Above Water: Designing Games for Sensitive Topics and Battling Mental Health Stigma (Preprint)

Mapping Intimacies ◽

10.2196/preprints.21376 ◽

2020 ◽

Author(s):

Rina Wehbe ◽

Colin RJ Whaley ◽

Yasaman Eskandari ◽

Ally Suarez ◽

Lennart E Nacke ◽

...

Keyword(s):

Mental Health ◽

Game Design ◽

Serious Games ◽

Behavioural Change ◽

User Preferences ◽

Mental Health Stigma ◽

Health And Wellness ◽

Domain Experts ◽

Sensitive Topics ◽

Entertainment Value

BACKGROUND While in many contexts unsuccessful games targeting learning, social interaction, or behavioural change have few downsides, when covering a sensitive domain such as mental health, care must be taken to avoid harm and stigmatization of people who live with mental health conditions. As a result, evaluation of the game to identify benefits and risks is crucial in understanding the game's success; however, assessment of these applications is often compared to the 'non-game' control condition, resulting in findings specifically regarding entertainment value and user preferences. Research exploring the design process, integrating field experts, and guidelines for designing a successful serious game for sensitive topics is limited. OBJECTIVE Our paper seeks to understand which elements of game design can guide a designer when designing a game for sensitive topics. METHODS To carefully probe the design space of serious games for mental health, we present Above Water, a game targeting the reduction of stigma surrounding mental health, now in its second iteration. This game serves as a research probe to understand the design and evaluation of games in the area of mental health by soliciting expert feedback from experts in domains related to Mental Health and Wellness, Game Design and User Experience (UX). RESULTS By using this deployment as a research probe to gather assessments by domain experts, this paper contributes to a better understanding of how to design specialized games to address sensitive topics. CONCLUSIONS The main contribution of the presented paper is a set of the guidelines for designing games for sensitive subjects. For each guideline, we present an example of how to apply the finding to the sample game (Above Water). Furthermore, we demonstrate the generalizability to other sensitive topics by providing an additional example of a game that could be designed with the presented guidelines. CLINICALTRIAL N/A

Download Full-text

Development of Serious Games for Behaviour Change: A Practical Methodology (Preprint)

10.2196/preprints.21862 ◽

2020 ◽

Author(s):

Carlos Alberto Catalina Ortega ◽

Svjetlana Kolić-Vehovec ◽

Barbara Rončević Zubković ◽

Sanja Smojver-Ažić ◽

Tamara Martinac Dorčić

Keyword(s):

Behaviour Change ◽

Game Design ◽

Serious Games ◽

Behavioural Change ◽

Intervention Mapping ◽

Psychological Perspective ◽

Game Development ◽

Development Methodology ◽

Intervention Mapping Protocol ◽

Post Test

UNSTRUCTURED Objectives: The main purpose of the paper is to define a new methodology that allows the design of Serious Games that promote a behavioural change. The methodology is based on the Intervention Mapping Protocol (IMP) to define all the information and interventions and Applied Behaviour Analysis (ABA) to promote the behaviour change. Materials and methods: The methodology is based on the experience of game designers and psychologies within the eConfidence H2020 research project in which a new methodology was designed and implemented in two serious games. The game development methodology is described in six steps to be followed, with the psychological perspective integrated with the game design. Both games were tested in 10 schools with a pre and post-test for the data analysis. Results: Both games developed within the methodology present relevant findings on the change of behaviour of the users. Additionally, the proposed metric integrated allows a database improvement of the games to get better results. Conclusion: New methodology for design and study effectiveness of Serious Games that promote behavioural changes, was designed and integrated into two serious games that demonstrate changes in the users. The methodology could help other teams in the work of design and assess the effectiveness of a Serious Game for behavioural change.

Download Full-text

Good Games Must Be Good Games: A Mixed-Methods Assessment of User Preferences to Improve Adherence and Engagement with Therapeutic Game Interventions in Adolescents (Preprint)

10.2196/preprints.11944 ◽

2018 ◽

Author(s):

Steven Barnes ◽

Julie Prescott

Keyword(s):

Mental Health ◽

Mixed Methods ◽

Game Design ◽

Digital Health ◽

User Preferences ◽

Self Report ◽

Mental Health Issue ◽

Early Results ◽

Therapeutic Game ◽

The Impact

BACKGROUND Anxiety Disorders (AD) are a major mental health issue in adolescents. While numerous psychological interventions have proven effective in reducing AD, including Cognitive Behavioural Therapy (CBT), and Attention-Bias Modification (ABM), their efficacy is limited by both social and practical barriers (including cost, stigma, and availability), and AD symptomatology (e.g. avoidance-behaviours). As a result, less than 50% of adolescents with AD are estimated to seek treatment, with less than 20% of these ultimately receiving a scientifically validated intervention. Therapeutic games have emerged as an effective medium to promote access to, and engagement with, the therapeutic process. While early results are promising, the mechanisms underlying the ability of therapeutic games to engage this demographic are unclear, with some studies finding initial engagement and reduction in AD symptoms may not be sustainable over time. Despite the importance of player-preferences and participatory design in the development of traditional games for entertainment, little is currently known of adolescent player-preferences in digital health solutions, nor is user-centred design commonplace in this field. Addressing this area has the potential to maximise the impact and economy of gamified interventions, encouraging adherence and engagement over prolonged periods. OBJECTIVE The aim was to conduct an exploratory mixed-methods assessment of adolescents’ player-preferences in therapeutic games for AD. Feedback regarding five digital health games purported to be relaxing or informative about mental health was assessed to establish preferences in game-features and design-styles, and their impact on both player motivation and perceived game-impact. METHODS Sixteen adolescent participants (mean age=17.13, SD=.79) spent at least one hour engaging with at least one of the games and provided feedback via an open- and closed-ended version of a self-report questionnaire. RESULTS Compliance in feedback was high for the quantitative self-report (87.5%) and average for qualitative feedback (56.25%). Across both measures, adolescents generally reported therapeutic games to be an acceptable and engaging medium for delivery of health interventions. A significant preference for games incorporating a variety of tasks was noted (P = .016), and thematic analysis revealed a recurring focus on aesthetics (especially environment colour). Multiple regression analysis demonstrated a range of variables (engagement, functionality, aesthetics, and information) contributed to overall perceptions of game-quality and likeability (F6, 23 = 181.098, P <.001, R2 = .979), but that these variables did not predict perceptions of game impact on the health behaviour (F5, 24 = 4.295, P = .006, R2 = .472). CONCLUSIONS These findings suggest that while adolescents place value on the quality of health information provided in therapeutic games, AD therapeutic game design must also consider design variables, such as game-world aesthetics, game-functionality and game-mechanics, to promote sustained engagement and adherence in this demographic. Implications for further research and participatory therapeutic game design are discussed.

Download Full-text