Abstract
BackgroundAlthough binge drinking peaks at age 21 to 25 years, there is limited research on the effects of serious games in 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.ObjectiveThis study utilized a conceptual model for serious video game processes. Using One Shot, the model assessed the following process stages: (1) Alcohol Use Disorders Identification Test-Concise (AUDIT-C); (2) in-game factors of game time and risky alcohol decisions; (3) game enjoyment; and (4) postgame outcomes of intention to drink less and drinking refusal self-efficacy.MethodsIn a one-group pretest-posttest quasi-experimental design, a sample (N=550) of young adults (age 21-25 years) who reported recent binge drinking played the One Shot game. Intention to drink less and drinking refusal self-efficacy were measured at pregame and postgame, 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. A structural equation model (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 2 postgame alcohol-related outcomes.ResultsA well-fitting SEM demonstrated support for the multistep model, with AUDIT-C predicting risky alcohol decisions (β=.30). Risky alcohol decisions (β=−.22) and game time (β=.18) predicted enjoyment, which, in turn, predicted intention to drink less (β=.21) and drinking refusal self-efficacy (β=.16). Enjoyment significantly (P<.001) mediated the effects of game time and risky alcohol decision on intention to drink less and drinking refusal self-efficacy.ConclusionsThe results support a conceptual model in which staggered individual and in-game factors influence alcohol-related outcomes. Enjoyment is important for participants’ intentions to drink less and beliefs that they can refuse alcohol.
Highlights
Background it is well recognized that alcohol use is a leading risk factor for morbidity and mortality, recent estimates indicate that it accounts for a larger percentage of global deaths than previously recognized, with 10% of deaths among 15 to 49-year-old individuals attributed to alcohol [1]
The sample of participants was recruited by Survey Sampling International (SSI) and is of US young adults aged 21 to 25 years who reported binge drinking in the 2 weeks preceding this study http://www.jmir.org/2020/11/e21652/
Similar tests were run on the 7 pregame and postgame manifest indicators of drinking refusal self-efficacy, which was instituted as a latent variable in the structural equation model (SEM)
Summary
Background it is well recognized that alcohol use is a leading risk factor for morbidity and mortality, recent estimates indicate that it accounts for a larger percentage of global deaths than previously recognized, with 10% of deaths among 15 to 49-year-old individuals attributed to alcohol [1]. Video games have been used to impart knowledge and change health behaviors [7], with much of this research focused on adolescents and college students because of the health and injury risks associated with underage drinking [8]. Binge drinking peaks at age 21 to 25 years, there is limited research on the effects of serious games in 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
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