Evidence map›Paper›PMID 42528757›Full record

Observational studyFrontiers in public health2026

From isolated openings to streaks: a sequential observational study of loot box openings in livestreamed gaming.

Rodrigo Borja-Block, Florentino Moreno Martín, Antonio Jesús Molina-Fernández, Nerea Cano-Alcalá, Jesús Saiz-Galdós

Abstract readObservational Study
In one paragraph

Observational study in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Rodrigo Borja-BlockSocial and Cultural Determinants of Health Research Group, Department of Social, Work and Differential Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain.
Florentino Moreno MartínSocial and Cultural Determinants of Health Research Group, Department of Social, Work and Differential Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain.
Antonio Jesús Molina-FernándezSocial and Cultural Determinants of Health Research Group, Department of Social, Work and Differential Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain.
Nerea Cano-AlcaláSocial and Cultural Determinants of Health Research Group, Department of Social, Work and Differential Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain.
Jesús Saiz-GaldósSocial and Cultural Determinants of Health Research Group, Department of Social, Work and Differential Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Loot boxes have become a major public health concern because they combine chance-based reward structures, repeated purchasing opportunities, and widespread exposure in digital gaming environments, including publicly accessible livestreams. The present study examined how loot box openings were organized, sustained, and terminated in livestreamed contexts, with particular attention to the sequential structure of opening behavior and the verbalizations accompanying it. Using an exploratory-to-analytic sequential observational design with integrated quantitative and qualitative components, we built a broader observational database spanning approximately 65 h and 28 min of streamed material across exploratory and analytic phases. The analyses reported here were based on 13 publicly accessible livestreams from Twitch and YouTube, totaling approximately 27 h and 16 min of video material in the main analytic phase. Across these streams, 490 loot box openings were coded at the level of streams, opening episodes, and individual openings. Results showed that loot box openings were organized predominantly as multi-opening streaks rather than isolated events, with 93.1% of coded openings occurring within streaks. The formation of streaks was more strongly associated with visible monetization-related interface cues, particularly temporary offers and virtual currency, than with broad contextual trigger categories. Once a streak had begun, continuation was the dominant pattern and was not strongly explained by reward rarity, visible affective valence, or near-miss events alone, suggesting a momentum-like sequential process. By contrast, termination appeared more closely associated with disruptions in the ongoing flow of the sequence, including more behaviorally marked moments and some reward outcome categories. Qualitative findings further indicated that streamer verbalizations functioned primarily as evaluative, interpretive, and performative accompaniments to opening activity rather than as reliable mechanisms of self-interruption. Taken together, these findings support a process-based account of livestreamed loot box openings and highlight the importance of sequential organization, monetization salience, and public verbal framing for understanding their potential public health relevance.

Indexed as

RewardVideo GamesDigital MediaHumansgambling-like mechanicslivestreamingloot boxesmonetization cuespublic healthstreak formationstreamer discourseverbalizations

Identifiers

PMID42528757
PMCPMC13414947

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.