During adolescence, judgment and decision-making skills develop, and the ability to correctly assess risks and make decisions is underdeveloped (1). As a result, there is a global increase in the prevalence of risky health behaviors among youth, such as addiction (2). Today, addiction mainly refers to the excessive use of substances such as cigarettes, alcohol or drugs. However, the addiction is not limited to these substances; it also includes other addictive behaviors, such as Internet addiction, which some psychiatrists consider a form of addiction. Internet addiction can lead to behavioral addictions and deserves attention. Addiction is a complex biological behavioral disorder characterized by loss of control, compulsive use, dependence, and a strong desire for a particular activity, substance, or food (3).
Adolescence is a crucial developmental stage characterized by profound physical, cognitive, emotional, social and behavioral changes. The biological and neural changes during this period make adolescents more susceptible to the initiation of substance abuse, the development of substance abuse disorders, and the experience of long-term and severe side effects associated with substance abuse (4).
The scientific definition of addiction is a chronic, recurring mental disorder in the brain (5) that results from the problematic and illegal use of psychotropic substances (3). Young people often perceive substances differently, which can lead to risky experiments, especially in the presence of peers (6). The onset of addiction is linked to harmful behaviours, aggression, conduct disorders and other mental health problems (7). Furthermore, abuse can negatively affect study results, lead to school dropouts and cause cognitive disorders in young people (8).
International organizations have provided significant statistics to highlight the magnitude of these issues. According to the WHO Division on Drug Abuse, 18.4% of people over the age of 15 worldwide report heavy alcohol consumption, 15.2% daily tobacco use, 3.8% cannabis and marijuana use, 0.77% amphetamine use, 0.37% opioid use, and 0 .35% cocaine use (8). In addition, studies in the United States have shown that 34.1% of youth under the age of 16 have their first experience with alcohol, marijuana, and cigarettes (9).
While the Internet serves various global purposes, such as education, business, and recreation, problems arise when its use negatively affects teenagers’ physical, mental, and social health (10, 11).
Today, besides drug addiction, there are other behaviors, such as Internet addiction, that psychiatrists believe can lead to behavioral addictions and warrant attention (10). Among internet users, young people are particularly vulnerable to internet addiction compared to other age groups (11).
Internet addiction is characterized by the inability to resist the urge to be online, difficulty spending time offline, and experiences of anxiety and aggression. It can also lead to disruption of family, friends and school relationships due to uncontrolled internet use. Internet addiction shares similar characteristics, including an inability to resist the urge to be online and difficulty engaging in face-to-face interactions. This problem can result in anxiety, aggression, strained family relationships, impaired social connections, and a decline in academic performance (12). The inappropriate use of the Internet can negatively affect young people’s mental health, social life, physical well-being and educational success (11).
A meta-analysis of data from 31 global studies in seven regions found that the prevalence of Internet addiction in the Middle East is 10.9%, while the lowest prevalence is in Northern and Western Europe at 2.6%. This study also revealed an inverse relationship between the prevalence of Internet addiction and quality of life (13). In Southeast Asia, studies indicate a varying prevalence of Internet addiction among students, ranging from 0 to 47.4%, with possible prevalence rates ranging from 7.4 to 46.4% (14).
Education is an important tool to prevent health problems, and interactive multimedia methods, among different media and virtual approaches, have been shown to be more effective in improving learning (15). These methods utilize multiple visual and auditory channels, increasing motivation and retention. They offer a convenient and engaging way to educate young people about health principles (16).
In contrast, traditional training methods often promote passive learning, neglect individual differences and the specific needs of students, and fail to address critical thinking and higher-level cognitive skills (17).
In recent years, e-learning technologies, especially smartphone-based learning, have developed significantly (18). In addition, gamification has gained increased interest as an effective approach. Using participatory methods in preventive education increases its effectiveness. As an interactive method, gamification can potentially increase youth motivation to participate in education and improve its effectiveness (19).
An innovative and engaging method to teach young people and explore the world of electronic multimedia is gamification. Gamification involves applying game-like elements to tasks that may not inherently involve play, turning otherwise boring activities or educational lessons into engaging experiences (18, 19).
Zickermann initially described gamification as a process that includes game thinking and mechanics to engage users in problem solving. He later refined this definition and stated that gamification involves engaging audiences through the application of game design, behavioral economics, and best practices in programs (20). Gamification involves using game elements in non-game contexts and has promising applications in managing global epidemics and chronic diseases (21).
Through gamification, teachers can actively engage their audience with natural stimuli, making education exciting and practical while capturing audience attention, promoting interaction, and enhancing learning (20). One of the primary goals of gamification is to stimulate motivation and promote cooperative learning, which leads to increased knowledge acquisition (14). In addition, gamification can extend its effect beyond learning, teaching different life skills and beliefs (19, 22).
Various studies have shown the positive effects of gamification on academic performance, health promotion, attitudes and learning behaviors (23,24,25).
Several studies have explored substance abuse prevention in youth, each focusing on specific aspects (26, 27, 6, 11). However, these studies often concentrate on singular dimensions of prevention. In some of these works, researchers emphasized the attitudinal variable, giving less consideration to knowledge about addiction and its consequences for academic performance, especially among 13-15-year-olds, a critical age group highly susceptible to the influence of addiction.
Furthermore, most of these studies relied on traditional training methods, paying less attention to innovative training techniques. In response to these gaps, this study aimed to assess the impact of gamification-based training on the knowledge and attitudes of male teenagers regarding the prevention of drug and Internet addiction. In addition, the study investigated how this educational program affects their academic performance.
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