Table 8.

Parent Focus Group Themes For Game Development

Themes	Patterns within these themes	Exemplar quotes
Knowledge and awareness	Info source provider Info source family Info source media Info source school Info source undefined	“And sometimes our kids are more apt to talk to someone else than talk to us…because sometimes it takes a second person” “In light of that, you also have to think of with children, some of their information does get across to them through education, through games” “That's what I want; I don't want them (my children) to ever be scared to come to me” “As parents, you know, we need to be that first line to put the information out there…” “So sometimes we have to take our experience and what we know and share with other parents and I think that will make it easier to some of them, even if they're kind of squeamish” “I mean, I trust them, so they're doctors…So I would feel confident in his decision…You know, you're trusting your physician…” “And I think if they (the provider) recommend it (the HPV vaccine) and you still decide you're not going to do it that day, they should do a follow up, like a call…I see these people really recommending it…” “And I think it helps if that provider, they have kids, they can say, well you know what, I have three, and I understand, and I made the decision…” “The age group it recommended for, how often it needs to be given, the ingredients, the percentage wise of effectiveness, and the cons of it, the negative”
Attitudes and intentions	Favorable Nonfavorable Intentions to get vaccine	“I said, so at least this way you're protected. And he (my son) was like, whatever I can to protect myself” “…the only time they (the provider) mention it is when you're going to get shots, they mention it on that day and you're like hello, it's the day of, no” “I would just say that when they (children) do become sexually active they're already protected, if they get the vaccine at an early age” “They (hesitant parents) use that as like a stepping stone instead of saying, I'm not ready to talk about it yet with their kids” “…but if it's beneficial in the long term, then yes, I would consider it, but you know, it's like I'm against the chicken pox vaccination, I'm one of those parents that believe you should still get chicken pox the natural way” “I think for a lot people what it is when you start hearing vaccination people, you get paranoid like, okay, what is this combination of stuff that you're saying we need to fight, and how will this affect me in the long term because of course there's that whole vaccination cause autism. Once people get in that frame of mind, there's no changing their mind” “You definitely want to know side effects because again, you're introducing the body to a foreign agent that is not used to, and like she said, with viruses constantly changing, every time it changes is because somebody's DNA put their own little stamp on it which made that change so then it's back to the drawing board. Let's figure out a new cocktail” “Again it's the whole weight of considering what cocktail of stuff you want to be putting in my baby to prevent something down the line” “…if the information is just backed up with just a little more benefit and not just this is what your child needs, and this is why, and you know, had it not been presented the way that it was presented, then I would be one of those parents who was like, okay, yes, this would be for your own protection…” “Yes, especially with everything always changing, you definitely want to know your rights, and if there's an opt out, things of that nature” “Well I've heard a couple of my co-workers, well, it seems like they're just pushing it toward the African American community, like it's our children that are the only ones out there having sex” “I think that where things, where kids act out a lot of stuff, what's not being done is it's being talked about so if you talk about it, you take the stigmatism off of it”
Health Belief Model	Perceived susceptibility Perceived severity Perceived benefits Perceived barriers Cues to action Self-efficacy	“I have all boys, and the things that I saw were mostly based toward girls” “So, when you, you know, the reason why it's in our minds like that is because that's how it's associated. Get this for your child because they are sexually active” “Well, let's just put it like this. Every few years there's going to be something new” “And that's even if it's preventable because you can still vaccinate and still get it” “So when he found out about HPV, I talked to him about it, you know, that's not saying that you want to go there and do anything, but you can be an adult and sleep with somebody for the first time and she can have it” “…it just seems like you just trying to vaccinate against sexually transmitted diseases which is impossible because people carry germs, and you got to build up an immunity to even fight something first”
Self determination	Transportation Autonomy Competence Intrinsic motivation Enjoyment Intentions for future play Conversations	“No, they (the preteens/children) need to have some type of input on what's taking place.” “…as a parent, you're not going to take that decision away from me at the visit saying this is what they need. No, this is what you're saying that they need” “It just that with that age comes more responsibility of individual decision thinking” “Well, the first thing that we do is I tell him, I say, since the world is full of information and it's accessible, let's get on the Internet to see what viable sources we can get it from” “You come tell me what you've learned, and then we discuss it together” “…the average parent, not going to really have the time to sit there and look at a video, and then be like, I don't need no video to talk, how to talk to my child” “Games are not real, but diseases are real. So it just needs to be presented to them as this is real”
Game elements/gamification		“Like a little time limit that is going to keep their attention long enough and still give them the amount of information that they need” “It's not going to work…it's because based off of the type of games that they are playing now and the graphics and everything they're already exposed to,—so if you want to get some information to them, you got to put a little shooting or something…” “…put it something similar to that, and you know, keep the same thing where you're rebuilding, you're earning points based off how much information you know, that's definitely going to be a winner to get them to play” “Something to keep them going, so if they don't pass it and they come back the next day, they try to pass it again, so they go up another level.”