research proposal about online games

Playing games: advancing research on online and mobile gaming consumption

Internet Research

ISSN : 1066-2243

Article publication date: 9 April 2019

Issue publication date: 9 April 2019

Seo, Y. , Dolan, R. and Buchanan-Oliver, M. (2019), "Playing games: advancing research on online and mobile gaming consumption", Internet Research , Vol. 29 No. 2, pp. 289-292. https://doi.org/10.1108/INTR-04-2019-542

Emerald Publishing Limited

Introduction

Computer games consistently generate more revenue than the movie and music industries and have become one of the most ubiquitous symbols of popular culture ( Takahashi, 2018 ). Recent technological developments are changing the ways in which consumers are able to engage with computer games as individuals – adult gamers, parents and children ( Christy and Kuncheva, 2018 ) – and as collectives, such as communities, networks and subcultures ( Hamari and Sjöblom, 2017 ; Seo, 2016 ). In particular, with the proliferation of online and mobile technologies, we have witnessed the emergence of newer forms of both computer games themselves (e.g. advertising games (advergames), virtual and augmented reality games and social media games) ( Rauschnabel et al. , 2017 ) and of gaming practices (e.g. serious gaming, hardcore gaming and eSports) ( Seo, 2016 ).

It is, therefore, not surprising that the issues concerning the ways computer games consumption is changing in light of these technological developments have received much attention across diverse disciplines of social sciences, such as marketing (e.g. Seo et al. , 2015 ), information systems (e.g. Liu et al. , 2013 ), media studies (e.g. Giddings, 2016 ) and internet research (e.g. Hamari and Sjöblom, 2017 ). The purpose of this introductory paper to the special issue “Online and mobile gaming” is to chart future research directions that are relevant to a rapidly changing postmodern digital gaming landscape. In this endeavor, this paper first provides an integrative summary of the six articles that comprise this special issue, and then draws the threads together in order to elicit the agenda for future research.

An integrative summary of the special issue

The six articles that were selected for this special issue advance research into online and mobile gaming in several ways. The opening article by Pappas, Mikalef, Giannakos and Kourouthanassis draws attention to the complex ecosystem of mobile applications in which multiple factors influence consumer behavior in mobile games. Pappas and his colleagues shed light on how price value, game content quality, positive and negative emotions, gender, and gameplay time interact with one another to predict the intention to download mobile games. This study offers useful insights by demonstrating how fuzzy set qualitative comparative analysis methodology can be applied to advance research into computer games consumption.

The study by Bae, Kim, Kim and Koo addresses the digital virtual consumption that occurs within computer games. This second paper explores the relationship between in-game items and mood management to determine the affective value of purchasing in-game items. The findings reveal that game users manage their levels of arousal and mood valence through the use of in-game purchases, suggesting that stressed users are more likely to purchase decorative items, whereas bored users tend to purchase functional items. This study offers an informative perspective of how mood management and selective exposure theories can be applied to understand the in-game purchases. Continuing this theme, the third study by Bae, Park and Koo investigates the effect of perceived corporate social responsibility (CSR) initiatives. Park and colleagues extend previous research by identifying important motivational mechanisms, such as self-esteem and compassion, which link CSR initiative perceptions with the intentions to purchase in-game items.

The fourth and fifth studies of this special issue draw our attention to the use of avatars and game characters. Liao, Cheng and Teng use social identity and flow theories to construct a novel model that explains how avatar attractiveness and customization impact loyalty among online game consumers. In the fifth study, Choi explores the importance of game character characteristics being congruent with product types in order to make advergames more persuasive.

The final study by Lee and Ko reviews the predictors of game addiction based on loneliness, motivation and inter-personal competence. The findings of these authors suggest that regulatory focus mediates the effect of loneliness on online game addiction, and that inter-personal competence significantly buffers the indirect effect of loneliness on online game addiction. This study advances our knowledge about online game addiction through an investigation of the important role played by loneliness.

Future directions for research

Taken together, our introductory commentary and the six empirical studies that make up this special issue deepen and broaden the current understanding of how online and mobile technologies augment the consumption of computer games. In this final section of our paper, we outline potential directions for future research.

First, this special issue highlights that computer games consumption is a diverse interdisciplinary phenomenon, where important issues range from establishing the factors that determine the adoption of particular computer games to what consumers do within these games; from whether computer games enhance consumer well-being (e.g. Howes et al. , 2017 ), to whether they engender addiction (e.g. Frölich et al. , 2016 ); and from establishing how computer gaming experiences are influenced by internal psychological mechanisms to querying the effects of broader social aspects of consumer lives on computer games consumption ( Kowert et al. , 2015 ). Informed by these findings, we assert that as computer games consumption becomes more complex and interactive, incorporating more technology brought about by the proliferation of online and mobile gaming, it is important that our theorizing follows by tracking the mutual imbrication of consumers, play, technology, culture, well-being and other salient issues.

Computer games consumption is a phenomenon of global significance, which is reflected by the international interest that we have received for this special issue. This prompts us to consider similarities and differences in the ways that computer games are consumed across cultures ( Elmezeny and Wimmer, 2018 ). Many computer games themselves now foster intercultural, multicultural and transcultural experiences ( Cruz et al. , 2018 ) by enabling consumers from different countries and regions to connect and build relationships within the shared virtual space. How do such experiences shape the consumption of computer games? This gap in the literature has been previously noted ( Seo et al. , 2015 ), but it has not been either sufficiently detailed or theorised. Future studies should explore the role of various transcultural experiences and practices within online and mobile games consumption.

Finally, one increasingly promising area for future research is the rise of virtual reality (VR) applications. Although the earliest references to VR date back to the 1990s (e.g. Gigante, 1993 ), it has been only recently that technological developments have allowed VR to evolve from a niche technology into an everyday phenomenon that is readily available to consumers ( Lamkin, 2017 ; Oleksy and Wnuk, 2017 ). Given that VR is an experientially distinct medium, how will it augment computer games consumption experiences and practices? Will it foster more diverse applications of computer games across various aspects of consumer lives (e.g. Tussyadiah et al. , 2018 ), or will it increase computer games addiction (e.g. Chou and Ting, 2003 )? What are the current and future intersections between VR technology, online and mobile games, and how are they likely to develop and affect consumers? We envision that these and many other questions related to the application and proliferation of VR technology in computer games consumption will be an exceptionally fruitful area for future research.

In summary, we hope that this paper and the special issue, with its emphasis on online and mobile gaming, will offer new insights for researchers and practitioners who are interested in the advancement of research on computer games consumption.

Chou , T.J. and Ting , C.C. ( 2003 ), “ The role of flow experience in cyber-game addiction ”, CyberPsychology and Behavior , Vol. 6 No. 6 , pp. 663 - 675 .

Christy , T. and Kuncheva , L.I. ( 2018 ), “ Technological advancements in affective gaming: a historical survey ”, GSTF Journal on Computing , Vol. 3 No. 4 , pp. 32 - 41 .

Cruz , A.G.B. , Seo , Y. and Buchanan-Oliver , M. ( 2018 ), “ Religion as a field of transcultural practices in multicultural marketplaces ”, Journal of Business Research , Vol. 91 , pp. 317 - 325 .

Elmezeny , A. and Wimmer , J. ( 2018 ), “ Games without frontiers: a framework for analyzing digital game cultures comparatively ”, Media and Communication , Vol. 6 No. 2 , pp. 80 - 89 .

Frölich , J. , Lehmkuhl , G. , Orawa , H. , Bromba , M. , Wolf , K. and Görtz-Dorten , A. ( 2016 ), “ Computer game misuse and addiction of adolescents in a clinically referred study sample ”, Computers in Human Behavior , Vol. 55 , pp. 9 - 15 .

Giddings , S. ( 2016 ), “ Pokémon Go as distributed imagination ”, Mobile Media and Communication , Vol. 5 No. 1 , pp. 59 - 62 .

Gigante , M.A. ( 1993 ), “ Virtual reality: definitions, history and applications ”, in Earnshaw , R.A. (Ed.), Virtual Reality Systems , Academic Press , New York, NY , pp. 3 - 14 .

Hamari , J. and Sjöblom , M. ( 2017 ), “ What is eSports and why do people watch it ”, Internet Research , Vol. 27 No. 2 , pp. 211 - 232 .

Howes , S.C. , Charles , D.K. , Marley , J. , Pedlow , K. and McDonough , S.M. ( 2017 ), “ Gaming for health: systematic review and meta-analysis of the physical and cognitive effects of active computer gaming in older adults ”, Physical Therapy , Vol. 97 No. 12 , pp. 1122 - 1137 .

Kowert , R. , Vogelgesang , J. , Festl , R. and Quandt , T. ( 2015 ), “ Psychosocial causes and consequences of online video game play ”, Computers in Human Behavior , Vol. 45 , pp. 51 - 58 .

Lamkin , P. ( 2017 ), “ Virtual reality headset sales hit 1 million ”, available at: www.forbes.com/sites/paullamkin/2017/11/30/virtual-reality-headset-sales-hit-1-million/#241697c42b61/ (accessed October 4, 2018 ).

Liu , D. , Li , X. and Santhanam , R. ( 2013 ), “ Digital games and beyond: what happens when players compete ”, MIS Quarterly , Vol. 37 No. 1 , pp. 111 - 124 .

