Designing a Serious Game (Above Water) for Stigma Reduction Surrounding Mental Health: Semistructured Interview Study With Expert Participants

Abstract

Background Although in many contexts unsuccessful games targeting learning, social interaction, or behavioral change have few downsides, when covering a sensitive domain such as mental health (MH), care must be taken to avoid harm and stigmatization of people who live with MH 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 apps is often compared with the nongame 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 The aim of this study is 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 MH, we present Above Water (AbW), a game targeting the reduction of stigma surrounding MH, now in its second iteration. The game, AbW, serves as a consistent research probe to solicit expert feedback. Experts were recruited from a range of topic domains related to MH and wellness, game design, and user experience. Results By using this deployment as a research probe, this study demonstrates how to synthesize gained insights from multiple expert perspectives and create actionable guidelines for successful design of serious games targeting sensitive topics. Conclusions Our work contributes to a better understanding of how to design specialized games to address sensitive topics. We present a set of guidelines for designing games for sensitive subjects, and for each guideline, we present an example of how to apply the finding to the sample game (AbW). 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.

A serious gaming approach to experiencing the effects of unsolicited help and loss of autonomy (Preprint)

“…[44]. Games seem to best construct this experience, as players exhibit more authentic behaviour through the magic circle [45,46] and flowstate [47]. Emotions always play a role in this flow state.…”

Measuring digital intervention user experience with a novel ecological momentary assessment (EMA) method, CORTO

“…Also interviewing can be used to discover such emergent topics. Interviewing may occur concurrently with the design use, such as when the participant reacts to designed mockups or prototypes ( Ospina-Pinillos et al, 2018 ; Pine et al, 2020 ; Wehbe et al, 2022 ) or in think-aloud usability tests ( Van Den Haak et al, 2003 ). Interviews can also be retrospective, which allows for creating an understanding on the aggregative experience the intervention and the associated processes have elicited ( Crane et al, 2017 ; T. Fleming et al, 2016 ).…”