Prevention of “dangerous games” on the Internet: the experience of the DimiCuida Institute line of action in digital environments

“Dangerous games” (“online challenges”) are part of the digital culture, attracting thousands of children and adolescents and causing severe damage to their health. This study aimed to analyze the experience of the DimiCuida Institute (DCI) in Fortaleza, state of Ceará, Brazil, a pioneering initiative to prevent online challenges, disseminated in different Web 2.0 environments, which can harm young people’s health. The specific objectives of this study sought to analyze the emergence of the Institute; identify the main partners involved in its network, assess the digital and analog environments in which they operate; and understand the prevention strategies developed. This is a case study based on document analysis. Our data, extracted from several digital platforms, was processed with Atlas Ti and subjected to thematic analysis. The DCI emerges from the existential and political resignification of a bereavement experience and is characterized by emphasizing alternatives to online activities, especially focusing on schools and their agents. Since this is still a field under construction and without previous references for lines of action, the prevention carried out in digital environments scarcely explores the language and resources of the Internet, betting on parental control and scarcely considering the experiences of the body and identity performances involved in the challenges.


Introduction
"Dangerous games" or, in their emic description, "online challenges" are a very specific type of digital content which has increasingly attracted young people and adolescents' attention on social networks. Often featured as a form of play or game, these challenges are shown in videos usually hosted on YouTube, although they also appear on other platforms. Challenges can involve performing unusual tasks, such as dipping one's head in a bag full of charcoal, or repulsive ones, such as eating large doses of cinnamon. Some challenges even consist of illegal acts, such as plundering and ransacking one's own school. Still, dangerous challenges gain the most recognition in the digital space.
The literature portrays these games and challenges (which several generations before the advent of the Internet experienced as "extreme sports") as competitions which may involve violence and other practices enabling adolescents and young people to experience risky experiences adults would rebuke and show their courage and irreverence. From the perspective of sociology of the body, such sentientbodily experiences are in line with younger people's search for identity construction, body self-knowledge, and emotional development (Le Breton, 2012). These practices show the impossibility of a society in which the institutions and agents dealing with adolescents fully control the risks to which the latter are fully exposed (Le Breton, 2000, 2010. Recent research (Deslandes et al., 2021;Miranda;Miranda, 2021) found that YouTube broadcasts dozens of challenges which are popular among children and adolescents and whose online enactment is a media strategy aimed at turning young people into celebrities among their peers, albeit at the expense of potential damage to their health. Their main objective is to incite their audiences' participation and adherence via the performance of tasks which can lead to self-harm, injuries to third parties and, in some cases, death, depending on the proposal of the challenge. Among these, "choking games" stand out for two reasons: first due to their enormously harmful potential since they can kill or cause temporary or permanent brain damage; and second because they cause intense body effects resembling those due to the consumption
Choking challenges have widely spread in the digital world and thousands of young followers carry them out (Defenderfer;Austin, Austin, Texas. Davies, 2016;Linkletter;Gordon, Dooley;2010). Still, several professionals and institutions have offered content aimed at preventing such practices, bringing information and examples of life stories which were negatively marked by the damage caused by these challenges. Moreover, this material draws parents' attention to the risks of lacking control over the content their children consume on the Internet.
Since the 1990s, parental involvement regarding the Internet has gained prominence with the Convention on the Rights of the Child (UN; Unicef, 1990), which defended the idea that parents should be held accountable for guiding and monitoring children and adolescents' use of the Internet for any purpose until they reach the age of majority, thus highlighting the exercise of parental control by considering it a fundamental practice in mediating children and adolescents' Internet access. Adopting a more conciliatory tone than what "control" would suggest, the literature also uses the category "parental mediation." Grizólio and Scorsolini-Comin's (2020) survey found no consensus regarding mediation models, with a considerable diversity of terminologies: "monitoring," "communication quality," "restrictive mediation," "authoritarian mediation," "authoritarian mediation and laissez-faire style," "active mediation," "supervision," among others. Thus, internet access mediation raises many more doubts than certainties in how to guide children and adolescents.