Oleksy , T. and Wnuk , A. ( 2017 ), “ Catch them all and increase your place attachment! The role of location-based augmented reality games in changing people–place relations ”, Computers in Human Behavior , Vol. 76 , pp. 3 - 8 .

Rauschnabel , P.A. , Rossmann , A. and tom Dieck , M.C. ( 2017 ), “ An adoption framework for mobile augmented reality games: the case of Pokémon Go ”, Computers in Human Behavior , Vol. 76 , pp. 276 - 286 .

Seo , Y. ( 2016 ), “ Professionalized consumption and identity transformations in the field of eSports ”, Journal of Business Research , Vol. 69 No. 1 , pp. 264 - 272 .

Seo , Y. , Buchanan‐Oliver , M. and Fam , K.S. ( 2015 ), “ Advancing research on computer game consumption: a future research agenda ”, Journal of Consumer Behaviour , Vol. 14 No. 6 , pp. 353 - 356 .

Takahashi , D. ( 2018 ), “ Newzoo: games market expected to hit $180.1 billion in revenues in 2021 ”, available at: https://venturebeat.com/2018/04/30/newzoo-global-games-expected-to-hit-180-1-billion-in-revenues-2021/ (accessed October 4, 2018 ).

Tussyadiah , I.P. , Wang , D. , Jung , T.H. and tom Dieck , M.C. ( 2018 ), “ Virtual reality, presence and attitude change: empirical evidence from tourism ”, Tourism Management , Vol. 66 , pp. 140 - 154 .

Acknowledgements

The guest editors would like to offer special thanks to the Editor of Internet Research , Christy Cheung, for supporting the publication of this special issue. The guest editors would also like to thank all of the authors who contributed to this research for the “Online and mobile gaming” special issue. Finally, the guest editors gratefully acknowledge the contribution of reviewers, who generously spent their time in helping to review submissions: Luke Butcher, Curtin University, Australia; Hsiu-Hua Chang, Feng Chia University, Taiwan; I-Cheng Chang, National Dong Hwa University, Taiwan; Chi-Wen Chen, California State University, USA; Zifei Fay Chen, University of San Francisco, USA; Sujeong Choi, Chonnam National University, Korea; Diego Costa Pinto, New University of Lisbon, Portugal; Angela Cruz, Monash University, Australia; Robert Davis, Massey University, New Zealand; Julia Fehrer, University of Auckland, New Zealand; Tony Garry, University of Otago, New Zealand; Tracy Harwood, De Montfort University, UK; Mu Hu, Beihang University, China; Tseng-Lung Huang, Yuan Ze University, Taiwan; Kun-Huang Huang, Feng Chia University, Taiwan; Chelsea Hughes, Virginia Commonwealth University, USA; Euejung Hwang, Otago University, New Zealand; Sang-Uk Jung, Hankuk University of Foreign Studies, Korea; Kacy Kim, Bryant University, USA; Dong-Mo Koo, Kyungpook National University, Korea; Jun Bum Kwon, University of New South Wales, Australia; Chun-Chia Lee, National Chiao Tung University, Taiwan; Jacob Chaeho Lee, Ulsan National Institute of Science and Technology, Korea; Loic Li, University of Auckland, New Zealand; Marcel Martončik, University of Presov, Slovakia; Mike Molesworth, University of Reading, UK; Gavin Northey, University of Auckland, New Zealand; James Richard, Victoria University of Wellington, New Zealand; Ryan Rogers, University of Pennsylvania, USA; Felix Septianto, University of Auckland, New Zealand; Zhen Shao, Harbin Institute of Technology, China; Kai-Shuan Shen, Fo Guang University, Taiwan; Jungmin Son, Chungnam National University; Korea; Yang Sun, Zhejiang Sci-Tech University, China; Eva van Reijmersdal, University of Amsterdam, Netherlands; Ekant Veer, University of Canterbury, New Zealand; John Velez, Indiana University, USA; Wei-Tsong Wang, National Cheng Kung University, Taiwan; Ya-Ling Wu, Tamkang University, Taiwan; Sheau-Fen Yap, Auckland University of Technology, New Zealand; and Sukki Yoon, Bryant University, USA.

Corresponding author

About the authors.

Yuri Seo is Senior Lecturer at the University of Auckland of Business School, New Zealand. His research interests include digital technology and consumption, cultural branding and multicultural marketplaces.

Rebecca Dolan is Lecturer at the University of Adelaide School of Business, Australia. Her research focuses on understanding, facilitating and optimizing customer relationships, engagement, and online communication strategies. She has a specific interest in the role that digital and social media play in the modern marketing communications environment.

Margo Buchanan-Oliver is Professor in the Department of Marketing and the Co-Director of the Centre of Digital Enterprise (CODE) at the University of Auckland Business School. Her research concerns interdisciplinary consumption discourse and practice, particularly that occurring at the intersection of the digital and physical worlds.

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This paper is in the following e-collection/theme issue:

Published on 23.4.2024 in Vol 26 (2024)

Electronic Media Use and Sleep Quality: Updated Systematic Review and Meta-Analysis

Authors of this article:

Xiaoning Han * , PhD ;
Enze Zhou * , MA ;
Dong Liu * , PhD

School of Journalism and Communication, Renmin University of China, Beijing, China

*all authors contributed equally

Corresponding Author:

Dong Liu, PhD

School of Journalism and Communication

Renmin University of China

No. 59 Zhongguancun Street, Haidian District

Beijing, 100872

Phone: 86 13693388506

Email: [email protected]

Background: This paper explores the widely discussed relationship between electronic media use and sleep quality, indicating negative effects due to various factors. However, existing meta-analyses on the topic have some limitations.

Objective: The study aims to analyze and compare the impacts of different digital media types, such as smartphones, online games, and social media, on sleep quality.

Methods: Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the study performed a systematic meta-analysis of literature across multiple databases, including Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar, from January 2018 to October 2023. Two trained coders coded the study characteristics independently. The effect sizes were calculated using the correlation coefficient as a standardized measure of the relationship between electronic media use and sleep quality across studies. The Comprehensive Meta-Analysis software (version 3.0) was used to perform the meta-analysis. Statistical methods such as funnel plots were used to assess the presence of asymmetry and a p -curve test to test the p -hacking problem, which can indicate publication bias.

Results: Following a thorough screening process, the study involved 55 papers (56 items) with 41,716 participants from over 20 countries, classifying electronic media use into “general use” and “problematic use.” The meta-analysis revealed that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. A significant cultural difference was also observed in these effects. General use was associated with a significant decrease in sleep quality ( P <.001). The pooled effect size was 0.28 (95% CI 0.21-0.35; k =20). Problematic use was associated with a significant increase in sleep problems ( P ≤.001). The pooled effect size was 0.33 (95% CI 0.28-0.38; k =36). The subgroup analysis indicated that the effect of general smartphone use and sleep problems was r =0.33 (95% CI 0.27-0.40), which was the highest among the general group. The effect of problematic internet use and sleep problems was r =0.51 (95% CI 0.43-0.59), which was the highest among the problematic groups. There were significant differences among these subgroups (general: Q between =14.46, P =.001; problematic: Q between =27.37, P <.001). The results of the meta-regression analysis using age, gender, and culture as moderators indicated that only cultural difference in the relationship between Eastern and Western culture was significant ( Q between =6.69; P =.01). All funnel plots and p -curve analyses showed no evidence of publication and selection bias.

Conclusions: Despite some variability, the study overall confirms the correlation between increased electronic media use and poorer sleep outcomes, which is notably more significant in Eastern cultures.

Introduction

Sleep is vital to our health. Research has shown that high sleep quality can lead to improvements in a series of health outcomes, such as an improved immune system, better mood and mental health, enhanced physical performance, lower risk of chronic diseases, and a longer life span [ 1 - 5 ].

Electronic media refers to forms of media or communication that use electronic devices or technology to create, distribute, and display content. This can include various forms of digital media such as smartphones, tablets, instant messaging, phone calls, social media, online games, short video platforms, etc. Electronic media has permeated every aspect of our lives [ 6 ]. Many prefer to use smartphones or tablets before sleep, which can negatively affect sleep in many aspects, including delayed sleep onset, disrupted sleep patterns, shortened sleep duration, and poor sleep quality [ 7 - 10 ]. Furthermore, problematic use occurs when the behavior surpasses a certain limit. In this study, problematic use of electronic media is not solely determined by the amount of time spent on these platforms, but rather by behavioral indicators that suggest an unhealthy or harmful relationship with them.

Smartphones or tablet use can affect sleep quality in many ways. At first, the use of these devices may directly displace, delay, or interrupt sleep time, resulting in inadequate sleep quantity [ 11 ]. The sound of notifications and vibrations of these devices may interrupt sleep. Second, the screens of smartphones and tablets emit blue light, which can suppress the production of melatonin, the hormone responsible for regulating sleep-wake cycles [ 12 ]. Third, consuming emotionally charged content, such as news, suspenseful movies, or engaging in online arguments, can increase emotional arousal, making it harder to relax and fall asleep. This emotional arousal can also lead to disrupted sleep and nightmares [ 13 ]. Finally, the use of electronic devices before bedtime can lead to a delay in bedtime and a shortened sleep duration, as individuals may lose track of time while engaging with their devices. This can result in a disrupted sleep routine and decreased sleep quality [ 14 ].

