Social Health Games: The Use of Online Games to Decrease Loneliness in Older Adults

Social Health Games: a Gamified Intervention to Decrease Loneliness in Older Adults - a Randomized Controlled Trial

This study examines whether social platform games are effective in expanding the social network and decreasing the experienced levels of loneliness in older adults. The newly developed social games will be compared to non-personal games and not playing games.

Study Overview

• Status: Terminated
• Conditions: Loneliness
• Intervention / Treatment: Other: SamenSpelen.app; Other: FijnSpelen.app

Detailed Description

Rationale: loneliness and social isolation are an increasing problem in older adults with the aging of society. One option to foster social contact is through online games, which allow social interaction at a distance.

Objective: to investigate whether playing social online games has a beneficial effect on subjective loneliness and social network in older adults, compared with playing non-personal games and not playing games.

Study design: 3-arm randomized controlled trial.

Study population: A sample of 300 human volunteers aged 65 and over, who have access to a smartphone and an internet connection. The sample will be evenly distributed across the three groups.

Everybody else is allowed to use the gaming portal; they will form the pool of people that the participants can play with. This pool will be tracked within the gaming portal and posed some questions regarding their fellow players and their experiences loneliness. People aged under 16 can play but will not be tracked.

Intervention (if applicable): Three groups: (I) Intervention group, who will be given access to an app with the social games, and are encouraged to use this app as much as possible, (II) active control group, who will be given access to an app with non-personal games, and are encouraged to use this app as much as possible, (III) passive control group, who will be given access to an app with no games. The platform has a chatbot designed to take the questionnaires.

Comparison between groups (I+II) and (III) will show whether playing games has an effect on loneliness/social network.

Comparison between groups (I) and (II) will show whether the social aspect of games has additional benefits over solo-games on loneliness/social network.

Main study parameters/endpoints: Primary outcome: change in perceived loneliness over time; secondary outcomes: change in (I) social network composition and (II) health-related outcomes over time. All acquired via chatbot questionnaires.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: the participants will have to download and install the app. Participants in the social games group will be invited to play games with people from their own network and may plan as often as they want with whom they want, but are encouraged to play at least twice a week. Participants in the non-personal games group will be invited to play games as often as they want but are encouraged to play at least twice a week. All participants are asked to complete questionnaires. In-app questionnaires will be administered monthly: the complete set of questionnaires at baseline, after 6 months, and after 12 months (duration 1.5 hours), and the loneliness questionnaire monthly (duration 10 minutes) Since the questionnaires contain questions on loneliness and mental wellbeing, some might be perceived as sensitive.

• Study Type: Interventional
• Enrollment (Actual): 76
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Netherlands
  • Gelderland
    • Nijmegen, Gelderland, Netherlands
      • Radboudumc

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Being 65 years or older
• Have access to a smartphone with an internet connection

Exclusion Criteria:

• Visual or cognitive impairments that limit independent use of a mobile phone
• Not being fluent in the Dutch language

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Social games; Participants in the social games group will be given access to an app with games that are either adaptations of well-known games or newly developed games, all designed to be played with just text messages and photos. A game is essentially a chat group with the people you invited to play that specific game with. Participants can play with their own network of family and friends, as well as other people in the same condition.	Other: SamenSpelen.app; An app designed to play simple, social games in a chat environment. These games are designed to elicit personal interaction.
Active Comparator: Non-personal games; Participants in the active control group will be given access to an app that offers 'non-personal games'. The portal will contain a subset of the social games, which have been adapted for non-personal play. This means that all aspects that make the games personal are removed and discouraged. The games that remain can still be played with others (family/friends and others in the same condition), but are designed not to elicit personal interaction. Participants are asked to play the games at least twice a week, but may play as often as they like.	Other: FijnSpelen.app; An app designed to play simple, social games in a chat environment. These games are designed to not elicit personal interaction.
No Intervention: Passive control; The passive control group will be given access to an app that contains no games. Similar to the other groups, the portal is used to complete the questionnaires. Use of other games, (gaming) apps or social media platforms is allowed in this group, as in the other groups. The only restriction they will not have access to the games offered in the social games and active control groups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Loneliness indirect	The change in indirectly measured loneliness (De Jong Gierveld loneliness scale (range 1-11, higher indicating more loneliness)) over three months between the three groups	Three months
Loneliness direct	The change in directly measured loneliness (Likert scale (range 1-5, higher indicating more loneliness) over three months between the three groups	Three months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Loneliness time series	The temporal variability in indirectly measured loneliness (De Jong Gierveld loneliness scale (range 1-11, higher indicating more loneliness)) over twelve months	Twelve months
Wellbeing	The change in wellbeing (SPF-IL) between the groups over twelve months	Twelve months
Social network composition	The change in social network composition (NESTOR-LSN) between the groups over twelve months	Twelve months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gaming behaviour and social interactions	Data on the games participants play (retrieved from the backend game data), when and with whom they play them (retrieved from questionnaires assessed after games have been played. Questions on relationship type and intensity have been adapted from the NESTOR-LSN questionnaire.)	Twelve months

Collaborators and Investigators

• Sponsor: Radboud University Medical Center
• Collaborators: Netherlands Organisation for Scientific Research
• Investigators: Principal Investigator: Marcel Olde Rikkert, MD PhD, Radboud University Medical Center

Publications and helpful links

Helpful Links

• The project website (in Dutch), including information on the study

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2021
• Primary Completion (Actual): March 28, 2022
• Study Completion (Actual): March 28, 2022

Study Registration Dates

• First Submitted: January 28, 2021
• First Submitted That Met QC Criteria: January 28, 2021
• First Posted (Actual): February 2, 2021

Study Record Updates

• Last Update Posted (Actual): March 31, 2023
• Last Update Submitted That Met QC Criteria: March 29, 2023
• Last Verified: January 1, 2021

More Information

Terms related to this study

• Keywords: Social network; Digital technology; Social games
• Other Study ID Numbers: 2020-6884; 645.003.002 (Other Grant/Funding Number: NWO)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Anonymized questionnaire and backend game data will be stored in the repisitory of the Data Archiving and Networked Services (DANS-Easy) after finalizing the project and all data analyses. After that, it is available open access.
• IPD Sharing Time Frame: After the end of the project (Mid 2024).
• IPD Sharing Access Criteria: Open Access
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No