Evidence map›Paper›PMID 40324175›Full record

SynthesisJMIR mental health2025

Game Design, Effectiveness, and Implementation of Serious Games Promoting Aspects of Mental Health Literacy Among Children and Adolescents: Systematic Review.

Michael Zeiler, Sandra Vögl, Ursula Prinz, Nino Werner, Gudrun Wagner, Andreas Karwautz, Natalie Zeller, Lorenz Ackermann, Karin Waldherr

Abstract readSystematic Review
In one paragraph

Synthesis in JMIR mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Michael Zeiler *Medical University of Vienna, Department for Child and Adolescent Psychiatry, Vienna, Austria.ORCID https://orcid.org/0000-0002-7087-6134
Sandra Vögl *Medical University of Vienna, Department for Child and Adolescent Psychiatry, Vienna, Austria.ORCID https://orcid.org/0009-0006-1530-1860
Ursula PrinzFerdinand Porsche FERNFH - Distance Learning University of Applied Sciences, Wiener Neustadt, Austria.ORCID https://orcid.org/0000-0002-2212-0949
Nino WernerFerdinand Porsche FERNFH - Distance Learning University of Applied Sciences, Wiener Neustadt, Austria.ORCID https://orcid.org/0009-0005-5606-6046
Gudrun WagnerMedical University of Vienna, Department for Child and Adolescent Psychiatry, Vienna, Austria.ORCID https://orcid.org/0000-0002-4845-9684
Andreas KarwautzMedical University of Vienna, Department for Child and Adolescent Psychiatry, Vienna, Austria.ORCID https://orcid.org/0000-0001-9053-998X
Natalie ZellerMedical University of Vienna, Department for Child and Adolescent Psychiatry, Vienna, Austria.ORCID https://orcid.org/0009-0005-4694-4503
Lorenz AckermannMedical University of Vienna, Department for Child and Adolescent Psychiatry, Vienna, Austria.ORCID https://orcid.org/0009-0003-9026-7269
Karin WaldherrFerdinand Porsche FERNFH - Distance Learning University of Applied Sciences, Wiener Neustadt, Austria.ORCID https://orcid.org/0000-0002-5852-2237

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effects of traditional health-promoting and preventive interventions in mental health and mental health literacy are often attenuated by low adherence and user engagement. Gamified approaches such as serious games (SGs) may be useful to reach and engage youth for mental health prevention and promotion.

objectiveThis study aims to systematically review the literature on SGs designed to promote aspects of mental health literacy among adolescents aged 10 to 14 years, focusing on game design characteristics and the evaluation of user engagement, as well as efficacy, effectiveness, and implementation-related factors.

methodsWe searched PubMed, Scopus, and PsycINFO for original studies, intervention development studies, and study protocols that described the development, characteristics, and evaluation of SG interventions promoting aspects of mental health literacy among adolescents aged 10 to 14 years. We included SGs developed for both universal and selected prevention. Using the co.LAB framework, which considers aspects of learning design, game mechanics, and game design, we coded the design elements of the SGs described in the studies. We coded the characteristics of the evaluation studies; indicators of efficacy, effectiveness, and user engagement; and factors potentially fostering or hindering the reach, efficacy and effectiveness, organizational adoption, implementation, and maintenance of the SGs.

resultsWe retrieved 1454 records through database searches and other sources. Of these, 36 (2.48%) studies describing 17 distinct SGs were included in the review. Most of the SGs (14/17, 82%) were targeted to a universal population of youth, with learning objectives mainly focusing on how to obtain and maintain good mental health and on enhancing help-seeking efficacy. All SGs were single-player games, and many (7/17, 41%) were embedded within a wider pedagogical scenario. Diverse game mechanics and game elements (eg, minigames and quizzes) were used to foster user engagement. Most of the SGs (12/17, 71%) featured an overarching storyline resembling real-world scenarios, fictional scenarios, or a combination of both. The evaluation studies provided evidence for the short-term efficacy and effectiveness of SGs in improving aspects of mental health literacy as well as their feasibility. However, the evidence was mostly based on small samples, and user adherence was sometimes low.

conclusionsThe results of this review may inform the future development and implementation of SGs for adolescents. Intervention co-design, the involvement of facilitators (eg, teachers), and the use of diverse game mechanics and customization to meet the needs of diverse users are examples of elements that may promote intervention success. Although there is promising evidence for the efficacy and effectiveness of SGs for promoting mental health literacy in youth, there is a need for more rigorously planned studies, including randomized controlled trials and real-world evaluations, that involve follow-up measures and the assessment of in-game performance alongside self-reports.

Indexed as

Health LiteracyHealth PromotionMental HealthVideo GamesAdolescentChildHumansadolescentsartificial intelligencechildrengame designgamificationmental health literacyserious gamessystematic review

Identifiers

PMID40324175
PMCPMC12089885

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.