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Visuals Make Connections: A Framework for Effective Visual Communication in Cross-Cultural Serious Games
University of Skövde, School of Informatics. University of Skövde, Informatics Research Environment. (GAME Research Group)ORCID iD: 0000-0003-0977-1285
2026 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Designing serious game visuals for multiple cultural contexts presents significant challenges, as imagery familiar to one audience may be misunderstood or carry different meanings in another. This thesis adopts the perspective that visuals in serious games are not merely decorative but function as connectors between game content and players’ cultural and perceptual contexts. It argues that visual elements must be both clear and appealing across different cultural and domain contexts, and therefore investigates how varying levels of visual fidelity influence players’ visual recognition and visual preferences in cross-cultural serious game contexts.

A mixed-methods research approach was adopted, combining a literature review, fieldwork, and multiple case studies, with qualitative and quantitative data collected in Nepal and Sweden. To support the empirical investigation, a serious game titled Happy Heart was designed and developed as both an educational game and a research instrument, enabling systematic evaluation of visual fidelity across culturally distinct contexts. In both locations, the same Happy Heart game was implemented in localized versions and playtested with local participants.

The findings indicate that higher levels of visual fidelity generally support improved recognition, increased preference, and greater familiarity with serious games in both cultural contexts. However, higher visual fidelity did not consistently result in stronger emotional responses. Participants in both Nepal and Sweden experienced difficulties identifying culturally specific food items, highlighting the role of visual literacy in shaping how visual representations are interpreted. The results further suggest that adolescents’ visual recognition and preferences are shaped more strongly by exposure to global media, such as video games, animation, and social platforms, than by everyday lived experiences. A clear preference for 3D graphics and globally recognizable game aesthetics was observed, reflecting increasing familiarity with shared visual design conventions across cultures.

Based on these findings, this thesis proposes a Visual Alignment Framework to support culturally inclusive serious game design. The framework offers structured guidance for selecting representational objects and determining appropriate levels of visual fidelity when designing for diverse audiences, thereby reducing the risk of visual miscommunication in cross-cultural contexts. This research contributes both empirically and conceptually to the field of serious games by providing cross-cultural evidence and a theoretical foundation for visual alignment in game visuals. By synthesizing insights from the Nepalese and Swedish case studies, the thesis advances understanding of how visual communication can be strategically aligned with players’ cultural and perceptual contexts to support more effective (in terms of visual recognition and visual preference) and inclusive educational game design. Future research is encouraged to further evaluate the framework across additional cultural settings and game genres.

Abstract [sv]

Att designa visuella element i serious games för flera kulturella kontexter innebär betydande utmaningar, eftersom bildspråk som är bekant för en målgrupp kan missförstås eller bära andra betydelser i en annan. Denna avhandling utgår från perspektivet att visuella element i serious games inte enbart är dekorativa, utan fungerar som länkar mellan spelets innehåll och spelarnas kulturella och perceptuella kontexter. Avhandlingen argumenterar för att visuella element måste vara både tydliga och tilltalande i olika kulturella och ämnesspecifika sammanhang, och undersöker därför hur varierande nivåer av visuell fidelitet påverkar spelares visuella igenkänning och visuella preferenser i tvärkulturella serious game-kontexter.

En flermetod (mixed method)-ansats tillämpades, där litteraturstudie, fältarbete och flera fallstudier kombinerades, med både kvalitativa och kvantitativa data insamlade i Nepal och Sverige. För att möjliggöra den empiriska undersökningen designades och utvecklades ett serious game med titeln Happy Heart, som fungerade både som ett utbildningsspel och som ett forskningsinstrument. Detta möjliggjorde en systematisk utvärdering av visuell fidelitet i kulturellt skilda kontexter. På båda platserna implementerades lokaliserade versioner av Happy Heart, vilka speltestades med lokala deltagare.

Resultaten visar att högre nivåer av visuell fidelitet generellt stödjer förbättrad igenkänning, ökad preferens och större förtrogenhet med serious games i båda kulturella kontexterna. Däremot ledde högre visuell fidelitet inte konsekvent till starkare emotionella responser. Deltagare i både Nepal och Sverige hade svårigheter att identifiera kulturellt specifika livsmedel, vilket belyser den visuella läskunnighetens (visual literacy) betydelse för hur visuella representationer tolkas. Vidare indikerar resultaten att ungdomars visuella igenkänning och preferenser i högre grad formas av exponering för globala medier – såsom datorspel, animation och sociala plattformar – än av vardagliga erfarenheter. En tydlig preferens för 3D-grafik och globalt igenkännbara spelestetiker observerades, vilket speglar en ökande förtrogenhet med gemensamma visuella designkonventioner över kulturella gränser.

