The Construction and Evaluation of a Design Framework for Narrative Games for Health

A larger number of games for health were developed over the past two decades to provide an engaging way of health care and behavior change intervention. However, many problems with the design of these games, as well as with the methodologies used to evaluate them emerged: the games were generally designed without the consultation or direct involvement of a professional game designer, and created without the guidance of a proper game design framework; the health messages delivered in the games were mostly simple and knowledge-oriented and not crafted based on theories from behavioral medicine; and the evaluation studies were also poorly designed.;To solve these problems, I define the DraGuNa (Drama-Guided Narrative Health Game) framework, a methodology that uses drama theory and sound principles from behavioral medicine to guide games for health design to solve the current problems in games for health. The dissertation introduces a methodology of game design, specifically developed for games for health, which addresses two key constructs: engagement---ensuring users stick with the game for the duration of the intervention; and adherence---ensuring users perform those actions in the game hypothesized by behavioral medicine theories to lead to health behavior change. The dissertation also provides a methodology to develop interactive narrative-based games based on existing story media, which also suggests a new path of research for the intelligent narrative community. Finally, the dissertation describes an experimental framework for testing the effects of a game on the two fundamental dimensions of player involvement in the intervention---engagement and adherence---and tests the relative contributions of each on health outcomes.