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How gamification could change the face of mental health research

What do you think of when someone talks about dementia and mental health studies? Perhaps a brain scanner, surveys or visiting a university for a series of tests. How about playing games on your smartphone?   

The Neureka Project is a novel approach to dementia and mental health research. Anyone can download the app for free, answer a series of questions and start playing games, which feed into a large-scale study with participants from across the globe.  

Funded by the Global Brain Health Institute, Trinity College, and Science Foundation Ireland, the Neureka project's primary focus is to increase our understanding of disorders of the mind, including a range of mental health conditions and dementia.  

We caught up with Dr Claire Gillan, an Assistant Professor of Psychology at Trinity College Dublin, MQ Fellow and the Principal Investigator on Neureka project. 

What do you think makes Neureka unique?   

Neureka addresses a lot of the limitations associated with the classic approaches to mental health research. Foremost, by using a smartphone app, we are able to dramatically scale up the sample sizes that we get. It is becoming clear that a great many of the effect sizes we are dealing with in mental health research are very small.

There are many external risk factors, biological, lifestyles, socioeconomic, genetic – you name it. They all conspire to someone's risk of having a mental health disorder, but none are deterministic by themselves. So, in order to actually use these risk factors to make predictions about who, for example, might get ill in the future, we have to consider multiple sources of evidence at once. To do this effectively, we need much larger samples of people than is possible using traditional methods where participants come into our lab to take part in a study.

 Neureka has a few other unique features – for example, the tests we have built are user-friendly, self-guided, takes far less time and you can do this before you go into a doctor's office. They are also cheaply delivered via smartphone; you don't need a brain scanner or live near a research centre to complete a test. this is really important because it means that, should we be successful, the tests are scalable, practical to deliver and economically viable.  

A feature we are really excited about is that we have a facility in the app for other research centres to use it for their own studies. We invested a lot of time and money working on this app, and other researchers don't need to develop their own. It's nice that as we move forward to share and have more standardised resources that the community can share.

A final thing that sets us apart is that by using this app we can study brain health over time – some studies in Neureka will span minutes, days, weeks or even months. Most mental health studies are cross-sectional, meaning the data that is collected is a snapshot in time. However, to really understand causation, prediction and precipitating factors, we need to study people as they transition into an episode of mental ill-health or in the case of dementia, have data gathered from them years before the illness emerges. We know prevention is better than cure – so the key thing is that we want to do science that can be used to one day actually stop someone from experiencing a deterioration in brain health.

Does this mean people who sign up to the app need to use it over a number of years?  

No – not at all! We have several different models, all running at once. You could sign on and do a study for an hour, which is a cross-sectional study but has lots of different variables at once.   

There are also studies on medium time scales, for example, we have once experiment  (‘science challenge’) in the app called 'multi mood' where you do a brief reflection of what you are thinking and feeling twice a day for eight weeks. It takes about a minute to do it each day. Although it is a relatively short timescale in mental health terms, with enough participants, in a subset, we will capture that transition I mentioned before. With smaller studies, it's impossible to capture this as we don't know who will transition with their mental health over such a short period.   

We will also have studies lasting a year or even five, although we anticipate that most people will not engage with the app over multiple years.  For those, who do, the may complete an assessment in 2020 and then we get in touch 5 years later and see how they're doing.

What can people personally get out of using the app?  

We're not able to tell people what their personal chances of developing depression or dementia are – simply because the science is not there yet. But, we are giving people the latest information (on a population level) to reduce their risk of developing dementia or a mental illness. At the end of each game, we tell people what we were measuring and give them tips that they can implement protective habits in their own lives.  

Could you talk us through the process of using the app for the first time?  

You register for the app, and you give some basic information. The main section is the ‘science challenge’ screen, where there are several activities for you to complete. Some may take an hour's worth of time that you can spread out over several days if you wish, there are others that you participate for eight weeks and you get push notifications on your phone. You decide which challenges you want to complete and when.   

We want everyone to complete the first science challenge, which is risk factors. You must do that to unlock unrestricted access to the games in the app.  

If you want to and are comfortable doing so, you can also provide sensitive information about your mental health. It is important information, but we also realise that some people may not want to share it.   

How will people's details be used?  

The app is fully GDPR compliant, but it isn't fully anonymous. You need to provide an email address to sign up and we send email prompts from time to time to encourage you to take part in new science challenges, or something a year later after you have taken part. All of the information is stored securely in an encrypted fashion.  

Have many people already started to take part?  

We launched in June and we have over 1000 registered users. We're very happy with that - it's a good start. We have participants from 50 countries around the world. We're just starting to gain traction, but we hope to scale considerably with time.   

You can download the Neureka App here and start playing today!  

Last updated: 23 July 2020

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