Healthy Gaming – Video Game Design to promote Health
14 October 2010
Accepted: 17 March 2011
16 December 2017 (online)
Background: There is an increasing interest in health games including simulation tools, games for specific conditions, persuasive games to promote a healthy life style or exergames where physical exercise is used to control the game.
Objective: The objective of the article is to review current literature about available health games and the impact related to game design principles as well as some educational theory aspects.
Methods: Literature from the big databases and known sites with games for health has been searched to find articles about games for health purposes. The focus has been on educational games, persuasive games and exergames as well as articles describing game design principles.
Results: The medical objectives can either be a part of the game theme (intrinsic) or be totally dispatched (extrinsic), and particularly persuasive games seem to use extrinsic game design. Peer support is important, but there is only limited research on multiplayer health games. Evaluation of health games can be both medical and technical, and the focus will depend on the game purpose. Conclusion: There is still not enough evidence to conclude which design principles work for what purposes since most of the literature in health serious games does not specify design methodologies, but it seems that extrinsic methods work in persuasion. However, when designing health care games it is important to define both the target group and main objective, and then design a game accordingly using sound game design principles, but also utilizing design elements to enhance learning and persuasion. A collaboration with health professionals from an early design stage is necessary both to ensure that the content is valid and to have the game validated from a clinical viewpoint. Patients need to be involved, especially to improve usability. More research should be done on social aspects in health games, both related to learning and persuasion.
- 1 Ferguson CJ. The good, the bad and the ugly: a meta-analytic review of positive and negative effects of violent video games. Psychiath Q 2007; Dec; 78 (Suppl. 04) 309-16. DOI: 10.1007/s11126-007-9056-9.
- 2 Paperny DM, Starn JR. Adolescent pregnancy prevention by health education computer games: computer-assisted instruction of knowledge and attitudes. Pediatrics 1989; May 83 (Suppl. 05) 742-52. Pubmed PMID:2654867.
- 3 Goldstein J, Cajko L, Oosterbroek M, Michielse M, van Houten O, Salverda F. Video games and the elderly. Social Behavior and Personality 1997; 25, 345-352. Available from: http://dx.doi.org/10.2224/sbp.1922.214.171.1245
- 4 Weaver JB, Mays D, Weaver S, Kannenberg W, Hopkins GL, Eroðlu D, Bernhardt JM. Health-risk correlates of video-game playing among adults. Am J Prev Med 2009; 37 (Suppl. 04) 299-305. PubMed PMID: 1976501.
- 5 6h Annual Games for Health Conference [Internet] Robert Wood Johnson Foundation, May 25-27, Boston, USA [cited 2010 Oct 12]. Available from: www.gamesforhealth.org
- 6 Fogg BJ. Persuasive Technology, using computers to change what we think and do, Ubiquity Article noNo: 5, 2002; DOI: http://portal.acm.org/citation.cfm?id=764008.763957
- 7 Lin JJ, Mamykina L, Lindtner S, Delajoux G, Strub HB. Fish‘n‘steps: Encouraging physical activity with an interactive computer game. Proceedings 8th International Conference: UbiComp 2006, Orange County, CA, USA, September 17-21, 2006, Springer, pp. 261-278. DOI: http://dx.doi.org/10.1007/11853565_16
- 8 Baranowski T, Buday R, Thompson DI, Baranowski J. Playing for real: video games and stories for health-related behavior change. Am J Prev Med. 2008 Jan 34. 01 74-82. PubMed PMID: 18083454, doi: 10.1016/j.amepre.2007.09.027 PubMed Central PMCID: PMC2189579
- 9 Adams SA. Use of "serious health games" in health care: a review. Stud Health Technol Inform. 2010;157:160-6. PubMed PMID: 20543383, DOI: http://dx.doi.org/10.3233/978-1-60750-569-3-160
- 10 Lustria ML, Cortese J, Noar SM, Glueckauf RL. Computer-tailored health interventions delivered over the Web: review and analysis of key components. Patient Educ Couns 2009; Feb 74 (Suppl. 02) 156-73. Epub 2008 Oct 22 PubMed PMID: 18947966 DOI: http://dx.doi.org/10.1016/j.pec.2008.08.023
- 11 Lieberman D. Designing Games for the Apps for Healthy Kids Competition, Health Game Challenge, 2010. Available from: www.healthgameschallenge.org/Game%20Design%20Tips%20for%20game%20jam%20participants.pdf Archived at: http://www.webcitation.org/5w9RoPwSr
- 12 Peter Kwok-Chan P, Sanders EBN, Evensen EA. Game Design for Personal Health Management: An Emotional and Educational Perspective. 6th Design & Emotion Conference, Hong Kong, October 2008, Available from: www.maketools.com/articles-papers/ChanSandersEvensen_Brief.pdf Archived at: http://www.webcitation.org/5w9SABYWW
- 13 Cannon-Bowers J, Clint Bowers C. Serious Game Design and Development: Technologies for Training and Learning. IGI Press, 2010. DOI: 10.4018/978-1-61520-739-8
- 14 Shell J. The Art of Game Design, A Book of Lenses, Morgan Kaufmann 2008. ISBN 978-0-12-369496-6
- 15 Khaled R, Noble J, Fisher R, Biddle R. Fine Tuning the Persuasion in Persuasive Games. Proceedings in Second International Conference on Persuasive Technology, PERSUASIVE 2007, Palo Alto, CA, USA, April 26-27, 2007, Revised Selected Papers, Springer. DOI: http://dx.doi.org/10.1007/978-3-540-77006-0_5
- 16 Gee JP. What Video games have to teach us about learning and literacy, Palgrave, MacMillian 2003, ISBN 1-4039-6538-2
- 17 Kharrazi H, Faiola A, Defazio J. Healthcare Game Design: Behavioral Modeling of Serious Gaming Design for Children with Chronic Diseases. In Proceedings of the 13th international Conference on Human-Computer interaction. San Diego, CA, July 19 - 24, 2009. Lecture Notes In Computer Science. Springer-Verlag, Berlin, Heidelberg, 335-344. DOI: http://dx.doi.org/10.1007/978-3-642-02583-9_37
- 18 Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot 1997; 12 (Suppl. 01) 38-48. [Medline].
