Amresh, Chung Jung Mun
{"title":"Empowering Unvaccinated Youth: Feasibility, Acceptability, and Efficacy of a COVID-19 Serious Game-Based Intervention.","authors":"Lihong Ou, Angela Chia-Chen Chen, Elizabeth Reifsnider, Michael Todd, Ashish Amresh, Chung Jung Mun","doi":"10.1089/g4h.2024.0011","DOIUrl":"10.1089/g4h.2024.0011","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate a serious game-based intervention's feasibility, acceptability, and efficacy in encouraging coronavirus disease (COVID-19) vaccination among 11-14-year-olds in the United States and assess participant experiences. <b><i>Materials and Methods:</i></b> The study, grounded in social cognitive theory and health belief model, recruited and engaged 32 English-speaking parent-child dyads with unvaccinated youths via snowball sampling and social media outreach. These dyads were randomly assigned to either the COVID-19 serious game-based intervention group (<i>n</i> = 16) or a usual care group (<i>n</i> = 16). The study measured beliefs, self-efficacy, and intentions regarding vaccination using surveys before and after the intervention, with follow-up at 2 months to evaluate vaccine uptake. Semistructured interviews provided insights into the gaming experience and study process. <b><i>Results:</i></b> All 32 eligible parent-youth dyads (16 in each group) completed the study with full participation. Most participants were Black or African American fathers, making up 75% and 81.3% of the intervention and control groups, respectively. The intervention impacted vaccine uptake, with 75% of the intervention group vaccinating their children compared with 37.5% of the control group [χ<sup>2</sup>(1, <i>n</i> = 32) = 4.57, <i>P</i> = 0.033]. Key factors for vaccine uptake included parents' motivation and youths' perceived susceptibility, with correlations of <i>r</i>(30) = 0.66, <i>P</i> = 0.006, and <i>r</i>(30) = 0.55, <i>P</i> = 0.029, respectively. The intervention reshaped youth perceptions about self and community protection. Participants expressed overall satisfaction with both the intervention and the study process. <b><i>Conclusions:</i></b> The intervention was found to be feasible and acceptable, with potential for integration into youth vaccination strategies to support COVID-19 vaccine decision-making.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"182-194"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}