Baserat på dessa resultat föreslår avhandlingen ett Visual Alignment Framework för att stödja kulturellt inkluderande design av serious games. Ramverket erbjuder strukturerad vägledning för val av representativa objekt och fastställande av lämpliga nivåer av visuell fidelitet vid design för diversifierade målgrupper, med syfte att minska risken för visuell misskommunikation i tvärkulturella sammanhang. Forskningen bidrar både empiriskt och konceptuellt till området serious games genom III att tillhandahålla tvärkulturella belägg samt en teoretisk grund för visuell anpassning av spelgrafik. Genom att syntetisera insikter från fallstudierna i Nepal och Sverige fördjupar avhandlingen förståelsen för hur visuell kommunikation strategiskt kan anpassas till spelares kulturella och perceptuella kontexter för att stödja mer effektiv (vad gäller visuell igenkänning och visuell preferens) och inkluderande design av serious games. För framtida forskning rekommenderas att vidareutvärdera ramverket i ytterligare kulturella miljöer och för andra spelgenrer. 

Place, publisher, year, edition, pages
Skövde: University of Skövde , 2026. , p. xvii, 114
Series
Dissertation Series ; 70
Keywords [en]
Visual Communication, Cross-Cultural Serious Games, Visual Development Framework, Visual Fidelity, Health
National Category
Computer and Information Sciences Human Computer Interaction
Research subject
GAME Research Group
Identifiers
URN: urn:nbn:se:his:diva-26889ISBN: 978-91-989081-4-5 (electronic)ISBN: 978-91-989081-3-8 (print)OAI: oai:DiVA.org:his-26889DiVA, id: diva2:2085295
Public defence
2026-09-18, G110, 13:00 (English)
Opponent
Supervisors
Note

Ett av sex delarbeten (övriga se rubriken Delarbeten/List of papers):

6. Bai, H., Wilhelmsson, U., Zhang, R., Alklind Taylor, A. S., Backlund, P., Krettek, A. Cultural Alignment and Effective Visual Design in Cross-Culture Serious Games. Submitted to International Journal of Computer Games Technology. (In review)

Available from: 2026-07-16 Created: 2026-07-08 Last updated: 2026-07-16Bibliographically approved
List of papers
1. Game graphics and effective learning: A review of visual communication research in serious games
Open this publication in new window or tab >>Game graphics and effective learning: A review of visual communication research in serious games
2022 (English)In: Proceedings of the International Conferences Interfaces and Human Computer Interaction 2022, Game and Entertainment Technologies 2022 / [ed] Katherine Blashki, IADIS Press, 2022, p. 165-173Conference paper, Published paper (Refereed)
Abstract [en]

The visuals of a game is a crucial element when it comes to providing good player experiences. Visuals are also an incredibly complex subject in a game context since different modes of visual representation can be more or less “appropriate” for different settings. For example, while one can look at photo-realism as an impressive feature of a game due to its technical complexity and functionally accurate representation of real-world objects, it might still not be a fitting choice for different audiences, or for different pedagogical strategies. Serious game research seldom focuses on understanding the design of these components or their applicability to different types of learning, and it more often focuses on games’ mechanics and how well they manage to capture subject matter content while still being engaging. The aim of this paper is to explore the gap in visual communication research, describing what studies tend to focus on providing some valuable context. This review was conducted on papers that dealt with visual aspects of serious games. The results show that visual communication is rarely addressed in serious game development research. Future research would benefit from taking visual communication in detail to facilitate the effectiveness of serious games.

Place, publisher, year, edition, pages
IADIS Press, 2022
Keywords
Serious Games, Literature Review, Visual Communication, Visual Design, Game Design, Learning Outcome
National Category
Computer and Information Sciences Human Computer Interaction
Research subject
GAME Research Group
Identifiers
urn:nbn:se:his:diva-21691 (URN)2-s2.0-85142268771 (Scopus ID)978-989-8704-41-2 (ISBN)
Conference
16th Multi Conference on Computer Science and Information Systems, International Conferences Interfaces and Human Computer Interaction 2022 and Game and Entertainment Technologies 2022 (MCCSIS), 19-22 July 2022, Lisbon, Portugal
Note