The idea that the Internet offers many opportunities for young people's development while representing risks and potential damages unites a set of institutions which defend a safer and more violence-free online reality. In this context, this study aims to undertake an exploratory analysis on the experience of the DimiCuida Institute (DCI), a pioneering initiative to prevent online challenges which can damage young people's health. Our specific objectives sought to evaluate the emergence of the Institute, its main partners, the digital and analog environments in which they operate, and the prevention strategies it develops. We believe that this study can contribute to improve initiatives using digital spaces to prevent similar phenomena in children and adolescents.

Methodology
This research was conducted from the case study perspective, enabling the production of inferences about certain social practices in light of our analysis of actors' history and experiences. A single case was selected not only for its intrinsic (its performance specificity) but also for its instrumental interest since its analysis enables inductions and insights which can be used in other similar institutional actions (Stake, 2000).
Since it is the institution which produced the most content on this theme, the DCI was chosen for its pioneering line of action to prevent choking games in Brazil. A strategy, consisting of two stages and articulating several methods, was adopted to identify and analyze the connections and materials in the DCI network.
First, the DCI digital environments hosted on Facebook, Instagram, and YouTube were mapped to identify their partners. We work with the "ego-centered network" described in Recuero's (2020, p. 70) synthesis: "that which weaves a network by setting a given node and following connections which are separated by certain degrees of separation." The degrees of separation between network actors (the distance between the central actor and others) are defined by research. Thus, we included neither second-level connections (partners of partners) nor interaction reciprocities.
By visiting partner institutional websites, new elements in the DCI network were identified, i.e., professionals and organizations supporting and helping it disseminate its content. Main partners are understood as profiles which like, share or comment on the material produced on the DCI website.
The collaborative software DRAW (for electronic publishing and vector drawing) was used to visually represent partner connections. It is an open-source multiplatform whose main feature is its versatile connectors between figures (available in a range of line styles) which facilitate diagram construction.
In the second stage of this research, the strategies the DCI and its direct partners proposed to prevent choking games were collected and qualitatively analyzed. Data were manually extracted from Facebook, Instagram, and YouTube during the first half of 2019. Captures were made in .jpeg and stored in folders named according to the platform from which the material was extracted. In addition to these images, other items were inserted, such as videos and texts.
This stage was functionally supported by a qualitative research software developed to process qualitative data, Atlas Ti, which is widely used by researchers for its functionalities and file and digital platform compatibility.
At first, 301 items were found in various file formats. An expressive number of repeated items was found by screening this material since the same content was posted on different digital platforms. Thus, those with greater reach, i.e., the most liked, shared or reposted were chosen and identical ones, excluded. Our final sample consisted of 212 texts, images, and videos.
This material was independently transcribed and coded by two researchers and classified into two subject groups with four categories capable of classifying the contents. Each classified material could be inserted into more than one subject group (Chart 1). Passages which could contain institutions or professionals' personal information were redacted.

Subject groups
Categories and subcategories Number of files The thematic analysis proposed by Mieles Barrera, Tonon, and Alvarado Salgado (2012) was applied to our qualitative data acknowledging that the reported experiences manifest structures to which subjects attribute relevant meanings and can be explained by interpreting them via orderings and typologies. The analysis process was guided by three methodological postulates: logical consistency, evinced in the theoretical-methodological clarity of this study and acuity of its categories; subjective interpretation, defending the focus of analysis as the sense actors make of actions; and adequacy, seeking a coherence horizon between the typifications of research and the meanings attributed by its subjects. Data were successively read so we could familiarize ourselves with the text, followed by theme identification, content codification, groupings, descriptive reports, and, finally, interpretative inferences.
After analysis, our interpretations were submitted to DCI managers and professionals who validated the produced inferences.

Results
We organized our results from a sequence which begins with the DCI history and ethos, describes its partnership networks, analyzes its main action strategies, and highlights the initiative of some of its partners.

