Aniek Wols

40 Chapter 2 deviations were provided for subgroups of participants, these were combined into a single value (Higgins, Li et al., 2022). Based on the target group and outcome measures, included papers were grouped into 1) studies including a (sub)clinical participant sample, further subdivided per problem behaviour/pathology, and 2) studies including a (mentally) healthy participant sample but in which mental health variables were measured, further subdivided into anxiety in medical settings, momentary effects on positive and negative affect, and studies using a longitudinal design measuring mental health traits. For each subsample target group, a summary in terms of age, gender, study design, country of research, and types of games and interventions being investigated will be provided in the Results section, followed by the calculated effect sizes of the included papers (see analytic procedure outlined below). For the purpose of this review, the specific intervention arms were coded as applied game, casual game, active condition, or passive condition. If an intervention arm included, for instance, both an applied game and treatment as usual or other therapy components, this intervention arm was coded as applied game. For the studies looking at anxiety in medical settings, intervention arms were coded as game distraction or standard care. At the end of the Results section, we will reflect on some methodological characteristics of the included papers (i.e., risk of bias, use of multi-modal interventions, intervention duration, and nonspecific factors). Analytic Procedure Because of the broad scope of the review, we intentionally included several types of games (i.e., serious games, gamified interventions, casual games, whether or not combined with treatment as usual or other treatment components) and a wide range of mental health outcomes and target groups. Consequently, the literature search revealed heterogeneity of target groups, outcome measures, interventions being investigated and control conditions being employed, hence a meta-analysis could not be undertaken. In addition, a meta-analysis would result in unit-of-analysis problems if cluster-randomised trials, crossover trials, and multiple intervention comparisons or multiple outcomes of the same trial were to contribute to the meta-analytic synthesis. We do, however, present effect sizes in separate forest plots per target group, grouping studies in subpanels based on the types of interventions that were compared within a study, with the intention to aid interpretation of individual study results and to (informally) explore differences but also overall patterns across studies (McKenzie & Brennan, 2022). Although no meta-analytic summary diamond will be provided in the forest plots and effect sizes will not

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