Review and special articlePlaying for Real: Video Games and Stories for Health-Related Behavior Change
Section snippets
Background
Usual school health curricular and other behavior-change interventions targeted at children have had limited effectiveness.1, 2 New channels are needed to reach children that offer promise of promoting substantial health-related behavior changes. One such new channel is the video game, since many children spend numerous hours playing them.3 Using video games to promote behavior change could capitalize on the children’s pre-existing attention to and enjoyment of them. No review has appeared of
Methods
A search was conducted for publications on video games for health-related behavior change by searching the authors’ personal files, contacting colleagues at professional meetings, and searching the following terms in PubMed: games, video games, and interactive multimedia, as well as combinations of these terms. Inclusionary criteria included using the word game to describe their software, with the goal of attempting to modify lifestyle behavior change. Exclusionary criteria were interactive
Results
There was substantial variability across studies in their design, the targets for change, and the characteristics (and reporting of characteristics) of the games. The two-group (treatment versus control) randomized clinical trial (RCT) was the most common outcome evaluation design, but several were single-group-only. Four of the physical-activity video game studies tested primarily whether the game offered the possibility of enhancing fitness,24, 25, 26, 27, 28, 29 with only two assessing
Discussion
Playing most of these behavior-change video games led to a broad spectrum of desirable outcomes from knowledge increases,32 to attitude changes,36 behavior changes,34 and other health-related38 changes. This bodes well for the future use of video games to promote health-related behavior changes and warrants an intensive analysis of aspects of video games that offer the most promise of promoting behavior change. There appear to be two primary methods by which video games can influence behavior.
Conclusion
Serious video game–based behavior change is an exciting form of media-based intervention. A peer-reviewed literature is emerging on this topic. The many desirable outcomes warrant moving forward in this area. A second generation of research requires models of pathways of effects, and testing theory-based propositions. This should include how to use story to affect variables on the pathways to change. Understanding how to harness the power of media-based video game interventions offers great
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