The DimiCuida Institute, a specialized, professional, and testimony line of action: mourning as a context for resignification
The DCI was created in 2014 in Fortaleza, Ceará, Brazil, after a 16-year-old lost his life practicing the fainting game on the Internet. As his parents grieved, they met other families who had suffered the same loss, setting ties with two international institutions -the American Erik's Cause and the French Association des Parents d'Enfants Accidentés par Strangulation (Association of Parents of Child Victims of Strangulation -Apeas) -founded by parents whose children also died in this way. Since then, these institutions have dedicated themselves to raising awareness on the subject and undertaking prevention actions. Later on, DCI professionalized itself and now has a small team with a psychologist, educator, and legal advisor.
Thus, in a journey which began with pain and mourning which were resignified by reconstructing a narrative to preserve the memory of victims, the DCI established itself as the first Brazilian organization dedicated to online dangerous games. Its stated initiatives are: i) research and studies involving trained health, education, and safety professionals; ii) exchange of information and experiences with similar entities in Brazil and the world; iii) prevention aimed at education, health, and public-safety professionals and parents; iv) qualified prevention methodology for children and adolescents; and iv) clarification and support for families who have experienced similar problems.
In recent decades, movements linked to victims of violence constitute one form of mobilization which has gained great visibility and produced a new political subjectivity (Fassin;Rechtman, 2007). Contemporary scientific production on various types of activism and social movements has pointed to an individualization process of collective causes which has spread and multiplied throughout the world. This literature emphasizes that the body has been used as a source of identification of causes/mobilizations characterizing victim activism (Mahoney, 1994;Janoff-Bulman, 1985).
According to From Pain to Power: Crime Victims Take Action (U.S. Department of Justice, 2007), the directly affected led civil and elderly rights, welfare, environmental protection, and AIDS research and treatment movements in the U.S. The document states that these movements arose from victimization and neglect, persecution, or marginalization. In all these cases, the involvement of victimized individuals legitimized their cause.
In The Empire of Trauma: An Inquiry into the question of victimhood, Fassin and Rechtman (2007) propose that the use of the term "trauma" is not a given, but a construction: (…) it (…) is produced through mobilizations of mental health professionals and defenders of victims' rights, and more broadly by a restructuring of the cognitive and moral foundations of our societies that define our relationship to misfortune, memory, and subjectivity. (Fassin;Rechtman, 2009, p. 6-7) Thus, victimization assumes an important role as producer of subjectivity in contemporary times. From Fassin and Rechtman's (2007) ideas, Sarti (2011) states that the contemporary construction of persons as victims is seen as a way of conferring social recognition to suffering, circumscribing it and giving it intelligibility.
In Brazil, studies corroborate the production of victim activism (Araújo, 2019). People who have lost relatives to police, urban, traffic, self-inflicted, and other forms of violence can transform what would be a private loss into a public cause by fighting for space in public policy agendas, aiming to produce campaigns, restitute rights, and change legislation, among other demands.
Institutions such as the DCI act, thus, at the intersection between activism (guided by an ethical-ideological commitment to a cause) and prevention (led by strategies which use professional knowledge).

Protection networks against online "dangerous games"
Starting from the affinity and approximation relations DCI has with other agents in the main digital platforms, we seek to visualize their connections with the different actors in this dangerous game prevention network. The diagram in Figure 1 contains two connection levels: level 1 corresponds to the direct partners of the DCI and level 2, to its indirect partners (partners of partners). We also found partners (especially public agencies in their states of origin) who indirectly act in their digital networks, developing joint actions.

Digital operation and the content produced by DCI and its partners
On both Facebook and Instagram, we see the low DCI post volume and reach. Its most disseminated posts shared links to videos made by television stations or other large communication vehicles. Prevention posts hardly reached 15 likes or views and rarely received any comments. We found they showed little digital interaction, i.e., information dissemination predominated, rather than the formation of associative bonds.
After analyzing the DCI digital environments, we realized that its partners and "followers" failed to As per the diagram, the DCI has few direct partners and a low connection degree (Recuero, 2020). However, some connect to larger and more complex networks, enabling approximation interactions and thus an expansion of associative bonds, reinforcing Granovetter's (1973) strength of weak bonds, bonds with less binding which can connect different groups, expanding relationship, opportunity, and belonging networks. Connections with ChildFund Brasil, SaferNet, and Nethics Digital Education offer DCI potential access to at least 60 other national and international institutions.
