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Narrative and Nurturing study, Lieberman, Games for Health 5-9-08


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Presents posttest-only preliminary findings from an experiment comparing three versions of a health game with high versus low amounts of dramatic narrative. It contrasts high narrative versions of the game with a low narrative version that puts more focus on game-play challenges instead of story line.

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Narrative and Nurturing study, Lieberman, Games for Health 5-9-08

  1. 1. Effects of Narrative, Nurturing, and Game-Play in an Action-Adventure Health Game Presentation to the Games for Health Conference Baltimore, MD Debra Lieberman, Ph.D. UC Santa Barbara May 9, 2008
  2. 3. Games are stories and games are challenges / mechanics <ul><li>Some emphasize the narrative mode and some the game-play mode </li></ul><ul><ul><li>E.g., Pacman or Zelda vs. Tetris, Re-Mission vs. Self-Esteem games </li></ul></ul><ul><li>A spectrum – the essence of a game: Story  Game mechanics </li></ul><ul><li>Narratology vs. Ludology – debate </li></ul>
  3. 4. Example: PIP <ul><li>Personal Input Pod – biosensor </li></ul><ul><li>Vyro Games </li></ul><ul><li>“ Teaching you to relax in a fun and engaging way” </li></ul><ul><li>Narrative : Will your character win the race? </li></ul><ul><li>Game-play : Relax more than your opponent </li></ul>
  4. 5. Two modes: narrative vs. game-play <ul><li>Across players: Some players prefer one mode over the other (always or sometimes) </li></ul><ul><li>Within players: Each mode may be cognitively and/or emotionally processed in different ways, and contribute to different outcomes </li></ul>
  5. 6. Research finds that using narrative skillfully in game design can increase players’… <ul><li>Involvement in the topic </li></ul><ul><li>Immersion in the game experience </li></ul><ul><ul><li>Related: Presence, Flow, Absorption, Transportation </li></ul></ul><ul><li>Identification with characters </li></ul><ul><li>Arousal : emotional and physiological </li></ul><ul><li>Learning : recall of message content </li></ul><ul><li>Persuasibility : acceptance of persuasive messages </li></ul>
  6. 7. Narrative creates emotion and context <ul><li>Why you’re doing what you’re doing </li></ul><ul><li>Characters you care about, or characters that are you </li></ul><ul><li>Curiosity about what will happen next </li></ul><ul><li>Desire to advance the story </li></ul><ul><li>A framework for remembering events / info </li></ul>
  7. 8. Pure game-play <ul><li>Focuses on the task, on the rules of the game </li></ul><ul><li>Cognitive load – none wasted </li></ul><ul><li>No distracting story line </li></ul><ul><li>In games with stories, good players often “see through” the story line to play with the “essence” of the game – its strategies and challenges </li></ul>
  8. 9. Nurturing <ul><li>A new concept in new (interactive) media </li></ul><ul><ul><li>Old media: Tinker Bell, Winky Dink, pause / answer </li></ul></ul><ul><li>New media — new ways to take care of characters </li></ul><ul><ul><li>Digital pets, Tamagotchi, WebKinz, NeoPets, Nintendogs </li></ul></ul><ul><ul><li>Adventure games often involve building a character’s health, strength, weapons, tools, etc. </li></ul></ul><ul><li>Nurturing is very motivating and involving, and elicits strong emotions </li></ul><ul><li>It is a component of narrative </li></ul><ul><li>How can health game designers make use of narrative , nurturing , and game-play ? </li></ul>
  9. 10. Re-Mission – video game <ul><li>Produced by HopeLab </li></ul><ul><li>For teens and young adults who have cancer </li></ul><ul><li>To improve cancer knowledge, adherence, self-care, quality of life </li></ul>
  10. 11. Our previous study found that Re-Mission influenced healthy players who had no cancer <ul><li>It changed attitudes and beliefs that are known to increase prevention behaviors and adherence behaviors </li></ul><ul><li>Factors in the Extended Parallel Process Model – Perceived severity, Perceived susceptibility, Self-efficacy, and Response Efficacy </li></ul><ul><li>Treatment – Play Re-Mission game for one hour </li></ul><ul><li>Control – Play Indiana Jones game for one hour </li></ul>
  11. 12. Cancer knowledge (Study 1, posttest scores)
  12. 13. Predicting prevention behaviors (Study 1, posttest scores)
  13. 14. Predicting adherence (Study 1, posttest scores)
  14. 15. First study gave us outcomes of Re-Mission <ul><li>New questions for second study: </li></ul><ul><li>How do narrative, nurturing, and game-play influence these outcomes in different ways? </li></ul><ul><li>In the following analysis of post-test findings from the second study, our hypotheses are supported. </li></ul>
  15. 16. Study design <ul><li>Randomized experiment, 488 participants </li></ul><ul><li>5 groups, each played a Re-Mission version: </li></ul><ul><li>Group 1: High narrative, High nurturing </li></ul><ul><li>Group 2: Original version of Re-Mission </li></ul><ul><li>Group 3: High narrative, Low nurturing </li></ul><ul><li>Group 4: Low narrative, High nurturing </li></ul><ul><li>Group 5: Low narrative, Low nurturing (game-play) </li></ul>
  16. 17. Today I’ll present preliminary findings for three groups <ul><li>Group 5: Low narrative, Low nurturing (game-play) </li></ul><ul><li>Group 2: Original version of Re-Mission </li></ul><ul><li>Group 1: High narrative, High nurturing </li></ul><ul><li>Participants were randomly assigned to play one game version in the lab; also pretest and posttest </li></ul>
  17. 18. Knowledge and perceived informativeness – lower in Low/Low (game-play) group (Study 2, posttest scores)
  18. 19. Attitudes about cancer learning – No differences (Study 2, posttest scores)
  19. 20. Caring about patients in the game (Study 2, posttest scores)
  20. 21. Narrative  personal risks and behaviors (Study 2, posttest scores)
  21. 22. Game-play  mechanics of cure (Study 2, posttest scores)
  22. 23. Narrative  personal risks and behaviors; and learning Game-play  mechanics of cure <ul><li>Empathy, nurturing, drama, story line – our data show positive correlations with perceived personal risks, self-efficacy, and learning </li></ul><ul><ul><li>Players see personal risks of health problems and personal susceptibility more strongly </li></ul></ul><ul><ul><li>Perceive more self-efficacy </li></ul></ul><ul><ul><li>Learn more about cancer than the Low/Low group </li></ul></ul><ul><li>Focus on game-play with medical treatment as the game challenge – is associated with greater trust in the medical cure, and adherence self-efficacy </li></ul>
  23. 24. Participants’ quotes while playing Re-Mission <ul><li>Pretty cool. You could learn from it while having fun. </li></ul><ul><li>Did we heal him? I’m so excited! </li></ul><ul><li>It makes it seem like cancer is a serious disease. </li></ul><ul><li>I keep killing these fools but they keep on coming. </li></ul><ul><li>I feel like I’m helping somebody. Not just playing a video game, I’m saving someone’s life. </li></ul><ul><li>I really like this game now. It sucks you in. I really don’t want this guy to have cancer. </li></ul><ul><li>Come on, white blood cells! </li></ul>
  24. 25. Thank you <ul><li>Debra Lieberman, Ph.D. </li></ul><ul><li>University of California, Santa Barbara </li></ul><ul><li>[email_address] </li></ul><ul><li>National Program Director, Health Games Research </li></ul><ul><li> </li></ul><ul><li>------------- </li></ul><ul><li>Re-Mission video game, from HopeLab </li></ul><ul><li> </li></ul>