Evaluation of Interventions to Promote Work-Life Balance Among Students at Gaming Schools

Introduction :

Internet Gaming Disorder (IGD) is characterized by an over-investment in video gaming leading to significant disruption of social, cognitive, and emotional functioning. Recognized in the DSM-5 since 2013 as a condition warranting further research, IGD is now increasingly documented in young populations worldwide. It is understood as a complex, multidimensional condition expressed on a continuum, shaped by a combination of internal risk factors (structural brain deficits, emotional difficulties, mental health vulnerabilities) and external ones (social environment, parental supervision, game-specific characteristics). In France, an estimated 14% of adolescents may be affected by problematic video game use, a figure that reflects a broader international trend, with prevalence rates ranging from 1.2% to 14.6% across European studies depending on the diagnostic criteria and age groups considered. Consequences are wide-ranging and can be severe: sleep disorders, weight gain, academic failure, reduced cognitive performance, social withdrawal, anxiety, and in the most serious cases, suicidal ideation and self-harm behaviors. Well-documented risk factors include poor family supervision, depressive symptoms, low frustration tolerance, and certain gaming practices such as frequent online multiplayer gaming. Gender also plays a role, with male gamers being more frequently identified in clinical and research settings, while female gamers appear to present distinct risk profiles and different patterns of impact on mental health, a dimension that remains underexplored in the literature.

Beyond these individual consequences, IGD also raises important public health challenges. Most affected young people do not seek professional help, citing cost, confidentiality concerns, and lack of trust as major barriers. This underscores the need for proactive, community-embedded prevention approaches that reach young people where they are, in formats they find credible and engaging. Despite growing recognition of the disorder, evidence-based prevention interventions specifically tailored to high-risk youth populations remain scarce. Existing studies focus predominantly on clinical settings or general adolescent populations, leaving a significant gap for populations at structurally elevated risk.

Gaming school students represent one such underserved group. For them, video gaming is simultaneously a central daily activity, a social identity, and a professional pathway, creating a unique and complex risk profile that standard public health approaches are ill-equipped to address. Reaching this population requires interventions that are culturally embedded, co-designed with the community, and capable of being delivered within their educational environment and through the digital channels they inhabit. The JERRI project was designed to respond directly to this gap.

Objective To evaluate the effectiveness of co-constructed school- and internet-based interventions on reducing IGD-related risks among first-year gaming school students, and to compare the relative impact of online versus in-person delivery formats. Secondary objectives include describing the implementation processes of each intervention (fidelity, dose, acceptability, and relevance), exploring individual and contextual factors that may moderate intervention effects, characterizing the nature and quality of stakeholder partnerships built throughout the project, documenting the prevalence of IGD and associated sociodemographic factors at baseline, and tracking the broader health trajectories of participants over the study period, including sleep, mental health, sedentary behavior, and social health.

Methods JERRI is a quasi-experimental comparative study conducted across two gaming schools in Bordeaux and Nantes (E-Art Sup). Students aged 18 to 25 are recruited over an academic year, targeting a total of 200 participants. School-level allocation determines exposure to an intervention online or in presence condition, without randomization. All interventions were co-designed upstream with volunteer students, popular gaming streamers, and teaching staff to ensure cultural relevance, credibility, and acceptability within this specific community. They are delivered either online or in-person, with format and setting varying by school and academic year.

Online interventions include streamer-led conferences broadcast on the school's digital platforms and co-animated by mental health professionals, promoting balanced and informed gaming habits through interactive discussions; and virtual building challenges taking place in online game environments, where participants are invited to explore themes of wellbeing, time management, and life balance through creative gameplay over several weeks. In-person interventions mirror this structure in a real-world setting: in-school conferences held in amphitheaters, combining expert presentations, gamer testimonials, and group discussion; and campus-based challenges where students work in teams over several weeks on concrete collective projects such as awareness campaigns, school events, and peer-led initiatives promoting healthier gaming environments.

The primary outcome is the change in IGD score measured by the Gaming Addiction Scale between baseline (M0) and six months (M6). Secondary outcomes include broader health dimensions such as sleep quality, mental health, sedentary behavior, and social health, assessed through self-administered online questionnaires at multiple time points. Implementation fidelity, dose, acceptability, and stakeholder engagement are monitored continuously through structured observations and informal interviews with students and school staff.

Expected outcomes A meaningful reduction in IGD scores among students exposed to the interventions, alongside robust evidence on the comparative effectiveness of online versus in-person formats. The study also aims to identify the individual and contextual factors that moderate intervention effects, generating knowledge that goes beyond simple efficacy assessment toward a deeper understanding of what works, for whom, and under what conditions. In the longer term, findings are expected to provide actionable insights for designing, adapting, and scaling school-based gaming disorder prevention programs that are genuinely embedded in gaming cultures and relevant to the populations they aim to serve.