In this set, we found agendas which converge with the DCI line of action: (1)  (2) activism, triggered by mourning establish actual network interactions. Content posted on a major digital platform failed to strongly bond to other profiles via sharing, commenting, or likes.
The DCI performs better on YouTube than in any other platform, with a good brand of subscribers but a modest number of views (Chart 2). Unlike this modest dynamic, we have SaferNet, a partner which has far-reaching posts receiving more than 100,000 views. However, we should emphasize that SaferNet deals with internet security from a much broader and diverse point of view, including, in addition to online challenges, topics such as racism, pedophilia, gender bias, and many others. DCI content is branded to detail what online challenges are and how to avoid them. A more expanded awareness strategy shows information in a simple and direct language, most often accompanied by images which illustrate the broadcast message. Our mapping showed that most of this content targets parents and especially educators. Posts show a predominance of formal language and scarcely explore algorithms (stories, lives, new applications, etc.). The elaborated themes indicate that the content in this network can barely target challenge consumers, i.e., children and adolescents.

Chart 2 -DCI performance on social networks, 2018/2019
The produced content also greatly concerns itself with young people's Internet abuse. Several posts bid parents concern themselves with their children's excessively long connection to the Internet. These messages reinforce the idea that the Internet is a space of risks which should be accessed and experienced under adult supervision, emphasizing somewhat constantly that, even in moments of fun, such as playing games or browsing social media, users may be in some danger, even if unconsciously.
Some publications encourage parents to use applications and tools to monitor their children's 2 Available at: https://pt-br.facebook.com/dimicuida/. Accessed on: June 7, 2022 browsing. Several posts show the advantages of parental control software in avoiding forms of violence and other dangers. The general idea is that managing internet risks is mainly up to parents, who need to invest more in digital literacy and receive support so they can search, download, and use applications and devices which control access to certain content. When they convey the operational details of such applications, these posts use a didactic language since they recognize that children and adolescents understand more about technology than their parents.
Despite the importance of using these strategies, the content in these posts emphasizes that "nothing replaces dialogue," recognizing the limits of a merely technological control initiative, as Figure 2 shows. The main argument corroborating the thesis that the Internet is an unsafe environment for this population consists of personal experiences of loss due to such challenges. The content this partner network produces constantly evokes examples of life trajectories which have been marked by losses (especially the DCI, Erik's Cause, and Apeas). Throughout this research, the case which most sensitized the DCI network was that of a seven-year-old girl who died after performing a challenge Youtubers proposed, which consisted of spraying aerosol deodorant into her mouth. She suffered a cardiac arrest a few minutes after inhaling a large amount of that spray. Her relatives and family friends posted several appeals on social networks, asking for parents and guardians to pay attention to the risks these and other challenges circulating on digital platforms bring, further reinforcing the association between danger and the Internet.
A striking feature of the DCI digital line of action is that the published material constantly invites its audience to leave the Internet and seek analog forms of prevention via lectures, courses, and face-to-face workshops. The DCI promotes several meetings with students, parents, and experts to discuss the topic in conversations and recreational activities. We also found that this prevention network aims, as one of its goals and expertise, to train education professionals in combating the damage such games can bring.
The analyzed data quite often refer to schools as an analog counterpoint to the danger the internet can bring to children and adolescents (Figure 3). Much of the dissemination material highlighted the importance of the information specialists conveyed in this space of conviviality. Data also often referred to pedagogues and psychologists in the offered content, courses, and lectures, as well as in the dissemination of these meetings. These professionals' information function discursively as a source of scientific truth opposing the possible untruths the Internet can bring. The most recurrent item in these posts was the 3 Available at: https://pt-br.facebook.com/dimicuida/. Accessed at: June 7, 2022 term "lecture and prevention of dangerous games in school," among the most liked and commented posts from the prevention network. In some cases, the network used large media to promote face-to-face events in schools in the state of Ceará, disseminating content more widely. Data analysis showed four types of strategies to encourage children to avoid engaging in these challenges: music, theater, sports, and food. Music therapy is available in courses and workshops with musicians and therapists and aims to stimulate creative activities which would reduce Internet abuse. Theater is another coping mechanism. These meetings seek to stimulate sociability and relationships among young people; posts on such activities show that work is done to "reconnect" them to their bodies. The DCI also promotes, though less often, workshops and courses on sports and food, aiming to minimize exposure to social networks.
