(PS7-B28) Using a Mobile Game for Exposures to Reduce Needle Phobia in Young Children

Introduction: Almost 20% of children ages 4-6 experience needle phobia (Majstorovic & Veerkamp, 2004), and at least 20% of them avoid critical public health vaccines like the influenza vaccine (McLenon & Rogers, 2019). With the COVID-19 pandemic still ongoing and its vaccine becoming available for young children, it is paramount to address needle phobia in young children to facilitate vaccine rollout. Although exposure, a core component of cognitive behavioral therapy (CBT), is effective in treating needle phobia (Orenius et al., 2018) it is not feasible to have every child undergo a full course of exposure therapy. Digital interventions show promise for addressing needle-related anxiety, given their success with other anxiety-related disorders, facilitating scalability, reduced cost, reduced number of office visits, and a more fun and engaging format for children (Lockwood et al., 2022; Silk et al., 2020; Sung et al., 2021). The current mixed-methods study investigates the acceptability and preliminary efficacy of a mobile game, “Dr. Zoo”, designed to reduce needle phobia in young children through exposure to needles.

Method: Thirty-six youth ages 3-6 years old (M_age = 4.44, SD = 1.11) and 30 parents (M_age = 35.87, SD = 4.39) were recruited between May and November of 2021. Parents were instructed to have their child play Dr. Zoo for at least 5 consecutive days leading up to their child’s medical appointment. In the game, children administer injections to a small community of animals. When their child was finished playing for the day, parents completed the Children’s Fear Scale to indicate their child’s fear levels while playing the game. Research staff scheduled and later completed an exit-survey and a semi-structured interview with parents.

Results: Parents were highly likely to recommend “Dr. Zoo” to other parents (M=4.41, Range=1-5, SD=.87). Furthermore, parents rated the helpfulness of the game in reducing their child’s fear of needles as moderately high (M=3.49, Range=1-5, SD=1.27). Wilcoxon signed-rank tests demonstrated that there was not a significant difference between parent report of their child’s initial fear scale ratings (Mdn=1) and final fear scale ratings (Mdn=0), (Z=-1.624, p=0.104). However, based on retrospective reports in the exit survey, parents rated their children’s fear as significantly lower after participating in the study (Mdn=3) compared to before (Mdn=5), (Z=-4.638, p< .001). Qualitative results revealed that 60% of parents reported that their child was excited to play the game each day, and 54.3% of parents reported that the game helped open up dialogue between them and their child to discuss the importance and purpose of vaccines.

Discussion: Results from this pilot study demonstrated that “Dr. Zoo” had high acceptability and potential preliminary efficacy, though more research should be conducted fully examine its impact on children’s needle phobia. Leveraging digital interventions is a promising solution to mitigate needle anxiety in young children as a public health concern. As more mobile games are being developed to combat needle anxiety and other anxiety-related disorders, it is imperative to integrate both evidence-based components and user input for the highest impact.