Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 20, 2020
Date Accepted: Oct 26, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Serious Game for Binge Drinkers: Enjoyment as a Means to Preventive Outcome
ABSTRACT
Background:
Binge drinking peaks at age 21-25 years, yet there is limited research on the effects of serious games on this population, as well as on the process by which playing serious games impacts alcohol-related outcomes. Designed with both health behavioral theory and game theory, One Shot is an online serious game that aims to prevent binge drinking.
Objective:
This study utilizes a conceptual model for serious video game process. Using One Shot, the model assesses the following process stages: 1) AUDIT-C; 2) in-game factors of game time and risky alcohol decisions; 3) game enjoyment; and 4) post-game outcomes of intention to drink less and drinking refusal self-efficacy.
Methods:
In a one-group pretest-posttest quasi-experimental design, a sample (N=550) of young adults (age 21-25) who reported recent binge drinking played the One Shot game. Intention to drink less and drinking refusal self-efficacy were measured pre- and post-game, with their effects lagged in statistical analysis. Participants were presented with various scenarios in the game that pertained to risky alcohol decisions, which, along with game time, were unobtrusively recorded by the server. Structural Equation Modeling (SEM) was used to test the conceptual model, with assessments made to determine if enjoyment mediated the effects of game time and risky alcohol decisions on the two post-game alcohol-related outcomes.
Results:
A well-fitting SEM demonstrated support for the multistep model, with AUDIT-C predicting risky alcohol decisions (=.30). Risky alcohol decisions (= -.22) and game time (=.18) predicted enjoyment, which, in turn, predicted intention to drink less (=.21) and drinking refusal self-efficacy (=.16). Enjoyment significantly mediated the effects of game time and risky alcohol decision on intention to drink and drinking refusal self-efficacy.
Conclusions:
Results support a conceptual model in which staggered individual and in-game factors influence alcohol-related outcomes. Enjoyment is critical to participants’ intending to drink less and believing that they can refuse alcohol.
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