Network intervention analysis of a school-based gaming disorder prevention program in Hong Kong primary school students

Background and aims The growing prevalence of gaming disorder has prompted the emergence of early prevention programs. While previous evaluations assessed overall efficacy, the specific symptom-level changes following program participation remain unknown. This study addressed the gap using network intervention analysis (NIA) to investigate how a newly validated prevention program, the Digital Netizen Alliance, was associated with changes in the network of gaming disorder symptoms. Methods In a school-clustered design, a sample of 600 Chinese Primary 4 to 6 students (48% female, age range: 9-12) was assigned to either the intervention or waitlist group. Participants completed validated questionnaires at baseline and three-month follow-up. Results Within this school-clustered intervention context, the NIA revealed that the program was related to reductions in three symptoms among at-risk gamers: gaming-driven affirmation dependence, craving, and jeopardizing relations. The analysis further showed correlated reductions in loss of interest, social escapism, and impaired control. Discussion This study presents the first application of NIA to examine patterns of symptom change following a gaming disorder prevention program. Unlike conventional approaches that evaluate effectiveness through overall outcome comparisons, our findings highlight which specific symptoms were greatly reduced and how these changes were associated with improvements in other symptoms. These insights demonstrate the value of NIA as a complementary evaluation approach for elucidating the cognitive-behavioral processes related to preventive change.