The Influence of Visual Recognition and Preference in Serious Game Development: A Mixed-Method Study in Nepal

Authors

DOI:

https://doi.org/10.17083/229hsa32

Keywords:

Visual communication, Serious games, Cross-cultural, Game graphic, Visual literacy, Health

Abstract

Understanding players’ diverse visual recognition and preferences, especially in cross-cultural contexts, is critical for the creation of effective serious games. This study aimed to examine how varying levels of fidelity affect players' visual recognition, preference, and overall experience in serious gaming, using a mixed-method case study in the Bhaktapur district, Kathmandu, Nepal. Forty-four participants, aged 13 to 16 years, were enrolled in an A/B gameplay test. Fourteen students participated in in-depth interviews, thirty-six completed a questionnaire, and twenty-two provided valid telemetry data. We found that higher fidelity led to more positive affect, higher familiarity, better recognition, stronger preference, and positive emotional response from players. However, challenges were encountered regarding the identification of local food items. This highlights the key role of visual literacy, as adolescents are more influenced by familiar media than by real-life experiences. Effective visual communication in serious games should consider individual differences and the playing environment.

 

 

 

Author Biographies

  • Hua Bai, University of Skövde

    Hua Bai is currently pursuing a Ph.D. at the School of Informatics, Division of Game Development at the University of Skövde in Sweden. Her research interests focus on serious games, with a specific interest in game visuals and player experience.

  • Dayana Shakya, University of Gothenburg; Kathmandu Medical College

    Dayana Shakya is an Assistant Professor in the Department of Nursing. She completed her B. Sc. Nursing from B. P. Koirala Institute of Health Sciences, Dharan and her Masters in Nursing from Maharajgunj Nursing Campus, Tribhuvan University, Institute of Medicine. She has combined her interest in non-communicable diseases and research to currently pursue her PhD from Gothenburg University, Sweden in the project titled “Digital intervention for school going adolescents: a serious games approach for cardiovascular health promotion in Nepal”.

  • Ulf Wilhelmsson, University of Skövde

    Ulf Wilhelmsson is an associate professor at the School of informatics, division of game development at the University of Skövde, Sweden. His research interests lie within games, game audio, player agency, inclusive game design and games for health.

  • Jon Victor Bankler, University of Skövde

    Jon Victor Bankler is lecturer in informatics at the School of Informatics, at the University of Skövde, where he is mainly teaching game design and game user research. Victor’s research focus has been on the development and use of educational games. He has also coordinated the educational project “Nordic Alliance for Sustainability in Gaming” which concerns the integration of sustainability perspectives in game education.

  • Ran Zhang, University of Skövde

    Dr. Ran Zhang is a senior lecturer in game graphics and a member of the Game Research Group at the University of Skövde, Sweden. Her research focuses on visual storytelling in interactive media, emphasizing visual perception, movement, and signposting within visual narrative.

  • Anna-Sofia Alklind Taylor , University of Skövde

    Dr Anna-Sofia Alklind Taylor is a senior lecturer in computer science and a member of the Interaction Lab research group at University of Skövde, Sweden. Her research interests focus on user experience (UX) of digital solutions, with a specific interest in game UX and game-based learning. She has been involved in projects involving games for fire-fighter training, stroke rehabilitation and more.

  • Abhinav Vaidya, Kathmandu Medical College; University of Skövde

    Abhinav Vaidya, MD PhD is Professor of Community Medicine at Kathmandu Medical College, Nepal. He holds Bachelor’s degree in medicine from Bangladesh (2000), MD in Community Medicine from BP Koirala Institute of Health Sciences Nepal (2006), and PhD in Medical Sciences from Gothenburg University, Sweden (2014).  He is a leading academician, researcher, and policy-influencer on non-communicable diseases (NCDs) in Nepal.  He contributed to Nepal’s Multisectoral Action Plan for prevention and control of NCDs, WHO STEPs surveys in Nepal, and NCD PEN Package implementation. He has provided consultation to the Government of Nepal to develop policy documents on Basic Healthcare Package, Antibiotic Resistance Control Directory, Emergency Health Services, and Patient Safety Strategic Action Plan.

  • Natalia Oli, Kathmandu Medical College; University of Skövde

    Natalia Oli is an Associate Professor at Department of Community Medicine at Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal. Being a clinician, Dr. Oli obtained Masters in Public Health at Institute of Medicine, Tribhuvan University, Nepal and PhD at the University of Gothenburg, Gothenburg, Sweden. Besides academic activities, Oli is involved in research. She is Scholar in Bernard Lown Scholars in Cardiovascular health program (Harvard T.H. Chan, School of Public Health, USA). Where she acts as PI for research project “Formative research to evaluate customers’ awareness and policy implementation gaps in nutritional labelling of packaged food in Nepal”.

  • Alexandra Krettek , University of Gothenburg; University of Skövde; UiT The Arctic University of Norway

    Alexandra Krettek holds a Doctor of Philosophy (Ph.D.) Medicine and Assoc. Professor Appointment, both in Cardiovascular Prevention, from University of Gothenburg. She was appointed Professor of Public Health in 2012 at the Nordic School of Public Health NHV and in 2015 at University of Skövde. Her research encompasses biomedical aspects on atherosclerosis development to public health focus with special emphasis on population-based studies for cardiovascular disease (CVD) prevention. Since 2008, Prof. Krettek’s research has been directed towards global health with the focal point on how health can be maintained in different populations by increasing knowledge about risk factors and a healthy lifestyle.

  • Mikael Lebram, University of Skövde

    Mikael Lebram, MSc in computer science, is a research engineer at the University of Skövde, Sweden. He has developed software and hardware solutions for research projects targeting a wide array of topics, from traffic behavior to online threat awareness for children.

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Published

2025-07-29

Issue

Vol. 12 No. 3 (2025)

Section

Articles

License

Copyright (c) 2025 Hua Bai, Dayana Shakya, Ulf Wilhelmsson, Jon Victor Bankler, Ran Zhang, Anna-Sofia Alklind Taylor , Abhinav Vaidya, Natalia Oli, Alexandra Krettek , Mikael Lebram

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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How to Cite

The Influence of Visual Recognition and Preference in Serious Game Development: A Mixed-Method Study in Nepal. (2025). International Journal of Serious Games, 12(3), 47-68. https://doi.org/10.17083/229hsa32