Evaluating the effectiveness of a Roblox video game (Super U Story) in improving body image among children and adolescents in the United States: Randomized controlled trial

Paraskeva, Nicole; Haywood, Sharon; Anquandah, Jason; White, Paul; Budhraja, Mahira; Diedichs, Phillippa; Williamson, Heidi

Abstract

Background: Body dissatisfaction is a global public health issue negatively impacting young people’s mental and physical well-being, underscoring an urgent need to develop early interventions. There is emerging evidence suggesting that microinterventions are acceptable and effective in delivering mental health care. Given the popularity of video games among young people, the gaming world holds great promise for housing body image microinterventions. As such, we developed Super U Story, a stand-alone, self-paced, narrative-based adventure video game for the popular gaming platform Roblox grounded in the tripartite influence model of body dissatisfaction and basic tenets of positive body image.
Objective: This trial evaluated the effectiveness of playing a purpose-built Roblox video game once from start to finish on American children and adolescents’ state and trait body image and related outcomes. Gameplay was capped at 30 minutes.
Methods: A sample of 1059 US-based girls and boys (n=460, 43.4% girls) aged 9 to 13 years (mean age 10.9, SD 1.36 years ) from diverse ethnic, socioeconomic, and geographic backgrounds were recruited online via a research agency into a 3-arm, web-based, parallel randomized controlled trial . Participants were assigned to an intervention group, active control group (a Roblox game called Rainbow Friends 2 Story [Color Story]), or attention control group (online word search). Participants completed self-report assessments at baseline (1 week before the intervention and before randomization), immediately before and after the intervention testing phase , and 1 week after the intervention. Outcomes included state measures of body satisfaction (primary outcome), mood, and body functionality and trait measures of body esteem, body appreciation, internalization of appearance ideals, and social media literacy. Data were evaluated using repeated-measure analysis of covariance controlling for baseline. Engagement and acceptability data were collected.
Results: Intervention participants showed improved state body satisfaction (F1, 694=5.20; P=.02; ηp2=0.01) relative to the active control but not in comparison to the attention control. State mood, state body functionality, internalization of appearance ideals, and social media literacy showed no significant effects. Relative to the intervention group, the active control showed improved trait body esteem (F1, 663=5.40; P=.02; ηp2=0.01) and body appreciation (F1, 663=6.08; P=.01; ηp2=0.01). Exploratory analyses found that age and gender did not moderate the effects. We were unable to examine dose-response effects. Acceptability scores were good. Self-report engagement data suggested that participants experienced a highly variable and often low-dose exposure.
Conclusions: This large-scale, fully powered trial is the first to assess the effectiveness of a Roblox-based body image intervention, demonstrating the potential for disseminating microinterventions to children and adolescents on large and popular commercial platforms. Overall, playing Super U Story did not cause harm; however, evidence is lacking to suggest that it improved body image. Learnings are discussed, including psychoeducation as an intervention technique, “chocolate-covered broccoli” phenomena (ie, losing players who recognize thinly disguised educational messages), and measuring intervention engagement.

Trial Registration: ClinicalTrials.gov NCT05669053; https://clinicaltrials.gov/study/NCT05669053

• Journal Article Type: Article
• Acceptance Date: May 23, 2025
• Online Publication Date: Jul 31, 2025
• Publication Date: 2025
• Deposit Date: Aug 6, 2025
• Publicly Available Date: Aug 8, 2025
• Print ISSN: 1438-8871
• Electronic ISSN: 1438-8871
• Publisher: JMIR Publications
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Article Number: e66625
• DOI: https://doi.org/10.2196/66625
• Public URL: https://uwe-repository.worktribe.com/output/14809284