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Aims:
The first aim of the study was to assess the effect of agency, i.e. the perception of making meaningful decisions, in an interactive digital narrative fear appeal on self-efficacy beliefs concerning the ability to reduce alcohol intake among college students. Second, we assessed whether the communicated timeframe (short-term / long-term) of the threat presented in the narrative moderates the effect of agency on self-efficacy. Lastly, to validate the effect of the intervention on behavioural outcomes we assesed whether self-efficacy has an effect on behavioural intention measures.
The study was a 2 (agency: low / high) x 2 (time-frame: immediate / distant) between-subjects online experiment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High agency and immediate threat | Experimental | Participants were asked to make decisions within the interactive digital narrative and were presented with acute alcohol poisoning of the main character in the story. |
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| High agency and distant threat | Experimental | Participants were asked to make decisions within the interactive digital narrative and were presented with multiple organ failure after years of alcohol consumption of the main character in the story. |
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| Low agency and immediate threat | Experimental | Participants were presented with a fixed (passive) narrative without decisions and were presented with acute alcohol poisoning of the main character in the story. |
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| Low agency and distant threat | Experimental | Participants were presented with a fixed (passive) narrative without decisions and were presented with multiple organ failure after years of alcohol consumption of the main character in the story. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High agency and immediate threat | Other | Participants were asked to make several decisions for the main character in the interactive digital narrative that related to drinking / turning down alcoholic drinks.The decisions made lead to a ending consistent with the decisions of the participant. In the story presented, a character dies from acute alcohol poisoning after ingesting too much alcohol in a short period of time. |
| Measure | Description | Time Frame |
|---|---|---|
| Perceived self-efficacy | Three items answered on 7-point Likert scales (ranging from 'Strongly Disagree' to 'Strongly Agree'):
| During the lab session |
| Behavioural intention | Four items answered on 7-point Likert scales (ranging from 'Strongly Disagree' to 'Strongly Agree'):
| During the lab session |
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| Measure | Description | Time Frame |
|---|---|---|
| Perceived Agency | Five items Items were measured on 7-point Likert scales from 'Strongly Disagree' to 'Strongly Agree'. For example, 'I felt that the actions I took were meaningful within the context of the story'. | During the lab session |
| Fear |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hendrik Engelbrecht | Tilburg University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tilburg University | Tilburg | North Brabant | 5037AB | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35699976 | Derived | Engelbrecht H, van der Laan LN, van Enschot R, Krahmer E. The Role of Agency and Threat Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Excessive Alcohol Use: Randomized Controlled Trial. JMIR Serious Games. 2022 Jun 13;10(2):e32218. doi: 10.2196/32218. |
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| ID | Term |
|---|---|
| D033262 | Narration |
| ID | Term |
|---|---|
| D003142 | Communication |
| D001519 | Behavior |
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Participants were not aware which arm of the study they were enrolled in.
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| High agency and distant threat | Other | Participants were asked to make several decisions for the main character in the interactive digital narrative that related to drinking / turning down alcoholic drinks.The decisions made lead to a ending consistent with the decisions of the participant. In the story presented, a character dies from multiple organ failure after ingesting too much alcohol over a long period of time. |
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| Low agency and immediate threat | Other | Participants were asked to read a narrative in which the main character turns down alcoholic drinks at a party. The participants can not influence the decisions of the main character and only consume the narrative passively.The decisions made lead to a ending consistent with the decisions of the participant. In the story presented, a character dies from acute alcohol poisoning after ingesting too much alcohol in a short period of time. |
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| Low agency and distant threat | Other | Participants were asked to read a narrative in which the main character turns down alcoholic drinks at a party. The participants can not influence the decisions of the main character and only consume the narrative passively.The decisions made lead to a ending consistent with the decisions of the participant. In the story presented, a character dies from multiple organ failure after ingesting too much alcohol over a long period of time. |
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Six items were scored on 7-point Likert scales from 'Not at all' to 'Very much'. The items ask participants about the intensity of affective response towards the message, for example, 'How much did this message make you feel frightened?'.
| During the lab session |
| Perceived Severity, Susceptability and Response-Efficacy | Severity, susceptibility and response-efficacy items were measured with three items each on 7-point Likert scales from 'Strongly Disagree' to 'Strongly Agree'. | During the lab session |
| Symptoms of Alcohol Abuse | We measured the consequences of alcohol related behavior indicating dependence. One example of an item is 'My drinking has gotten me into sexual situations I later regretted.'. The brief young adult alcohol consequences questionnaire (BYAACQ) consists of 24 statements that are scored with binary yes / no answers. A score above 15 positive answers indicates alcohol dependence. The scale was developed by (Kahler et al., 2008). | During the lab session |
| Drinking Frequency | Frequency was measured by asking participants how often they 'drink alcohol in excess' and was measured on a 7-point Likert scale ranging from 'Never' to 'Very Frequently'. | During the lab session |
| Perceived Control | Perceived control was measured by two items asking participants whether or not they can 'control' and 'stop' drinking alcohol whenever they want. These two items were measured on 7-point Likert scales ranging from 'Strongly Disagree' to 'Strongly Agree'. | During the lab session |
| Behavioural inhibition | The items to measures disinhibition were taken over unchanged from the scale by Lee & Shinn (2011), but altered from 9-point to 7-point Likert scales ranging from 'Strongly Disagree' to 'Strongly Agree'. | During the lab session |