Some studies have conducted meta-analyses on screen media use and sleep outcomes in 2016, 2019, and 2021 [ 15 - 17 ]. However, these studies had their own limitations. First, the sample size included in their meta-analyses was small (around 10). Second, these studies only focused on 1 aspect of the effect of digital media on sleep quality. For example, Carter et al [ 16 ] focused only on adolescents, and both Alimoradi et al [ 15 ] and Kristensen et al [ 17 ] only reviewed the relationship between problematic use of digital media or devices and sleep quality. Despite of the high heterogeneity found in the meta-analyses, none have compared the effects of different digital media or devices. This study aims to clarify and compare the effects of these different channels.

Literature Search

The research adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines ( Multimedia Appendix 1 ) and followed a predetermined protocol [ 18 , 19 ]. As the idea and scope of this study evolved over time, the meta-analysis was not preregistered. However, the methodology was defined a priori and strictly followed to reduce biases, and the possible influence of post hoc decisions was minimized. All relevant studies in English, published from January 1, 2018, to October 9, 2023, were searched. We searched the following databases: Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar. The abstracts were examined manually. The keywords used to search were the combination of the following words: “sleep” OR “sleep duration” OR “sleep quality” OR “sleep problems” AND “electronic media” OR “smartphone” OR “tablet” OR “social media” OR “Facebook” OR “Twitter” OR “online gaming” OR “internet” OR “addiction” OR “problematic” ( Multimedia Appendix 2 ). Additionally, the reference lists of relevant studies were examined.

Two trained coders independently screened the titles and abstracts of the identified papers for eligibility, followed by a full-text review of the selected studies. Discrepancies between the coders were resolved through discussion until a consensus was reached. The reference lists of the included studies were also manually screened to identify any additional relevant studies. Through this rigorous process, we ensured a comprehensive and replicable literature search that could contribute to the robustness of our meta-analysis findings.

Inclusion or Exclusion Criteria

Titles and abstracts from search results were scrutinized for relevance, with duplicates removed. Full texts of pertinent papers were obtained, and their eligibility for inclusion was evaluated. We mainly included correlational studies that used both continuous measures of time spent using electronic media use and sleep quality. Studies must have been available in English. Four criteria were used to screen studies: (1) only peer-reviewed empirical studies, published in English, were considered for inclusion in the meta-analysis; (2) the studies should report quantitative statistics on electronic media use and sleep quality, including sample size and essential information to calculate the effect size, and review papers, qualitative studies, case studies, and conference abstracts were excluded; (3) studies on both general use and problematic use of electronic media or devices should be included; and (4) only studies that used correlation, regression, or odds ratio were included to ensure consistency.

Study Coding

Two trained coders were used to code the characteristics of the studies independently. Discrepancies were discussed with the first author of the paper to resolve. Sample size and characteristics of participants were coded: country, female ratio, average age, publication year, and electronic types. Effect sizes were either extracted directly from the original publications or manually calculated. If a study reported multiple dependent effects, the effects were merged into one. If a study reported multiple independent effects from different samples, the effects were included separately. Additionally, to evaluate the study quality, the papers were classified into 3 tiers (high, middle, and low) according to Journal Citation Reports 2022 , a ranking of journals based on their impact factor as reported in the Web of Science. The few unindexed papers were rated based on their citation counts as reported in Google Scholar.

Meta-Analysis and Moderator Analyses

The effect sizes were calculated using the correlation coefficient ( r ) as a standardized measure of the relationship between electronic media or device use and sleep quality across studies. When studies reported multiple effect sizes, we selected the one that best represented the overall association between electronic media use and sleep quality. If studies did not provide correlation coefficients, we converted other reported statistics (eg, standardized regression coefficients) into correlation coefficients using established formulas. Once calculated, the correlation coefficients were transformed into Fisher z scores to stabilize the variance and normalize the distribution.

Previous meta-studies have shown high levels of heterogeneity. Hence, the random effects model was adopted for all analyses. To explore potential factors contributing to the heterogeneity and to further understand the relationship between electronic media use and sleep quality, we conducted moderator analyses. The following categorical and continuous moderators were examined: media types (online gaming, social media, smartphone, or intent), participants’ average age, culture, female ratio, and sleep quality assessment method. For categorical moderators, subgroup analyses were performed, while for continuous moderators, meta-regression analyses were conducted. All analyses were completed in the Comprehensive Meta-Analysis software (version 3.0; Biostat, Inc).

Publication Bias

We used statistical methods such as funnel plots to assess the presence of asymmetry and a p -curve test to test the p -hacking problem, which may indicate publication bias. In case of detected asymmetry, we applied techniques such as the trim-and-fill method to adjust the effect size estimates.

By addressing publication bias, we aimed to provide a more accurate and reliable synthesis of the available evidence, enhancing the validity and generalizability of our meta-analytic findings. Nevertheless, it is essential for readers to interpret the results cautiously, considering the potential limitations imposed by publication bias and other methodological concerns.

Search Findings

A total of 98,806 studies were identified from databases, especially Scopus (n=49,643), Google Scholar (n=18,600), Science Direct (n=15,084), and Web of Science (n=11,689). Upon removing duplicate records and excluding studies that did not meet the inclusion criteria, 754 studies remained for the screening phase. After screening titles, abstracts, and full texts, 703 studies were excluded. A total of 4 additional studies were identified from the references of relevant reviews. Finally, 55 studies [ 20 - 74 ] were included in the meta-analysis. The flow diagram of the selection is shown in Figure 1 .

Characteristics of Included Studies

In 20 studies, 21,594 participants were included in the analysis of the general use of electronic media and sleep quality. The average age of the sample ranged from 9.9 to 44 years. The category of general online gaming and sleep quality included 4 studies, with 14,837 participants; the category of general smartphone use and sleep quality included 10 studies, with 5011 participants; and the category of general social media use and sleep quality included 6 studies, with 1746 participants.

These studies came from the following countries or areas: Germany, Serbia, Indonesia, India, China, Italy, Saudi Arabia, New Zealand, the United Kingdom, the United States, Spain, Qatar, Egypt, Argentina, and Portugal. The most frequently used measure of electronic media use was the time spent on it. The most frequently used measure of sleep was the Pittsburgh Sleep Quality Index.

In 35 studies, 20,122 participants were included in the analysis of the problematic use of electronic media and sleep quality. The average age of the sample ranged from 14.76 to 65.62 years. The category of problematic online gaming and sleep quality included 5 studies, with 1874 participants; the category of problematic internet use and sleep quality included 2 studies, with 774 participants; the category of problematic smartphone use and sleep quality included 18 studies, with 12,204 participants; and the category of problematic social media use and sleep quality included 11 studies, with 5270 participants. There was a study that focused on both social media and online gaming, which led to its inclusion in the analysis. These studies came from 14 countries or areas: Turkey, the United States, Indonesia, China, France, Taiwan, India, South Korea, Hong Kong, Iran, Poland, Israel, Hungary, and Saudi Arabia. The most frequently used measures of problematic electronic media use were the Internet Gaming Disorder Scale-Short Form, Smartphone Addiction Scale-Short Form, and Bergen Social Media Addiction Scale.

With respect to study quality, the 56 papers were published in 50 journals, 41 of which were indexed in Journal Citation Reports 2022 , while the remaining 9 journals were rated based on their citation counts as reported in Google Scholar. As a result, of the 56 papers included in the study, 22 papers were assigned a high rating, 18 papers were assigned a middle rating, and 16 papers were assigned a low rating. More information about the included studies is listed in Multimedia Appendix 3 [ 20 - 74 ].

Meta-Analysis

The results of the meta-analysis of the relationship between general electronic media use and sleep quality showed that electronic media use was associated with a significant decrease in sleep quality ( P <.001). The pooled effect size was 0.28 (95% CI 0.21-0.35; k =20), indicating that individuals who used electronic media more frequently were generally associated with more sleeping problems.

The second meta-analysis showed that problematic electronic media use was associated with a significant increase in sleep problems ( P ≤.001). The pooled effect size was 0.33 (95% CI 0.28-0.38; k =36), indicating that participants who used electronic media more frequently were more likely to have more sleep problems.

Moderator Analyses

At first, we conducted subgroup analyses for different media or devices. The results are shown in Tables 1 and 2 . The effect of the relationship between general online gaming and sleep problems was r =0.14 (95% CI 0.06-0.22); the effect of the relationship between general smartphone use and sleep problems was r =0.33 (95% CI 0.27-0.40); and the effect of the relationship between general social media use and sleep problems was r =0.28 (95% CI 0.21-0.34). There are significant differences among these groups ( Q between =14.46; P =.001).

The effect of the relationship between problematic gaming and sleep problems was r =0.49, 95% CI 0.23-0.69; the effect of the relationship between problematic internet use and sleep problems was r =0.51 (95% CI 0.43-0.59); the effect of the relationship between problematic smartphone use and sleep problems was r =0.25 (95% CI 0.20-0.30); and the effect of the relationship between problematic social media use and sleep problems was r =0.35 (95% CI 0.29-0.40). There are significant differences among these groups ( Q between =27.37; P <.001).

