Before patients can be taught self-management to manage chronic illness, they need to show interest in learning the skills. This is often a flaw that weakens later actions taken by patients: they may simply not want to learn and perform what they need to do to take control. Adolescents with chronic illnesses often wish to avoid these responsibilities. To overcome the problem, researchers have developed a number of ways to motivate patients. These often include new wrinkles in the use of computers and other electronic devices. Beale and coworkers described the use of a video game, Re-Mission, to involve young people with cancer in their own treatment. The efficacy of Re-Mission was investigated in a randomized, controlled study with 375 adolescent and young adult cancer patients. Participants either received a regular commercial game (control) or both the regular game plus Re-Mission (Re-Mission group). Participants were given a mini-PC course with the games installed and requested to play for an hour each week for three months. A test on cancer-related knowledge was given prior to game play (baseline) and again after one and three months. At three months, the Re-Mission group also rated the acceptability and credibility of the program. Analyses of the knowledge test scores showed that whereas scores of both groups improved significantly over the follow-up periods, the scores of the Re-Mission group improved significantly more. The size of this effect was related to usage of Re-Mission.

VALUE OF STUDY TO READER: The results showed strong effects of Re-Mission play on cancer knowledge that was not attributable to patients' expectations. The authors concluded that video games could be an effective vehicle for health education in adolescents and young adults with chronic illnesses. This was a nice study showing how tools of interest to patients, such as computers, can be used to teach knowledge about a condition and, hopefully, self-management skills.

I.L. Beale et al. Improvement in cancer-related knowledge following use of a psychoeducational video game for adolescents and young adults with cancer. Journal of Adolescent Health, 2007; 41:263-270.