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Table 3 Description of domains of the narrative engagement framework and relationship to selection of intervention components

From: Development of a theory-based video-game intervention to increase advance care planning conversations by healthcare providers

Domain Description Function Selection of intervention components
Narrative knowledge Narrative knowledge is defined as information that is presented already integrated within a mental model (defined as a representation of the decision problem) • Reduces cognitive load required for processing complex information
• Reduces counter-arguing provoked by exposure to a new or controversial argument
• Increases memorability of the knowledge contained in the story
• Game content – Teaching cases
Behavioral modeling Behavioral modeling is defined as opportunities to observe others’ behavior • Allows the development of new rules for one's own actions.
• Offers vicarious experience with the consequences of effective and ineffective behavior
• Game content – Teaching cases
Engagement Engagement is defined as immersion in the health narrative promoted by:
• Realism: believable actions and consequences
• Interest: intensity of attention attracted to the story
• Identification: a feeling of unity with the characters
• Transportation: a cognitive or emotional shift in the state of consciousness.
• Increases acceptance of the knowledge embedded in the story
• Increases willingness to practice the modeled behaviors
• Increases memorability of the experience.
• Game content - Teaching cases (realism)
• Game content - Diagnostic cases (interest)
• Game content - Resuscitation cases (interest, transportation)
• Game content - flashbacks, mystery, in-game relationships (interest, identification, transportation)
• Game mechanics (e.g. tap to act) (interest, transportation)
• Game design (e.g. music) (transportation)
• Game graphics (e.g. color of text bubbles) (interest, transportation)