Serious games for smoking prevention and cessation: A systematic review of game elements and game effects

M E Derksen, S van Strijp, A E Kunst, J G Daams, M W M Jaspers, M P Fransen, M E Derksen, S van Strijp, A E Kunst, J G Daams, M W M Jaspers, M P Fransen

Abstract

Objective: Serious health games might have the potential to prevent tobacco smoking and its health consequences, depending on the inclusion of specific game elements. This review aimed to assess the composition of serious games and their effects on smoking initiation prevention and cessation and behavioral determinants.

Materials and methods: We systematically searched MEDLINE, Embase, PsycINFO, and Web of Science for publications that evaluated serious games aimed at changing smoking behavior or behavioral determinants. A taxonomy by King et al was used to classify game elements.

Results: We identified 15 studies, evaluating 14 unique serious games. All games combined multiple game elements (mean 5.5; range, 3-10). Most frequently used were general and intermittent rewards, theme and genre features, and punishments. Six studies on smoking prevention together assessed 20 determinants and found statistically significant positive effects for 8 determinants (eg, attitude, knowledge, intention). Of 7 studies on smoking cessation, 5 found positive, statistically significant effects on smoking cessation or status. These studies found statistically significant positive effects for 6 of 12 determinants (eg, self-efficacy, attitude, intention). The majority of included studies had poor or fair methodological quality, lacked follow-up measures, and had fixed (as opposed to free, on-demand) play sessions.

Conclusions: Serious games included multiple types of game elements. The evidence from a number of studies suggests that games may have positive effects on smoking-related outcomes, particularly smoking cessation. However, as most studies had important methodological limitations, stronger designs are needed to demonstrate, quantify, and understand the effects of serious games.

Keywords: game elements; serious games; smoking cessation; smoking initiation; smoking prevention; systematic review.

© The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram. ICTRP: International Clinical Trials Registry Platform; WHO: World Health Organization.

