Robot-Assisted Immersive Escape Room Game for Tobacco Harm Prevention Among Elementary School Students

This study adapted the Tobacco Harm Knowledge Scale from the Youth Smoking Behavior Survey Questionnaire (Health Promotion Administration, 2021). The scale covers e-cigarette components, legal regulations, and health impacts to assess students' understanding of basic tobacco knowledge gained from the curriculum. The 10-item scale uses objective scoring (1 point for correct answers, 0 points for incorrect or "don't know" responses) and demonstrates acceptable internal consistency (Cronbach's Alpha = 0.66).

This study adapted the scale from Kueh, M. T. W., Rahim, F. F., & Rashid, A. (2022). The questionnaire uses a 5-point Likert scale ranging from "Strongly Disagree" to "Strongly Agree." It begins with students' recognition of tobacco harm risks, such as "Smoking increases the risk of lung cancer" or "Smoking causes changes in appearance," to measure the strength of students' health beliefs and their awareness of smoking-related harms.

The 12-item scale employs a 5-point scoring system, with higher scores indicating stronger health beliefs. The scale demonstrates good internal consistency (Cronbach's Alpha = 0.87).

This study adapted the Chinese version of the General Self-Efficacy Scale (GSES) from Zhang JX, Schwarzer R, Jerusalem M (1995), consisting of 7 items. It uses a 5-point Likert scale, with higher scores indicating greater self-efficacy. The scale demonstrates excellent internal consistency (Cronbach's Alpha = 0.94).

This study was adapted from scale items by Gupta et al. (2021), Moon & Kim (2001), and Venkatesh et al. (2012) to measure expectation confirmation regarding the e-cigarette prevention escape room game. It consists of 20 items using a 5-point Likert scale, with higher scores indicating greater expectation confirmation. The scale demonstrates excellent internal consistency (Cronbach's Alpha = 0.94).

This study was adapted from Zaichkowsky (1994) to assess participants' engagement level with the e-cigarette prevention escape room game. It includes two dimensions-"cognitive engagement" and "emotional engagement"-comprising 10 items total. The scale uses a 7-point Likert format, with higher scores indicating greater agreement. The scale demonstrates good internal consistency (Cronbach's Alpha = 0.83).

This study's behavioral intention measurement tool aims to assess specific behaviors for actual e-cigarette prevention. It was revised after expert review and pilot testing to ensure applicability, validity, and reliability. The scale was evaluated by three experts for semantic clarity and contextual appropriateness, with wording refined post-pilot. It demonstrates good internal consistency reliability (Cronbach's α = 0.77), consists of 3 items using a 5-point Likert scale, with higher scores indicating greater likelihood of taking action.

This study's advocacy intention measurement tool aims to assess participants' willingness to promote e-cigarette prevention policies. It was revised after expert review and pilot testing to ensure applicability, validity, and reliability. The scale was evaluated by three experts for semantic clarity and contextual appropriateness, with wording refined post-pilot. It demonstrates good internal consistency reliability (Cronbach's α = 0.75), consists of 2 items using a 5-point Likert scale, with higher scores indicating greater likelihood of advocacy action.