The document summarizes research from 21 grantees studying health games. It describes the types of games studied (including exergames and self-care games), platforms used, and goals of the research (including assessing outcomes, testing theories, and identifying design principles). Key findings include that competitive play improved cognitive functioning more than cooperative play; games providing autonomy and competence support increased enjoyment and motivation; and a robot providing social support was more motivating for exercise. Future plans are to publish and disseminate the research findings to inform health game design.

1. Health Games Research National Program:
Discoveries and Game Design Principles
from Our Grantees' Research
Presentation to the Games for Health Conference
Boston, MA
Debra Lieberman, Erica Biely,
Susana Peinado, Chan Thai
UC Santa Barbara
June 13, 2012

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3. Our 21 Health Games Research grantees
 Universities and medical centers
 Multi-disciplinary
 Medicine
 Kinesiology
 Public Health and health promotion
 Psychology
 Communication
 Cinema studies
 Engineering

4. Grantees’ games
 Physical activity games and self-care games
 Custom created games and off-the-shelf games
 Platforms
 Computer, various consoles and interfaces (such as
controller, dance pad, Kinect, Wii balance board)
 Mobile phone (two games with web connections, another
with microphone and breath as interface)
 Robots
 Cybercycles
 Alternate reality game

5. Goals of grantee research
 Outcome studies: Did the game work? Did health behaviors
change immediately and over time? Did health outcomes
improve? Clinical utilization?
 Theory testing – How and why did the game work?
 Many studies assessed usage, implementation strategies,
engagement, satisfaction, and perceived game quality and
usefulness
 Outcomes of game vs. treatment-as-usual
 Principles of health game design – translate findings into
strategies for future health game design

6. Crazy Taxi – University of Florida
 Off-the-shelf game
 Helps seniors learn to focus
attention and ignore
distractions
 Effective form of therapy in
the clinic and as leisure-time
entertainment to stay
cognitively sharp

7. Mindless Eating Challenge – Cornell
 Mobile game
 Helps teens improve
breakfast nutrition
 Choose your pet to nurture
via your own healthy eating

8. Cornell: Geri Gay
 Mindless Eating Challenge
 Adolescents – problem with breakfast nutrition
 Mobile phone and virtual pet game
 Take a picture of your breakfast and send it to your pet
– so your nutrition feeds your pet
 Outcomes:
 Better breakfast nutrition and more likely to eat breakfast
 Stronger effects if player sees pet thriving and being ill
(negative feedback )(compared to thriving or neutral only)
 More enjoyment, attachment to pet, and nutrition attitude
change when negative feedback is included

9. Georgetown University: Sandy Calvert
 Exergames at school for inner city students
 Competitive vs. cooperative play – Wii
 Competitive play improved executive functioning more,
and led to more physical exertion during game play

10. Maine Medical Center: Ann Maloney
 DDR for overweight children and their families
 Generally found increased physical activity when
DDR went to the home

11. Michigan State University: Deborah Feltz
 Buddy Up; partnered exergames
 College student participants
 Virtually-presented partner in conjunctive tasks
 Partner should be moderately more skillful than the
player, to increase player exertion

12. Michigan State University: Wei Peng
 Active games for children, using upper and lower
body exertion to control characters in an adventure
game
 Increased energy expenditure and effort

13. Michigan State University: Wei Peng
 Self-Determination Theory: Design the exergames to satisfy
needs for autonomy and competence
 Autonomy-supportive games – ability to customize characters,
select how characters will grow in skills, select messages to
convey to game characters
 Competence-supportive games – dynamic difficulty level,
heroism meter, achievement badges
 Autonomy-supportive games more strongly increase game
enjoyment and motivation to exercise
 Competence-supportive games more strongly increase game
enjoyment, motivation to exercise, and self-efficacy for
physical activity

14. Seniors Cybercycling

15. Seniors Cybercycling

16. Union College: Cay Anderson-Hanley
 Seniors Cybercycling
 Randomized trial of older adults in senior living centers
 Virtual biking, with interesting locations to bike in
 Racing against personal best time, against others, against
virtual competitors; race alone or in teams
 Cognitive benefits of interactive decision-making and
physical activity:
 Improved executive function
 Reduced risk of progressing to mild cognitive impairment

17. University of North Carolina: Deborah Tate
 Exergames: entertainment games vs. exercise-themed
 Young adults ages 18-35
 Exercise-themed games were less fun but led to more
physical exertion
 Dilemma for designing exergames: entertainment theme or
exercise theme?
 Use entertainment theme for unmotivated people, to attract
them to the fun of the game
 Motivated people may prefer exercise theme so they can
focus on physical activity as their goal

18. University of Southern California: Maja Mataric
 Robot Motivator
 Human torso robot leads an older adult in upper-body
exercises by demonstrating the movements
 Robot presents a game:
 Asks player to repeat a series of demonstrated movements
 Sees the player and gives feedback on accuracy
 Relational condition – where the robot establishes social
connection, gives praise, refers to user by name – was
more effective in motivating exercise and users liked it
more

19. Future plans for grantee research findings
 Publicize the findings and principles of health game
design – many more will be published soon
 Reach a variety of constituencies / decision-makers
 Health care providers, insurers, educators
 Game designers, publishers
 Researchers
 Funders, foundations, federal agencies, investors
 Help develop new norms among our constituents:
 Game designers: use theory and evidence as the
foundation, and conduct outcome studies to demonstrate
effectiveness
 Purchasers, users: demand evidence, quality, outcome
studies

20. Thank you!
And check out our DATABASE!
Debra Lieberman, Erica Biely,
Susana Peinado, Chan Thai
wwwhealthgamesresearch.org
Database: wwwhealthgamesresearch.org/db
lieberma@isber.ucsb.edu