Fostering Engagement in Health Behavior Change: Iterative Development of an Interactive Narrative Environment to...

Area of Science:

• Adolescent Health
• Behavioral Science
• Digital Health Interventions

Background:

• Accidents and unintentional injuries are leading causes of adolescent mortality, frequently involving alcohol and substance use.
• Existing clinical preventive care can be enhanced with theoretically grounded interventions for adolescent health behavior change.

Purpose of the Study:

• To describe the iterative design and development of the Interactive Narrative System for Patient-Individualized Reflective Exploration (INSPIRE).
• To create a narrative-centered behavior change environment for adolescents aimed at reducing alcohol use.

Main Methods:

• Adolescents participated in over 20 focus groups and iterative pilot testing with more than 145 individuals.
• Qualitative findings from focus groups and quantitative data from pilot sessions (questionnaires, interaction logs) were collected.

Main Results:

• Adolescents found INSPIRE engaging, believable, and relevant, with 84% relating to the protagonist and 79% to virtual characters.
• Key chosen goals in the interactive narrative were 'stay in control' (60%) and 'do not get in trouble' (55%).

Conclusions:

• INSPIRE leverages a strong theoretical framework (social-cognitive theory) and technology (narrative-centered learning environments).
• The field is poised to develop impactful health behavior change systems for adolescent preventive health.