A Digital Intervention to Prevent Initiation of Opioid Misuse in Adolescents in School-based Health Centers

Yale University

Status: Completed

Conditions: Opioid Misuse

Treatments: Behavioral: Play Smart Mini-Game; Behavioral: PlaySmart Storyline; Behavioral: PlaySmart

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04109599

1UG3DA050251-01 (U.S. NIH Grant/Contract)

2000026247

Details and patient eligibility

About

This study's specific aims were to: develop a digital intervention as a prevention intervention through focus groups with 40 youth; pilot-test the developed digital intervention with 30 adolescents, using methods from the investigator's prior research; develop implementation strategies and partners through focus groups with 50 School Based Health Alliance affiliates and 30 adolescents from an Advisory Council.

Full description

Most opioid misuse begins during adolescence and young adulthood. Adolescence is the time to intervene with prevention interventions (i.e., interventions focused on adolescents who have not yet misused opioids) in settings like school-based health centers (HCs), yet few interventions exist that prevent initiation of opioid misuse. "Serious videogame" interventions can improve health behaviors. They meet adolescents "where they are," and compared to standard interventions, they can reach large populations, with consistent fidelity, place limited demands on personnel/resources, and facilitate rapid sustainable distribution, all at a potentially lower cost.

This study harnessed the power of videogame interventions and incorporated components of effective substance use prevention programs to develop an evidence-informed intervention to prevent the initiation of opioid misuse in adolescents. Building on our experience developing videogame interventions and in partnership with the national School-Based Health Alliance (SBHA), we developed and tested a new videogame intervention, PlaySmart.

PlaySmart was built upon our PlayForward videogame intervention platform that has demonstrated efficacy in improving attitudes and knowledge related to risk behaviors. Through rigorous formative work and with input from adolescents, and our SBHA and game development partners, we created the PlaySmart videogame intervention.

PlaySmart is designed to provide players with behavioral skills and knowledge through repetitive and engaging videogame play to target adolescent perception of risk of harm from initiating opioid misuse.

The gap in the research on preventing initiation of opioid misuse in youth and in implementing prevention programs with good fidelity needs to be urgently addressed given the high prevalence of adolescent opioid misuse and overdose. This research has the potential to create a videogame intervention to prevent initiation of opioid misuse with far-reaching and sustained impact on adolescents.

Enrollment: 33 patients

Sex: All

Ages: 16 to 19 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adolescent participants must attend high school that has a school-based health center, to participate in pilot testing

Exclusion criteria

• Failure to meet Inclusion Criteria

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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33 participants in 9 patient groups

PlaySmart Full Game

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in the pilot testing of the adapted game. PlaySmart is a digital intervention targeted towards preventing opioid misuse in older adolescents.

Treatment:

Behavioral: PlaySmart

Trading Wisdom Storyline

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in beta testing this PlaySmart storyline where the player receives an opioid prescription from their dentist. This storyline includes information about safe use of opioids and the difference between use and misuse.

Treatment:

Behavioral: PlaySmart Storyline

Lean on Me Storyline

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in beta testing this PlaySmart storyline where the player is offered opioids at a party. This storyline includes information about different forms of opioids and their effects.

Treatment:

Behavioral: PlaySmart Storyline

Tough Love Storyline

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in beta testing this PlaySmart storyline where the player navigates supporting their partner struggling with opioid misuse. This storyline includes information about treatment and recovery resources for opioid misuse \& Opioid Use Disorder.

Treatment:

Behavioral: PlaySmart Storyline

Grandma's Pills Storyline

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in beta testing this PlaySmart storyline where the player witnesses the sharing of an opioid prescription within their family. This storyline includes information about medication safety and opioid overdose identification and response.

Treatment:

Behavioral: PlaySmart Storyline

A Friend in Need Storyline

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in beta testing this PlaySmart storyline where the player interacts with a friend that is in distress. This storyline includes information about how to navigate peer-to-peer support.

Treatment:

Behavioral: PlaySmart Storyline

A New Direction Storyline

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in beta testing this PlaySmart storyline where the player seeks out therapy as an option to manage stress. This storyline includes information about how to seek professional help for mental health.

Treatment:

Behavioral: PlaySmart Storyline

Risk Sense All Levels

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in beta testing all levels of this PlaySmart mini game intended to increase perceived risk of harm of opioid misuse.

Treatment:

Behavioral: Play Smart Mini-Game

PlaySmart Full Game: Focus on Character Development

Experimental group

Description:

Adolescents, boys and girls, aged 16-19 participated in the pilot testing of the adapted game. PlaySmart is a digital intervention targeted towards preventing opioid misuse in older adolescents. Participants in this arm focused on beta testing character development aspects throughout the game.

Treatment:

Behavioral: PlaySmart