Designing a Serious Game (Above Water) for Stigma Reduction Surrounding Mental Health: Semistructured Interview Study With Expert Participants

Rina R Wehbe; Colin Whaley; Yasaman Eskandari; Ally Suarez; Lennart E Nacke; Jessica Hammer; Edward Lank

doi:10.2196/21376

Designing a Serious Game (Above Water) for Stigma Reduction Surrounding Mental Health: Semistructured Interview Study With Expert Participants

JMIR Serious Games. 2022 May 19;10(2):e21376. doi: 10.2196/21376.

Authors

Rina R Wehbe^{1

2

3}, Colin Whaley^{3

4

5}, Yasaman Eskandari^{2

3

5

6}, Ally Suarez^{2

3

7

8}, Lennart E Nacke^{3

8}, Jessica Hammer⁹, Edward Lank^{2

10}

Affiliations

¹ Human Computer Interaction for Social Good (HCI4GOOD), Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada.
² Methods Group, Human Computer Interaction Lab, Cheriton School of Computer Science, Faculty of Mathematics, University of Waterloo, Waterloo, ON, Canada.
³ The Games Institute, University of Waterloo, Waterloo, ON, Canada.
⁴ Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
⁵ School of Pharmacy, University of Waterloo, Waterloo, ON, Canada.
⁶ Faculty of Science, University of Waterloo, Waterloo, ON, Canada.
⁷ Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada.
⁸ Human Computer Interaction (HCI) Games Group, Stratford School of Interaction Design and Business, Faculty of Arts, University of Waterloo, Waterloo, ON, Canada.
⁹ OH! Lab, Human Computer Interaction Institute, Carnegie Mellon University, Pittsburgh, PA, United States.
¹⁰ Équipe LOKI, Inria Lille-Nord Europe, University of Lille, Lille, Villeneuve d'Ascq, France.

PMID: 35588056
PMCID: PMC9164096
DOI: 10.2196/21376

Abstract

Background: Although in many contexts unsuccessful games targeting learning, social interaction, or behavioral change have few downsides, when covering a sensitive domain such as mental health (MH), care must be taken to avoid harm and stigmatization of people who live with MH conditions. As a result, evaluation of the game to identify benefits and risks is crucial in understanding the game's success; however, assessment of these apps is often compared with the nongame control condition, resulting in findings specifically regarding entertainment value and user preferences. Research exploring the design process, integrating field experts, and guidelines for designing a successful serious game for sensitive topics is limited.

Objective: The aim of this study is to understand which elements of game design can guide a designer when designing a game for sensitive topics.

Methods: To carefully probe the design space of serious games for MH, we present Above Water (AbW), a game targeting the reduction of stigma surrounding MH, now in its second iteration. The game, AbW, serves as a consistent research probe to solicit expert feedback. Experts were recruited from a range of topic domains related to MH and wellness, game design, and user experience.

Results: By using this deployment as a research probe, this study demonstrates how to synthesize gained insights from multiple expert perspectives and create actionable guidelines for successful design of serious games targeting sensitive topics.

Conclusions: Our work contributes to a better understanding of how to design specialized games to address sensitive topics. We present a set of guidelines for designing games for sensitive subjects, and for each guideline, we present an example of how to apply the finding to the sample game (AbW). Furthermore, we demonstrate the generalizability to other sensitive topics by providing an additional example of a game that could be designed with the presented guidelines.

Keywords: empirical analysis; expert participants; game design; games for change; games for mental health; human–computer interaction; sensitive topics.

©Rina R Wehbe, Colin Whaley, Yasaman Eskandari, Ally Suarez, Lennart E Nacke, Jessica Hammer, Edward Lank. Originally published in JMIR Serious Games (https://games.jmir.org), 19.05.2022.