Samantha Clarke Sylvester Arnab

Alex Woolner

PR:EPARE: Developing Practitioner and Student

Motivation in Relationship and Sex Education (RSE) through a

Game Based Approach.

SEX

Overview

• PR:EPARE Serious Game for RSE

• Positive Relationships: Eliminating Pressure & coercion from Adolescent Relationships

Introduction

• Funding from the Health Innovation & Education Cluster (HIEC) West Midlands (South) – part of the NHS confederation in the UK

• Proposed development & evaluation of a serious game for RSE using an intervention mapping approach (Bartholomew et al., 2011)

• Iterative process for health promotion• Theory & evidence and stakeholders• Evaluation and implementation

Introduction• Aim: to develop and evaluate an interactive

intervention object that addressed an identified need in RSE– Met the needs of stakeholders– Involved end-users and stakeholders in the

development– Drew on the theory and evidence base to maximise

the likelihood that the intervention would have a positive impact on identified outcome measures

• Rapid systematic literature review– Sex education can be effective when it is

multi-faceted– Limits of a single Serious Game

Game development• Brown, Bayley & Newby (2012)• Stakeholder groups

– Professionals– 4 x young peoples’ groups

• Identified sexual coercion as a major issue for young people

• More literature review to identify factors that predict experience of coercion– Cultural, environmental, previous abuse– Interested in psychological predictors

Change objectives & methods• Expect there to be negative consequences of

allowing unwanted sexual advances to continue– Provide information about and depict the possible

negative consequences

• Identify the nature and levels of sexual coercion– Give feedback on identification of situations as

coercive or not (include a range of natures and levels to consider)

• Recognise self as at potential risk of sexual coercion– Encourage thinking about how common coercion

can be in its different forms and levels

Matrices of change examples

Application in a game concept• Full game concept developed in

collaboration with SASH colleagues• Interpreted into gaming techniques• Part 1 – game show quiz

– Scenarios around what is coercion?– Yes, no, maybe responses

• Part 2 – first person role play– Scenario 1 - Play role of coerced– Scenario 2 - Play role of person being

coercive

Game demo

Design

• Two factors to consider:

• Participatory Design

• User Research….Who are the users?

• Where does the motivation lie?

Design Breakdown

• Practitioner Centred Design:Lesson planning, Time Management, Group Discussion, Control of Scenarios, Fits with technology available (Smartboards), Score (Evaluation)

• Student Centred DesignCombination of 3D and 2D Graphics, Game show Narrative, Audio, Group play or solo play encouraging open communication, Competitive element for motivation,

Treat them like adults….

Design Hurdles?Where to start….

• The Participatory Approach..

• Constraints….• Time, Budget, Team, Ideals…

• Attitudes to Sex Education• Culture, Religion, Ethics, Upbringing, Curriculum

.

Evaluation design• Study 1 small-scale cluster randomised

controlled trial based on part1 of game only (N=505) – 17 clusters (7 control; 10 game)

• Study 2 pre-post evaluation study based on whole game (N=257)

• Participants were male and female secondary school students in Warwickshire and the West Midlands

• In school year 9, aged13-14 years

Scale refinement• 16 measures aligned with change objectives• Exploratory factor analysis – 5 underlying

factors – but items only loaded onto 3• Confirmatory factor analysis – forced 3

factor solution and varimax rotation– Factor 1 – confidence to recognise and act– Factor 2 – knowledge and positivity towards

saying no/others saying no– Factor 3 – understanding of personal risk and

consequences

Findings study 1

• 2 (time) x 2 (condition) mixed MANOVA– Significant main effect of time F[3,501]=2.847,

p=0.037, ŋp2=.0.17

– Significant time x condition interaction F[3,501]=15.306, p<.001, ŋp2=.0.84

• Lower score represents greater psychological preparedness for coercion

Findings study 1 (factor 1)

Findings study 1 (factor 2)

Findings study 1 (factor 3)

Findings study 2

• Repeated measures MANOVA comparing pre-post scores amongst a 2nd cohort of game players.

• Picture mixed – nothing significant relating to confidence to recognise & act

• Reduction in positivity around refusal • Increase in understanding of personal risk

and consequences

Discussion• Somewhat mixed picture emerging

– Confidence to recognise coercion and act – some evidence that there’s a positive effect from the CRCT study 1 (both conditions) plus null finding in study 2

– Knowledge and positive attitudes towards saying no/others saying no – evidence is concerning -control does better than game in CRCT initial study

– Understanding personal risk and consequences – findings from both studies show significant for improvements

Conclusions and next steps• There are some positive outcomes in

relation to impact of game on psychological preparedness for dealing with coercion

• There’s a need for further exploration – this was early beta testing

• The next stages need to examine the impact of participatory design on motivation.

• What Design elements worked?• PR:EPARe is being deployed in Coventry

and Warwickshire area.

Thanks for listening!

samantha@sgs-lab.com

www.seriousgamesinstitute.co.uk