We also used age, gender, and culture as moderators to conduct meta-regression analyses. The results are shown in Tables 3 and 4 . Only cultural difference in the relationship between Eastern and Western culture was significant ( Q between =6.694; P =.01). All other analyses were not significant.

a Not applicable.

All funnel plots of the analyses were symmetrical, showing no evidence of publication bias ( Figures 2 - 5 ). We also conducted p -curve analyses to see whether there were any selection biases. The results also showed that there were no biases.

Principal Findings

This study indicated that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. General use was associated with a significant decrease in sleep quality. Problematic use was associated with a significant increase in sleep problems. A significant cultural difference was also observed by the meta-regression analysis.

First, there is a distinction in the impact on sleep quality between problematic use and general use, with the former exhibiting a higher correlation strength. However, both have a positive correlation, suggesting that the deeper the level of use, the more sleep-related issues are observed. In addressing this research question, the way in which electronic media use is conceptualized and operationalized may have a bearing on the ultimate outcomes. Problematic use is measured through addiction scales, while general use is predominantly assessed by duration of use (time), leading to divergent results stemming from these distinct approaches. The key takeaway is that each measurement possesses unique strengths and weaknesses, and the pathways affecting sleep quality differ. Consequently, the selection of a measurement approach should be tailored to the specific research question at hand. The duration of general use reflects an individual’s comprehensive involvement with electronic media, and its impact on sleep quality is evident in factors such as an extended time to fall asleep and reduced sleep duration. The addiction scale for problematic use illuminates an individual’s preferences, dependencies, and other associations with electronic media. Its impact on sleep quality is evident through physiological and psychological responses, including anxiety, stress, and emotional reactions.

Second, notable variations exist in how different types of electronic media affect sleep quality. In general, the positive predictive effects of smartphone, social media, and online gaming use durations on sleep problems gradually decrease. In the problematic context, the intensity of addiction to the internet and online gaming has the most significant positive impact on sleep problems, followed by social media, while smartphones exert the least influence. On one hand, longitudinal comparisons within the same context reveal that the content and format of electronic media can have varying degrees of negative impact on sleep quality, irrespective of whether it involves general or problematic use. On the other hand, cross-context comparisons suggest that both general and problematic use play a role in moderating the impact of electronic media types on sleep quality. As an illustration, problematic use reinforces the positive impact of online gaming and social media on sleep problems, while mitigating the influence of smartphones. Considering smartphones as electronic media, an extended duration of general use is associated with lower sleep quality. However, during problematic use, smartphones serve as the platform for other electronic media such as games and social media, resulting in a weakened predictive effect on sleep quality. Put differently, in the context of problematic use, the specific type of electronic media an individual consumes on their smartphones becomes increasingly pivotal in shaping sleep quality.

Third, cultural differences were found to be significant moderators of the relationship between electronic media use and sleep problems in both our study and Carter et al [ 16 ]. Kristensen et al [ 17 ], however, did not specifically address the role of cultural differences but revealed that there was a strong and consistent association between bedtime media device use and sleep outcomes across the studies included. Our findings showed that the association between problematic social media use was significantly larger in Eastern culture. We speculate that the difference may be attributed to cultural differences in social media use patterns, perceptions of social norms and expectations, variations in bedtime routines and habits, and diverse coping mechanisms for stress. These speculations warrant further investigation to understand better the underlying factors contributing to the observed cultural differences in the relationship between social media use and sleep quality.

Fourth, it was observed that gender and age had no significant impact on sleep quality. The negative effects of electronic media use are not only confined to the sleep quality of adults, and the association with gender differences remains unclear. Recent studies point out that electronic media use among preschoolers may result in a “time-shifting” process, disrupting their sleep patterns [ 75 ]. Similarly, children and adolescent sleep patterns have been reported to be adversely affected by electronic media use [ 76 - 78 ]. These findings underscore the necessity of considering age group variations in future research, as electronic media use may differently impact sleep quality across age demographics.

In conclusion, our study, Carter et al [ 16 ], and Kristensen et al [ 17 ] collectively emphasize the importance of understanding and addressing the negative impact of electronic media use, particularly problematic online gaming and smartphone use, on sleep quality and related issues. Further research is warranted to explore the underlying mechanisms and specific factors contributing to the relationship between electronic media use and sleep problems.

Strengths and Limitations

Our study, supplemented with research by Carter et al [ 16 ] and Kristensen et al [ 17 ], contributes to the growing evidence supporting a connection between electronic media use and sleep quality. We found that both general and problematic use of electronic media correlates with sleep issues, with the strength of the correlation varying based on the type of electronic media and cultural factors, with no significant relationship observed with age or gender.

Despite the vast amount of research on the relationship between electronic media use and sleep, several gaps and limitations still exist.

First, the inclusion criteria were restricted to English-language, peer-reviewed empirical studies published between January 2018 and October 2023. This may have led to the exclusion of relevant studies published in other languages or before 2018, potentially limiting the generalizability of our findings. Furthermore, the exclusion of non–peer-reviewed studies and conference abstracts may have introduced publication bias, as significant results are more likely to be published in peer-reviewed journals.

Second, although we used a comprehensive search strategy, the possibility remains that some relevant studies may have been missed. Additionally, the search strategies were not linked with Medical Subject Headings headers and may not have captured all possible electronic media types, resulting in an incomplete representation of the effects of electronic media use on sleep quality.

Third, the studies included in our meta-analysis exhibited considerable heterogeneity in sample characteristics, electronic media types, and measures of sleep quality. This heterogeneity might have contributed to the variability in effect sizes observed across studies. Although we conducted moderator analyses to explore potential sources of heterogeneity, other unexamined factors may still have influenced the relationship between electronic media use and sleep quality.

Fourth, our meta-analysis relied on the correlation coefficient ( r ) as the primary effect size measure, which may not fully capture the complex relationships between electronic media use and sleep quality. Moreover, the conversion of other reported statistics into correlation coefficients could introduce additional sources of error. The correlational nature of the included studies limited our ability to draw causal inferences between electronic media use and sleep quality. Experimental and longitudinal research designs would provide stronger evidence for the directionality of this relationship.

Given these limitations, future research should aim to include a more diverse range of studies, examine additional potential moderators, and use more robust research designs to better understand the complex relationship between electronic media use and sleep quality.

Conclusions

In conclusion, our updated meta-analysis affirms the consistent negative impact of electronic media use on sleep outcomes, with problematic online gaming and smartphone use being particularly impactful. Notably, the negative effect of problematic social media use on sleep quality appears more pronounced in Eastern cultures. This research emphasizes the need for public health initiatives to increase awareness of these impacts, particularly for adolescents. Further research, including experimental and longitudinal studies, is necessary to delve deeper into the complex relationship between electronic media use and sleep quality, considering potential moderators like cultural differences.

Acknowledgments

This research was supported by the Journalism and Marxism Research Center, Renmin University of China (MXG202215), and by funds for building world-class universities (disciplines) of Renmin University of China (23RXW195).

A statement on the use of ChatGPT in the process of writing this paper can be found in Multimedia Appendix 4.

Data Availability

The data sets analyzed during this study are available from the corresponding author on reasonable request.

Conflicts of Interest

None declared.

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist.

Search strategies.

Characteristics of included studies.

Large language model statement.

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Abbreviations

Edited by G Eysenbach, T Leung; submitted 20.04.23; peer-reviewed by M Behzadifar, F Estévez-López, R Prieto-Moreno; comments to author 18.05.23; revised version received 15.06.23; accepted 26.03.24; published 23.04.24.

©Xiaoning Han, Enze Zhou, Dong Liu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 23.04.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

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What role can videogames play in the COVID-19 pandemic?

Hannah r. marston.

1 Health and Wellbeing Strategic Research Area, Open University, UK, Milton Keynes, Buckinghamshire, MK7 6AA, UK

Rachel Kowert

2 Take This, Seattle, WA, USA

Associated Data

No data is associated with this article.

Peer Review Summary

Video games are often thought of as trite activities for younger generations. However, research in game studies over the last few decades have revealed that games can be valuable tools for growth and connection, particularly among older generations. Exploring the ways digital games can be used as tools for connection has gained increased attention in recent months with global quarantines as a result of COVID-19. This article reviews the research that has examined the utility of digital games for older adults, focusing specifically on the ways in which games can be tools for social connectedness and psychological healing for older adults and intergenerationally. Special focus will be placed on the role games can play for post-traumatic stress among first responders.

Introduction

Videogames have become a phenomenal form of entertainment over the last 60 years and their history has been documented through various texts ( Forster, 2005 ; Herman, 2001 ; Kent, 2000 ). Scholarly activity and research have illustrated this growing interest from academe, with many scholars focusing on the impact, user experience and design of videogame, as illustrated by Marston & del Carmen (2020) in their recent scoping review that focuses on the Generation X cohort. This cohort has to date received little attention from academe ( Brown & Marston, 2018 ), unlike the Baby Boomer cohort, which has received substantial interest from scholars across the fields of gerontology, gerontechnology, media and communications.

