INSPIRE is a self-adaptive personalized behavior change environment for adolescent preventive health. In INSPIRE, teens become active participants in dynamically unfolding interactive narratives that address issues of peer pressure, social norms, and alternative consequences of alcohol use. Players adopt the role of a teenage protagonist who “relives” the events and decisions of a high-school get-together involving alcohol. Players interact with a cast of virtual characters who model a broad range of health behaviors, and the outcomes for the protagonist, his/her friends, and the story line are actively shaped by the player’s decisions. INSPIRE is designed to enhance adolescents’ knowledge, personal efficacy, and self-regulatory processes, encouraging players to set goals, adopt problem-solving strategies, reason about the consequences of their actions, and reflect on their observed outcomes to adjust their future behaviors.
INSPIRE utilizes a social-cognitive theory of behavior change built around a tight feedback loop in which adolescents engage with the narrative-centered behavior change environment to produce improved behaviors in patients. These, in turn, yield patient outcome data, which will be used by a machine learning-based patient behavior modeling system and behavior change optimization system to produce refined computational behavior change models. The resulting models will drive the next generation of the narrative-centered behavior change environment and produce extended computational theories of behavior change.
The project team has used an adolescent-centered design approach for iteratively designing and developing INSPIRE’s rich and immersive story scenarios, characters, interactive 3-D environment. We have conducted more than 20 focus groups and pilot tests with diverse groups of adolescent youth to obtain feedback on intermediate versions of the environment. During these sessions, adolescents have interacted with iterative versions of the narrative-centered behavior change environment, provided feedback on the narrative, software usability, and design of embedded scaffolding features, as well as completed questionnaires on their self-efficacy for alcohol avoidance, alcohol usage behaviors, and engagement with the behavior change environment.
Primary support for the project has been provided by the National Science Foundation under grants IIS-1344803 and IIS-1344670 and the National Cancer Institute grant R01CA247705. Additional support has been provided by the Health Resources and Services Administration (HRSA)/Maternal and Child Health Bureau of the U.S. Department of Health and Human Services (HHS) under cooperative agreement UA6MC27378 and the Maternal and Child Health (MCHB) Leadership Education in Adolescent Health Training grant T71MC00003.