For adolescents struggling with substance abuse, traditional in-person interventions such as counseling are not always effective, and rural areas often lack access to these services.

A researcher at the University of Missouri is thinking outside the box, aiming to help game designers develop fun, digital games that make ditching bad habits easier by meeting adolescents where they already are: online.

Mansoo Yu, a professor in the College of Health Sciences, looked at 26 studies involving digital interventions, including online games, virtual reality games, mobile app games and video games, to identify the key elements that make these interventions effective in helping adolescents reduce drinking, smoking and illicit drug use. He found the most effective games were personalized to the individual playing the game, had a social component for users to compete against their friends and family, and included content that encouraged behavior change.

The findings, appearing in Children, can provide a blueprint for designing digital game-based interventions in ways that are most likely to help adolescents reduce substance abuse and encourage positive development.

“When it comes to designing the most effective interventions, you always want to meet people where they are, and the younger generation often prefers to meet up virtually instead of in person,” Yu said. “Online interventions also increase accessibility in rural areas where in-person clinics and counseling services are not always available.”

Yu added that unhealthy behaviors such as smoking often serve as a way of coping with underlying mental health issues, including anxiety and depression. Therefore, a key element of a successful digital game-based intervention is emphasizing positive activities that can serve as an alternative to unhealthy behaviors.

“Whether it’s sports, mentorship programs, music, painting, outdoor activities or recreation centers, providing resources for healthier alternatives can be very helpful,” Yu said. “There can also be a social component, such as a point system for rewarding good behavior, to create friendly competition and allow users to play with their friends, parents and teachers. Peer modeling can be very impactful for adolescents.”

Games that begin by asking for the user’s specific interests could help create more personalized interventions, ultimately increasing user engagement.

“Hopefully this research helps game designers going forward create the most customized, effective interventions possible,” Yu said. “Mizzou’s strong foundation in both public health and social work, along with its mission as a land-grant university, has given me the opportunity to explore these intersections and advance this work.”

Yu collaborated on the study with colleagues from Ewha Womans University in South Korea.