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Accepted for/Published in: JMIR Serious Games

Date Submitted: Jul 19, 2021
Date Accepted: Mar 16, 2022

The final, peer-reviewed published version of this preprint can be found here:

The Role of Agency and Threat Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Excessive Alcohol Use: Randomized Controlled Trial

Engelbrecht H, van der Laan N, van Enschot R, Krahmer E

The Role of Agency and Threat Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Excessive Alcohol Use: Randomized Controlled Trial

JMIR Serious Games 2022;10(2):e32218

DOI: 10.2196/32218

PMID: 35699976

PMCID: 9237780

Warning: This is an author submission that is not peer-reviewed or edited.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.

The Role of Agency and Threat-Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Alcohol Abuse: An Empirical Study Among College Students

  • Hendrik Engelbrecht; 
  • Nynke van der Laan; 
  • Renske van Enschot; 
  • Emiel Krahmer

ABSTRACT

Background:

Serious games for the training of prevention behaviors have been widely recognized as a potentially valuable tool for adolescents and young adults across a variety of risk behaviors. However, the role of agency, as a distinguishing factor from traditional health interventions, has seldomly been isolated and grounded in persuasive health communication theory. Fear appeals have different effects on intentions to perform a prevention behavior depending on the immediacy of the consequences. Looking into how to increase self-efficacy beliefs for health behavior with distant consequences is a first step to improving game-based interventions for adverse health outcomes.

Objective:

The current study investigated the effect of agency on self-efficacy and intention to drink less alcohol in an interactive digital narrative fear appeal. Further, the communicated immediacy of threat outcomes was evaluated as a potential moderator of the effect of agency on self-efficacy.

Methods:

An experimental study was conducted among university students (N=178). Participants were presented with a fear appeal outlining the consequences of alcohol abuse in an interactive narrative format. Participants either had perceived control over the outcome of the narrative scenario (high-agency) or no control over the outcome (low-agency). The threat was either framed as a short-term or long-term negative health outcome resulting from the execution of the risk behavior (drinking too much alcohol).

Results:

Self-efficacy and intention to limit alcohol intake were not influenced by the agency manipulation. Self-efficacy was shown to be a significant predictor of behavioral intention. Immediacy of the threat did not moderate the relationship between agency and self-efficacy.

Conclusions:

Although the agency manipulation was successful, we could not find evidence for an effect of agency or threat immediacy on self-efficacy. The implications for different operationalizations of different agency concepts is discussed, as well as the malleability of self-efficacy beliefs for long-term threats. The usage of repeated, versus single, interventions and different threat types (e.g., health and social threats) should be tested empirically to establish a way forward for diversifying intervention approaches.


 Citation

Please cite as:

Engelbrecht H, van der Laan N, van Enschot R, Krahmer E

The Role of Agency and Threat Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Excessive Alcohol Use: Randomized Controlled Trial

JMIR Serious Games 2022;10(2):e32218

DOI: 10.2196/32218

PMID: 35699976

PMCID: 9237780

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