Full length articleBridging behavior science and gaming theory: Using the Intervention Mapping Protocol to design a serious game against cyberbullying
Introduction
Cyberbullying is commonly defined as intentionally and repeatedly sending or posting electronic messages or images to cause the victim harm (Kiriakidis and Kavoura, 2010, Tokunaga, 2010). Cybervictimization rates among adolescents largely vary between 3% and 24% (Hinduja and Patchin, 2012, Olweus, 2012), depending on the definition and timeframe that is used (Olweus, 2012, Tokunaga, 2010). These varying prevalence rates were summarized in a recent meta-analysis across 80 studies in adolescents (aged 12–18 years), to a rate of 15% for victimization and to 16% for penetration of cyberbullying (Modecki, Minchin, Harbaugh, Guerra, & Runions, 2014). A systematic review suggested a curvilinear linear between age and cyberbullying victimization, with a peak in 7th and 8th grade, and decreasing towards later adolescence (Tokunaga, 2010). Other studies found a weak linear correlation between age and cyberbullying involvement (Zych, Ortega-Ruiz, & Del Rey, 2015). Both cyberbullying perpetration and victimization relate to numerous psychosocial problems (Kowalski, Giumetti, Schroeder, & Lattaner, 2014). Recent longitudinal research has shown that cybervictimization in adolescents which was stable at a one-year follow-up was associated with the highest levels of depressive symptoms and problematic alcohol use compared to non-stable victims or non-victims (Gámez-Guadix, Gini, & Calvete, 2015). Cyberbullying prevention and intervention efforts are consequently needed to end or prevent a stable pattern of cybervictimization and reduce its harm among adolescents.
In traditional bullying prevention programs, several elements were considered as key ingredients for effectiveness: whole school programs, programs which lasted longer and consisted of more sessions, interventions using videos and devoting attention to environmental factors, e.g. by providing teacher and parent training (Ttofi & Farrington, 2011). Recent systematic reviews on cyberbullying prevention and intervention programs indicated that these elements were not frequently incorporated in current anti-cyberbullying programs (Della Cioppa et al., 2015, Van Cleemput et al., 2014). A recent review of cyberbullying prevention and intervention programs indicated a lack of evidence-based rather than evidence-informed programs, that used a whole-school approach, and that included components addressing several individual behavioral determinants and the social context (e.g. family) (Della Cioppa, O'Neil, & Craig, 2015).
For cyberbullying prevention and intervention programs, no clear key success factors have yet been established. One potential success factor suggested for cyberbullying prevention and intervention programs, was underpinning these by behavior change theories (Tokunaga, 2010). Behavior change theories explain the dynamics and determinants of health behavior, and relate these to methods and processes for change (Shegog, 2010). Behavior change theories have, indeed, shown to be a lever in increasing intervention effectiveness in other health promotion programs (Glanz & Bishop, 2010). Very few cyberbullying prevention and intervention programs, included in the review mentioned above, were founded in behavior change theories (i.e. Social Cognitive Theory, Theory of Planned Behavior), while a variety of other theoretical models were used by most programs, such as peer support models, cooperative and constructive learning theories (Van Cleemput et al., 2014). A similar hypothesis was made about serious game design: the key to serious game effectiveness may lie in its use of behavioral and motivational theory (Shegog, 2010).
Theories should, moreover, be implemented using standardized definitions. The precise application of theories in behavior change programs has often shown to be problematic, causing wide diversity in intervention effectiveness (Michie et al., 2011). Following standardized definitions of theories (e.g. Social Cognitive Theory) and standardized applications of theoretical concepts (e.g. guided practice), allows to assess the accurate implementation of scientific evidence and allows a reliable linking of mechanisms of action to the intervention effectiveness (Michie et al., 2011). In sum, while no evidence is yet available on key ingredients of these programs, behavior change theories may be critical drivers of success, but require a systematic implementation and standardized application to practice.
The Intervention Mapping Protocol (IMP) was designed by leading behavior change experts (Bartholomew, Parcel, Kok, Gottlieb, & Fernàndez, 2011) to aid in the systematic and stepwise application of theory to behavioral change programs. The systematic approach of the IMP necessitates a detailed description of intervention content, which meets recent demands for more thorough reporting (Michie, Fixsen, Grimshaw, & Eccles, 2009). It aims to increase both efficacy and effectiveness, by a reiterative process of evidence review, application of theory-based strategies, and stakeholder consultation in six well-defined steps (Bartholomew et al., 2011). The Intervention Mapping Protocol was suggested as a model that can facilitate evidence- and theory-based serious health game design. It examines the steps that should be taken by game developers to acquire design information, and can provide a common basis for process decisions, and enable the cooperation between serious game developers and health professionals (Shegog, 2010).
The aim of this study was to describe the application of the Intervention Mapping protocol, developed by Bartholomew et al. (2011), to the design of a serious game against cyberbullying. The Intervention Mapping protocol aids in a systematic intervention design based on evidence and behavior change theories. As mentioned earlier, this may be a critical driver of success for cyberbullying intervention and prevention programs, whereas this particular theory-based design is currently not often used in cyberbullying programs.
Several theories have been reported in literature to understand or predict cyberbullying involvement, such as personal deficit models, stress coping models, computer-mediated communication models or behavior prediction models (for an overview, see DeSmet, 2015). The Intervention Mapping Protocol was not used as a theoretical framework to understand cyberbullying behavior, but as a method for evidence- and theory-based intervention design grounded in behavior change theories.
