title: A video game improves behavioral outcomes in adolescents and young adults with cancer: a randomized trial.
abstract: OBJECTIVE
  Suboptimal adherence to self-administered medications is a common problem. The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia, lymphoma, and soft-tissue sarcoma.
  
  
  METHODS
  A randomized trial with baseline and 1- and 3-month assessments was conducted from 2004 to 2005 at 34 medical centers in the United States, Canada, and Australia. A total of 375 male and female patients who were 13 to 29 years old, had an initial or relapse diagnosis of a malignancy, and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were randomly assigned to the intervention or control group. The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults. Outcome measures included adherence, self-efficacy, knowledge, control, stress, and quality of life. For patients who were prescribed prophylactic antibiotics, adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices (n = 200). Adherence to 6-mercaptopurine was assessed through serum metabolite assays (n = 54).
  
  
  RESULTS
  Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group. Self-efficacy and knowledge also increased in the intervention group compared with the control group. The intervention did not affect self-report measures of adherence, stress, control, or quality of life.
  
  
  CONCLUSIONS
  The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy. The findings support current efforts to develop effective video-game interventions for education and training in health care.
authors.affiliation: Department of Pediatrics, Stanford Hospital, Stanford, California, USA. pkato@umcutrecht.nl
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Kato
authors.forename: Steve W
authors.initials: SW
authors.lastname: Cole
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Bradlyn
authors.forename: Brad H
authors.initials: BH
authors.lastname: Pollock
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods*; D016012:Poisson Distribution; D011336:Probability; D011788:Quality of Life; D012016:Reference Values; D020377:Self Efficacy; D018910:Video Games