This study will employ a mixed methods design to assess the acceptability, feasibility, and therapeutic potential of a CVG with psychological well-being concepts among 13-15-year-old students.
The study will involve 3 phases. First, we will recruit 13-15-year-old students from 2-4 classrooms in a local secondary school within the Wellington region of New Zealand. Once participants have returned their consent and assent forms, they will be asked to download Match Emoji onto their phone or digital device. During the second phase, participants will be encouraged to play the game 3-4 times a week for 5-15 minutes for a 2-week period. Game play time and sessions will be collected through the Unity platform to help inform the feasibility and acceptability of the recommended game play. During the third phase, researchers will follow up 2 weeks after the recommended regimen of Match Emoji and collect secondary outcomes measures (from the Child and Adolescent Mindfulness Measure [CAMM], General Help-Seeking Questionnaire [GHSQ], Flourishing Scale [FS], and Revised Children's Anxiety and Depression Scale [RCADS]), followed by short interviews with participants about their experience.
Approximately 40 students from a local secondary school in Wellington, New Zealand, will take part in playing Match Emoji 3-4 times a week for 5-15 minutes over a 2-week period. Participants will be invited from year 9 and 10 classrooms and are typically between 13 and 15 years of age. As this is an acceptability and feasibility study, a total of 40 participants will provide a large enough sample size to show a meaningful difference in the primary and secondary outcomes between baseline, postintervention, and a 3-week follow-up.
Young people will be included in the study if they are between the ages of 13 and 15 years, have provided written consent from a parent or caregiver, and are able to understand and sign the assent form.
Young people will be excluded from participation if they do not meet the inclusion criteria. The appropriate personnel within the secondary school will be engaged if a participant self-reports a high level of mental health need. This will be determined through the 4 questionnaires. Those participants who are engaged with existing therapeutic support are able to participate in the research study if consent has been obtained from the young person.
Match Emoji is a match-3 CVG with psychological well-being concepts designed for young adolescents. The aim of Match Emoji is to match similar colored emojis together to earn points and progress through the game. There is a total of 6 different colored and shaped emojis that represent a unique digital expression such as an emotion, idea, or personality. When the user has successfully matched the required number of emojis with a fixed number of moves or time frame, a micromessage appears on the screen. Each micromessage consists of a short psychological well-being concept such as “notice what is going on around you” or “sometimes talking to a friend can help” and is delivered via a dynamic messaging loading system that identifies the “optimal” time to display the message. Hints are used throughout the game if players get stuck. For example, if the player waits too long before making a move, Match Emoji identifies a potential combination of similar colored emojis by moving a successful sequence of items back and forth to capture the user's attention. An example of the game can be seen in
Image of the Match Emoji game.
The primary outcomes of the study are (1) acceptability of Match Emoji (ie, is Match Emoji acceptable among young adolescents), as assessed via a short semistructured intervention with participants after the recommended regime of game play and game analytics including the number of sessions and minutes played recorded via the Unity platform, and (2) feasibility of Match Emoji (ie, is it easy to complete the study with young adolescents within a secondary school context) as measured by the number of students interested in participating in completing the 4 questionnaires, playing the recommended regimen of Match Emoji, and attending the follow-up interview.
The secondary outcome (measured at baseline before accessing Match Emoji, on completing the 2 weeks of recommended game play, and at the 3-week follow-up) is efficacy (ie, does Match Emoji promote psychological well-being skills). This will be assessed by measuring changes over time in the CAMM, GHSQ, FS, and RCADS. It is estimated to take participants approximately 10-15 minutes to complete all questionnaires.
The CAMM is a 10-item measure of mindfulness for use with children and adolescents and has been reported to have good internal consistency and significant correlations between CAMM scores and measures of psychological functioning and distress [
The 8-item FS is a valid and reliable brief summary measure of psychological well-being suited for young people [
Interviews lasting approximately 30 minutes will take place with no more than 6 participants at one time to understand experiences with playing Match Emoji. Interviews will be conducted by the first author (RP) at the local school in a setting familiar to the participants. Responses will be recorded in a paper-based format. Questions will involve (1) What parts of the game did you like? (2) What parts of the game could be improved? (3) What did you learn from playing the game? (4) Did you try and use any of the ideas from the game and if so, which ones? (5) Do you think you will continue to play Match Emoji? Interviews will not involve more than 6 participants at a time. At the end of the interview, participants will be able to read and correct answers.
Quantitative data from the 4 assessments and game play usage will be analyzed using Microsoft Excel, SPSS version 26, and the metrics recorded from the Unity platform including number of sessions and minutes played [
As this is an acceptability and feasibility study, a sample size of 40 participants will be a large enough sample to show a meaningful difference in primary and secondary outcomes between baseline and the end of the interview. Chi-square tests and
This study received ethics approval from the New Zealand Health and Disability Ethics Committee (21/NTA/34) on May 28, 2021. After the college principal or senior management staff member has understood and approved the research, participants will be provided with information about the study. Students will be provided with time to ask questions before deciding to provide informed decision about their voluntary participation through an assent form. A consent form will also be required from the parent or guardian.
All the project data and materials sent for publication will be de-identified by removing statements identifying participants. Participants who disclose mental health needs that meet the threshold for a clinical diagnosis will be handled by appropriate school personnel such as a school counsellor. The data will be stored securely in a password-protected computer accessible only to the research team. The de-identifiable findings will be included in the first author’s (RP) doctoral thesis as well as being disseminated through peer-reviewed academic journals, national and international conferences, and public events. If parents ask for their child’s individual results such as game analytics, we will seek permission from the child first.