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Title: Leisure and problem gaming behaviors among children and adolescents during school closures caused by COVID-19 in Hong Kong : quantitative cross-sectional survey study
Authors: Zhu, S 
Zhuang, Y 
Lee, P
Li, JCM 
Wong, PWC
Issue Date: Apr-2021
Source: JMIR serious games, Apr.-June 2021, v. 9, no. 2, e26808
Abstract: Background: School closures during the COVID-19 pandemic may have exacerbated students' loneliness, addictive gaming behaviors, and poor mental health. These mental health issues confronting young people are of public concern.
Objective: This study aimed to examine the associations between loneliness and gaming addiction behaviors among young people in Hong Kong and to investigate how familial factors, psychological distress, and gender differences moderate these relationships.
Methods: This cross-sectional study was conducted in June 2020 when schools reopened after 6 months of school closures. Participants included 2863 children and adolescents in primary (Grades 4 to 6) and secondary (Grades 7 and 8) schools (female participants: 1502/2863, 52.5%). Chi-square tests, one-way analyses of variance, and independent-samples t tests were performed to compare the differences of distribution in gaming addiction behaviors across gender, age, and other sociodemographic characteristics. Multinomial logistic regression analyses were conducted to identify factors that relate to excessive or pathological gaming behaviors separately, in comparison with leisure gaming.
Results: A total of 83.0% (2377/2863) of the participants played video games during the COVID-19 pandemic. The prevalence of excessive and pathological game addiction behaviors was 20.9% (597/2863) and 5.3% (153/2863), respectively. More male students had gaming addiction symptoms than female students. The multinomial logistic regressions showed that feeling lonely was associated with more problematic gaming behaviors, and the association was stronger for older female students. Low socioeconomic status, less parental support and less supervision, and poor mental health were risk factors for gaming addiction behaviors, especially among primary school students.
Conclusions: Loneliness was associated with gaming addiction behaviors; the findings from this study suggested that this association was similar across gender and age groups among young people. Familial support and supervision during school closures can protect young people from developing problematic gaming behaviors. Results of this study have implications for prevention and early intervention on behalf of policy makers and game developers.
Keywords: COVID-19
COVID-19 lockdown
Excessive gaming
Familial factors
Leisure gaming
Pathological gaming
School closure
Publisher: JMIR Publications
Journal: JMIR serious games 
EISSN: 2291-9279
DOI: 10.2196/26808
Rights: ┬ęShimin Zhu, Yanqiong Zhuang, Paul Lee, Jessica Chi-Mei Li, Paul W C Wong. Originally published in JMIR Serious Games (, 07.05.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
The following publication Zhu S, Zhuang Y, Lee P, Li JC, Wong PWC Leisure and Problem Gaming Behaviors Among Children and Adolescents During School Closures Caused by COVID-19 in Hong Kong: Quantitative Cross-sectional Survey Study JMIR Serious Games 2021;9(2):e26808 is available at
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