Taking a Break: Participatory Game Design by Joel Virothaisakun May 2017 Presented to the Division of Science, Information Arts and Technologies University of Baltimore In Partial Fulfillment of the Requirements for the Degree of Master of Science Approved by: ________________________________ [Bridget Blodgett, Thesis Advisor] ________________________________ [Greg Walsh, Committee Member] Abstract Anxiety is an issue that the majority of people have struggled with in their lives. While there are many different types of treatment for anxiety, not all of them are effective. As a society we have come to rely more on technology and our smartphones. Combining the issues of health and technology is a new way to attempt to help alleviate stressors that could potentially cause anxiety. This paper shows the result of a participatory design research project aimed at creating a solution for anxiety. The finished product being a working prototype of a game based off the research. Table of Contents List of Tables ...................................................................................................................... ii List of Figures .................................................................................................................... iii Literature Review.................................................................................................................1 Introduction ..........................................................................................................................6 Research ...............................................................................................................................7 Design Process ...................................................................................................................12 Theme 12 Mechanics ............................................................................................................. 13 Audio 14 Graphics ................................................................................................................ 15 Beta Test ............................................................................................................................17 Conclusion .........................................................................................................................18 References ..........................................................................................................................20 i List of Tables Table 1 Participatory Design Session Demographic.......................................................... 9 ii List of Figures Figure 1. Screenshot of Living Color Game Prototype 14 Figure 2. Moodboard used for design for Living Color 16 iii Taking A Break: Participatory Game Design 1 Literature Review Anxiety is an emotion that everyone has felt at some point in their lives. Whether the anxiety be from an upcoming academic test, a fear of flying, or from accidentally lighting the stove on fire, everyone knows what it is like to feel anxious. There is a practical purpose for feeling anxiety sometimes. For example, anxiety about an upcoming academic test might have the effect of making the student study harder. However, there are some people that are plagued with anxiety that serves no purpose and occurs for reasons that seem illogical to them and the ones around them. There are many different types of remedies for an anxiety, however, more recently our level of technology has offered options that were not available before. Mobile phones are now being considered as a potential remedy for many different types of health issues, anxiety included. Health and mobile are currently two thriving industries, however, the combination of these two industries to help anxiety is still a new practice and its effectiveness is still debatable. Anxiety is described as the feeling of nervousness, apprehension, fear, or worry (“Anxiety Causes, Symptoms, Treatment - What are Symptoms and Signs of Anxiety?,” n.d.). This feeling can make it extremely difficult for an individual to complete their daily activities, and for some people it happens chronically and without cause. There are some people who have anxiety so badly that they have difficulty leaving their house or being in public. While most people who suffer from anxiety do not feel it to the extreme that they are not able to leave their house, The National Health Institute says that 18% of adults suffer from some form of anxiety disorder (“Any Anxiety Disorder Among Adults,” n.d.). Sometimes there is no underlying cause for anxiety, however, there are many common reasons for why someone might feel anxiety. Some more common cause for anxiety are stress at work, stress at school, relationship issues, drug abuse, side effects of medication, and symptoms of a medical illness (“Anxiety Causes, Symptoms, Treatment © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 2 - What are Symptoms and Signs of Anxiety?,” n.d.). Individuals experience anxiety differently and have different tolerance levels before experiencing a level of anxiety that will negatively affect their day to day life. There are also some common symptoms of anxiety that individuals experience. Often when people reach a high level of anxiety they will start avoiding eye contact, moving their hands and arms, constantly rebalancing, and/or shaking their head (Miranda, Calderón, & Favela, 2014). Individuals who suffer from chronic anxiety disorder may completely avoid situations that could cause them anxiety, and this could prevent them from completing