In parallel to the content produced for the Web 2.0 main platforms, this online challenge prevention network has especially aimed to produce analog content, such as books, booklets, and printed reports, usually disseminating it in classrooms. An example of this type of material widely disseminated in digital environments was the book Tem perigo no ar (There is danger in the air), published by DCI and released in several Brazilian cities. According to posts, it targets children aged five to 11 and playfully shows how the brain needs oxygen to function well. This material aims to warn children and adults about the danger of choking games. Thus, we again find that analog content is of fundamental importance for the DCI in preventing the possible harm online challenges can bring.
As its main objective is hindering adolescents' access to violent/dangerous content, the DCI shows great concern about the legal resources which violence can trigger. The network promotes meetings and lectures with jurists and lawyers to discuss legislation on digital practices which parents and educators can use to pressure the removal of videos encouraging violence to themselves and third parties from the platforms hosting them. At the time of this study, discussions pointed to efforts and a partnership with YouTube toward that. Unlike pedagogues and psychologists, who are a constitutive part of this prevention network, lawyers and jurists serve as consultants who advise prevention actions. However, we found no legal action toward formulating policies to control these platforms.
The analyzed data showed a great affinity between challenge and suicide prevention networks. Death by challenge -as much as we recognize the collective character of these games and the number of people involved, even if digitally -is, in the vast majority of cases, considered a suicidal act. Thus, in several face-to-face events and publications, technically-trained psychologists and pedagogues addressed suicide prevention.

Discussion
After the covid-19 pandemic, the Internet became a fundamental tool to manage contemporary daily life. The literature addressing its consumption among young people and adolescents in this worldwide network points to tensions between the positive and negative characters permeating these new relations. On the one hand, a set of authors (Arab;Diaz, 2015;Simons, 2010) emphasizes the opportunities the Internet can bring, such as educational learning and digital literacy, civic participation and commitment, creativity, self-expression, social identity and connections, socialization, entertainment, skill development, and learning motivation. On the other hand, associated negative aspects enter the debate, such as the risks of commercial damage, sexual harassment, violence, attack on values, affective distancing, and hearing loss.
In a context in which tension between opportunity and risk characterizes the internet, the DCI emerges as the center of a network producing content against the damage online challenges can bring. Dangerous games, especially suffocation ones, have existed for a few decades and have always been a cause for concern among parents and educators (Bada; Clayton, 2020). However, with the creation of YouTube in 2005, millions of young people could watch videos which propagated and trivialized this type of behavior (Miranda;Miranda, 2021;Linkletter;Gordon;Dooley, 2010). Thus, it is not by chance that the DCI activism emerges from family loss and resignification (Fassin;Rechtman, 2007;Sarti, 2011).
DCI is a small non-governmental organization (NGO) with budgetary limitations and a limited group of hired professionals, which somewhat restricts the scope of its activities. However, it distances itself from the voluntary and religious model which predominates in most third-sector organizations (Cazzolato, 2009); basing its actions on some of the hegemonic scientific knowledge on contemporary childhood management, psychology, and pedagogy. DCI content shows lower engagement than online challenges but has a wide variety of actors who share, like, and comment it. According to Granovetter (1973), so-called weak ties are fundamental to disseminate innovation since individuals with diverse experiences and backgrounds make up these networks. They are important because they connect us to several other groups, breaking the configuration of "isolated islands" (clusters) and configuring a social network. We observe, thus, that the DCI has a potential space for expansion, given its efforts toward greater connectivity with the partners of its partners, further developing its own network (Recuero, 2020).
Because it is a field under construction and without previous action references, face-to-face spaces still greatly influence digital dangerous game prevention. We found that one solution to avoid the dangers of the Internet was developing face-to-face activities which attracted the attention of the population more at risk. Data showed that this form of prevention especially explored schools, trying to get children away from computers and inviting them to face-to-face sociability.