One sub-domain of the Game Studies discipline has garnered interest: the Games for Health (G4H) movement. G4H actively facilitates interdisciplinary research in a bid to achieve the primary aims and objectives of this domain, and to date scholarly activity has shown how videogames can be designed, developed and used for a myriad of health conditions. For example, obesity ( Lu et al. , 2013 ), fall prevention ( Marston et al. , 2015 ), dementia ( Cutler et al. , 2016 ), and social connectedness ( Schell et al. , 2016 ). Since 2010, there has been several scholarly reviews published, with the focus on the benefits of videogames over the last decade ( Bleakley et al. , 2015 ; Hall et al. , 2012 ; Marston et al. , 2016 ; Marston & Smith, 2012 ; Miller et al. , 2014 ).

The purpose of this opinion piece is to discuss the contemporary landscape of videogames and the relationship that they can and do play from the standpoint of COVID-19.

Intergenerational, social connectedness and loneliness

From the standpoint of intergenerational gaming, over the last decade there has been a growing interest in videogames from this perspective. Contemporary literature illustrates this growth, with a systematic review published in 2017 ( De la Hera et al. , 2017 ), which comprised of 16 papers. This review highlighted four categories: (1) reinforcing family bond, (2) enhancing reciprocal learning, (3) increasing understanding of the other generation, and finally (4) reducing social anxiety. In addition, research conducted by Voida & Greenberg (2010) ; Voida & Greenberg (2009) purport positive design challenges by fostering intergenerational gaming practices. Similarly, De la Hera & colleagues’ (2017) research aligns with the notions of Voida & Greenberg (2012) , and also reason the positive relations between intergenerational gaming and design by understanding the barrier and enablers to existing game console design.

There has been a swathe of contemporary research associated with social connectedness and loneliness by scholars in the field of Gerontology, positing various social factors relating to the experience of social and emotional loneliness, and a disconnect with members of the community and society ( Drennan et al. , 2008 ; Heylen, 2010 ).

De Jong Giervel (1998) defines loneliness as an unpleasant and negative feeling, especially when there is a perception of disconnection between achieving and desiring the quality and/or quantity of social connections. Additionally, Wenger & Burholt (2004) have noted that social isolation is an objective measure associated to the dearth of social contact/connections. Markers and experiences in our lives, such as retirement, bereavement, illness, disability or caring responsibilities, can be triggers to loneliness. With this in mind, the COVID-19 pandemic has exacerbated loneliness and social isolation amongst society, not only amongst older populations ( Drennan et al. , 2008 ; Ejlskov et al. , 2019 ; Marston & Morgan, Forthcoming 2020 ; Yang & Victor, 2011 ), but also younger cohorts ( Ejlskov et al. , 2019 ), young disabled adults ( Morris, 2001 ), men ( Ratcliffe et al. (2019) and childless adults who in/voluntary experience childlessness ( Hadley, 2020 ; Hadley, 2018a/b ; Hadley, 2019 ). Hadley (2018b) argues,

“While many age related issues such as isolation, loneliness and dementia have recently gathered extensive attention (and funding) people ageing without children is a subject that remains unreported, under-researched and under-represented at all levels” ( Hadley, 2018b , p. 76–77).

Furthermore, a tri-country study ( Kendig et al. , 2007 ) ascertained associations between childless men and poor health, such as depression, excessive smoking, drinking and difficulty sleeping. Dykstra & Hagestad (2007) state,

“The childless ‘are vulnerable - a group at risk of social isolation, loneliness, depression, ill health and increased mortality’” ( Dykstra & Hagestad, 2007 , p. 1288).

In recent weeks, contemporary research posits the potential benefits of technology for all citizens during the COVID-19 pandemic ( Marston et al. , 2020 ; Sheerman et al. , 2020 ; White et al. , 2020 ). In addition to existing narratives and discourse, technology is playing a pivotal role in various ecosystems as a means of continuing and enhancing social connections, be it amongst young gamers and/or from an intergenerational standpoint ( De la Hera et al. , 2017 ; Voida & Greenberg, 2010 ; Voida & Greenberg, 2009 ; Wang et al. , 2018 ).

Conversely, does technology and videogames play a greater significant role in the lives of childless middle-and-older adults? To date, there is an absence in the Game Studies, Gerontology and Gerontechnology literature surrounding the benefits and barriers to using technology by adults who are childless.

Health and wellbeing for emergency responders and frontline workers

There has been growing scholarly activity surrounding the health, wellbeing and post-traumatic stress (PTSD) of emergency services personnel (ESP) in the UK. Contemporary research suggests PTSD is greater in ESPs than in the general population ( Arble & Arnetz, 2017 ; Brooks et al. , 2019 ; Counson et al. , 2019 ; Mildenhall, 2019 ; Varker et al. , 2018 ).

Currently, research is starting to illustrate and clarify how ESPs are becoming more disproportionately exposed to specific experiences/situations in conjunction to a more overall general working environment. In the context of COVID-19, Mildenhall (2020) offers guidance in the area of psychosocial and mental wellbeing, primarily aimed at paramedics, personnel and managers, while from a policing perspective, Hesketh et al. (2018) offers guidance associated to PTSD, targeting police personnel across the UK.

In a forthcoming scoping review, Marston et al. ( Marston et al. , 2020 ) demonstrate the paucity in contemporary literature surrounding the design, use and deployment of specific technologies, such as mobile health (mHealth) apps, targeting ESPs, specifically police personnel and support staff. Conversely, the Blue Light Wellbeing Framework ( Hesketh & Williams, 2017 ) has been designed with the objectives of health and wellbeing provision for both uniformed and support staff. A web portal – Oscar Kilo (OK), deployed for the National Police Wellbeing Service (NPWS) – comprises of a set of independent standards, aimed at police personnel and ESPs, and affords organisations and police forces the opportunity to audit and benchmark themselves against this framework.

The OK framework was co-designed by a myriad of actors (e.g. practitioners (all levels), professionals and academics), and includes five areas: (1) strategic and tactical planning templates, (2) psychological risk management guidance ( Hesketh et al. , 2017 ), (3) responding to trauma guidance ( Hesketh & Tehrani, 2019 ), (4) the GAIN pyramid ( Hesketh et al. , 2017 ), and (5) a series of real stories presented in animations. Whilst there is a growing body of evidence, there is still little scholarly evidence to understanding how technologies, such as mHealth apps and/or videogames, can facilitate health, wellbeing and PTSD to front line ESPs and support staff.

The use of videogames to facilitate support and offer treatment for PTSD ( Holloway & Reger, 2013 ; Macleod & Sloan, 2017 ) has garnered greater attention in recent years, with the use of videogames and online virtual environments. While the online virtual environment – Second Life ( https://secondlife.com/ ) has previously been used as a tool to offer support to military personnel and their families in an attempt to alleviate PTSD ( Hemmerly-Brown, 2019 ). From a US military personnel perspective, a study by Colder Carras et al. (2018) has been performed, comprising of 20 participants who engaged with videogames as a means of understanding mood and stress levels. Overall, this qualitative study reported positive results by veterans associated with behavioural recovery and PTSD health. The respective authors suggested videogames can act as a form of personal medication, as a way of promoting recovery ( Colder et al. , 2018 , pg. 2). While a systematic review ( Callejas-Cuervo et al. , 2017 ) conducted in 2017 and comprising of 15 articles also ascertained positive directions to rehabilitation for PTSD treatment, relating to emotional recognition and videogames.

The videogame Tetris has been used in the environment of an emergency department as an approach of reducing trauma after a traffic accident. Using a randomized control trial (RCT) design, Iyadurai et al. (2018) conducted an intervention that occurred within six hours of the incident. The control group were required to write an activity log for 20 minutes, and the intervention group were required to play Tetris for 20 minutes. Over a period of one week, the aim of the RCT was to compare the number of intrusive trauma memories. Although findings from this proof-of-concept study showed positive benefits at one week, the respective authors suggest a larger and longer trial is needed to understand the benefits at one month.

Gaming in a time of COVID-19

Videogames have become a feature in the homes of many citizens old and young over the last several decades, transforming the home to one which now accepts the videogame console as a feature. Flynn (2003) describes the domestication of the home and states,

“The home is once again framed as ‘a machine for living in’ with the user most ‘at home’ when playing the game console” ( Flynn, 2003 , pg. 558).

The history of the videogames is long documented ( Forster 2005 ; Herman, 2001 ; Kent, 2000 ), detailing the move of videogames from public space into private – the home. Flynn (2003) purports how the videogame consoles over the decades has been implemented into the living space – of the digital hearth to feature and sit alongside the additional pieces of furniture in this physical space. At the time of writing this specific piece (21 st Century), Flynn pontificates and narrates the perceptions and portrayals of digital consumption 100 years earlier, describing the difference between a country house environment and prospective future housing environmental design. Whereby over the decades, one’s lifestyle, gender and media influences has led to redefining how key pieces of technology are represented and identified specifically by women ( Massey, 2000 ). For example,

“From this examination of the contemporary ideal home, it would appear that for the middle-class female readership of lifestyle magazines, the video console is still an alien machine in relation to narratives of identity associated with domesticity and family togetherness.” ( Flynn, 2003 , pg. 565).