activities in their day to day life. With anxiety being such a prevalent issue in our society, doctors have come up with many ways to combat it. One of the more common ways for treating anxiety is known as Cognitive Behavior Therapy. In Cognitive Behavior Therapy, patients log instances where they are feeling anxious into a journal where they can later review their fears with a professional in a more rational way (Rennert & Karapanos, 2013). When a patient starts to analyze situations that make them feel anxious, they might start to realize that their fears are irrational and feel less anxious in the future. However, the authors of Mental Health App Design– A Journey From Concept to Completion argues that the cost of this type of treatment can be expensive and out of reach of many who suffer from anxiety (Topham, Caleb-Solly, Matthews, Farmer, & Mash, 2015). While Cognitive Behavior Therapy is the most popular method for reducing chronic anxiety, there are several other methods that are commonly used. The authors of Scoop! A Movement-based Math Game Designed to Reduce Math Anxiety discusses the use of power poses to reduce anxiety before taking a math test (Isbister, Karlesky, Frye, & Rao, 2012). A power pose is a position that a person puts themselves in that is supposed to increase the person’s confidence. However, there was no discussion on how using power poses could be used for adults and in other scenarios that cause anxiety. Another method that is commonly being used for reducing anxiety with patients who suffer from Post-Traumatic Stress Disorder is Exposure Therapy (Repetto et al., 2013). In © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 3 Exposure Therapy, patients are put into controlled situations that give them anxiety. The idea is that if the patient has the opportunity to experience the situation that is causing them anxiety in a controlled setting, it will reduce the anxiety that the patient feels once they are in this situation in the real world. While this might work for users who have a fear of being out in public, there are many types anxiety causing situations that could not or should not be replicated in a controlled setting. There is some debate in the healthcare industry on whether using a smartphone for healthcare purposes is a viable option. One the major arguments for using smartphones for healthcare is the availability of smartphones to the public. A research study suggests that 56% of people in the United States own a smartphone (Middelweerd, Mollee, van der Wal, Brug, & te Velde, 2014). With so many smartphone users in our society, using a smartphone to deliver healthcare services could increase the amount of anxiety sufferers that can get access to healthcare solutions. Also, if there were a smartphone application that was effective at reducing anxiety, it would be a substantially cheaper than going to a healthcare professional. However, the effectiveness of using a smartphone application to treat anxiety is something that has been questioned. While many sources say that there is potential for using a smartphone to help reduce anxiety, most of them are very careful to state that a smartphone application would not be a replacement for seeing a healthcare professional. There has also been some discussion that smartphone usage can actually cause anxiety and sleep issues for the user. However, a research study conducted looking into smartphone usage found that smartphone users only had increased anxiety and trouble sleeping if they were using their smartphone excessively (Demirci, Akgönül, & Akpinar, 2015). Currently there is a great deal of smartphone applications tailored towards creating behavioral change for the user, and even some for reducing anxiety. Many health applications try to take advantage of the smartphone’s ability to automatically collect data (Patrick, Griswold, Raab, & Intille, 2008). For example, a smartphone application can use © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 4 the built in GPS and accelerometer to track how much movement a user has made in given day. The user does not have to directly input any data into the smartphone, but the application can still reward the user for being overly active in a day, or suggest that the user take a walk if they have been sedentary for a long period of time. Many of the smartphone applications geared towards creating behavioral change follow this type of format. The majority of smartphone applications geared towards reducing anxiety attempt to use Cognitive Behavior Therapy. Unlike with tracking physical activity, there is no easy way to automatically track a user’s anxiety level. One smartphone application attempts to solve this problem by using a heart rate monitor and Google Glasses (for tracking blink patterns). In this way data can be collected automatically when a user is feeling anxious. However, this is most likely more technology than most people would be willing to wear on a daily basis, and is expensive (Miranda et al., 2014). This is why most smartphone applications attempting to help users reduce anxiety involve the user manually logging data throughout the day. Some of these applications are designed to work in addition to in-person healthcare sessions that the user is already attending. Users would log when they were feeling anxiety and why they were feeling anxiety, and then discuss this with their healthcare professional. However, others smartphone applications have attempted to make standalone applications that are meant to be used without any healthcare professional. The