University of Alberta Playing with food: Exploring the effects of food messaging in video games on adolescents by Westerly A Luth A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Health Policy Research Public Health Sciences © Westerly A Luth Spring 2014 Edmonton, Alberta ABSTRACT The effects of food messaging in video games remain unexplored despite the popularity of the medium among adolescents and the growing potential for food messaging in video games. My three research objects were to: (1) identify how healthy and unhealthy foods are depicted in video games; (2) gather adolescent and other stakeholder perceptions of the effects of food messaging in video games on adolescent food habits; and (3) test the effects of healthy and unhealthy food messaging in video games on the attitudes and food choices of adolescents empirically. I did a content analysis of popular video games to address (1). I interviewed adolescents, parents and video game industry representatives to address (2). I did an experiment to address (3). This thesis provides recommendations for adolescent media literacy training to address food messaging in video games. ACKNOWLEDGEMENT First, thank you to my research participants. I am eternally grateful to my supervisor, Dr. Tania Bubela, whose guidance made me a better researcher and writer. Thank you to Dr. Connie Varnhagen for your expertise on experimental methods and for your continued involvement in my academic development. Thank you, Dr. Paul Veugelers for your insight into working with adolescents and nutrition and advice. Thank you to my arm’s length examiner, Dr. Candace Nykiforuk, and Dr. A. Sentil Senthilselvan for chairing my thesis defence. I am very grateful to Stephanie Kowal for testing the confirmability of my interview data, and Emma Camicioli for double-coding the video game footage. Thank you Dale Storie, for helping develop literature review strategies. Thank you to Felicity Hik for testing the experimental video game, and developing several video game levels. Thank you to my expert video game player, who dutifully, but not always happily, made his play into work for science. Thank you to all the members of the Law and Risk Communication in Health (LaRCH) research group for your moral support and insightful contributions to this thesis. Thank you to my parents, for your patience and support of my educational pursuits and my happiness. And thank you to my brothers and friends for your patience, help, and repeated offers of ice cream. Finally, I gratefully acknowledge the support of my funders, including the Canadian Institutes of Health Research, the University of Alberta Faculty of Graduate Studies and Research, and the University of Alberta School of Public Health. TABLE OF CONTENTS CHAPTER ONE: INTRODUCTION ................................................................. 1 1.1 Literature Review ................................................................................................... 1 Adolescents, obesity and food choices ....................................................................... 1 Adolescents and media ............................................................................................... 3 Food advertising and product placement ................................................................... 4 Video games: a new medium for food messaging ...................................................... 6 What is a video game? ........................................................................................................ 6 Video games, messaging and advertising ........................................................................... 8 1.2 Research Objectives .............................................................................................. 10 1.3 Thesis Outline ........................................................................................................ 10 1.4 Bibliography .......................................................................................................... 12 CHAPTER TWO: RESEARCH METHODS .................................................. 25 2.1 Statement of Personal Perspectives ..................................................................... 26 2.2 Video Game Content Analysis ............................................................................. 27 Data collection ......................................................................................................... 27 Data analysis ............................................................................................................ 28 Rigour ....................................................................................................................... 28 2.3 Ethics ...................................................................................................................... 29 2.4 Interviews .............................................................................................................. 31 Participants .............................................................................................................. 32 Participant inclusion ................................................................................................ 32 Adolescents ....................................................................................................................... 32 Parents ............................................................................................................................... 32 Video game industry representatives ................................................................................ 32 Recruitment .............................................................................................................. 33 Adolescents and parents .................................................................................................... 33 Video game industry representatives ................................................................................ 33 Data collection ......................................................................................................... 33 Data analysis ............................................................................................................ 34 Data management ..................................................................................................... 34 Trustworthiness ........................................................................................................ 34 2.5 Experiment ............................................................................................................ 35 Participants .............................................................................................................. 36 Development of the experimental food choice video game ...................................... 36 Presentation of experimental food choice video game ............................................. 36 Implicit tests of attitude: the Implicit Association Test ............................................ 37 Food selection and discussion .................................................................................. 38 Discussion and return of results ............................................................................... 38 Data analysis ............................................................................................................ 39 Data management ..................................................................................................... 39 Rigour ....................................................................................................................... 40 2.6 Bibliography .......................................................................................................... 41 CHAPTER 3: HAMBURGERS AND MUSHROOM STEW: EXPLORING PERSPECTIVES ON FOOD IN VIDEO GAMES .......................................... 49 3.1 Introduction ........................................................................................................... 49 3.2 Methods ................................................................................................................. 50 Video game content analysis .................................................................................... 50 Interviews ................................................................................................................. 52 Recruitment ....................................................................................................................... 52 Data collection .................................................................................................................. 52 Data analysis ..................................................................................................................... 53 3.4 Results .................................................................................................................... 53 Video game content analysis .................................................................................... 53 Food messaging ................................................................................................................. 53 Food advertisements .......................................................................................................... 55 Interviews ................................................................................................................. 56 Food messaging