Data Extravaganza Presentation - 7 minutes International Positive Psychology Association 7th IPPA World Congress 2021

Shadow’s Edge mobile game promotes identity formation among adolescent and young adult survivors of pediatric cancer: Short-term results of a randomized clinical trial  (#83)

Bonnie Essner 1 2 , Jenna Shapiro 1 2 , Noor Abdelfattah 2 , Katie Devine 3 , Karina Danner-Koptik 2 , Anna Dickson 2 , Edna Romero 1 2 , Jennifer Reichek 2 4
  1. Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
  2. Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
  3. Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States
  4. Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Background Adolescent and young adult cancer survivors (AYACS) have chronic health conditions secondary to their disease treatment that negatively impact quality of life and limit social role development. Serious games may be a natural tool for promoting wellbeing among AYACS, who are digital natives. Shadow’s Edge is a mobile game in which players revive a desolate cityscape by responding to journal prompts, creating digital art, and engaging with the in-game community. Rooted in narrative and creative arts therapies, and leveraging the known benefits of accessibility, engagement, and enjoyment that serious gaming offers, Shadow’s Edge may be a universal-level intervention for promoting resilience resources and resilience outcomes among AYACS. 

Hypotheses/Research Questions We hypothesized that AYACS who played Shadow’s Edge would report significantly greater adaptive change in resilience as compared to comparison group participants.  

Sample Characteristics and Sample Size Participants were 177 AYACS (13-24 years; Mage=18.06; 49% female; 41% Hispanic; 39% White Non-Hispanic).

Design This is a two-group, randomized controlled trial (RCT). Game-play participants (N=95) played Shadow’s Edge daily for six weeks while the comparison group (N=82) had no study procedures. Participants completed standardized measures of identity formation, life meaning and purpose, positive affect, and benefit-finding. ANCOVAs were used to assess group differences at post-intervention, controlling for baseline levels of each outcome. 

Results Game-play group participants endorsed higher levels of identity exploration (F(3,110)=7.73, p<.001, β=.20, t(113)=2.47, p=.015) as compared to comparison group participants post-intervention. There were no other group differences in outcomes at post-intervention.

Scientific Contribution Playing Shadow’s Edge promoted adaptive identity formation characterized by exploration and curiosity. This is one of the first, and largest, rigorous RCTs to demonstrate the benefits of serious gaming for AYACS. As the prevalence of AYA cancer survivorship grows, the role of serious games, and Shadow’s Edge specifically, in enhancing resilience should be explored further.

  • Keywords: Health and Medicine