The strong link between prevention content and the school community sets a much-discussed paradox with the arrival of Web 2.0. This prevention content finds some limits in its form of communication by insisting on an online-versus-offline division in which the offline space directly refers to schools and the security its specialists (teachers, pedagogues, and psychologists) guarantee and the internet consists of an unsafe space with numerous potential damages. As stated earlier (Deslandes et al. 2021), our everyday lives have definitely incorporated and embodied technology. As Hine (2015, p. 15) summarizes, it is "embedded, embodied, and everyday." Any binary opposition between real/virtual and digital/analog loses its meaning the moment smartphones, tablets, and watches incorporate applications; digital algorithms presentifying several platforms on mobile devices. Thus, the idea of offering analogue activities in place of the Internet may be ineffective today due to the blurred boundaries between online and offline spaces. It is currently no longer possible to leave the internet, even if it offers risks. We must consider that play culture itself has migrated to "digitality" (Fortuna, 2014), in which young people find an important space for body and identity experimentation (Fassin;Rechtman, 2007).
Thus, online challenges become experiences marking their digital identities since they explore one of the main characteristics of digital sociability: overexposure. Under the pretense of being loved, appreciated, and applauded, individuals would be subjected to what Sibilia (2008) called "tyranny of visibility," having to style and cultivate their images along the lines of audiovisual media characters. We found that the sociability the digital world mediates depends on how the "I" presents itself to "others" who, in turn, the discourse this digital "I" builds will presentify in various ways.
The online world constantly constructs and mediates an online world whose digital sociability evokes a very particular form of corporality. The more dangerous and damaging to the body is the challenge, the greater the chance of it becoming more popular (Deslandes et al., 2020).
Another point this form of prevention explores (widely discussed in the online challenge literature) reminds us of the concept of technopanic, i.e., technology phobia, observed when certain (real or unreal) risks technology can bring are amplified (Bada; Clayton, 2020).
We find another paradox by proposing parental control as a measure to prevent the risks of online challenges. Even if we recognized that the Internet is a means to contemporary sociability and that parents and children have different digital literacies, in practice, parents' self-taught actions fail to offer a solution to this impasse.
By understanding digital literacy as the knowledge necessary to handle technological resources to read and write in the digital environment and participate in the social practices of this culture (Ribeiro;Freitas, 2011), we can claim that children and adolescents are "digital natives," born and socialized in the digital culture. Their parents received digital literacy after spending much of their life in a world of analog devices and logics.
Thus, the controlled understanding much more about the environment than the controller questions the effectiveness of parental control in the digital universe. The paradox between parents and their children's digital literacy can lead to a false sense of security and control of children and adolescents' attitudes.
We should also emphasize that analog actions are very important to prevent the possible damages online challenges can bring, as long as they complement digital initiatives. This is due to the countless resources to be explored and the fact that children are exposed to risks in the digital space, in which prevention resources are to be found. For this complementarity to be effective, digital content must attract its target audience via a temporality and language compatible with their digital experience. We need a digital education which discusses length of exposure, website browsing, and play adherence and is constantly supported by parental dialogue -considering that transgressions will always occur.
Thus, it seems important to bet on digital literacy which emphasizes individuals' creativity and emancipation (Maidel;Vieira, 2015;Ribeiro;Freitas, 2011) as a way to prevent internet practices harming their health.
We conclude that analyzing the DCI experience enables us to expand our reflection to other institutions dedicated to preventing self-inflicted and other forms of digitally produced or disseminated violence. Most prevention institutions concentrating their initiatives in institutional spaces (school, health services, etc.) face the challenge of acting on the Internet and dominating its aesthetics, language, culture of use, and interactional logics. Moreover, they also show unequal digital literacies, including their own professionals and interlocutors' (parents, educators, and healthcare providers). Thus, they should invest in partnerships with actors who have such skills and can help them define the appropriate actions for digital expression and take advantage of its resources. Finally, we should note that, in addition to information and communication technology professionals, children and adolescents themselves can be extremely skilled partners in this regard.