CC BY-NC-ND 4.0

IADIS - International Association for the Development of the Information Society

Available from: 2022-08-18 Created: 2022-08-18 Last updated: 2026-07-16Bibliographically approved
2. An Exploratory Study on Nepalese Teenager’s Visual Recognition and Preferences in Serious Games
Open this publication in new window or tab >>An Exploratory Study on Nepalese Teenager’s Visual Recognition and Preferences in Serious Games
2022 (English)In: Proceedings 2022 IEEE International Conference on e-Business Engineering ICEBE 2022: 14-16 October 2022 Bournemouth, United Kingdom, IEEE Computer Society, 2022, p. 13-18Conference paper, Published paper (Refereed)
Abstract [en]

In serious game development, effective communication through both languages, sounds, and icons can be crucial for a game to have its intended impact. While this is also true for entertainment games, serious games have added layers of challenges as they are a) often played by audiences outside of the “typical” game ecosystem, and b) miscommunication can lead to players missing important lessons or even learning incorrect information. When a serious game is intended to be used in different parts of the world, however, clear visual communication gets an added layer of complexity: culturally informed symbol interpretation and visual preference. In order to examine how these might affect players’ experiences when playing serious games, this paper presents the results of a mixed-method study conducted in two schools in Nepal. The study included 10 participants, between 13-16 years old, who played a prototype of a mobile game currently in development, which has the purpose of teaching young players about food nutrition and healthy habits. After playing the prototype, they took a short survey where they were asked to identify different food types, and they were also interviewed to discuss their opinions of the game’s visual style. The results of the study indicate that, while higher fidelity images were much easier to correctly identify by the participants, the participants’ preference for visual fidelity varied to a large degree.

Place, publisher, year, edition, pages
IEEE Computer Society, 2022
Keywords
serious games, educational games, visual fidelity, visual preference, healthy habits, art direction
National Category
Human Computer Interaction Other Engineering and Technologies
Research subject
GAME Research Group
Identifiers
urn:nbn:se:his:diva-21988 (URN)10.1109/ICEBE55470.2022.00011 (DOI)2-s2.0-85148649716 (Scopus ID)978-1-6654-9244-7 (ISBN)978-1-6654-9245-4 (ISBN)
Conference
IEEE International Conference on E-Business Engineering (ICEBE), 14–16 October 2022 Bournemouth, United Kingdom
Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2026-07-16Bibliographically approved
3. Developing a digital cardiovascular health education for adolescents in Nepal
Open this publication in new window or tab >>Developing a digital cardiovascular health education for adolescents in Nepal
Show others...
2026 (English)In: INTERNATIONAL JOURNAL OF SERIOUS GAMES, E-ISSN 2384-8766, Vol. 13, no 3, p. 25-44Article in journal (Refereed) Published
Abstract [en]

The high prevalence of cardiovascular disease risk factors among adolescents of Nepal necessitates targeted interventions among this age group. Adolescents need a user friendly, acceptable and hands on media for cardiovascular health education. Digital technologies such as serious games have proven pedagogic potential. In this study, we aim to describe the steps followed to develop a serious game tailored to the needs of the adolescents in a sub-urban community in Nepal. We adopted a three-step development process: (1) defining learning goals, (2) developing and testing the game design and (3) incorporating active culturalization throughout the iterative game development process. We describe how culturalization was applied in each step to achieve educational viability. The final game called Happy Heart consisted of seven mini games: Name the food, Food sorter, Sugar rush, Salt seeker, Fat buster, Plan your meal and Activate. The game was augmented by an in-game journal that addressed complex concepts that could not be integrated into the game mechanics. The final game was culturally adapted and addressed the learning gaps of the target population. Learning through games has high potential in a lower middle-income country like Nepal.

Place, publisher, year, edition, pages
Serious Games Society, 2026
Keywords
Serious games, Digital health, Cardiovascular health, Health promotion, Interdisciplinary, Adolescents, Game development, Culturalization
National Category
Public Health, Global Health and Social Medicine Human Computer Interaction
Research subject
Interaction Lab (ILAB); GAME Research Group; Research on Citizen Centered Health, University of Skövde (Reacch US)
Identifiers
urn:nbn:se:his:diva-26813 (URN)10.17083/svahca52 (DOI)001806865900003 ()2-s2.0-105042306746 (Scopus ID)
Funder
Swedish Research Council, 2020-03333
Note

CC BY-NC-ND 4.0

This study was funded by the Swedish Research Council, project 2020-03333, to Alexandra Krettek. We acknowledge the support of the schools during on-site visits and meeting with adolescents. The support of Scribendi Inc. (Chatham, ON, Canada) is acknowledged for their professional language editing and proofreading.