- 19 Becker MH. The health belief model and personal health behavior. Health Educ Monog 1974; (Suppl. 02) 324-473.
- 20 Health Game Research 2010 [Internet] Princeton, New Jersey, USA: Robert Wood Johnson Foundation [cited 2010 Oct 12]. Available from: http://www.healthgamesresearch.org
- 21 Hypos at school [Internet], Diabetes Australia, [cited 2010 Oct 12]. Available from: http://www.diabeteskidsandteens.com.au/playandlearn_hypo.html
- 22 Game Food Pyramid [Internet], USA: Playnormous [cited 2010 Oct 12]. Available from: http://www.playnormous.com/game_food_pyramid.cfm
- 23 “Heart Sense” [Internet], USA: University of Pennsylvania, [cited 2010 Oct 12]. Available from: http://www.acasa.upenn.edu/heartsense/about.htm
- 24 Trigger Happy [Internet].. Dallas, Texas, USA: BlockDot Inc [cited 2010 Oct 12]. Available from: http://www.blockdot.com/caseStudies/gsk-alli.aspx
- 25 Lumosity Games [Internet].. LivenStrong.com, Demand Media, Inc [cited 2010 Oct 12]. Available from: http://www.livestrong.com/article/139512-lumosity-brain-exercises
- 26 Brain Fitness Games.. [Internet]. Santa Barbara, CA, USA: Dakim Inc [cited 2010 Oct 12]. Available from: http://www.dakim.com/preview-brain-games
- 27 Vigorous mind.. [Internet] Newton, MA, USA: Vigorous Mind, Inc [cited 2010 Oct 12]. Available from: http://www.vigorousmind.com
- 28 Nintendo Wii Sport.. [Internet] Redmond, Washington, USA: Nintendo of America Inc [cited 2010 Oct 12]. Available from: http://www.nintendo.com/wii
- 29 Konami Froggers Hop, Skip & Jumpin’ Fun [Internet] Parents Choice Org.. [cited 2010 Oct 12]. Available from: http://www.parents-choice.org/product.cfm?product_id=24944&StepNum=1
- 30 SmartCycle [Internet] FisherPrice Inc [cited 2010 Oct 12]. Available from: http://www.fisher-price.com/fp.aspx?st=10&e=smartcyclelanding
- 31 Playstation EyeToy [Internet], Wikipedia Foundation, [cited 2010 Oct 12] Available from: http://en.wikipedia.org/wiki/EyeToy
- 32 Schiesel S.P.E. Classes Turn to Video Game That Works Legs, The New York Times. 30 April 2007. [cited 2010 Oct 12]. Available from: http://www.nytimes.com/2007/04/30/health/30exer.html?_r=1
- 33 Didget [Internet] UK: BayerHealthCare [cited 2010 Oct 12]. Available from: http://www.bayerdidget.co.uk
- 34 Rex Ronan [Internet] Wikipedia Foundation [cited 2010 Oct 12]. Available from: http://en.wikipedia.org/wiki/Rex_Ronan
- 35 Body Mechanics: Escape from Obeez City [Internet] Australia: Big Red Frog [cited 2010 Oct 12]. Available from: http://www.bodymechanics.tv/KidsZone
- 36 My Stop Smoking Coach with Allen Carr [Internet] USA:Ubisoft Entertainmen.. [cited 2010 Oct 12]. Available from: http://www.ubi.com/US/Games/Info.aspx?pId=7150
- 37 Escape from Diab [Internet] Houston, Texas, USA: Archimage, Inc [cited 2010 Oct 12]. Available from: http://www.escapefromdiab.com
- 38 Boren SA. A review of health literacy and diabetes: opportunities for technology. Diabetes Sci Technol 2009; Jan 3 (Suppl. 01) 202-9. PubMed PMID 20046666, PubMed Central PMCID: PMC2769840.
