Identifying adolescents’ gaming preferences for a tobacco prevention social game: A qualitative study

Abstract

Introduction Considering the dangers of adolescent tobacco use, the successful design of behavioral programs is crucial for tobacco prevention. According to preliminary research, social game interventions can improve adolescent tobacco outcomes. The current qualitative study aims to (1) uncover the gaming elements that adolescents deem important for a positive learning experience, and (2) confirm these gaming elements with adolescents who are presented with a tobacco prevention game concept that applies these elements. Methods Findings from this study are drawn from two phases. Phase 1 involved in-person focus group discussions (n = 15) and Phase 2 included three online focus groups and a paired interview with another set of adolescents (n = 15). The study was conducted under a project that aimed to design and test a social game-based tobacco prevention program for adolescents (Storm-Heroes). With open coding and thematic analysis, two research team members identified repeated topics and relevant quotes to organize them into themes. The themes evolved as new content was identified during the process. This process was repeated until thematic saturation was reached. Results Thematic analysis across Phase 1 and Phase 2 revealed four major themes: 1) Balance during gaming challenges, 2) Healthy social interaction, 3) Performance and creative freedom, and 4) Fictional world and game mechanics for tobacco prevention. Conclusion This study identified specific intervention features that best fit the needs of adolescents in the context of a social game for tobacco prevention. For future research, we will use a participatory approach to allow adolescents to take part in the design process, improve Storm-Heroes, and develop health promotional messages that can be incorporated into the program. Ultimately, a board game for tobacco prevention is expected to bring adolescents together to create lasting memories that nudge them away from tobacco use and the harm it can cause.

Improved Risk Perception and Knowledge Following a Social Game-based Tobacco Prevention Program for Adolescents: A Pilot Randomized Comparative Trial (Preprint)

“…With social gaming, Storm-Heroes relies on the social learning theory by promoting interpersonal discussions and boosting self-efficacy through the practice of skills to stay tobacco-free. Additionally, Storm-Heroes conveys normative feedback, influencing adolescents' risk perceptions regarding tobacco use [21]. This aligns with the health beliefs model, which posits that psychosocial factors such as social interaction and peer pressure can promote risk perception and ultimately encourage behavior change [22].…”

“…In addition, along with other theoretical frameworks, the program design is grounded in the health belief model and empowerment theory, promoting perceived susceptibility [41] and self-efficacy [42,43]. The game-based social activities in Storm-Heroes allow adolescents to engage in interactive learning experiences that empower them to recognize and internalize the harms of tobacco, motivating them towards tobacco-free lifestyles [21].…”

“…This line of research on gaming elements for tobacco prevention led to the design of a social game-based intervention, called Storm-Heroes, which is ideal for education systems (e.g., schools and after-school programs). As a social game, Storm-Heroes offers adolescents the opportunity to witness and model healthy behaviors, such as rejecting tobacco, thereby promoting tobacco risk education [21]. With social gaming, Storm-Heroes relies on the social learning theory by promoting interpersonal discussions and boosting self-efficacy through the practice of skills to stay tobacco-free.…”

“…By including various gaming elements (eg, competition, collaboration, reward, goal setting, and storytelling), games can provide flexibility in addressing different issues pertaining to tobacco use. One qualitative study for the design of tobacco prevention games examined adolescents' gaming preferences and showcased the elements of cooperation, storytelling, and physical performance, as key experiential learning elements for tobacco prevention [21]. The findings suggest that gaming elements can be combined to design an effective and engaging tool that covers the complexities of different tobacco products and addresses unique topics pertaining to this risky behavior.…”

Donate Life! Validation of a board game about knowledge of organ and tissue donation and transplantation (Preprint)

“…Validation studies conducted on educational games often highlight the importance of user feedback in fine-tuning game mechanics and content [35]. Studies using board games have found a reduction in depression in institutionalized elderly [36], improvement in cognitive capacity in Alzheimer's patients [37], promotion of healthy eating, smoking cessation, and safer sexual practices [38].…”