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Title: Expert and adolescent user identification of the implementation of behaviour change techniques in a serious game against cyberbullying

item DESMET, ANN - Ghent University
item DIREITO, ARTUR - University Of Auckland
item Thompson, Deborah - Debbe
item SPOOK, JORINDE - Wageningen University
item DE BOURDEAUDHUIJ, ILSE - Ghent University

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 2/12/2019
Publication Date: 4/9/2019
Citation: Desmet, A., Direito, A., Thompson, D.J., Spook, J., De Bourdeaudhuij, I. 2019. Expert and adolescent user identification of the implementation of behaviour change techniques in a serious game against cyberbullying [abstract]. CBC Digital Health Conference - Behaviour Change for Health: Digital and other Innovative Methods. April 9-10, 2019; London, UK. Oral Presentation.

Interpretive Summary:

Technical Abstract: Behaviour change techniques (BCTs) are the smallest active ingredients of a behaviour change intervention. A common obstacle in interventions lies in an inaccurate translation of BCTs into practical applications. Especially in serious games, where apart from behaviour change theory the creative aspect plays an important role, inaccurate translations may occur that reduce intervention effectiveness. The aim of this study was to assess whether the intended BCTs were recognized by independent health promotion experts, and by adolescent users the game was designed for. A serious game against cyberbullying among adolescents (Friendly ATTAC) was tested in a dual-phase study. In phase 1, 11 health promotion experts played/user-tested the game and rated it for inclusion of BCTs using a coding sheet. The game was revised based on these findings, and rated by 5 new experts. In phase 2, the coding sheet was adjusted to adolescent layman's terms, pilot tested with a 12-year old, and revised by 3 experts not involved in BCT coding or game design. Eight adolescents (12-14y, 3 girls) played the revised game and completed the adolescent coding sheet version in a semi-structured interview. They could replay the game to resolve uncertainties. The majority of experts identified the following BCTs in the game: giving instructions, creating intentions, performance feedback, rewards, identification of role models, information on consequences, persuasive arguments and encouraging practice. Adolescents mostly recognized receiving information on the behaviour-health link, general encouragement, coping planning, cues, instructions, performance feedback, identification of role models, and tailoring. Interestingly, identification of role models was unintended during the game design. Users did not identify report of rewards, a vital element of games. Neither users nor experts recognized self-monitoring, a BCT that has been associated with higher effectiveness in several studies. Differences between the intervention and game designers' intentions and expert and user ratings underline the need for expert and user testing prior to effectiveness testing. To our knowledge, no study has assessed adolescents' recognition of BCTs. This is important since BCTs that assume central processing to change behaviour, but that are unnoticed by users are unlikely to impact behaviour.