The notion of videogames portrayed in magazines illustrated the alternative physical space or third place (e.g. the bedroom) to game playing, rather than the living room or the digital hearth as previously described by Flynn (2003) . Whereas, the previous notion of the living room as the familial space – or the suburban living room – as the gaming/meeting place was been replaced by such advertisements purported by games industry companies ( McGuire, 2003 ).

Existing research ( De la Hera et al. , 2017 ; Voida & Greenberg, 2010 ; Voida & Greenberg, 2009 ; Wang et al. , 2018 ) and the work presented by Flynn (2003) , illustrates how videogames can enhance interaction within the physical space(s) with other gamers, and adults alike. During this unprecedented time in society, COVID-19 is impacting many physical spaces and ecosystems ( Marston et al. , 2020 ; Sheerman et al. , 2020 ; White et al. , 2020 ), be it a community group, a family, middle-aged or older adults living on their own, or a keyworker. Yet, videogames and their peripheral technologies can and do have a role to play in continuing and enhancing social connections, relationships and engagements, from within the ecosystem and/or across WiFi communications.

It is important to note the unique contribution that games provide to mediated socialization. The fact that games are playful, fun, interactive spaces differentiates them from other forms of mediated communication, such as text messaging or social media ( Kowert, 2015 ). They allow individuals to connect through play, which is an important facet of psychological well-being throughout the lifespan ( Connell & Dunlap, 2020 ). Play in and of itself is associated with reduced stress and depression, as well as a releasing of endorphins ( Robinson et al. , 2019 ). Combined with the various benefits of in-game socialization (i.e., reduced stress, depression, and sense of loneliness; see Kowert, 2015 ) makes games a useful tool for mitigating some of the negative impacts of COVID-19 for adults.

Taking a different route in this discussion and turning our attention to the growth of evidence positively supporting and facilitating health, wellbeing and PTSD in different populations, in addition to enhancing intergenerational relationships, further considerations are needed. For example, in this opinion piece, we have explored contemporary literature surrounding intergenerational gaming. However, for those citizens who are ageing without children or grandchildren, how can videogames facilitate positive health and wellbeing, social connections and reduce a sense of loneliness? We suggest here that future research should explore how videogames are used as a means of understanding social connections and reducing loneliness by middle-age and older adults. As previously noted by Hadley (2018b) , scholarly research is underrepresented in the field of people ageing without children. Given the situation(s) that this pandemic has placed on citizens, for those who perceive themselves as gamers, and who may not have children or grandchildren, they may have already chosen to use videogames as a means of socially connecting with friends in an online environment. Using videogames as a means of socially connecting with un/known gamers may afford a person a sense of positive feeling.

From the standpoint of ESPs, evidence is growing that illustrates the need for identifying appropriate solutions for treatment of PTSD and for continuing positive health and wellbeing practices within the workforce. As noted in their forthcoming review, Marston et al. (under review, 2020) purport the paucity of existing literature surrounding technology use and deployment for ESPs in association with health, wellbeing and PTSD. Furthermore, they provide a series of recommendations in an attempt to move this interdisciplinary work forward, and given the current situation within society (associated to COVID-19), there is the likelihood that health practitioners, and social care keyworkers may require health, wellbeing and PTSD rehabilitation/recovering in the future. For instance, keyworkers such as those who are working in our hospitals are witnessing multiple deaths throughout their shifts, and days, and in some instance of their colleagues. Furthermore, deaths of citizens are also been reported from care/nursing homes, and many health and social care workers have chosen to ‘live in’ and shield the residents from COVID-19.

Conclusions

In this opinion piece, we have demonstrated how videogames can play a pivotal role in various societal ecosystems from the individual/digital hearth to the larger ecosystem surrounding ESPs, health practitioners, and social care workers, who at present are exposed to various situations and trauma.

Moving this debate forward, interdisciplinary research is needed to focus on two landscapes. Firstly, from the standpoint of social sciences and how videogames can impact the lives of middle-and-older adults who are ageing without children. As previously noted, there is a paucity of research specifically focusing on adults who are ageing without children. Social connectedness and loneliness are key experiences, and more information and understanding are required to offer solutions to reduce these risks.

Secondly, more research is required from the standpoint of videogames and ESPs and the role in which videogames can be a means of reducing trauma, offering positive health, wellbeing and PTSD solutions. This would require efforts from a myriad of actors, forming a co-designed and co-produced approach to ensure all key information and take-up is included.

Data availability

[version 1; peer review: 2 approved]

Funding Statement

The author(s) declared that no grants were involved in supporting this work.

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Reviewer response for version 1

Frans mäyrä.

1 Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland

This is an interesting and well-studied article that brings together a lot of research from game studies and the games-for-health field in particular. It is good to note that health and well-being is here approached from a wide-ranging and inclusive perspective, taking sociocultural aspects of health also into consideration. The role of loneliness and social connectedness is particularly emphasised, which is a relevant choice, considering the role of games and play as particular kinds of popular social activities. There is also a topical framing of this article in the recent COVID-19 pandemic and its associated risks for social isolation and loneliness.

The main body of research literature and discussion in this short article is directed towards addressing games’ potential for positively supporting health, particularly in the case of PTSD (post-traumatic stress disorder). The suggestion of authors is that under the pandemic, health workers would particularly benefit from the use of games for recovery. This seems plausible, and also supported by literature (though, it should be noted that I am not an expert in health or therapies). What might be missing, or not given similar kind of treatment, is the games’ relationship to the socially isolating and stressful conditions in everyday lives of ”non-professionals” (i.e. in lives of families, students, and many other people). But, as said, this is a short article and a certain focus is a good thing.

From a game studies perspective, it should also be noted that there is not much discussion about the differences between different genres or forms of games and play that actually vary a lot. Games are discussed in very overarching and generalising terms. There are also significant differences in players’ responses of games, and while one kind of game might be relaxing and therapeutic for some, it might be frustrating and anxiety creating for someone else. Such, more fine-grained discussions that are relevant to game studies have fallen outside of the scope of this short article, but it would be welcome to see at least some short references into such directions.

The article is logically structured and generally well-written, but there were some instances of word choices and sentence structures that left me wishing for yet one more round of minor stylistic proof-reading. Maybe such small amendments could still be made into the text? Otherwise I think that this article is solid work, puts forward a valuable perspective and contribution, and should indeed be indexed.

Is the topic of the opinion article discussed accurately in the context of the current literature?

Are arguments sufficiently supported by evidence from the published literature?

Are all factual statements correct and adequately supported by citations?

Are the conclusions drawn balanced and justified on the basis of the presented arguments?

Reviewer Expertise:

Game studies, game culture studies, humanities, art and culture studies.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

Dorothy Newbury-Birch

1 School of Social Sciences Humanities and Law, Teesside University, Middlesbrough, UK

This is a very good piece of work that is worthy of publication. I only have a couple of small things to consider:

On page 3 when talking about COVID-19 I suggest that papers relating to COVID-19 are referenced separately to other data that says the same thing.

I think there should be some mention of testing through proper RCTS the effectiveness and cost-effectiveness of interventions. The Lyadurai et al study had a one week follow up and the paper indicates that it would be better at a month however that is not a long enough time to really consider whether it is effective.

Well done to the authors - this is a well written article.

Public Health

Anti-'woke' activist investor group targets Kohl's with proposal to shareholders

A conservative activist investor is pressuring Kohl’s Corp. over the company’s philanthropic efforts directed at minority and LGBTQ anti-suicide organizations.

Kohl's shareholders should support creation of a committee "on corporate financial sustainability to oversee and review the impact of the Company’s policy positions, advocacy, partnerships and charitable giving on social and political matters, and the effect of those actions on the Company’s financial sustainability," according to the proposal by National Center for Public Policy Research .

The Washington D.C.-based group criticizes Kohl’s Diversity and Inclusion Task Force, particularly what it called a $1 million contribution “to the BLM movement and related causes since 2020.”

“These causes have been accused of squandering assets and supporting racism and antisemitism and highly divisive and dangerous programs such as police-defunding and ‘anti-racist’ racial discrimination,” the organization states.

More: PolitiFact: Has Kohl’s Corp. donated to Black Lives Matter? Short answer: no

The Kohl's board of directors unanimously urged shareholders to reject the group's efforts in balloting before the retailer's annual meeting on May 15. Shareholders are voting on more routine matters including board members, executive compensation, an independent accounting firm, and a long-term compensation plan. Results are expected to be tabulated after the meeting.

The Kohl's directors called the proposal “unnecessary, duplicative, and not an effective use of company resources," according to the proxy statement.

The company said the board and other standing committees “already devote substantial resources to the oversight of social and political matters, including Kohl’s policy positions, advocacy, partnerships, and charitable giving, and the related impacts on the company’s financial sustainability.”

More: Kohl's Corp to bring 200 Babies 'R' Us to stores with new partnership

According to the proxy statement, the National Center for Public Policy Research has owned “at least $2,000” of Kohl’s stock for three years.

Group pressures other companies over philanthropic efforts

Kohl's is not the only company that the group has pressured over its philanthropic efforts.

The organization has about 60 such proposals with companies across the country., said Stefan Padfield, deputy director of the group's Free Enterprise Project.

