Understanding adolescent bystander behavior in cyberbullying and the potential of serious digital games to promote prosocial behavior and other healthy lifestyles

Cyberbullying entails bullying, an intentional act to cause repeated harm or distress to the victim, using electronic or digital media. Cyberbullying among adolescents can be considered a public health problem that warrants specific research attention and interventions. The quality-of-life and health problems that youngsters who are involved in cyberbullying experience, may be reduced by promoting positive bystander behavior. Positive bystander behavior includes comforting the victim or giving advice, reporting it to adults or assertively defending the victim. Passive bystanding, reinforcing or joining the bully is considered negative bystander behavior that can sustain or aggravate the cyberbullying and its harm. Serious digital games are interventions which are both engaging and educational, and may hold promise to address cyberbullying, since the appeal of this medium to adolescents. This doctoral thesis aims to contribute to literature by addressing the development of interventions to end cyberbullying and reduce its harm. The aims of the original research included in the thesis were threefold. A first aim was to improve the understanding of health problems related to cyberbullying in adolescents, and to understanding cyberbullying bystander behavior. A second aim related to the potential of serious digital games to improve social behavior and other healthy lifestyles. A third aim was to describe the development of a serious digital game to promote positive bystander behavior among adolescents. The results of studies addressing the first aim showed that cyberbullying relates to some different health problems than traditional bullying and warrants specific attention in research and interventions. Bystander behavior plays a role in cyberbullying, and is a context-dependent form of behavior determined by several factors, such as intentions, attitudes, self-efficacy, skills and environmental facilitators. These findings support the use of a behavior change and socio-ecological theoretical perspective. Considering bystander behavior as fixed, stable roles does not seem endorsed. Adolescents need support from educators and parents to act as a positive bystander, whereas this support is currently largely lacking. Educators, especially teachers, are in need of training on how to handle cyberbullying. The studies addressing the second aim showed that serious digital games are on average effective in promoting social behavior and other healthy lifestyles. Although effects on behavior were small, they were significant and in line with effects of other computer-delivered interventions. Effects were largest on knowledge, also consistent with findings from computer-delivered interventions. Efforts are needed to increase the effectiveness of serious games on other determinants of behavior, such as behavioral intention and self-efficacy. Several moderators exist that can increase games’ effectiveness. Games that were developed using a gaming theory, or both gaming theories and behavioral prediction theories were more effective than other games. This underlines the specificity of games as a health promotion tool compared to other interventions which can be effective when only using behavior change theories. The higher effectiveness of using theories that can increase games’ motivational appeal, combined with theories that can effectively change health behavior, shows the need for a sound theoretical foundation of ‘fun and learning’, which are considered the main characteristics of serious games, to deliver that promise. Next, games were more effective when they were tailored or adapted to the individual user’s characteristics, confirming findings from other computer-delivered and print interventions. Serious games were more effective if they had simpler challenges, with fewer game levels and used fewer game features that are considered to be highly immersive (i.e. that may increase the fun, but could distract from the learning content). This means that serious digital games may not need all the ‘bells and whistles’ of commercial games to be effective, and that simpler designs may in fact yield better learning or behavior change outcomes. Unlike other health promotion interventions, the use of personal goalsetting or planning techniques was related to lower effectiveness, where more research is needed to understand this finding. Some game characteristics related to higher effectiveness only for certain outcomes (e.g. knowledge, skills) but not for others, emphasizing that game design should be specific for a certain health behavior or behavioral determinant in mind. Active involvement of users in the game design, which may be important to ensure reach and adoption during implementation of the intervention, was associated with less effective games. Based on the research findings, some recommendations were made for active user involvement that can improve effectiveness: involving users as informants instead of in co-design, involving them in decisions on the challenge, levels, rewards, game dynamics, and not involving them in game aesthetics. The research addressing the third aim described the development of a serious digital game to promote positive bystander behavior. Although no effectiveness data are yet available, the evidence- and theorybased intervention development increases the chances of reaching the desired effects on the program outcomes, and may serve as a starting point for the design of other anti-cyberbullying programs