makers of an application called SAM –Self help for Anxiety Management claims that all of the existing applications for reducing anxiety attempt to mimic in-person session with a healthcare professional. The designers for SAM are trying to design their applications differently, and have made an application that does not mimic in-person sessions (Topham et al., 2015). The designers of this application say that since interactions with a smartphone are different than with a healthcare professional, that the application needs to be designed in a way that tries to cater to this difference instead of trying to mimic in-person sessions. © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 5 Another field that is currently being investigated in the healthcare industry is Serious Games. Serious Games are games designed not just for entertainment, but also to provide some benefit to the user or general population. An example of this is a smartphone game that looks very similar to Space Invaders and was created to help people exercise more (Wylie & Coulton, 2008). The user plays the game as they normally would, but when the user is not doing well the game will pause and check the user's heart rate. If the user gets their heart rate to the designated number displayed on the screen, they are awarded a bonus. The advantage of using a game to change a user’s behavior is that the game can make the behavior change fun and entertaining. However, making a Serious Game fun over a long period of time has been a struggle for game designers (Baranowski, 2014). Serious Games generally do not have big budgets like many of the games that are intended just for entertainment. This makes it hard for Serious Games to compete against other types of games. However, the expectation for smartphone games is generally lower than for console or computer games. This could make it easier for smartphone Serious Games to compete against other games in the market. With the amount of people who suffer from anxiety on the rise, finding new effective ways of helping people who suffer from anxiety is increasingly important. By using a smartphone application, or smartphone Serious Game, it could be possible to provide relief to people who suffer from anxiety in a cheap, convenient, and efficient way. However, figuring out how to make a smartphone application that helps users with anxiety is not easy. There are many smartphone applications currently on the Android and iOS markets, but research conducted on all of these applications in the Google Play Store showed that they are lacking in effectiveness (Van Singer, Chatton, & Khazaal, 2015). While there is a large body of work dedicated to helping users with anxiety, more time and effort needs to be spent researching how this can be brought to a smartphone platform in a way that works. © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 6 Introduction Management of anxiety can feel like a full-time job for the patient or persons with the disease. It is extremely important for someone with chronic anxiety to find healthy methods that help them alleviate their anxiety, otherwise the anxiety could prevent them from completing activities in their daily life. With the prevalence of smartphones in our society being at an all-time high, the creation of a mobile application seems like the obvious tool for helping users alleviate their anxiety. while there are already some applications in the market that are designed specifically for this purpose, their effectiveness for alleviating anxiety is questionable. Having the end users involved in the creation of the mobile application will hopefully allow for the application being designed to be more effective than the rest of the mobile applications currently in the market. This research uses a user centered design process combined with participatory design to try and create a mobile application that can reduce anxiety. To my knowledge, this is the first time participatory design has been used to create a mobile application that helps users with their anxiety. Getting the end users involved with the development of this application as early as possible was one of the main objectives of this research. While I did have some general ideas of what types of applications I thought would help users alleviate their anxiety, the decision of what type of application to create was 100% based off the applications designed in the participatory design sessions. Having the participatory sessions as early as possible in my research allowed me the flexibility to rapidly prototype different types of applications before starting development of the final product. My process for creating this mobile application was split up into four main phases: research, participatory design, prototyping, and beta testing. © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 7 Research Management of anxiety can feel like a full-time job for the patient or persons with the disease. It is extremely important for someone with chronic anxiety to find healthy methods that help them alleviate their anxiety, otherwise the anxiety could prevent them from completing activities in their daily life. With the prevalence of smartphones in our society being at an all-time high, the creation of a mobile application seems like the obvious tool for helping users alleviate their anxiety. while there are already some applications in the market that are designed specifically for this purpose, their effectiveness for alleviating anxiety is questionable. This research uses a user centered design process combined with