# A digital intervention to prevent the initiation of opioid misuse in adolescents in school-based health centers

> **NIH NIH UG3** · YALE UNIVERSITY · 2020 · $685,729

## Abstract

Most opioid misuse begins during adolescence and young adulthood. Adolescence is the time to intervene with
prevention interventions in settings like school-based health centers (HCs), yet few exist that prevent initiation
of opioid misuse. “Serious videogame” interventions can improve health behaviors. They meet adolescents
“where they are,” and compared to standard interventions, they can reach large populations, with consistent
fidelity, place limited demands on personnel/resources, facilitate rapid sustainable distribution, all at a
potentially lower cost. This proposal harnesses the power of videogame interventions and incorporates
components of effective substance use prevention programs to develop an evidence-informed intervention to
prevent the initiation of opioid misuse in adolescents. Building on our experience developing videogame
interventions and in partnership with the national School-Based Health Alliance (SBHA), we will develop and
test a new videogame intervention, PlaySmart. PlaySmart will build upon our PlayForward videogame
intervention platform that has demonstrated efficacy in improving attitudes and knowledge related to risk
behaviors. Through rigorous formative work and with input from adolescents, and our SBHA and game
development partners, we will create the PlaySmart videogame intervention. PlaySmart will be designed to
provide players with behavioral skills and knowledge through repetitive and engaging videogame play to target
adolescent perception of risk of harm from initiating opioid misuse. The specific aims of this proposal are to:
1) Phase 1 (UG3): Develop and pilot-test the PlaySmart game and, working with SBHA stakeholders, develop
implementation strategies and partners; and 2) Phase 2 (UH3): Conduct a randomized controlled trial (RCT)
with 532 high-risk 16-19 year old adolescents, in 10 local school-based (HCs), comparing the PlaySmart game
to attention/time control games, and work with the SBHA to examine strategies for implementing PlaySmart in
school-based HCs nationally. The main outcomes for the RCT will be the proportion of participants who report
a perception of great risk of harm from misuse of opioids, intentions to misuse opioids, self-efficacy for refusing
opioids, and initiation of opioid misuse. We hypothesize that participants in the PlaySmart group, compared to
the control group, will have improved outcomes at 6 weeks (completion of gameplay), and at 3, 6 and 12
months. During the trial, we will collect implementation data from participants and school-based HCs and from
the videogame software (e.g. dose). We will use an implementation framework to examine barriers and
facilitators to implementing PlaySmart in school-based HCs nationally, and evaluate the cost-effectiveness of
the intervention and the cost of the implementation strategies. This research, conducted by an experienced
team of videogame intervention researchers and the national SBHA, holds the promise of creating an effective,
engag...

## Key facts

- **NIH application ID:** 10023176
- **Project number:** 5UG3DA050251-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Lynn Elizabeth Fiellin
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $685,729
- **Award type:** 5
- **Project period:** 2019-09-30 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10023176

## Citation

> US National Institutes of Health, RePORTER application 10023176, A digital intervention to prevent the initiation of opioid misuse in adolescents in school-based health centers (5UG3DA050251-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10023176. Licensed CC0.

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