Embedded Narrative in Interactive Game Design for Improving Medication Adherence of Schizophrenia

Study Overview
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Brief Summary
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This study explores the potential of an interactive narrative game to enhance medication adherence among stable schizophrenia patients. Employing participatory design methods, game's development and testing process actively involved patients and individuals closely connected to their daily lives. Artificial Intelligence-Generated Content (AIGC) facilitated swift iterations in game's visual style and content. During game therapy, patients are tasked with making decisions based on presented situations, which influence the course of the narrative.

Detailed Description
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Our game design is inspired by Cognitive Behavioral Therapy (CBT), specifically the autonomic engagement and emotion regulation for the treatment of stable schizophrenic patients. This design aims to motivate patients to practice the basic principles of CBT in a virtual environment with the aim of producing positive psychological and behavioral changes in real life. To ensure that the interactive design in the game can effectively promote cognitive reconstruction and emotional regulation in patients, the investigators used the following game interaction strategies: Situational simulation: By simulating real-life situations, patients face challenges and make decisions in the game that are similar to those in real life, so as to train their cognitive and emotional regulation. Immediate feedback: Provide patients with immediate feedback during the game so that they can understand the impact of their decisions on the outcome of the game, thus encouraging them to make more positive decisions in real life. Role-imitation: Encourage patients to take an in-depth look at their thoughts and behaviors from a third-person perspective by having them take on the role of a therapy practitioner.

Official Title
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Embedded Narrative in Interactive Game Design for Improving Medication Adherence of Schizophrenia：Exploratory Research

Conditions
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Schizophrenia and Related Disorders, Medication Adherence, Mental Health Issue, Gamification

Intervention / Treatment
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* Combination Product: Healing Town: Embedded Narrative in Interactive Game Design


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Stable Phase Schizophrenia on long-term medication medication adherence was problematic Exclusion Criteria: Serious Schizophrenia Lack of basic cognitive abilities

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Healing Town: Embedded Narrative in Interactive Game Design<br>The game-based medication intervention game Wanping Town in this study employed a multidisciplinary participatory design approach rooted in narrative theory and behavioral psychology models. The game consists of two perspectives: narrative decision stories and cognitive games. The investigators initially employed participatory design methods to determine the plot and elements within the game, then embedded the conclusions into the therapeutic elements of the game. | Combination Product: Healing Town: Embedded Narrative in Interactive Game Design<br>* The game-based medication intervention game Wanping Town in this study employed a multidisciplinary participatory design approach rooted in narrative theory and behavioral psychology models. The game consists of two perspectives: narrative decision stories and cognitive games. The investigators initially employed participatory design methods to determine the plot and elements within the game, then embedded the conclusions into the therapeutic elements of the game<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 8-item Morisky Medication Adherence Scale , MMAS-8 | The MMAS-8 scale is a comprehensive but concise scale that covers multiple dimensions, including participants' understanding of medication, self-management skills, and compliance behavior during treatment. The items have been carefully designed to reveal the difficulties and challenges that patients may face during treatment from different perspectives, and help to fully characterize the dynamics of their adherence behavior. | 10 minutes | 
| the In-Game Core Scale (iGEQ) | This questionnaire covers 7 dimensions: immersion, fluency, challenge, positive emotions, negative emotions, uneasiness/irritability, and competence dimensions. | 10 minutes |