Is Participatory Design Associated with the Effectiveness of Serious Digital Games for Healthy Lifestyle Promotion? A Meta-Analysis

Abstract

Background Serious digital games can be effective at changing healthy lifestyles, but large differences in their effectiveness exist. The extent of user involvement in game design may contribute to game effectiveness by creating a better fit with user preferences. Participatory design (PD), which represents active user involvement as informant (ie, users are asked for input and feedback) or codesigner (ie, users as equal partners in the design) early on and throughout the game development, may be associated with higher game effectiveness, as opposed to no user involvement or limited user involvement. Objective This paper reports the results of a meta-analysis examining the moderating role of PD in the effectiveness of serious digital games for healthy lifestyle promotion. Methods Four databases were searched for peer-reviewed papers in English that were published or in press before October 2014, using a (group-) randomized controlled trial design. Effectiveness data were derived from another meta-analysis assessing the role of behavior change techniques and game features in serious game effectiveness. Results A total of 58 games evaluated in 61 studies were included. As previously reported, serious digital games had positive effects on healthy lifestyles and their determinants. Unexpectedly, PD (g=0.075, 95% CI 0.017 to 0.133) throughout game development was related to lower game effectiveness on behavior (Q=6.74, P <.05) than when users were only involved as testers (g=0.520, 95% CI 0.150 to 0.890, P <.01). Games developed with PD (g=0.171, 95% CI 0.061 to 0.281, P <.01) were also related to lower game effectiveness on self-efficacy (Q=7.83, P <.05) than when users were not involved in game design (g=0.384, 95% CI 0.283 to 0.485, P <.001). Some differences were noted depending on age group, publication year of the study, and on the specific role in PD (ie, informant or codesigner), and depending on the game design element. Games developed with PD were more effective in changing behavioral determinants when they included users in design elements on game dynamics (beta=.215, 95% CI .075 to .356, P <.01) and, more specifically, as an informant (beta=.235, 95% CI .079 to .329, P <.01). Involving users as informants in PD to create game levels was also related to higher game effectiveness (Q=7.02, P <.01). Codesign was related to higher effectiveness when used to create the game challenge (Q=11.23, P <.01), but to lower game effectiveness when used to create characters (Q=4.36, P <.05) and the game world (Q=3.99, P <.05). Conclusions The findings do not support higher effectiveness of games deve...

E-baby skin integrity: evidence-based technology innovation for teaching in neonatal nursing

“…As examples, there is usability analysis and user-centered design, the emotional design that analyzes human computer linkage through the positive or negative emotions generated in interaction, participatory design and playability, in the context of computational-based educational games. 9,20,23,26 During validation, the problems encountered focused mainly on levels that do not require corrections, reinforcing that the serious game was designed in line with the interests of serving the end user in a useful, enjoyable and educational way. In this way, we discuss in this section the items of heuristics in which problems of level 3 and 4 were identified.…”

Problematic Attachment to Social Media: the Psychological States vs Usage Styles

“…Co-creation methods integrate user perspectives with expert opinion and scientific evidence to develop interventions [39]. Participatory design has been used successfully to improve the dynamics and challenge of serious games for health promotion [40]. Participatory design methods may, therefore, help reduce this conflict by developing platforms acceptable to users, in terms of ease of use and need satisfaction, and developers, in terms of promoting wellbeing, in line with corporate responsibility.…”

Gaming for safer sex

“…Having created an account, participants were asked to build their own avatar in order to increase their engagement in the game (Birk, Atkins, Bowey, & Mandryk, 2016;Christou & Michael, 2014;Lindgren, 2013). We decided that this would be beneficial even though it has been shown that a participant's input on game aesthetics has only a limited influence on its effectiveness (DeSmet et al, 2016). They could opt for a female or a male avatar and were free to choose among five different style options for caps, hairstyles, shirts, trousers (and skirts for females), and shoes.…”

“…However, the effectiveness of tailoring might also reach a limit. As DeSmet et al (2016) pointed out in a recent meta-analysis, a participatory design (PD) approach that involves the target group in the development of a serious game either as informants or as co-designers was less effective in changing health behavior compared to an approach that integrated the target group as testers in the game. As DeSmet points out, this unexpected result could be explained by a need of substantial game design skills of future users instead of just being part of the target group, and by a need to adjust codesign techniques to the level of user design experiences.…”

“…Young people preferred a design that reflects a real-world scenario (not a fantasy world) and includes realistic settings and daily activities. One important way of creating real-world scenarios is to increase self-identification with the virtual avatar that is supposed to depict the player (although there are limits to its effectiveness, see DeSmet et al, 2016), preferably by using a first-person visual perspective. This is also reflected in the importance participants placed on being able to customize their avatar.…”