Serious games for smoking prevention and cessation: A systematic review of game elements and game effects

Marloes E. Derksen · Sander van Strijp · Anton Eduard Kunst · Joost G. Daams · Monique Jaspers · Mirjam P. Fransen

43 citations0/0 files storedJournal of the American Medical Informatics Association

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Educational Games and Gamification Substance Abuse Treatment and Outcomes Smoking Behavior and Cessation

Abstract

OBJECTIVE: Serious health games might have the potential to prevent tobacco smoking and its health consequences, depending on the inclusion of specific game elements. This review aimed to assess the composition of serious games and their effects on smoking initiation prevention and cessation and behavioral determinants. MATERIALS AND METHODS: We systematically searched MEDLINE, Embase, PsycINFO, and Web of Science for publications that evaluated serious games aimed at changing smoking behavior or behavioral determinants. A taxonomy by King et al was used to classify game elements. RESULTS: We identified 15 studies, evaluating 14 unique serious games. All games combined multiple game elements (mean 5.5; range, 3-10). Most frequently used were general and intermittent rewards, theme and genre features, and punishments. Six studies on smoking prevention together assessed 20 determinants and found statistically significant positive effects for 8 determinants (eg, attitude, knowledge, intention). Of 7 studies on smoking cessation, 5 found positive, statistically significant effects on smoking cessation or status. These studies found statistically significant positive effects for 6 of 12 determinants (eg, self-efficacy, attitude, intention). The majority of included studies had poor or fair methodological quality, lacked follow-up measures, and had fixed (as opposed to free, on-demand) play sessions. CONCLUSIONS: Serious games included multiple types of game elements. The evidence from a number of studies suggests that games may have positive effects on smoking-related outcomes, particularly smoking cessation. However, as most studies had important methodological limitations, stronger designs are needed to demonstrate, quantify, and understand the effects of serious games.

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2009Software survey: VOSviewer, a computer program for bibliometric mapping 2005Serious Games: Games That Educate, Train, and Inform 2014Mapping learning and game mechanics for serious games analysis 2023Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy 2014An Overview of Serious Games 2016Study quality assessment tools 2014A meta-analysis of serious digital games for healthy lifestyle promotion 2009Video Game Structural Characteristics: A New Psychological Taxonomy

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