High rates of substance abuse (SA) and relationship violence (RV) among teens suggests a need to create innovative prevention programs. Our study evaluated Choice and Consequences (C&C), a social, multi-user, tablet-based game to reduce the risks associated with SA and RV. For 7 class periods across two weeks, 35 students played the game, selecting activities to create a fun, but safe weekend. C&C presented various scenarios, such as someone starts touching you without your consent. Players received points and rationales for each action they selected that informed them as to the fun and risk associated with the actions. Following game playing, students (n=24) participated in three separate gender focus groups. Each focus group addressed the level of realism of the game, ability to learn from the game and aspects they liked/disliked about the game. Focus groups were audiotaped and transcribed. Transcriptions were analyzed using NVivo 9. Results from the focus groups found that boys and girls liked the concept of the game and its activities; they especially liked the social atmosphere during the game. They liked the facts that gave information on each action and consequence. They liked rating the fun level of each action. Youth preferred the delivery method over a didactic presentation. Youth agreed that the consequences of the actions choices were realistic; a player lost points for taking drugs, but gained points for looking cool with peers. Youth stated the game could help prevent SA and RV if played before they experience the problems presented in the game in real-life. The youth stated that the RV information may be more helpful than the SA information. Results suggest that game delivery method, using multi-media is a promising prevention program method for youth. Results also suggest gaming may be applied to other areas of prevention.

1. Outcomes of a social, multi-user, tablet-
based game to prevent substance abuse and
relationship violence
By
Beverly Black & Dick Schoech
U of TX Arlington, Texas, USA
beverlyblack@uta.edu; schoech@uta.edu
Social Work: Javier Boyas (University of Mississippi); Nada Elias-
Lambert (Texas Christian University)
Computer Science & Engineering: Manfred Huber, David Levine,
Gergely Zaruba, Amanda Vines
Venture School: Connie & Gary Grossman and many students
Funding: ($112,000) from UT Arlington SSW via iCAP Project;
Carter Foundation

2. Project Goals
• To develop a prototype tablet-based game to
deliver a curriculum to prevent substance
abuse (SA) and relationship violence (RV) in
middle school youth.
• To work with teens at our community partner,
Venture School, to develop the curriculum and
conduct “proof of concept” testing of the game
in order to seek future funding if warranted.
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3. Brief Description of Game
• Players play “solo” or in teams for one hour per
day for approximately one week to 10 days
• Team designing the most safe and risk free
weekend of activities for a 13 y/o girl/boy wins
• Players received points and rationales informing
them of expert’s opinions about the risk of actions
taken for a 13 y/o
• Players indicate how fun actions are for a 13 y/o
• Teams network via chat
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4. Example Scenario Format
• Activity (26 activities in game): 13 year old girl goes to a movie
• Options (54 options in game): Go either with parents or a friend
• Challenge (194): With friend, meet 2 boys. Friend and one boy
start making out. Other boy tries to make out with 13 year old. She
says no. He continues
• Choice of action (1228): Push him away, say have boyfriend,
threaten him, slap him, move seats, text parents to go home, give in
• Consequences (2504): If slap him, lose points because violence
tends to escalate the situation. Penalty: lose 10 points because he
slaps her back
• Facts (253): You may be in an unhealthy relationship if your partner
pushes, hits, slaps, punches, kicks, or bites you
• Next Activity or subchallenge: i.e., she whimpers, he becomes more
aggressive in making out.
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5. Selection of Game Screen
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6. Home Page
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7. Select Activity (Party with Strict Parents)
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8. Party=Challenge; Action = Leave
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9. Consequence for Call Parents
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10. Fact for activity=party, Action=call parents
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11. Feedback Screen
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12. Selected Questionnaire Results
(1=Strongly disagree – 5=(Strongly agree) (Total = 20
students)
Question: 1=Leadership students; 2=students struggling to succeed
Average
1 2
I recommend other students play C&C to learn about substance abuse/relationship
violence
4.22
I like the idea of a game to design a fun, risk free weekend 4.22 3.44
Playing C&C will help me avoid drugs, alcohol, and cigarettes 4.22 2.44
I learned most from playing C&C as a member of my team 4.11 2.56
Playing C&C will help me assist others who have substance abuse problems 4.11 3.11
Playing C&C increased my understanding of relationship violence and its
consequences
4.11 3
Playing C&C increased my understanding of substance abuse and its consequences 4.00 2.44
Playing C&C will help me assist others who are in violent relationships 3.89 3.78
I learned most from the discussion we had while playing C&C 3.89 3.78
Playing C&C will help me avoid getting into a violent relationship 3.89 3.44
I prefer playing a game like C&C to traditional “work book & discussion” prevention
programs
3.89 3.22
C&C is one of the best prevention programs I have participated in 3.78 3.89
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13. Focus Group Results (1 of 2)
• All preferred C&C over traditional approaches because it is
interactive, engaging, and challenging.
• All said the consequences of actions were realistic since you can
lose points for taking drugs, but gain points for looking cool in
front of peers.
• All said C&C could help prevent SA and DV if youth played before
they experience those problems in real life.
• Several boys stated that they learned more about RV than SA, since
they don’t discuss RV as often in school.
• All liked the team the discussion and social atmosphere.
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14. Focus Group Results (2 of 2)
Students learned many new lessons
• One girl learned the people in abusive
relationships don’t usually know they are in an
abusive relationship
• Several boys learned more about relationship
abuse since they don’t discuss that as often in
school
• Several boys said the game made them think
about how to respond when they are
confronted with these challenges in real life
• Several boys stated that they learned that they
could talk about a problem instead of fighting

15. Discussion (1 of 2)
• Most prevention programs are implemented much
longer than our test.
• Teams became very competitive after a mock
competition round.
• All wanted better graphics, but research is needed to
determine if better graphics yields better outcomes.
• We worked with older teens to develop scenarios.
Most 13 year olds do not have the experience to
provide feedback on SA & RV.
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16. Discussion (2 of 2)
• Goal of having an exciting, fun, & challenging
game (engineering team) can conflict with the
goal of changing behavior and supporting
youth (social work team).
• C&C needs funding for efficacy studies before
marketing to schools.
• Difficult to hold a team together for the long
time it takes to develop and evaluate game
prevention outcomes.
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17. Questions & Discussion
Talk to us:
Beverly Black & Richard Schoech
beverlyblack@uta.edu
schoech@uta.edu
For more details, see: Schoech, D, Boyas, J., Black, B. Elias-
Lambert, N. (2013). Gamification for Behavior Change: Lessons
from Developing a Social, Multiuser, Web-Tablet based
Prevention Game for Youths. Journal of Technology in Human
Services, 31/3, 197-217. DOI:10.1080/15228835.2013.812512
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