The study was hence innovative in using a systematic approach to design a cyberbullying prevention program underpinned by behavioral change theories. A similar approach to the Intervention Mapping protocol is described by the Behaviour Change Wheel (Michie, Atkins, & West, 2014). This approach was fairly new and not yet available in intervention design guidelines at the start of our project. Consequently, the choice was made to use IMP (Bartholomew et al., 2011; soon available in 4th edition, Bartholomew et al., 2016) as a well-validated approach in the design of behavior change interventions.
Our study is, furthermore, the first to apply this protocol to the design of a serious game intervention against cyberbullying. Games are tools that, if attuned correctly to the educational context (Bourgonjon, Valcke, Soetaert, & Schellens, 2010), are highly appreciated by adolescents compared to traditional teaching methods (Vogel et al., 2006). And lastly, this study is innovative in its evidence-based intervention components to address social environmental influences of educators and parents in cyberbullying.
The IMP recognizes both individual and environmental, bi-directional, influences of behavior (e.g. peers, family relations, school policy), in line with an ecological model of health behavior (Sallis, Owen, & Fisher, 2008). An ecological model was also considered important for studying bullying and peer victimization, and for designing appropriate bullying prevention and intervention strategies (Hong & Espelage, 2012). This protocol was applied to several health behaviors, such as healthy diet and physical activity (e.g. Verbestel et al., 2011), sexual health (e.g. Brown, Bayley, & Newby, 2013), mental health promotion (e.g. Kraag, Kok, Abu-Saad, Lamberts, & Fekkes, 2005), and recently also to cyberbullying (Jacobs, Völlink, Dehue, & Lechner, 2014). The latter intervention transformed an existing intervention into an online tool, and aimed to enhance victim's coping strategies. It was founded in Rational, Emotional (Behavioral) Therapy. The program focused on improving individual coping behavior; environmental level influences were not included (Jacobs et al., 2014).
Our study applied the IMP to design a serious game against cyberbullying among young adolescents (12–14y). As mentioned above, a socio-ecological approach was used. In line with the socio-ecological model, this game was intended as part of a wider school approach that would also address educator and parental behavior, who are important environmental agents in influencing adolescent behavior in cyberbullying. Its development was guided by the Reasoned Action Approach (also named integrated model, Fishbein & Ajzen, 2010), by Social Cognitive Theory (Bandura, 2002, Bandura, 2007) and the Bystander Intervention Model (Latane & Darley, 1970). The MDA (Mechanics, Dynamics, Aesthetics) Framework was used as a game-based learning theory in game design (Hunicke, LeBlanc, & Zubek, 2004). Where evidence related to cyberbullying was lacking, insights from traditional bullying were used and additional research was conducted (e.g. behavioral determinants of bystander, educator and parental behavior). This paper describes the application of the Intervention Mapping Protocol to the design of the program (Step 1–4) and planned actions for implementation and evaluation (Step 5 and 6). This study provides result and process information at each design step.
Presented below is a detailed description of the design process, based on published or submitted findings (e.g. literature review, qualitative study, quantitative study among adolescents and educators, meta-analysis, initial concept test), and unpublished findings (e.g. quantitative study among parents, narrative preferences, usability tests, comparisons between behavior change techniques and game design methods).
The results of this design process will also provide a broad overview of insights in bystander behavior in cyberbullying, and of strategies to balance behavior change methods and gaming features in serious game design, to maximize both effectiveness and game engagement. These insights may aid professionals who wish to tackle cyberbullying, as well as professionals involved in serious game design.
In sum, there is a need for evidence- and theory-based cyberbullying prevention and intervention programs, using a whole-school approach, including components that address several individual behavioral determinants and the social context. Our study aims to meet this current lack in literature and practice.
Section snippets
Methods and results
The Intervention Mapping Protocol consists of six different steps: 1) needs assessment, 2) preparing matrices of change objectives, 3) selection of theory-informed intervention methods and practical strategies, 4) development of the intervention program, 5) planning for adoption, implementation and sustainability, and 6) development of an evaluation design. In the following sections, these steps are described. They are described consecutively, although the process is in fact iterative. The IMP
Discussion
This study showed a meticulous, evidence-based planning process of a cyberbullying prevention program for adolescents. A recent review of cyberbullying prevention and intervention programs indicated a lack of evidence-based programs, that used a whole-school approach, and that included components addressing several individual behavioral determinants and the social context (e.g. family) (Della Cioppa et al., 2015). Our cyberbullying prevention program attempts to meet this current lack in
Conclusions
This paper presented an evidence- and theory-based development of a serious game against cyberbullying among adolescents, by promoting positive bystander behavior. Based on systematic reviews, qualitative and quantitative studies among adolescents, parents and educators, performance objectives were designed to aid in the attainment of the desired reduction in cyberbullying and its harm. Studies were guided by several theories, such as the socio-ecological approach, Reasoned Action Approach,
Disclosure statement
This study received a grant (no. 110051) from the Flemish agency for Innovation by Science and Technology. All authors' contribution to this study was funded by this grant, apart from Maïté Verloigne, who is supported by the Research Foundation Flanders (FWO) (postdoctoral research fellowship: FWO13/PDO/191). The funding agency had no role in study design, analysis or report writing. No competing financial interests exist.
Acknowledgment
The authors wish to thank all other Friendly Attac project members for their contributions to the project (in alphabetical order: Edgar Cebolledo, Gie Deboutte, Gaetan Deglorie, Olga De Troyer, Samantha Fernandez, Olivier Janssens, Koen Samyn, Wouter Spaas, Bart Uytdenhouwen, Frederik Van Broeckhoven, and Sofie Van Hoecke).
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