- 39 Obesity and Overweight [Internet] U.. S. Obesity Trends. CDC –Center of Disease Control and Prevention. USA. [cited 2010 Oct 12] Available from http://www.cdc.gov/obesity/data/trends.html
- 40 Prevalence of excess body weight and obesity in children and adolescents [Internet] European Environment and Health Information System.. (ENHIS) Fact Sheet No. 2.3 May 2007. [cited 2010 Oct 12]. Available from: http://www.euro.who.int/obesity
- 41 American Heart Association and Nintendo Partnership [Internet] American Heart Association [cited 2010 Oct 12]. Available from: http://www.activeplaynow.com
- 42 Unnithan VB, Houser W, Fernhall B. Evaluation of the energy cost of playing a dance simulation video game in overweight and non-overweight children and adolescents. Int J Sports Med 2006; Oct 27 (Suppl. 10) 804-9. PubMed PMID, 17006803 DOI: 10.1055/s-2005-872964.
- 43 Haddock BL, Shannon R, Siegel SR, Wilkin LD. The Addition of a Video Game to Stationary Cycling: The Impact on Energy Expenditure in Overweight Children. Open Sports Sci J 2009; January 1, 2: 42-46. PubMed PMID:19946380, PubMed Central PMCID: PMC2784676, doi: 10.2174/1875399X00902010042.
- 44 Siegel SR, Haddock BL, Dubois AM, Wilkin LD. Active Video/Arcade Games (Exergaming) and Energy Expenditure in College Students. Int J Exerc Sci 2009; 2 (Suppl. 03) 165-174 PubMed Central PMCID: PMC2856349.
- 45 Neufeldt C. Wii play with elderly people, International reports on socio-informatics, volume 3 issue 3: Enhancing Interaction Spaces by Social Media for the Elderly. a workshop report. 2009; p50-59 [cited 2010 Oct 12]. Available from: http://www.docstoc.com/docs/24360891/Wii-play-with-elderly-people
- 46 Consolvo S, Klasnja P, McDonald D, Landay J. Goal-setting Considerations for Persuasive Technologies that Encourage Physical Activity, In proceedings of the 4th International Conference on Persuasive Technology 2009. ACM International Conference Proceeding Series; Vol. 350, DOI: http://doi.acm.org/10.1145/1541948.1541960
- 47 Healthseeker [Internet] Diabetes Hands Foundation & Joslin Diabetes Center [cited 2010 Oct 12]. Available from: http://apps.facebook.com/healthseeker/missions
- 48 Barr P, Khaled R, Noble J, Biddle R. “Well Done!”, The Development Cycle in Role-Playing Games, Proceedings in First International Conference on Persuasive Technology for Human Well-Being, PERSUASIVE 2006, Eindhoven, The Netherlands, May 18-19, 2006. Springer. DOI: http://dx.doi.org/10.1007/11755494_13
- 49 Brox E, Heggelund A, Evertsen G. Competence Complexity and Obvious Learning; Experience from Developing a Language Learning Game, Springer Series SCIA, Design and Use of Serious Games. 2009 p. 83-96 DOI: 10.1007/978-1-4020-9496-5_6
- 50 Aoki N, Ohta S, Masuda H, Naito T, Sawai T, Nishida K. et al. Edutainment tools for initial education of type-1 diabetes mellitus: initial diabetes education with fun. Stud Health Technol Inform. 2004 107. (Pt 2) 855-9. PubMed PMID:15360933 Available from: http://cmbi.bjmu.edu.cn/news/report/2004/medinfo2004/pdffiles/papers/5163Aoki.pdf
- 51 Christakis NA, Fowler JH. The spread of Obestiy in a Large Social Network over 32 years. N Engl J Med 2007 Jul 26 357 (Suppl. 04) 370-9. Epub 2007 Jul 25. PubMed PMID:17652652.
- 52 Nousiainen T, Kankaanranta M. Exploring Children’s Requirements for Game-Based Learning Environments, Hindawi publishing Corporation, Advances in Human-Computer Interaction, Volume 2008; doi:10.1155/2008/284056
- 53 IJsselsteijn W, Nap HH, de Kort Y. Digital game design for elderly users. In Proceedings of the 2007 Conference on Future Play (Toronto, Canada, Nov 14 - 17, 2007). Future Play ‘07. ACM, New York, NY, 17-22 DOI: http://doi.acm.org/10.1145/1328202.1328206