An Internet-Based Psychological Intervention With a Serious Game to Improve Vitality, Psychological and Physical Condition, and Immune Function in Healthy Male Adults: Randomized Controlled Trial.

Lemmy Schakel,Simone A Joosten,Henriët Van Middendorp,Leo G Visser,Andrea W M Evers,Dieuwke S Veldhuijzen,Anne M H F Drittij,Frank Vrieling,Corine Prins,Tom H M Ottenhoff

doi:10.2196/14861

Abstract

BackgroundRecently, internet-based cognitive behavioral therapy (ICBT) and serious gaming interventions have been suggested to enhance accessibility to interventions and engagement in psychological interventions that aim to promote health outcomes. Few studies, however, have investigated their effectiveness in the context of simulated real-life challenges.ObjectiveWe aimed to examine the effectivity of a guided ICBT combined with a serious gaming intervention in improving self-reported psychophysiological and immunological health endpoints in response to psychophysiological and immune-related challenges.MethodsSixty-nine healthy men were randomly assigned to the intervention condition, receiving ICBT combined with serious gaming for 6 weeks, or the control condition, receiving no intervention. Self-reported vitality was the primary endpoint. Other self-reported psychophysiological and immunological endpoints were assessed following various challenges, including a bacillus Calmette-Guérin vaccination evoking pro-inflammatory responses, 1 and 4 weeks after the intervention period.ResultsAlthough the intervention did not affect vitality-associated parameters, self-reported sleep problems (P=.027) and bodily sensations (P=.042) were lower directly after the intervention compared with controls. Furthermore, wellbeing (P=.024) was higher in the intervention group after the psychophysiological challenges. Although no significant group differences were found for the psychophysiological and immunological endpoints, the data provided preliminary support for increased immunoglobulin antibody responses at the follow-up time points (P<.05). Differential chemokine endpoints between conditions were observed at the end of the test day.ConclusionsThe present study provides some support for improving health endpoints with an innovative ICBT intervention. Future research should replicate and further extend the present findings by consistently including challenges and a wide range of immune parameters into the study design.Trial RegistrationNederlands Trial Register NTR5610; https://www.trialregister.nl/trial/5466

Highlights

Psychological interventions have been shown to be effective in improving self-reported health outcomes [1,2] and immune status [3,4,5]
The present study provides some support for improving health endpoints with an innovative internet-based cognitive behavioral therapy (ICBT) intervention
Adherence rates in ICBT are lower compared to face-to-face interventions; engagement should be taken into account [11,12]

Summary

Introduction

Psychological interventions have been shown to be effective in improving self-reported health outcomes [1,2] and immune status [3,4,5]. Novel developments in psychological treatments may potentially further enhance the effectiveness of psychological interventions in improving self-reported and immunological health outcomes [7]. A rather novel development focuses on providing psychological interventions based on cognitive behavioral therapy (CBT) via the internet (ICBT). A meta-analysis showed that the effectiveness of guided ICBT interventions is comparable to face-to-face interventions in patients with chronic somatic conditions [9]. Internet-based cognitive behavioral therapy (ICBT) and serious gaming interventions have been suggested to enhance accessibility to interventions and engagement in psychological interventions that aim to promote health outcomes. Few studies have investigated their effectiveness in the context of simulated real-life challenges

Methods

Results

Conclusion