First episode psychosis is a serious mental health condition that affects youth and young adults, often between the ages of 15 and 30. The illness is marked by hallucinations, delusions, withdrawal, poor organization skills, and diminished cognitive and social functioning. Recent research has demonstrated that programs designed to treat people experiencing early psychosis can reduce hospitalization, decrease psychiatric symptoms, improve quality of life, and result in better social and occupational functioning. Despite this promising picture, few tools have been developed to support optimal engagement and participation in care. In response to this need, the Center for Social Innovation (C4) has partnered with researchers at the Research Foundation for Mental Hygiene, Inc. (RFMH); Columbia University; and the University of Maryland School of Medicine (UMSOM) to develop and test OnTrack>An Online Role-Playing Game (OnTrack>The Game, or OTG). Based on cutting- edge practices in serious gaming, OnTrack>The Game offers players the opportunity to experience a community that includes the player's apartment, treatment provider's office, school, work, gym, parks, and a movie theater that shows videos of hope and recovery from real people who have experienced first episode psychosis. Interactions with family, friends, co-workers, and treatment providers allow players to simulate and rehearse real-life situations in a safe, non-threatening environment. To evaluate the impact of the game, this Phase II study involves a mixed-methods randomized controlled trial in which we will recruit 200 young people from first-episode programs in New York State. Participants will be randomized into 1 of 2 conditions: (1) OnTrack>The Game or (2) Recovery Videos (RV), a website that includes information and videos about first episode psychosis (FEP). We will use standardized measures and semi-structured qualitative interviews to achieve the following aims: 1. Refine, expand, and finalize OnTrack>The Game. Building on the Phase I prototype, we will improve functionality, expand the play spaces and levels, add interaction with non-player characters, include more resources on FEP, and expand the library of videos on hope and recovery. 2. Evaluate the effectiveness of a role-playing game (OnTrack>The Game or OTG) in increasing empowerment, decreasing stigma concerns, and improving treatment engagement. 3. Determine if changes in empowerment and stigma concerns mediate the effect of OnTrack>The Game on treatment engagement. Early intervention for psychosis has emerged as an effective way to improve outcomes for young people, yet few tools exist to connect them with supporting treatment providers and to build confidence in their recovery. OnTrack>The Game has the potential to fill this void and to help improve outcomes for young people with psychosis as they strive to build meaningful lives in community.

Public Health Relevance

OnTrack>An Online Role-Playing Game is an interactive game designed for people who have experienced first episode psychosis. The game provides players with knowledge and skills to address stigma, understand psychosis, and engage in treatment. Through the game's levels, zones, and interactions with friends, family, treatment providers, and the broader community, players develop a greater sense of hope and the possibility of recovery.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1)
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Haim, Adam
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Center for Social Innovation, LLC
United States
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