“Most people would go to Kohl’s because they want good quality products at a reasonable price, right? And most people are not interested in being lectured to or having their money, whether that’s as consumers or as shareholders, used to advance divisive ideological issues,” Padfield said. “When that becomes revealed, you have a values problem.”

Christina O'Connell, senior campaign manager for shareholders investments for Eko, a nonprofit focused on corporate accountability, said the National Center for Public Policy Research is within its rights as a shareholder to make proposals on issues it feels to be important.

“They definitely, I would say, exaggerate their claims,” O’Connell said. “They’re part of a campaign to oppose what they call ‘woke capitalism.’ And all of this circles around claims that companies are giving in to what they describe as extreme or radical left-wing interests. And they see their goal as solving that through these proposals.”

O'Connell and Eko monitor the proposals the National Center for Public Policy Research directed at major companies like Kohl's, Target and Best Buy.

Group claims Kohl's gave money to Black Lives Matter

The group's appeal to investors includes a link to a database created by Claremount Institute for the American Way of Life , which lists Kohl’s as one of the companies that have contributed to the Black Lives Matter movement.

That database links to a 2020 company pledge to distribute $1 million to five local nonprofits : Milwaukee Urban League, Employ Milwaukee, Acts Housing, Safe & Sound and Boys and Girls Clubs of Greater Milwaukee.

None of those groups are directly connected to Black Lives Matter.

“We don’t have the resources to dig down layer after layer for every proposition,” Padfield said when asked about the discrepancy.

“So when we have a reputable organization, like Claremont, and they put out this information and we do a couple of checks and it seems very reasonable, then we find that’s appropriate to use as a basis, among the many other issues that we cite that are seemingly related in this sort of left-leaning, what seems like a left-leaning, agenda that Kohl’s is supporting.”

Padfield said the company has had plenty of opportunities to challenge the accusation it donated $1 million to Black Lives Matter “and related causes,” but “they haven’t done that.”

O'Connell said the group seemed to be engaging in a deliberate effort to embarrass Kohl's.

“They’re focused on Black Lives Matter and that kind of taking a set of local donations and claiming that they’re Black Lives Matter donations seems to be part of their strategy,” O’Connell said.

More: Store openings, layoffs, profits and executive changes: A year with Kohl's CEO Tom Kingsbury

Bradley Foundation supports National Center of Public Policy Research

The National Center for Public Policy Research was started in 1981 and became a non-profit in 1981, according to the group's website.

The Free Enterprise Project launched in 2007 is described as the “original and premier opponent of the woke takeover of American corporate life and defender of true capitalism.” The group's president David Ridenour has a base salary of roughly $358,000.

The organization says it receives 350,000 donations a year from 60,000 active donors.

In 2021 the group received nearly $13.1 million in donations and grants, and in 2022 it received more than $12.2 million, according to filings with the Internal Revenue Service.

Because the National Center for Public Policy Research is a nonprofit, the donors are anonymous. However organizations that donate to do report their contributions.

For example, the conservative and Milwaukee-based Lynde and Harry Bradly Foundation, started donating to the organization in 2019 when it gave $220,000 to support the Free Enterprise Project, according to IRS filings.

In 2020 and 2021, the Bradley Foundation gave $250,000 and $500,000 , respectively, to the organization. In 2022, the Bradley Foundation gave $1 million , and in 2023 donated $250,000.

Padfield said there are roughly 60 shareholder proposals currently in the process of being discussed or voted on with companies around the country.

When asked if any of the center's proposals have been approved by shareholders, Padfield’s response was blunt.

“No,” he said. “The approval rate for proposals is generally low and we typically have the Big 5 asset managers/proxy advisors against us as they lean demonstrably left.”

Padfield said the “Big 5” are Blackrock, State Street, and Vangauard, which invest in hundreds of companies around the country, and proxy advisors Glass Lewis and Institutional Shareholder Services.

O'Connell said calling a company like Blackrock, the world's largest asset manger with trillions of dollars of assets, a left-learning organizations is “pretty startling.”

“I’ve never thought of Blackrock as leading the leftwing extremists in our country,” O’Connell said adding these proposals get very little support from shareholders. “These are clearly not issues of grave concern to investors... far from it."

The Trevor Project contribution also criticized

In 2019, Kohl's announced a $100,000 contribution to The Trevor Project, a suicide prevention and crisis intervention organization that focuses primarily on LGBTQ+ youth , and provides information, research and a 24/7 hotline for those who are in need of help.

In the same press release, the company said it was donating $100,000 to the United Service Organization which helps military service members and their families.

The National Center for Public Policy Research criticized The Trevor Project donation and not the USO donation.

“Who doesn’t want to reduce childhood suicide?” Padfield said. “Who doesn’t want to affirm people, so they feel good? Again, once we look under the hood the problem is we see all sorts of issues that the country is deeply divided about. Should children have transition surgery? Should they be given puberty blockers? Should they be transitioned in schools behind the backs of their parents? Should men who identify as women be allowed to compete in team sports?”

O'Connell said the National Center for Public Policy Research in recent years has focused on gender and LGBTQ+ issues as part of the organization's strategy to push companies away from supporting those organizations.

“This kind of questioning of any support that they would give to an organization that helps to prevent youth suicide is really shocking,” O’Connell said. “Seeing that as ‘extreme’ or ‘radical’ and something to stop, is really a disturbing position to take.”

Padfield insisted the group doesn’t advocate for businesses to donate to conservative or right leaning organizations over progressive organizations.

“We have to pick our spots and we are conservative, so that’s going to be part of our guide. But we want corporations to get back to neutral.”

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Pokémon Go guide

Pokémon Go ‘Rediscover Kanto’ Special Research quest steps, rewards

Return to Gen 1 in celebration of biomes and a visual refresh

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Going clockwise — Kanto Pokémon Venusaur, Bulbasaur, Ivysaur, Vileplume, and Butterfree standing in front of trailers emerging from a portal in the woods

“Rediscover Kanto” is a Special Research quest in Pokémon Go which sees players revisit the first generation of Pokémon.

As well as the Special Research, there is a time limited event of the same name running April 22 to May 9, 2024 . This offers spawns of Pokémon from the Kanto region in the wild, bonus XP for completing certain activities, and boosted Friendship level increases.

The event celebrates an April 2024 visual and biome refresh in Pokémon Go , and as part of that, discovering starters Bulbasaur, Charmander, and Squirtle in their respective biomes increases their chances of being shiny.

Finally, as Pokémon Go wasn’t busy enough, the opening week of “Rediscover Kanto” coincides with 2024’s “ Sustainability Week ” event.

‘Rediscover Kanto’ Special Research quest steps and rewards

All players who log in April 22 to May 9, 2024 will receive the following Special Research for free.

Once acquired, “Rediscover Kanto” Special Research does not expire — meaning there is no need to rush through all the following quest steps.

Step 1 of 5

Use 5 Berries to help catch Pokémon (Bulbasaur encounter)
Feed your Buddy 5 times (Charmander encounter)
Catch 20 Pokémon originally discovered in the Kanto region (Squirtle encounter)

Rewards: 5,000 XP, 2,500 Stardust , 1 Lucky Egg

Step 2 of 5

Use 10 Berries to help catch Pokémon (10 Poké Balls)
Play with your Buddy 5 times (15 Great Balls)
Catch 30 Pokémon originally discovered in the Kanto region (10 Ultra Balls)

Rewards: 5,000 XP, 2,500 Stardust , 3 Fast TM

Step 3 of 5

Use 15 Berries to help catch Pokémon (10 Razz Berry)
Earn 25 hearts with your Buddy (10 Nanab Berry)
Catch 40 Pokémon originally discovered in the Kanto region (10 Pinap Berry)

Rewards: 5,000 XP, 2,500 Stardust , 3 Charged TM

Step 4 of 5

Use 20 Berries to help catch Pokémon (25 Bulbasaur Candy)
Earn 4 Candy exploring with your Buddy (25 Charmander Candy)
Catch 50 Pokémon originally discovered in the Kanto region (25 Squirtle Candy)

Rewards: 5,000 XP, 2,500 Stardust , 1 Lure

Step 5 of 5

Use 151 Berries to catch Pokémon (15,100 XP)
Earn 15,100 Stardust (15,100 XP)
Catch 151 Pokémon originally discovered in the Kanto region (15,100 XP)

Rewards: 10,000 Stardust , 1 Incubator

Though it’s worth noting the steps involving catching Pokémon originally found in the Kanto region will be easier while the “Rediscover Kanto” event is still active (as, unlike the Special Research, that does have an end date), Kanto Pokémon are common enough in Pokémon Go that completing these won’t be an issue long term.

