Making SPARX Fly in Nunavut: Pilot Testing an E-intervention for Boosting Resilience Against Youth Depression

Evaluating the Utility of a Psychoeducational Serious Game (SPARX) in Protecting Inuit Youth From Depression: A Pilot Study

The goal of this pilot trial was to test SPARX with Inuit youth in Northern Canada. SPARX is an educational video game designed to teach cognitive behavioural therapy strategies and techniques. This "serious game" has previously shown promise in addressing symptoms of depression with Māori youth in New Zealand. Researchers in this study tested SPARX's suitability with Inuit youth in the territory of Nunavut using surveys that youth completed before and after gameplay.

Hypothesis 1: Youth who completed SPARX were expected to experience a decrease in depressive symptoms and risk factors related to depression. Hypothesis 2: Youth who completed the SPARX program were expected to experience an increase in factors related to resilience.

A team of Nunavut-based community mental health staff facilitated youth's participation in this remote pilot trial with 24 youth aged 13-18 across 11 communities in Nunavut. These youth had been identified by community facilitators as showing low mood, depression, and/or significant levels of stress.

Study Overview

• Status: Completed
• Conditions: Depressive Symptoms; Emotion Regulation
• Intervention / Treatment: Other: SPARX (Smart, Positive, Active, Realistic, X-Factor thoughts)

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M3J 1P3
      • York University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years to 18 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participants had been identified by the community facilitators as exhibiting low mood, negative affect, depressive presentations, and/or significant levels of stress. Youth had to demonstrate sufficient English language comprehension to use and understand SPARX

Exclusion Criteria:

• Initially, youth were excluded if they showed limited cognitive abilities, psychotic presentation, severe depression, or elevated suicide risk, or if they were currently receiving or had previously received CBT, Interpersonal Therapy (IPT), or antidepressant medication within the past three months. However, due to safety and ethics concerns about vulnerable youth feeling left out, at the discretion of local mental health experts on the team, these exclusion criteria were relaxed.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: "Play now" intervention group; The sequence of SPARX play differed for the youth depending on whether they were in Group A ("play now" intervention group) or Group B ("play later" waitlist group). Both groups completed the pre-intervention surveys at Time 1, the beginning of the study. Group A youth then began to play SPARX for seven weeks while Group B waited. During their wait time of seven weeks, Group B youth were not required to participate in any SPARX activities or meet with the community facilitator during their wait period, and they were provided with no additional SPARX-related information. After seven weeks (Time 2), Group A youth completed post-intervention surveys, while Group B youth began their engagement with SPARX by first completing an additional set of pre-intervention surveys, immediately followed by seven weeks of SPARX play. Once Group B youth completed their SPARX gameplay (Time 3), they completed post-intervention surveys.	Other: SPARX (Smart, Positive, Active, Realistic, X-Factor thoughts); SPARX (Smart, Positive, Active, Realistic, X-Factor thoughts) is a psychoeducational serious game (an e-intervention that utilizes gaming for serious purposes) that teaches established cognitive behavioural therapy strategies and techniques across seven levels or modules. The game is designed to address depressive symptoms in youth by helping them cope with negative thoughts and feelings, represented in the game as GNATs-Gloomy Negative Automatic Thoughts. SPARX was originally designed and developed at the University of Auckland with the specific needs of certain underserved groups of youth in mind, including Māori rangatahi, the Indigenous young people of Aotearoa, New Zealand.
Active Comparator: "Play later" waitlist group; The sequence of SPARX play differed for the youth depending on whether they were in Group A ("play now" intervention group) or Group B ("play later" waitlist group). Both groups completed the pre-intervention surveys at Time 1, the beginning of the study. Group A youth then began to play SPARX for seven weeks while Group B waited. During their wait time of seven weeks, Group B youth were not required to participate in any SPARX activities or meet with the community facilitator during their wait period, and they were provided with no additional SPARX-related information. After seven weeks (Time 2), Group A youth completed post-intervention surveys, while Group B youth began their engagement with SPARX by first completing an additional set of pre-intervention surveys, immediately followed by seven weeks of SPARX play. Once Group B youth completed their SPARX gameplay (Time 3), they completed post-intervention surveys.	Other: SPARX (Smart, Positive, Active, Realistic, X-Factor thoughts); SPARX (Smart, Positive, Active, Realistic, X-Factor thoughts) is a psychoeducational serious game (an e-intervention that utilizes gaming for serious purposes) that teaches established cognitive behavioural therapy strategies and techniques across seven levels or modules. The game is designed to address depressive symptoms in youth by helping them cope with negative thoughts and feelings, represented in the game as GNATs-Gloomy Negative Automatic Thoughts. SPARX was originally designed and developed at the University of Auckland with the specific needs of certain underserved groups of youth in mind, including Māori rangatahi, the Indigenous young people of Aotearoa, New Zealand.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
"Centre for Epidemiologic Depression Scale - Revised"	20-item, self-report scale that aims to measure current depressive symptomatology	Pre-gameplay (T=0)
"Centre for Epidemiologic Depression Scale - Revised"	20-item, self-report scale that aims to measure current depressive symptomatology	Post-gameplay (T=7 weeks)
"Hopelessness Scale for Children"	17 true-false items, which describe negative future expectations and negative present attitudes	Pre-gameplay (T=0)
"Hopelessness Scale for Children"	17 true-false items, which describe negative future expectations and negative present attitudes	Post-gameplay (T=7 weeks)
"Cognitive Emotion Regulation Questionnaire - Short"	18-item measure used with adolescents composed of nine coping styles, which are each coded as separate subscales of emotion regulation	Pre-gameplay (T=0)
"Cognitive Emotion Regulation Questionnaire - Short"	18-item measure used with adolescents composed of nine coping styles, which are each coded as separate subscales of emotion regulation	Post-gameplay (T=7 weeks)
"Child and Youth Resilience Measure - Short"	12-item self-report measure that includes three dimensions (Individual, Relational, and Contextual) that reflect the major categories of resilience	Pre-gameplay (T=0)
"Child and Youth Resilience Measure - Short"	12-item self-report measure that includes three dimensions (Individual, Relational, and Contextual) that reflect the major categories of resilience	Post-gameplay (T=7 weeks)

Collaborators and Investigators

• Sponsor: York University
• Collaborators: Government of Nunavut; Qaujigiartiit Health Research Centre
• Investigators: Principal Investigator: Yvonne Bohr, PhD, York University

Study record dates

Study Major Dates

• Study Start (Actual): September 8, 2014
• Primary Completion (Actual): April 22, 2015
• Study Completion (Actual): April 22, 2015

Study Registration Dates

• First Submitted: January 10, 2023
• First Submitted That Met QC Criteria: January 18, 2023
• First Posted (Actual): January 27, 2023

Study Record Updates

• Last Update Posted (Actual): January 27, 2023
• Last Update Submitted That Met QC Criteria: January 18, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Keywords: resilience; rumination; hopelessness; catastrophizing
• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: 02 004 15N-M

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

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