Reducing concussion symptoms among teenage youth: Evaluation of a mobile health app

ABSTRACT

Objective: To evaluate whether a mobile health application that employs elements of social game design could compliment medical care for unresolved concussion symptoms.

Design: Phase I and Phase II (open-label, non-randomized, ecological momentary assessment methodology).

Setting: Outpatient concussion clinic.

Participants: Youth, aged 13–18 years, with concussion symptoms 3+ weeks after injury; Phase I: n = 20; Phase II: n = 19.

Interventions: Participants received standard of care for concussion. The experimental group also used a mobile health application as a gamified symptoms journal.

Outcome measures: Phase I: feasibility and satisfaction with intervention (7-point Likert scale, 1 high). Phase II: change in SCAT-3 concussion symptoms (primary), depression and optimism.

Results: Phase 1: A plurality of participants completed the intervention (14 of 20) with high use (110 +/− 18% play) and satisfaction (median +/− interquartile range (IQR) = 2.0+/− 0.0). Phase II: Groups were equivalent on baseline symptoms, intervention duration, gender distribution, days since injury and medication prescription. Symptoms and optimism improved more for the experimental than for the active control cohort (U = 18.5, p = 0.028, effect size r = 0.50 and U = 18.5, p = 0.028, effect size r = 0.51, respectively).

Conclusions: Mobile apps incorporating social game mechanics and a heroic narrative may promote health management among teenagers with unresolved concussion symptoms.

KEYWORDS:

• Rehabilitation
• intervention
• children
• concussion
• mobile health
• gaming

Declaration of interest

Funding was provided by NIH-NICHD SBIR grant 1R43HD075638-01A1. (Clinicaltrials.gov Identifier: NCT01398566). SuperBetter was developed under the auspices of SuperBetter, LLC and is now owned by Cherry Street Innovation, both for-profit organizations. JM founded SuperBetter LLC and is Chief Scientific Officer of Cherry Street Innovation. LWC has served as a Science Advisor to SuperBetter Labs, LLC, on a pro bono basis. No other authors have any conflict to report.