participatory design to try and create a mobile application that can reduce anxiety more effectively than any that have previously been made. My process for creating this mobile application was split up into four main phases: research, participatory design, prototyping, and beta testing. Participatory design is a method for conducting research that pairs the stake holders with the end users. Using this method, the end user is able to add input to how a product is made and effect the product’s design. Using participatory design can help designers better understand the needs of the end user of the product. “The passion I have for [participatory design] methods is due to my belief that the best way to solve problems is to enable the affected groups to work directly with those that can craft a solution” said Greg Walsh, a professor at the University of Baltimore and a proponent for participatory design (“Greg Walsh - Research,” n.d.). While the end user may have the ability to influence the final design of a product in participatory design, it should be noted that the final design decisions are still with the stake holder. Participatory design is one of the tools that researchers can use to better make products for users. The initial research phase was used for gathering information about existing methods that are being used for relieving anxiety, specifically in the technology industry. © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 8 There is already quite a large amount of mobile applications that are being designed to reduce a user's anxiety. It was important to review these applications to determine the strengths and weaknesses of what is currently out in the market. A review of topics in the fields of behavioral change, mobile application design, and participatory design is also part of this initial research phase. This research helped guide the participatory design sessions so that I could be sure that the designs were moving in an appropriate direction. Participatory design sessions were the basis for how I decided what type of mobile application to create, and how the design of the application was created. Here is an outline for how the group participatory design sessions were run: 1. Demographic collection form 2. Explanation of session 3. Discussion: Identify important features 4. Design: Paper Prototype 5. Discussion: Prioritize features 6. Design: Design/Revise Paper Prototype 7. Discussion: Final thoughts In total, 6 sessions were run with 2-3 people in each session. All of the participants used their phones frequently throughout the day. 100% of the users used their phones for email, social media, and messaging at least once a day. 60% of the users used their phones for news and to play video games at least once a day. Having only participants that used their phones frequently was a deliberate decision for this research. Participants who frequently use their mobile devices will be more familiar with the platform, and therefore more prepared to design for it. All but two of the users were iPhone users, the rest were Android users. There were no users who preferred Windows or Blackberries. This research was instrumental for me determining the type of © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 9 applications that should be created as part of the prototyping face. While there were many different applications that were designed in the sessions, all of the applications seemed to fall into 3 categories: Journaling, organization, and video gaming. A demographic questionnaire was given to all users who participated in the participatory design sessions (see Table 1). Table 1 Participatory Design Session Demographic Responses Age 30 years (average) Gender 70% Female 30% Male Education 75% Some College 25% College Degree 25% High School Daily Mobile User 100% Operating System 87.5% iPhone 12.5 Android Mobile Used For 100% Email 100% Social Media 100% Messaging 62.5% News 62.5% Games A journaling application was the most obvious method for handling anxiety that the participants suggested. This is a method that doctors currently use for helping © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 10 patients, so it makes sense that this type of application would come up a lot in the participatory design sessions. The idea behind a journaling application is that users would log when they were feeling anxious and the cause of their anxiety. They would then be able to track trends and potentially avoid situations that might cause them anxiety in the future. One participant suggested that this application could send notifications to the user reminding them to log throughout the day. This user wanted the application to not only track things that made the user anxious, but also things that made the user relaxed. The application would then suggest activities for the user to do based on their activity. It was also discussed that the notifications should be “Soft Notifications” that were not too obtrusive to the user. The participants believe that the notifications could potentially increase the user’s anxiety, so the notifications should not make noise or take up too much space on the screen. Another participant suggested that the application could track the user’s sleeping patterns. The notifications could then be scheduled around when the user wakes up and goes to sleep, and the sleep data would be another metric for the application to use to measuring a user’s anxiety level. Another interesting feature that was suggested is that the application would suggest an activity based on how the user was feeling. If a user was feeling anxious, the app might suggest to the user to call a friend or family member. If the user was feeling relaxed, the app might suggest that the user do something productive, like cleaning their house. Currently there are quite a few different journaling mobile applications currently in the market. Many of them have had medical professionals in the field helping them design the application. If I were to make an application like this, I would also want to have professionals consult on the design of the application. Since this is out of the scope of this project, I decided to create another type of mobile application. Many of the participants of my research said that organizing things reduced their anxiety. There were 2 types of organization mobile applications that the participants suggested. One was a mobile application that helped the user organize their day to day © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 11 life. This application could give daily, weekly, monthly, or annual notifications to remind the user to complete a specific task. The application would also suggest dates for these notifications. If a user already has a lot of notifications on a specific date, it would suggest that the reminder be given on the next day. Also, if a task does not get completed, the application will suggest a new reminder date for this task. One participant suggested that the tasks could have a priority level that could be associated to them. Then the application would automatically have high priority tasks reminded to the user first. Another participant suggested that the organization application give rewards to the user for completing tasks. This would be in an attempt to keep the user motivated to complete their tasks. The application would also be able to generate a random task for the user, if the user did not have any tasks to complete on that day. Another type of organization mobile application that was suggested was allowing the user to organize items on the phone itself. This could be organization shapes, colors, or numbers. One participant suggested that she would like a mobile application that allowed her to organize a digital messy room, or closet. This is an activity that she would regularly do to relieve her anxiety. While an organization application has a lot of promise, there are even more organization mobile applications in the market than journaling applications so I decided against created this type of application. Almost every single participant in my research said that they either played a videogame at some point to reduce their anxiety, or that they do regularly. The reasoning behind this is that all of the users wanted to be distracted when they felt anxiety. A distraction was the main theme for most of the mobile applications that users came up with in the participatory design sessions. Other suggestions that were not part of the three main categories that I cover in my research were social media, news, or any type of activity on the mobile phone that distracted the user from the environment that they were in. The participants had a lot of different types of mobile video games that they would want to play to reduce their anxiety, but there were a lot of familiar themes between their © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 12 designs. Sound was very important part of the games that the participants designed. A lot of emphasis was put on the music that would be played in the background. The music should have a calming effect on the user, and should not produce any kind of anxiety. The sound effects should be designed in the same way. While the sound should notify the user of his or her actions, it should do so with a sound effect that was also relaxing. Even if the action taken by the user was negative in the game. One participant said that the sound should make the user laugh. They suggested that the game should have the sounds of babies laughing, because this is a sound that made them laugh every time they heard it. Another participant said that the music should be something that she could sing along too, because singing is something that they did to reduce their anxiety. The game that the participants design also had a lot of emphasis on the visual aspect of the game being as soothing as possible. All of the colors should have a calming effect on the users. One of the participants also suggested that the game not have any hard edges for any of the shapes in the game. With so many of my participants already playing games to reduce their anxiety, it makes sense to create a game with this objective in mind. Design Process Theme While coming up with the theme of this game I decided that I did not want the theme to suggest that it was a game for reducing anxiety, even though the game is being designed specifically for that purpose. The reasoning behind this is that none of the participants that I spoke with, or people that I spoke with outside of my research, had ever played a game that was themed as a game that reduced anxiety. I was not able to determine why people with anxiety would not try to play a game that might reduce their anxiety, there are quite a few games available in the market. It is possible that the thought © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 13 of downloading a game that might reference anxiety while you are playing it seemed unappealing. This lead me to come up with the game Living Color. The idea around Living Color is that the world that was once full of color, but color has come alive and