Dataset Information

The Role of Agency and Threat Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Excessive Alcohol Use: Randomized Controlled Trial.

ABSTRACT:

Background

Serious games for the training of prevention behaviors have been widely recognized as potentially valuable tools for adolescents and young adults across a variety of risk behaviors. However, the role of agency as a distinguishing factor from traditional health interventions has seldom been isolated and grounded in the persuasive health communication theory. Fear appeals have different effects on intentions to perform prevention behaviors depending on the immediacy of the consequences. Looking into how to increase self-efficacy beliefs for health behavior with distant consequences is the first step toward improving game-based interventions for adverse health outcomes.

Objective

This study aimed to investigate the effect of agency on self-efficacy and the intention to drink less alcohol in an interactive digital narrative fear appeal. Furthermore, the communicated immediacy of threat outcomes was evaluated as a potential moderator of the effect of agency on self-efficacy.

Methods

A web-based experimental study was conducted with university students (N=178). The participants were presented with a fear appeal outlining the consequences of excessive alcohol use in a fully automated web-based interactive narrative. Participants either had perceived control over the outcome of the narrative scenario (high agency) or no control over the outcome (low agency). The threat was either framed as a short-term (high immediacy) or long-term (low immediacy) negative health outcome resulting from the execution of the risk behavior (drinking too much alcohol).

Results

A total of 123 valid cases were analyzed. Self-efficacy and intention to limit alcohol intake were not influenced by the agency manipulation. Self-efficacy was shown to be a significant predictor of behavioral intention. The immediacy of the threat did not moderate the relationship between agency and self-efficacy.

Conclusions

Although agency manipulation was successful, we could not find evidence of an effect of agency or threat immediacy on self-efficacy. The implications for different operationalizations of different agency concepts, as well as the malleability of self-efficacy beliefs for long-term threats, are discussed. The use of repeated versus single interventions and different threat types (eg, health and social threats) should be tested empirically to establish a way forward for diversifying intervention approaches.

Trial registration

ClinicalTrials.gov NCT05321238; https://www.clinicaltrials.gov/ct2/show/NCT05321238.

SUBMITTER: Engelbrecht H

PROVIDER: S-EPMC9237780 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundInteractive narrative-based digital health interventions hold promise for effectively addressing the complex determinants of vaccine hesitancy and promoting effective communication across a wide range of settings and vaccine types. Synthesizing evidence related to the implementation and evaluation of these interventions could offer valuable perspectives for shaping future strategies in vaccine communication. Prior systematic and scoping reviews have examined narrative-based vaccine communication interventions but not the inclusion of interactivity in such interventions.ObjectiveThe overall objective of the scoping review is to summarize the evidence on the use of interactive narrative-based digital health interventions for vaccine communication. Specific research questions focus on describing the use of interactive narrative-based digital health interventions (RQ1), describing evaluations of the impact of interactive narrative-based digital health interventions on promoting vaccine uptake (RQ2), and factors associated with their implementation (RQ3).MethodsA detailed search string will be used to search the following databases for records that are relevant to the review questions: PubMed, Embase, Scopus, Web of Science, CINAHL, and PsycINFO. Two reviewers will independently screen the titles and abstracts of identified records against the predefined eligibility criteria. Subsequently, eligible records will undergo comprehensive full-text screening by 2 independent reviewers to assess their relevance to review questions. A data charting tool will be developed and used to extract relevant information from the included articles. The extracted information will be analyzed following the review questions and presented as a narrative summary. Tabular or graphical representations will be used to display review findings, as relevant.ResultsPublic health informationists were consulted to develop the detailed search strategy. The final search string comprised terms related to narrative communication, digital health, and vaccines. The search string was customized to each proposed publication database and implemented on April 18, 2023. A total of 4474 unique records were identified using the search strategy and imported into the Covidence (Veritas Health Innovation Ltd) review management software for title and abstract screening. Title and abstract screening of identified records are ongoing as of December 29, 2023.ConclusionsTo our knowledge, this will be the first scoping review to investigate the features of interactive narrative-based digital health interventions and their role in vaccine communication. The goal of this study is to provide a comprehensive overview of the current research landscape and identify prevailing gaps in knowledge. The findings will provide insights for future research and development of novel applications of interactive narrative-based digital health vaccine communication interventions.International registered report identifier (irrid)DERR1-10.2196/51137.