References

    1. Michael DR, Chen SL.. Serious Games: Games that Educate, Train, and Inform. Florence, KY: Muska & Lipman/Premier-Trade; 2005.
    1. Laamarti F, Eid M, Saddik AE.. An overview of serious games. Int J Comput Games Technol 2014; 2014: 358152.
    1. Ferguson B. The emergence of games for health. Games Health J 2012; 1 (1): 1–2.
    1. DeSmet A, Van Ryckeghem D, Compernolle S, et al. A meta-analysis of serious digital games for healthy lifestyle promotion. Prev Med 2014; 69: 95–107.
    1. Street TD, Lacey SJ, Langdon RR.. Gaming your way to health: A systematic review of exergaming programs to increase health and exercise behaviors in adults. Games Health J 2017; 6 (3): 136–46.
    1. Lamboglia CMGF, da Silva VTBL, de Vasconcelos Filho JE, et al. Exergaming as a strategic tool in the fight against childhood obesity: a systematic review. J Obes 2013; 2013:438364.
    1. Eichenberg C, Schott M.. Serious games for psychotherapy: A systematic review. Games Health J 2017; 6 (3): 127–35.
    1. DeSmet A, Shegog R, Van Ryckeghem D, Crombez G, De Bourdeaudhuij I.. A systematic review and meta-analysis of interventions for sexual health promotion involving serious digital games. Games Health J 2015; 4 (2): 78–90.
    1. Deterding S, Dixon D, Khaled R, Nacke L. From game design elements to gamefulness: defining “gamification”. In: MindTrek ’11: Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments. New York, NY: Association for Computing Machinery; 2011: 9–15. doi: 10.1145/2181037.2181040
    1. Michie S, Hyder N, Walia A, West R.. Development of a taxonomy of behavior change techniques used in individual behavioral support for smoking cessation. Addict Behav 2011; 36 (4): 315–9.
    1. Arnab S, Lim T, Carvalho MB, et al. Mapping learning and game mechanics for serious games analysis. Br J Educ Technol 2015; 46 (2): 391–411.
    1. Brigham TJ. An introduction to gamification: adding game elements for engagement. Med Ref Serv Q 2015; 34 (4): 471–80.
    1. Wilczynski NL, McKibbon KA, Haynes RB.. Search filter precision can be improved by NOTing out irrelevant content. AMIA Annu Symp Proc 2011; 2011: 1506–13.
    1. van Eck N, Waltman L.. Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics 2010; 84 (2): 523–38.
    1. National Heart Lung and Blood Institute. Study Quality Assessment Tools. Bethesda, MD: National Institutes of Health.
    1. CochraneAirways. Data collection. Accessed May 20, 2018.
    1. King D, Delfabbro P, Griffiths M.. Video game structural characteristics: a new psychological taxonomy. Int J Ment Health Addict 2010; 8 (1): 90–106. DOI 10.1007/s11469-009-9206-4
    1. Robinson D, Bellotti V. A preliminary taxonomy of gamification elements for varying anticipated commitment. In: proceedings CHI 2013 Workshop on Designing Gamification: Creating Gameful and Playful Experiences; April 27 to May 2, 2013; Paris, France.
    1. An LC, Demers MR, Kirch MA, et al. A randomized trial of an avatar-hosted multiple behavior change intervention for young adult smokers. J Natl Cancer Inst Monogr 2013; 2013 (47): 209–15.
    1. Bordnick PS, Traylor AC, Carter BL, Graap KM.. A feasibility study of virtual reality-based coping skills training for nicotine dependence. Res Soc Work Pract 2012; 22 (3): 293–300.
    1. Brinker TJ, Seeger W, Buslaff F.. Photoaging mobile apps in school-based tobacco prevention: the mirroring approach. J Med Internet Res 2016; 18 (6): e183.
    1. DeLaughter KL, Sadasivam RS, Kamberi A, et al. Crave-out: a distraction/motivation mobile game to assist in smoking cessation. JMIR Serious Games 2016; 4 (1): e3.
    1. Duncan LR, Hieftje KD, Pendergrass TM, Sawyer BG, Fiellin LE.. Preliminary investigation of a videogame prototype for cigarette and marijuana prevention in adolescents. Subst Abus 2018; 39 (3): 275–9.
    1. Girard B, Turcotte V, Bouchard S, Girard B.. Crushing virtual cigarettes reduces tobacco addiction and treatment discontinuation. Cyberpsychol Behav 2009; 12 (5): 477–83.
    1. Gordon JS, Armin J, Hingle MD, et al. Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers. Transl Behav Med 2017; 7 (2): 172–84.
    1. Khazaal Y, Chatton A, Prezzemolo R, Hoch A, Cornuz J, Zullino D.. A game for smokers: a preliminary naturalistic trial in a psychiatric hospital. Patient Educ Couns 2008; 70 (2): 205–8.
    1. Khazaal Y, Chatton A, Prezzemolo R, et al. Impact of a board-game approach on current smokers: a randomized controlled trial. Subst Abuse Treat Prev Policy 2013; 8 (1): 3.
    1. Metcalf M, Rossie K, Stokes K, Tallman C, Tanner B.. Virtual reality cue refusal video game for alcohol and cigarette recovery support: summative study. JMIR Serious Games 2018; 6 (2): e7.
    1. Nemire K, Beil J, Swan RW.. Preventing teen smoking with virtual reality. Cyberpsychol Behav 1999; 2 (1): 35–47.
    1. Parisod H, Pakarinen A, Axelin A, Löyttyniemi E, Smed J, Salanterä S.. Feasibility of mobile health game “Fume” in supporting tobacco-related health literacy among early adolescents: a three-armed cluster randomized design. Int J Med Inform 2018; 113: 26–37.
    1. Rath JM, Williams V, Rubenstein R, Smith L, Vallone D.. Assessing the impact of an interactive mobile game on tobacco-related attitudes and beliefs: the truth campaign’s flavor monsters. Games Health J 2015; 4 (6): 480–7.
    1. Song H, Kim J, Kwon RJ, Jung Y.. Anti-smoking educational game using avatars as visualized possible selves. Comput Hum Behav 2013; 29 (5): 2029–36.
    1. Xu X, Aron A, Westmaas JL, Wang J, Sweet LH.. An fMRI study of nicotine-deprived smokers’ reactivity to smoking cues during novel/exciting activity. PLoS One 2014; 9 (4): e94598.
    1. Reeves B, Read JL.. Total Engagement: How Games and Virtual Worlds are Changing the Way People Work and Businesses Compete. Brighton, MA: Harvard Business Press; 2009.
    1. Blok DJ, de Vlas SJ, van Empelen P, van Lenthe FJ.. The role of smoking in social networks on smoking cessation and relapse among adults: a longitudinal study. Prev Med 2017; 99: 105–10.
    1. Simons-Morton BG, Farhat T.. Recent findings on peer group influences on adolescent smoking. J Prim Prev 2010; 31 (4): 191–208.
    1. Phua JJ. The reference group perspective for smoking cessation: an examination of the influence of social norms and social identification with reference groups on smoking cessation self-efficacy. Psychol Addict Behav 2013; 27 (1): 102–12.
    1. Naslund JA, Kim SJ, Aschbrenner KA, et al. Systematic review of social media interventions for smoking cessation. Addict Behav 2017; 73: 81–93.
    1. Charlier N, Zupancic N, Fieuws S, Denhaerynck K, Zaman B, Moons P.. Serious games for improving knowledge and self-management in young people with chronic conditions: a systematic review and meta-analysis. J Am Med Inform Assoc 2016; 23 (1): 230–9.
    1. Reitsma J, Rutjes A, Whiting P, Vlassov V, Leeflang M, Deeks J.. Chapter 9: Assessing methodological quality In: Deeks JJ, Bossuyt PM, Gatsonis C, eds. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. London, UK: The Cochrane Collaboration.
    1. Verschueren S, Buffel C, Vander Stichele G.. Developing theory-driven, evidence-based serious games for health: framework based on research community insights. JMIR Serious Games 2019; 7 (2): e11565.
    1. Livingstone-Banks J, Norris E, Hartmann-Boyce J, et al. Relapse prevention interventions for smoking cessation. Cochrane Database Syst Rev 2019; 2: CD003999.
    1. Gorber SC, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M.. The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res 2009; 11 (1): 12–24.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner