Abstract

BackgroundSerious games for health have been gaining in popularity among scholars and practitioners. However, there remain a few questions to be addressed.ObjectiveThis study tests the effects of a serious game and fear appeals on smoking-related outcomes. More specifically, this research aims to understand how serious games function as a more effective vehicle for a health campaign than a traditional medium, such as a print-based pamphlet. Further, while serious games utilize a variety of persuasive strategies in the game’s content, it is not clear whether fear appeals, which are widely used persuasive-message strategies for health, can be an effective strategy in serious games. Thus, we are testing the effect of fear appeals in a serious game.MethodsWe created a computer game and a print brochure to educate participants about the risks of smoking. More specifically, a flash-based single-player game was developed in which players were asked to avoid cigarettes in the gameplay context. We also developed an online brochure based on existing smoking-related brochures at a university health center; antismoking messages on the computer game and in the brochure were comparable. Then, an experiment using a 2 (media type: game vs. print) x 2 (fearful image: fear vs. no-fear) between-subjects design was conducted. The study recruitment was announced to undergraduate students enrolled in a large, public Midwestern university in the United States. After a screening test, a total of 72 smokers, who reported smoking in the past 30 days, participated in the experiment.ResultsOverall, gameplay, when compared to print-based pamphlets, had greater impacts on attitudes toward smoking and the intention to quit smoking. Further, the game’s persuasive effects were especially pronounced when messages contained fear appeals. When fearful images were presented, participants in the game condition reported significantly more negative attitudes toward social smoking than those in the print condition [F(1,67)=7.28; P=.009; ηp2=0.10]. However, in the no-fear condition, there was no significant difference between the conditions [F(1,67)=0.25; P=.620]. Similarly, the intention to quit smoking [F(1,67)=4.64; P=.035; ηp2=0.07] and susceptibility [F(1,67)=6.92; P=.011; ηp2=0.09] were also significantly different between the conditions, but only when fear appeals were used.ConclusionsThis study extends fear appeal research by investigating the effects of different media types. It offers empirical evidence that a serious game can be an effective vehicle for fear appeals.

Highlights

  • Smoking and Smoking Cessation InterventionsSmoking is one of the most prevalent risky health behaviors

  • There are more than 35 million Americans that identify as smokers [1]

  • More than 16 million Americans are living with a disease that was caused by smoking [3]

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Summary

Introduction

Smoking and Smoking Cessation InterventionsSmoking is one of the most prevalent risky health behaviors. There are more than 35 million Americans that identify as smokers [1]. The number of smokers has consistently declined over the years, smoking has frequently been associated with negative health outcomes that often lead to death. Worldwide, smoking is responsible for more than 7 million deaths per year [2]. In the United States alone, more than 480,000 deaths a year are due to smoking, which includes 41,000 deaths due to second-hand smoking [3]. Researchers and medical professionals have identified smoking as one of the most important risk factors for various health problems, such as different types of cancer [4], kidney failure [5], and cardiovascular disease [6]. More than 16 million Americans are living with a disease that was caused by smoking [3].

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