P Orpin

Integrating Health Behavior Theory and Design Elements in Serious Games

Background Internet interventions for improving health and well-being have the potential to reach many people and fill gaps in service provision. Serious gaming interfaces provide opportunities to optimize user adherence and impact. Health interventions based in theory and evidence and tailored to psychological constructs have been found to be more effective to promote behavior change. Defining the design elements which engage users and help them to meet their goals can contribute to better informed serious games. Objective To elucidate design elements important in SPARX, a serious game for adolescents with depression, from a user-centered perspective. Methods We proposed a model based on an established theory of health behavior change and practical features of serious game design to organize ideas and rationale. We analyzed data from 5 studies comprising a total of 22 focus groups and 66 semistructured interviews conducted with youth and families in New Zealand and Australia who had viewed or used SPARX. User perceptions of the game were applied to this framework. Results A coherent framework was established using the three constructs of self-determination theory (SDT), autonomy, competence, and relatedness, to organize user perceptions and design elements within four areas important in design: computer game, accessibility, working alliance, and learning in immersion. User perceptions mapped well to the framework, which may assist developers in understanding the context of user needs. By mapping these elements against the constructs of SDT, we were able to propose a sound theoretical base for the model. Conclusions This study’s method allowed for the articulation of design elements in a serious game from a user-centered perspective within a coherent overarching framework. The framework can be used to deliberately incorporate serious game design elements that support a user’s sense of autonomy, competence, and relatedness, key constructs which have been found to mediate motivation at all stages of the change process. The resulting model introduces promising avenues for future exploration. Involving users in program design remains an imperative if serious games are to be fit for purpose.

Insights and principles for supporting social engagement in rural older people

ABSTRACT Staying socially engaged is known to improve health and longevity in older people. As the population ages, maintaining levels of social engagement among older people becomes increasingly important. Nevertheless, advancing age brings with it many challenges to social engagement, especially in rural areas. A three-year Australian Research Council Linkage Project sought to improve understandings of age-related triggers to social disengagement in six Tasmanian communities that are representative of rural Australian experience, and thus of wider salience. A collaboration between academics and health and social professionals, the project investigated design solutions for service frameworks that may be useful before ageing individuals become isolated and dependent, and that may support those individuals to actively contribute to and benefit from social life. The purpose of this paper is to report on perspectives about diminishing levels of social engagement held by older rural participants and service providers, and to advance a number of key insights on ways in which to nurture social engagement and improve the experience of ageing.

Visual Art in Physical Rehabilitation: Experiences of People with Neurological Conditions

Aims: The aims of this study were to understand the experience of participation in visual art from the perspective of adults undergoing outpatient physical rehabilitation and to determine whether art has a place in this context. Method: This qualitative study involved interviewing adults who attended a weekly art class run by a qualified art teacher and occupational therapists in an outpatient physical rehabilitation setting. Nine participants with neurological conditions discussed their experience of the programme and the goals they were working towards or had achieved through painting. Findings: The themes that emerged from the study show that art contributed to the participants meeting their individual rehabilitation goals. It also assisted the participants in using time, increasing enjoyment, regaining confidence and planning for engagement in future activities. All these achievements were seen by the participants to contribute to their rehabilitation or recovery. The identified themes align with the aims of rehabilitation and are similar to findings from many other studies investigating the use of art by people affected by illness or disability. Conclusion: The findings of this study inform clinical practice in the use of visual art with clients in rehabilitation and validate its place in a physical rehabilitation programme.

Skill development for volunteering in rural communities

This paper examines the skills required of volunteers in the voluntary sector organisations that operate in three rural Tasmanian communities. It reports how volunteers acquire those skills and reveals the challenges faced by voluntary sector organisations in rural communities whose industries and, following from this, community members have a low‐qualification profile. Training for volunteers in these rural communities must take account of motivations for volunteering, rural context, preferred learning styles, education and training, and the volunteers’ confidence as learners.

Partner or perish: experiences from the field about collaborations for reform

Collaborations between researchers, policy makers, service providers and community members are critical to the journey of health service reform. Challenges are multifaceted and complex. Partners come with a variety of challenging agendas, value sets and imperatives, and see the drivers for reform from different perspectives. Different skills are required for managing the partnership and for providing academic leadership, and different structural frameworks need to be put in place for each task in each project. We have found through a series of partnerships across our research theme of healthy ageing, and consequent translation into policy and practice, that significant and innovative effort is required for both the collaboration and the research to succeed. A shared understanding of the issues and challenges is a start, but not sufficient for longer-term success. In addition to managing the research, our experience has demonstrated the need to understand the different challenges faced by each of the partners, recognise and respect personal and organisational value systems, and to establish separate mechanisms to manage strong egos alongside, but outside of, the research process.

‘I come for the friendship’: Why social eating matters

To explore an innovative social eating programme model for older Tasmanians, Eating with Friends (EWF), from the perspectives of its participants, to establish how successfully it is meeting the organisational aims of strengthening community, reducing social isolation and enhancing mental well‐being.

Eating and ageing in rural Australia: applying temporal perspectives from phenomenology to uncover meanings in older adults’ experiences

ABSTRACT Nutritious and enjoyable eating experiences are important for the health and wellbeing of older adults. Social gerontology has usefully engaged with the role of time in older adults’ eating lives, considering how routines and other temporal patterns shape experiences of food, meals and eating. Building on this foundation, the paper details one set of findings from qualitative doctoral research into older adults’ experiences of food, meals and eating. Informed by phenomenological ethnography, it engages with one of four dimensions of the human lifeworld – the temporal dimension. The research involved repeated in-depth interviews, walking interviews and observation with 21 participants aged 72–90 years, living in rural Tasmania, Australia. The temporal elements of older adults’ experiences are detailed in terms of the past, present and future. The findings show that older adults have vivid memories of eating in uncertain and austere times, and these experiences have informed their food values and behaviours into old age. In the present, older adults employ several strategies for living and eating well. Simultaneously, they are oriented towards their uncertain eating futures. These findings reveal the implicit meanings in older adults’ temporal experiences of food, meals and eating, highlighting the importance of understanding older adults’ lifeworlds, and their orientation towards the future, for developing effective responses to concerns about food and eating in this age group.

Book reviews : COPING WITH CLOSURE: AN INTERNATIONAL COMPARISON OF MINE TOWN EXPERIENCES Cecily Neil, Marku Tykkylainen and John Bradbury (eds) London, Routledge, 1992, xvii, 427 pp.,

Conversations’, documenting a cultural difference in telephone opening sequences, Heritage and Greatbatch’s apparent commitment to formal, sequential turn-taking systems raises questions about the meaning and relationship of ’structure’ and ’action’. Both in their details and in the problems that they raise, these studies provide a resource for those with similar interests in the problem of social order. In contrast, the four opening papers, as position papers, are more problematic. Boden and Zimmerman, in ’Structure-in-Action : An Introduction’, find themselves in an irreconcilable dilemma: