The Role of Agency and Threat-Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Alcohol Abuse: An Empirical Study Among College Students (Preprint)

BACKGROUND Serious games for the training of prevention behaviors have been widely recognized as a potentially valuable tool for adolescents and young adults across a variety of risk behaviors. However, the role of agency, as a distinguishing factor from traditional health interventions, has seldomly been isolated and grounded in persuasive health communication theory. Fear appeals have different effects on intentions to perform a prevention behavior depending on the immediacy of the consequences. Looking into how to increase self-efficacy beliefs for health behavior with distant consequences is a first step to improving game-based interventions for adverse health outcomes. OBJECTIVE The current study investigated the effect of agency on self-efficacy and intention to drink less alcohol in an interactive digital narrative fear appeal. Further, the communicated immediacy of threat outcomes was evaluated as a potential moderator of the effect of agency on self-efficacy. METHODS An experimental study was conducted among university students (N=178). Participants were presented with a fear appeal outlining the consequences of alcohol abuse in an interactive narrative format. Participants either had perceived control over the outcome of the narrative scenario (high-agency) or no control over the outcome (low-agency). The threat was either framed as a short-term or long-term negative health outcome resulting from the execution of the risk behavior (drinking too much alcohol). RESULTS Self-efficacy and intention to limit alcohol intake were not influenced by the agency manipulation. Self-efficacy was shown to be a significant predictor of behavioral intention. Immediacy of the threat did not moderate the relationship between agency and self-efficacy. CONCLUSIONS Although the agency manipulation was successful, we could not find evidence for an effect of agency or threat immediacy on self-efficacy. The implications for different operationalizations of different agency concepts is discussed, as well as the malleability of self-efficacy beliefs for long-term threats. The usage of repeated, versus single, interventions and different threat types (e.g., health and social threats) should be tested empirically to establish a way forward for diversifying intervention approaches.