is on the run. It is the objective of the player to catch all of the color, and bring color back to the world. Mechanics In the game Living Color, the player controls an object in the center of the screen in the shape of the letter “C”. The player can move in a 360-degree motion by moving his or her thumb on the left or right side of the screen. A large amount of time was spent on the controls for the player. The intention is that the game is as easy to learn as possible. In the participator design session, a participate said “I like playing simple mindless games when I’m anxious”. The method for controlling the player is similar to that of how a person drives a car. The player rotates counter clockwise if the player moves their left thumb down or right thumb up on the screen, and the player rotates clockwise of the player moves their left thumb up or their right thumb down. The player is instructed to play the game with both thumbs on the screen at the same time. While this is not required for the user to play, the user can actually move the player faster by using both thumbs at the same time. Since the player itself is in the shape of a circle, just like a steering wheel, this gives some affordance to the player for how the player should be control. It is my hope that the controls being easy as possible will reduce any anxiety from having to learn how to play the game. As the player rotates in the center, colored objects moved towards the player. These colored objects are how the point system for the game works. The player can either collect these objects by letting the object into the opening of the player, or avoid collecting the object by letting it bounce off the side of the player. The player must collect the same color object as the center color of the player. As the player collects the © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 14 correct colors, color starts to return to the background. The movement of the objects to the player were designed to be easy to catch, especially in the early rounds of the game. It would have been possible to create objects that move in more random seeming paths towards the player, however, making the objects too hard to track could have made the game too anxiety producing. In the first 5 levels, there is no lose scenario. A participant during the participatory design sessions suggested that the game not have any lose scenario at all. However, I believe that this type of game would not keep the attention of the user for long without a lose scenario to challenge them. Below is a screenshot of the final prototype that was created. Figure 1. Screenshot of Living Color Game Prototype Audio The music for Living Color was produced specifically for creating a feeling of calmness from the person listening to it. Many of the participants in the participatory design sessions said that listening to music was a method that they used to relieve their anxiety. The participants’ responses for what type of music best alleviated their anxiety © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 15 varied based on their personal preferences of music. One participant said “Any music that I can sing along with helps my anxiety”. However, several participants claimed that natural sounds helped them the most. Examples of natural sounds were sounds of the beach and the sound of rain. The music from Living Color incorporates these natural sounds in attempt to create a composition that is soothing to the user. A lot of time was also spent on what type of sound effects to use while playing the game as well. The sound for when a user collects an object is the sound of a water drop. This is in an attempt to incorporate more relaxing natural sounds into the game. Something that was difficult to decide on was what sound effect to use when a user collects the wrong object. Since this is a negative action, I wanted to convey this with the sound without using a sound that caused any additional anxiety. The sound of several piano keys is the sound that is currently being used. This sound is soothing enough to not cause anxiety, and is different enough from the water drop sound to be distinguishable by the user. Graphics All of the graphics for Living Color were designed in a way that would reduce anxiety for the user. A great deal of time was spent deciding on the color palette to use for the game. In a participatory design session, a user said “The colors in the game should be calming…”. According to an article written by the 1st Web Design team, the color blue has calming properties (The Psychology of Colors in Web Design). This is why the base color of the entire game is a vibrant blue. The color red was avoided because it has been known to evoke a strong emotional response. Below is a moodboard that was created to help define the art style of Living Color. © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 16 Figure 2. Moodboard used for design for Living Color The shapes of the objects themselves were also designed in a way that should be soothing to the user. All of the objects in the game are circles and have soft edges. The animation for the collectible objects themselves is meant to somewhat resemble that of water. This animation parallels the idea that natural sounds can be calming to users. Since we are already using the sound of the beach in the music, the animation of the objects resembling water is supposed to reinforce this calming effect. The last graphical element that is meant to calm the player is the background. There were several participants of the participatory design session that created drawing mobile applications. These participants said that coloring had a calming effect on them, and that it reduced their anxiety. While the user is not actually coloring the background in Living Color, color is appearing on the screen as a direct result of the user's action. It is © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 17 my thought that this coloring of the background will have the same calming effect that the participants were experiencing from coloring in real life, or at least a small calming effect. Beta Test Once the prototype had been created it was released on the iPhone market as a closed beta test and on the Android market as an open beta test. Unfortunately, participation to the beta test of Living Color was low, so only qualitative data could be pulled. All of the participants to the beta test found the game soothing, and a good distraction from the things that were causing them anxiety. One user said “The music was calming. As long as you're doing well, you continue to get positive reinforcement as more color is revealed. If you make an error, you simply start over, making it pressurefree”. Only one user said that their anxiety level had not decreased while they were playing the game. Participants thought that the music and slow pace of the game to be the most soothing aspects of it. “The lack of timer and simplicity of the game play were a great joy” said one of the participants who enjoyed the fact that there was no timer, and the game could be played at the user’s pace. While all of the users did enjoy the game, it seems like the majority of them thought that the game was too slow. When asked how the game could be improved, a user said: “More distractions maybe. Although that might not help anxiety”. The participants thought that the game would be more distracting if there were more objects on the screen at one time, or if there were more actions that the user could take. While one participant recognized that this might actually increase their level of anxiety level while playing the game, most of the participants believe that it would reduce their anxiety more if they were more distracted and engaged with the game. © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 18 Conclusion This research project has taught me a lot about anxiety, and how people cope with it differently. Some people prefer to listen to loud fast paced rap music and play videogames, while others prefer to listen to classical music and organize their room. Both these methods seem very different, but after my research it seems clear what people want when they feel anxious. They want to be distracted. While I cannot say whether this is the best long term solution to the problem of anxiety, it does seem to help in the now. Living Color shows a lot of promise for being able to distract users and reduce the user’s anxiety in the moment, and I believe the idea of using a game for this purpose has merit. While there was a great deal of useful information gained from this research, there are some areas where additional resources would have been useful. With just one person running the participatory design sessions, the moderator also had to be the note taker. This meant that the moderator had to occasionally slow down the participants’ discussions in order to gather as much feedback as possible from the participants. Another shortcoming to the research was the lack of demographic variation in participants to the participatory design sessions. While it was the intention during recruitment to only have frequent smartphone users, all of the users were between 27 and 33 and from the same general geographic location. Having a wider demographic range could have yielded a wider variety of mobile application concepts. Perhaps my one fault when designing Living Color was that I spent so much time thinking of ways to make the game soothing to the user, and not enough time thinking of ways to distract the user. That being said, I think by simply tweaking the design strategy to focus more on making the game more engaging would solve this problem. When designing a game that is supposed to reduce the user's anxiety it is important to keep color, shape, and the player’s interactions in mind. These are elements that can quickly change a person’s mental state if used correctly, or incorrectly. I believe this research can © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 19 help game designers determine how to use these elements to get the desired reaction out of the user. © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 20 References Anxiety Causes, Symptoms, Treatment - What are Symptoms and Signs of Anxiety? (n.d.). Retrieved August 17, 2016, from http://www.emedicinehealth.com/anxiety/article_em.htm Asakawa, T., Muramatsu, A., Hayashi, T., Urata, T., Taya, M., & MizunoMatsumoto, Y. (2014). Comparison of EEG propagation speeds under emotional stimuli on smartphone between the different anxiety states. Frontiers in Human Neuroscience, 8, 1006. http://doi.org/10.3389/fnhum.2014.01006 Baranowski, T. (2014). The Five Most Important Research Issues in Effective Game for Health Design (from a Behavioral Scientist’s Perspective). In Proceedings of the 2014 ACM International Workshop on Serious Games (pp. 1–2). New York, NY, USA: ACM. http://doi.org/10.1145/2656719.2656720 Demirci, K., Akgönül, M., & Akpinar, A. (2015). Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students. Journal of Behavioral Addictions, 4(2), 85–92. http://doi.org/10.1556/2006.4.2015.010 Ferri, G., Sluis-Thiescheffer, W., Booten, D., & Schouten, B. (2016). Playful Cognitive Behavioral Therapy Apps: Design Concepts and Tactics for Engaging Young Patients. In Proceedings of the The 15th International Conference on Interaction Design and Children (pp. 486–498). New York, NY, USA: ACM. http://doi.org/10.1145/2930674.2930698 © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 21 Isbister, K., Karlesky, M., Frye, J., & Rao, R. (2012). Scoop!: A Movement-based Math Game Designed to Reduce Math Anxiety. In CHI ’12 Extended Abstracts on Human Factors in Computing Systems (pp. 1075–1078). New York, NY, USA: ACM. http://doi.org/10.1145/2212776.2212389 Klasnja, P., & Pratt, W. (2012). Healthcare in the pocket: Mapping the space of mobile-phone health interventions. Journal of Biomedical Informatics, 45(1), 184–198. http://doi.org/10.1016/j.jbi.2011.08.017 Lee, J.-H., Jung, H.-K., Lee, G., Kim, H.-Y., Park, S.-G., & Woo, S.-C. (2013). Effect of behavioral intervention using smartphone application for preoperative anxiety in pediatric patients. Korean Journal of Anesthesiology, 65(6), 508. http://doi.org/10.4097/kjae.2013.65.6.508 Lindner, P., Ivanova, E., Ly, K. H., Andersson, G., & Carlbring, P. (2013). Guided and unguided CBT for social anxiety disorder and/or panic disorder via the Internet and a smartphone application: study protocol for a randomised controlled trial. Trials, 14, 437. http://doi.org/10.1186/1745-6215-14-437 Middelweerd, A., Mollee, J. S., van der Wal, C. N., Brug, J., & te Velde, S. J. (2014). Apps to promote physical activity among adults: a review and content analysis. International Journal of Behavioral Nutrition and Physical Activity, 11, 97. http://doi.org/10.1186/s12966-014-0097-9 © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 22 Miranda, D., Calderón, M., & Favela, J. (2014). Anxiety Detection Using Wearable Monitoring. In Proceedings of the 5th Mexican Conference on HumanComputer Interaction (p. 34:34–34:41). New York, NY, USA: ACM. http://doi.org/10.1145/2676690.2676694 Morris, M. E., Kathawala, Q., Leen, T. K., Gorenstein, E. E., Guilak, F., Labhard, M., & Deleeuw, W. (2010). Mobile Therapy: Case Study Evaluations of a Cell Phone Application for Emotional Self-Awareness. Journal of Medical Internet Research, 12(2). http://doi.org/10.2196/jmir.1371 Patrick, K., Griswold, W. G., Raab, F., & Intille, S. S. (2008). Health and the Mobile Phone. American Journal of Preventive Medicine, 35(2), 177–181. http://doi.org/10.1016/j.amepre.2008.05.001 Patwardhan, M., Stoll, R., Hamel, D. B., Amresh, A., Gary, K. A., & Pina, A. (2015). Designing a Mobile Application to Support the Indicated Prevention and Early Intervention of Childhood Anxiety. In Proceedings of the Conference on Wireless Health (p. 8:1–8:8). New York, NY, USA: ACM. http://doi.org/10.1145/2811780.2811954 Rennert, K., & Karapanos, E. (2013). Faceit: Supporting Reflection Upon Social Anxiety Events with Lifelogging. In CHI ’13 Extended Abstracts on Human Factors in Computing Systems (pp. 457–462). New York, NY, USA: ACM. http://doi.org/10.1145/2468356.2468437 © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 23 Repetto, C., Gaggioli, A., Pallavicini, F., Cipresso, P., Raspelli, S., & Riva, G. (2013). Virtual Reality and Mobile Phones in the Treatment of Generalized Anxiety Disorders: A Phase-2 Clinical Trial. Personal Ubiquitous Comput., 17(2), 253–260. http://doi.org/10.1007/s00779-011-0467-0 Tait, L., & Berrisford, G. (2011). Generalised anxiety disorder: the importance of life context and social factors. British Journal of General Practice, 61(587), 378–379. http://doi.org/10.3399/bjgp11X572625 Tanenbaum, J. G., Antle, A. N., & Robinson, J. (2013). Three Perspectives on Behavior Change for Serious Games. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (pp. 3389–3392). New York, NY, USA: ACM. http://doi.org/10.1145/2470654.2466464 The Psychology of Colors in Web Design. (2017, January 19). Retrieved March 19, 2017, from https://1stwebdesigner.com/psychology-of-colors/ Topham, P., Caleb-Solly, P., Matthews, P., Farmer, A., & Mash, C. (2015). Mental Health App Design: A Journey From Concept to Completion. In Proceedings of the 17th International Conference on Human-Computer Interaction with Mobile Devices and Services Adjunct (pp. 582–591). New York, NY, USA: ACM. http://doi.org/10.1145/2786567.2787136 © 2017 Joel Virothaisakun Taking A Break: Participatory Game Design 24 Van Singer, M., Chatton, A., & Khazaal, Y. (2015). Quality of Smartphone Apps Related to Panic Disorder. Frontiers in Psychiatry, 6. http://doi.org/10.3389/fpsyt.2015.00096 Vella, K., & Johnson, D. (2012). Flourishing and Video Games. In Proceedings of The 8th Australasian Conference on Interactive Entertainment: Playing the System (p. 19:1–19:3). New York, NY, USA: ACM. http://doi.org/10.1145/2336727.2336746 Wylie, C. G., & Coulton, P. (2008). Mobile Exergaming. In Proceedings of the 2008 International Conference on Advances in Computer Entertainment Technology (pp. 338–341). New York, NY, USA: ACM. http://doi.org/10.1145/1501750.1501830 Xu, Y., Poole, E. S., Miller, A. D., Eiriksdottir, E., Kestranek, D., Catrambone, R., & Mynatt, E. D. (2012). This is Not a One-horse Race: Understanding Player Types in Multiplayer Pervasive Health Games for Youth. In Proceedings of the ACM 2012 Conference on Computer Supported Cooperative Work (pp. 843–852). New York, NY, USA: ACM. http://doi.org/10.1145/2145204.2145330 Greg Walsh - Research. (n.d.). Retrieved May 7, 2017, from https://home.ubalt.edu/gwalsh/ © 2017 Joel Virothaisakun
© Copyright 2026 Paperzz