Purpose: Adolescents with chronic illnesses have been shown to have management and treatment issues resulting in poor outcomes. These issues may arise from non-interest in self care and illness knowledge. A video game, "Re-Mission," was developed to actively involve young people with cancer in their own treatment. Re-Mission provides opportunities to learn about cancer and its treatment.

Method: The efficacy of Re-Mission was investigated in a multi-site, randomized, controlled study with 375 adolescent and young adult cancer patients. Participants received either a regular commercial game (control) or both the regular game plus Re-Mission (Re-Mission group). Participants were given a mini-PC with the games installed and requested to play for an hour each week for 3 months. A test on cancer-related knowledge was given prior to game play (baseline) and again after 1 and 3 months. At 3 months the Re-Mission group also rated the acceptability and credibility of Re-Mission.

Results: Analyses of the knowledge test scores showed that whereas scores of both groups improved significantly over the follow-up periods, the scores of the Re-Mission group improved significantly more. The size of this effect was related to usage of Re-Mission. Credibility scores were negatively correlated with level of knowledge but not with change in knowledge level at 1 month or 3 months.

Conclusions: The results indicate a specific effect of Re-Mission play on cancer knowledge that is not attributable to patients' expectations. It is concluded that video games can be an effective vehicle for health education in adolescents and young adults with chronic illnesses.