Available from: 2026-07-01 Created: 2026-07-02 Last updated: 2026-07-14Bibliographically approved
4. A Model for Balancing Clarity and Appeal in Serious Game Visuals
Open this publication in new window or tab >>A Model for Balancing Clarity and Appeal in Serious Game Visuals
2023 (English)In: Proceedings of the 17th European Conference on Games Based Learning, Academic Conferences International Limited , 2023, p. 46-52Conference paper, Published paper (Refereed)
Abstract [en]

In serious game development, graphic design needs to be eye-catching, while also depicting subject matter content in a responsible, accurate, and clear way. Previous research has shown that abstract and symbolic game visuals seem to be preferable for learning and providing an engaging experience. Our research focuses on describing the challenges involved in creating effective visual communication through game graphics in cross cultures. In particular, we’re interested in examining if certain styles of visual communication are more or less effective between different cultural demographics. To examine this, we have created a serious game which aims to promote healthy food and nutrition habits to teenagers in both Nepalese and Swedish schools and by doing so also motivate behavioral changes toward healthier eating habits. We are currently conducting studies to see whether preferences and image recognition differ between the two demographical spheres. This paper will only discuss the exploratory study done in Nepal. Ultimately, this paper aims to contribute development guidelines that can aid developers in creating more effective visual communication in their serious games, and we primarily focus on exploring what we call the compromise of ‘clarity’ and ‘appeal’ in the creation of game graphics. We present an initial model for choosing at what level in terms of realism/abstraction and taxonomic hierarchy the graphical components of serious games optimally should be produced in order to solve the dilemma of precise, unmistakable, yet appealing visuals in serious games. It all comes down to two primary decisions: defining the taxonomic hierarchy of the items to depict, and choosing the style in which to depict them. With a better understanding of when different game visuals are more or less appropriate, both in terms of style and in which objects are represented, game developers will be able to balance production costs better while also creating something that strikes the compromise between clarity and appeal.

Place, publisher, year, edition, pages
Academic Conferences International Limited, 2023
Series
Proceedings of the European conference on games-based learning, ISSN 2049-0992, E-ISSN 2049-100X ; 17:1
National Category
Human Computer Interaction Other Engineering and Technologies
Research subject
GAME Research Group
Identifiers
urn:nbn:se:his:diva-23296 (URN)10.34190/ecgbl.17.1.1633 (DOI)2-s2.0-85179006436 (Scopus ID)978-1-914587-88-7 (ISBN)978-1-914587-89-4 (ISBN)
Conference
The 17th European Conference on Games Based Learning, ECGBL, 5 - 6 October 2023, Enschede, Netherlands
Available from: 2023-10-06 Created: 2023-10-06 Last updated: 2026-07-08Bibliographically approved
5. The Influence of Visual Recognition and Preference in Serious Game Development: A Mixed-Method Study in Nepal
Open this publication in new window or tab >>The Influence of Visual Recognition and Preference in Serious Game Development: A Mixed-Method Study in Nepal
Show others...
2025 (English)In: INTERNATIONAL JOURNAL OF SERIOUS GAMES, E-ISSN 2384-8766, Vol. 12, no 3, p. 47-68Article in journal (Refereed) Published
Abstract [en]

Understanding players’ diverse visual recognition and visual 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, visual 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, better recognition, stronger preference, higher familiarity, 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 in terms of visual recognition and preference. Effective visual communication in serious games should consider individual differences and the playing environment. This study contributes to serious game research by providing insights into an underrepresented demographic and demonstrating the importance of cultural context in visual communication. Findings offer practical guidance for game developers to design more inclusive and effective serious games.

Place, publisher, year, edition, pages
Genova: Serious Games Society, 2025
Keywords
Visual communication, serious games, cross-cultural, game graphic, visual literacy, health
National Category
Human Computer Interaction Public Health, Global Health and Social Medicine
Research subject
Research on Citizen Centered Health, University of Skövde (Reacch US); Interaction Lab (ILAB); GAME Research Group
Identifiers
urn:nbn:se:his:diva-25700 (URN)10.17083/229hsa32 (DOI)001542011000005 ()2-s2.0-105013126119 (Scopus ID)
Funder
Swedish Research Council, 2020-03333
Note

CC BY-NC-ND 4.0

Alternativ titel:

The Influence of Visual Recognition and Preference in Serious Games:A Pilot Study in Nepal

"We acknowledge support from the Swedish Research Council to A. Krettek (grant number 2020-03333) and Shanghai Gongqiao Technology to Hua Bai (grant number FS 2021/7)."

Available from: 2025-08-05 Created: 2025-08-05 Last updated: 2026-07-08Bibliographically approved

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34567896 of 11
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