Co-creating a gamified tool for cannabis and tobacco use monitoring: Participant-driven development

The growing use of cannabis, often alongside tobacco, presents challenges for substance use treatment programs (SUTPs), as it intensifies withdrawal symptoms. To address dual dependencies and improve engagement, we developed a gamified web app for individuals in SUTP who use cannabis to monitor their use. This paper describes the tool's co-creation process and and, findings that guided alignment with target needs.

Seventeen adults with current or past cannabis use were recruited from SUTPs in Catalonia (2021-2023). Using a qualitative, participatory design, the study involved reflexive thematic analysis and co-creation with researchers, clinicians, and gamification experts. Development followed four phases: (1) Discovering, expectations and motivations through interviews; (2) Deepening in Co-design, exploring needs and profiles; (3) Narrative Development, basing stories on real experiences; and (4) Technical Development, adapting features to goals.

In Phase 1, two archetypes were identified: "socializers" and "explorers", along with core values, such as acceptance, social connection, and life control. Phase 2 revealed expectations for content on autonomy, stigma reduction, empathy, self-confidence, tranquility, and curiosity as key motivators. Phase 3 created three stories. Phase 4 produced a customized tracking app, integrating questionnaires.

This study highlights the value of co-creation in designing interventions for SUTPs and demonstrates usefulness of participatory approaches to create mHealth tools. These approaches informed the app's design to align with individuals' motivations and preferences, grounded in lived experiences. The resulting web app provides personalized support for substance use treatment. Future research should explore clinical and behavioral impacts.