‘Rediscover Kanto’ quest steps 2/5 in Pokémon Go

‘Rediscover Kanto’ event bonuses

Alongside the Special Research steps, the “Rediscover Kanto” event offers a handful of bonuses active April 22 to May 9, 2024:

Increased XP for seven day PokéStop spin and Pokémon catch streaks
Double Friendship level boost (when opening Gifts, trading, or battling together)
Increased chance of shiny Bulbasaur, Charmander, and Squirtle when spawning in their respective biomes
Ivysaur, Charmeleon, and Wartortle will gain Charged attacks Frenzy Plant, Blast Burn, and Hydro Cannon respectively when evolved

‘Rediscover Kanto’ Field Research tasks, rewards

Spinning a PokéStop during the event period can offer one of the following Field Research tasks:

Power Up Pokémon 5 Times (25 Venusaur, Charizard, or Blastoise Mega Energy)
Pokémon Go guides
“Rediscover Kanto” Special Research
“World of Wonder” Special Research
Ditto disguises

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Partisan divides over K-12 education in 8 charts

Proponents and opponents of teaching critical race theory attend a school board meeting in Yorba Linda, California, in November 2021. (Robert Gauthier/Los Angeles Times via Getty Images)

K-12 education is shaping up to be a key issue in the 2024 election cycle. Several prominent Republican leaders, including GOP presidential candidates, have sought to limit discussion of gender identity and race in schools , while the Biden administration has called for expanded protections for transgender students . The coronavirus pandemic also brought out partisan divides on many issues related to K-12 schools .

Today, the public is sharply divided along partisan lines on topics ranging from what should be taught in schools to how much influence parents should have over the curriculum. Here are eight charts that highlight partisan differences over K-12 education, based on recent surveys by Pew Research Center and external data.

Pew Research Center conducted this analysis to provide a snapshot of partisan divides in K-12 education in the run-up to the 2024 election. The analysis is based on data from various Center surveys and analyses conducted from 2021 to 2023, as well as survey data from Education Next, a research journal about education policy. Links to the methodology and questions for each survey or analysis can be found in the text of this analysis.

Most Democrats say K-12 schools are having a positive effect on the country , but a majority of Republicans say schools are having a negative effect, according to a Pew Research Center survey from October 2022. About seven-in-ten Democrats and Democratic-leaning independents (72%) said K-12 public schools were having a positive effect on the way things were going in the United States. About six-in-ten Republicans and GOP leaners (61%) said K-12 schools were having a negative effect.

A bar chart that shows a majority of Republicans said K-12 schools were having a negative effect on the U.S. in 2022.

About six-in-ten Democrats (62%) have a favorable opinion of the U.S. Department of Education , while a similar share of Republicans (65%) see it negatively, according to a March 2023 survey by the Center. Democrats and Republicans were more divided over the Department of Education than most of the other 15 federal departments and agencies the Center asked about.

A bar chart that shows wide partisan differences in views of most federal agencies, including the Department of Education.

In May 2023, after the survey was conducted, Republican lawmakers scrutinized the Department of Education’s priorities during a House Committee on Education and the Workforce hearing. The lawmakers pressed U.S. Secretary of Education Miguel Cardona on topics including transgender students’ participation in sports and how race-related concepts are taught in schools, while Democratic lawmakers focused on school shootings.

Partisan opinions of K-12 principals have become more divided. In a December 2021 Center survey, about three-quarters of Democrats (76%) expressed a great deal or fair amount of confidence in K-12 principals to act in the best interests of the public. A much smaller share of Republicans (52%) said the same. And nearly half of Republicans (47%) had not too much or no confidence at all in principals, compared with about a quarter of Democrats (24%).

A line chart showing that confidence in K-12 principals in 2021 was lower than before the pandemic — especially among Republicans.

This divide grew between April 2020 and December 2021. While confidence in K-12 principals declined significantly among people in both parties during that span, it fell by 27 percentage points among Republicans, compared with an 11-point decline among Democrats.

Democrats are much more likely than Republicans to say teachers’ unions are having a positive effect on schools. In a May 2022 survey by Education Next , 60% of Democrats said this, compared with 22% of Republicans. Meanwhile, 53% of Republicans and 17% of Democrats said that teachers’ unions were having a negative effect on schools. (In this survey, too, Democrats and Republicans include independents who lean toward each party.)

A line chart that show from 2013 to 2022, Republicans' and Democrats' views of teachers' unions grew further apart.

The 38-point difference between Democrats and Republicans on this question was the widest since Education Next first asked it in 2013. However, the gap has exceeded 30 points in four of the last five years for which data is available.

Republican and Democratic parents differ over how much influence they think governments, school boards and others should have on what K-12 schools teach. About half of Republican parents of K-12 students (52%) said in a fall 2022 Center survey that the federal government has too much influence on what their local public schools are teaching, compared with two-in-ten Democratic parents. Republican K-12 parents were also significantly more likely than their Democratic counterparts to say their state government (41% vs. 28%) and their local school board (30% vs. 17%) have too much influence.

A bar chart showing Republican and Democratic parents have different views of the influence government, school boards, parents and teachers have on what schools teach

On the other hand, more than four-in-ten Republican parents (44%) said parents themselves don’t have enough influence on what their local K-12 schools teach, compared with roughly a quarter of Democratic parents (23%). A larger share of Democratic parents – about a third (35%) – said teachers don’t have enough influence on what their local schools teach, compared with a quarter of Republican parents who held this view.

Republican and Democratic parents don’t agree on what their children should learn in school about certain topics. Take slavery, for example: While about nine-in-ten parents of K-12 students overall agreed in the fall 2022 survey that their children should learn about it in school, they differed by party over the specifics. About two-thirds of Republican K-12 parents said they would prefer that their children learn that slavery is part of American history but does not affect the position of Black people in American society today. On the other hand, 70% of Democratic parents said they would prefer for their children to learn that the legacy of slavery still affects the position of Black people in American society today.

A bar chart showing that, in 2022, Republican and Democratic parents had different views of what their children should learn about certain topics in school.

Parents are also divided along partisan lines on the topics of gender identity, sex education and America’s position relative to other countries. Notably, 46% of Republican K-12 parents said their children should not learn about gender identity at all in school, compared with 28% of Democratic parents. Those shares were much larger than the shares of Republican and Democratic parents who said that their children should not learn about the other two topics in school.

Many Republican parents see a place for religion in public schools , whereas a majority of Democratic parents do not. About six-in-ten Republican parents of K-12 students (59%) said in the same survey that public school teachers should be allowed to lead students in Christian prayers, including 29% who said this should be the case even if prayers from other religions are not offered. In contrast, 63% of Democratic parents said that public school teachers should not be allowed to lead students in any type of prayers.

Bar charts that show nearly six-in-ten Republican parents, but fewer Democratic parents, said in 2022 that public school teachers should be allowed to lead students in prayer.

In June 2022, before the Center conducted the survey, the Supreme Court ruled in favor of a football coach at a public high school who had prayed with players at midfield after games. More recently, Texas lawmakers introduced several bills in the 2023 legislative session that would expand the role of religion in K-12 public schools in the state. Those proposals included a bill that would require the Ten Commandments to be displayed in every classroom, a bill that would allow schools to replace guidance counselors with chaplains, and a bill that would allow districts to mandate time during the school day for staff and students to pray and study religious materials.

Mentions of diversity, social-emotional learning and related topics in school mission statements are more common in Democratic areas than in Republican areas. K-12 mission statements from public schools in areas where the majority of residents voted Democratic in the 2020 general election are at least twice as likely as those in Republican-voting areas to include the words “diversity,” “equity” or “inclusion,” according to an April 2023 Pew Research Center analysis .

A dot plot showing that public school district mission statements in Democratic-voting areas mention some terms more than those in areas that voted Republican in 2020.

Also, about a third of mission statements in Democratic-voting areas (34%) use the word “social,” compared with a quarter of those in Republican-voting areas, and a similar gap exists for the word “emotional.” Like diversity, equity and inclusion, social-emotional learning is a contentious issue between Democrats and Republicans, even though most K-12 parents think it’s important for their children’s schools to teach these skills . Supporters argue that social-emotional learning helps address mental health needs and student well-being, but some critics consider it emotional manipulation and want it banned.

In contrast, there are broad similarities in school mission statements outside of these hot-button topics. Similar shares of mission statements in Democratic and Republican areas mention students’ future readiness, parent and community involvement, and providing a safe and healthy educational environment for students.

Education & Politics
Partisanship & Issues
Politics & Policy

Jenn Hatfield is a writer/editor at Pew Research Center

About 1 in 4 U.S. teachers say their school went into a gun-related lockdown in the last school year

About half of americans say public k-12 education is going in the wrong direction, what public k-12 teachers want americans to know about teaching, what’s it like to be a teacher in america today, race and lgbtq issues in k-12 schools, most popular.

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Playing games: advancing research on online and mobile gaming consumption

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The Effects of Online Games Towards The Academic Performance Of Selected Information Technology Students In Partial Requirement for The Completion in The Course Methods of Research

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Electronic Media Use and Sleep Quality: Updated Systematic Review and Meta-Analysis

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Characteristics of Included Studies

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Abbreviations

What role can videogames play in the COVID-19 pandemic?

Rachel Kowert

Associated Data

Peer Review Summary

Introduction

Intergenerational, social connectedness and loneliness

Health and wellbeing for emergency responders and frontline workers

Gaming in a time of COVID-19

Conclusions

Data availability

Funding Statement

Reviewer response for version 1

Dorothy Newbury-Birch

Anti-'woke' activist investor group targets Kohl's with proposal to shareholders

Group pressures other companies over philanthropic efforts

Group claims Kohl's gave money to Black Lives Matter

Bradley Foundation supports National Center of Public Policy Research

The Trevor Project contribution also criticized

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