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36035 Reducing the Negative Impact of Tobacco through Video Games and Gamification

Jay M. Bernhardt, PhD, MPH, Center for Health Communication, University of Texas at Austin, Austin, TX, Lenora Johnson, DrPH, MPH, CHES, Office of the Director, National Heart Lung and Blood Institute at the National Institutes of Health, Bethesda, MD, Sanjay Koyani, MPH, Office of Health Communication and Education, FDA Center for Tobacco Products, Rockville, MD and Amanda Hall, PhD, MS, Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA

Theoretical Background and research questions/hypothesis:  Recent research has shown that video games and gaming features have significant potential as tools for health promotion and disease self-management, but limited research has been conducted to date related to the potential use of video games for tobacco prevention and cessation. To address this gap, we conducted several formative research projects, with the support of the FDA Center for Tobacco Product and the NCI Office of Communication Education.

Methods:  One phase involved a comprehensive review of the scientific and grey literature on games for health for tobacco. Another phase involved a systematic content analysis of all currently available video games video games across all platforms designed for tobacco-related health promotion. Another phase involved identifying diverse experts on video games, gaming, health, and tobacco and conducting video-captured, in-depth interviews to establish best practices and needs for additional research.

Results:  The literature review identified nine articles that met criteria for inclusion and were analyzed in the final review. Games were code for purpose, game play, and tobacco prevention outcome measures. The majority of games were school-based and focused on the harmful health consequences and social influences of tobacco use.  The game analysis involved systematically coding 96 games for characteristics, content, and quality using a reliable and valid coding instrument developed for this research. The majority of games included at least two components of interactivity (75.0%), and at least one mechanism for rewarding (69.3%). However, most games lacked a story line (97.8%) and components for sense of control (25.0%). The subject matter expert phase involved qualitative analysis of 25 in-depth individual interviews to explore advice and lessons learned on the development and evaluation of video games for tobacco-related prevention education and communication for youth and adolescents. Three main themes emerged from the data analysis:  The current state of games for health for youth and adolescents to promote healthy behaviors; Strategies to design, develop, and evaluate games for health for quality and impact; and, Recommendations for using video games as a means to effectively target youth and adolescents for tobacco prevention and smoking cessation.

Conclusions:  The findings from these formative studies offer stakeholders recommended strategies to effectively design, implement, and evaluate games for health within their current and future work, particularly related to video games designed for tobacco prevention and smoking cessation aimed at youth and adolescents.

Implications for research and/or practice:  More research is needed to develop and evaluate video games, game elements, and their impact on tobacco prevention among youth and adolescents.

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