BACKGROUND: Coronavirus Disease 2019 has spread worldwide and generated tremendous stress on human beings. Unfortunately, it is often hard for distressed individuals to access mental health services under conditions of restricted movement or even lockdown. In this research, we developed an online coloring game and tested its effectiveness as an accessible and engaging instrument for maintaining subjective well-being (SWB) as well as for reducing anxiety during the pandemic. OBJECTIVE: The study first aims to develop an online digital intervention package on a commercial released coloring game. The second aim is to test the effectiveness of difference interventions package for players to maintain SWB and reduce anxiety during the pandemic. METHODS: An evidence-based coloring intervention package was developed and uploaded to an online coloring game covering almost 1.5 million players worldwide in January 2021. Global players participated to color either four rounds of images characterized by awe, pink, nature, and blue or four rounds of irrelevant images. Participants' subjective well-being (SWB), anxiety, and perceived effectiveness of the game in reducing anxiety (subjective effectiveness, SE) were assessed one week before the intervention (T1), after completing pictures in each round (T2-T5), and after the intervention (T6). Independent t-tests were used to examine the general intervention effect and the intervention effect of each round. One-way ANOVA was used to examine whether these outcome variables were influenced by the number of rounds completed. RESULTS: In total, 1390 global players responded and completed at least one assessment. Overall, the general intervention group showed a statistical significantly greater increase in SWB than the general control group (N=164, t=3.59, Cohen's d 0.58[95% CI 0.36 to -1.24], P<0.001). Compared to the control group, the best effectiveness of intervention group showed in the Awe round, in which the increasing of SWB is significant (N=171, t=2.51, Cohen's d 0.39[95% CI 0.10 to -0.82], P=0.013), and players who colored all four pictures had nearly significant improvement in SWB (N=171, F(4,170)=2.34, Å2=0.053, P=0.058) and a significant decrease in anxiety(N=171, F(4,170)=3·39, Å2=0·075, P=0.011). CONCLUSIONS: These data suggest that the effectiveness of online psychological interventions, such as coloring game, for mental health in the special period. It shows the feasibility of applying existing commercial games embedded scientific psychological interventions that can fill the gap of mental crises and services for a wider group of people during the pandemic. The result would inspire the innovations of against the psychological problems caused by public emergencies, and encourages more games, especially most popular ones, to take more positive action for the common crisis of mankind.
Let's color: An online coloring game improves subjective well-being and reduces anxiety during the COVID-19 pandemic