Gaming for Good: Using Games to Create Change (Presented at SXSW 2015)
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Most everyone agrees that video games are highly entertaining. But can they spark positive health behavior change at a time of crisis? In this presentation, Fred Dillon, Director of Product Development at HopeLab, shows how Re-Mission 2 helps young cancer patients fight their disease. He also shares insights into the highly collaborative and iterative product development process at HopeLab. Learn more at www.hopelab.org.
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Gaming for Good: Using Games to Create Change (Presented at SXSW 2015)
- 1. #SXSW #games4good @HopeLab Gaming for Good Fred Dillon Director of Product Development HopeLab @FredDillon .
- 8. Cancer Knowledge Baseline Follow-up Intervention-targetedknowledge(%correct) Control Re-Mission 55 60 65 70 Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission p = .034 p = .027 30 40 CapEvents Antibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 r Knowledge line Follow-up Control Re-Mission Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission = .034 p = .027 ntibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Base 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Chemo 3.2 3.4 3.6 3.8 Base Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Baseline Follow-up Control Re-Mission 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Control Re-Mission Chemotherapy: Oral 6MP p = .002 3.2 3.4 3.6 3.8 Baseline Follow-up #SXSW #games4good @HopeLab Pediatrics – August 2008 Re-Mission Outcomes Study RCT 34 hospitals, 375 AYA with cancer
- 9. Cancer Knowledge Baseline Follow-up Intervention-targetedknowledge(%correct) Control Re-Mission 55 60 65 70 Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission p = .034 p = .027 30 40 CapEvents Antibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 r Knowledge line Follow-up Control Re-Mission Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission = .034 p = .027 ntibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Base 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Chemo 3.2 3.4 3.6 3.8 Base Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Baseline Follow-up Control Re-Mission 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Control Re-Mission Chemotherapy: Oral 6MP p = .002 3.2 3.4 3.6 3.8 Baseline Follow-up #SXSW #games4good @HopeLab Pediatrics – August 2008 Re-Mission Outcomes Study RCT 34 hospitals, 375 AYA with cancer
- 10. Cancer Knowledge Baseline Follow-up Intervention-targetedknowledge(%correct) Control Re-Mission 55 60 65 70 Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission p = .034 p = .027 30 40 CapEvents Antibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 r Knowledge line Follow-up Control Re-Mission Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission = .034 p = .027 ntibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Base 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Chemo 3.2 3.4 3.6 3.8 Base Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Baseline Follow-up Control Re-Mission 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Control Re-Mission Chemotherapy: Oral 6MP p = .002 3.2 3.4 3.6 3.8 Baseline Follow-up #SXSW #games4good @HopeLab Pediatrics – August 2008 Re-Mission Outcomes Study RCT 34 hospitals, 375 AYA with cancer
- 11. Cancer Knowledge Baseline Follow-up Intervention-targetedknowledge(%correct) Control Re-Mission 55 60 65 70 Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission p = .034 p = .027 30 40 CapEvents Antibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 r Knowledge line Follow-up Control Re-Mission Self-Efficacy Cancer-specificself-efficacy(1-7scale) 5.6 5.8 6.0 6.2 Baseline Follow-up Control Re-Mission = .034 p = .027 ntibiotics p = .008 P(log10) Re-Mission Chemotherapy: Oral 6MP p = .002 3.6 3.8 Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Base 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Chemo 3.2 3.4 3.6 3.8 Base Baseline Follow-up Intervention-targetedknowl Control Re-Mission 55 60 65 Cancer-specificself-effica 5.6 5.8 6.0 Baseline Follow-up Control Re-Mission 0 10 20 30 40 TotalMEMSCapEvents Control Antibiotics p = .008 Plasma6MP(log10) Control Re-Mission Chemotherapy: Oral 6MP p = .002 3.2 3.4 3.6 3.8 Baseline Follow-up #SXSW #games4good @HopeLab Pediatrics – August 2008 Re-Mission Outcomes Study RCT 34 hospitals, 375 AYA with cancer
- 12. PLOS ONE – March 2012 Re-Mission Attitudes Study #SXSW #games4good @HopeLab
- 13. Playing PLOS ONE – March 2012 Re-Mission Attitudes Study #SXSW #games4good @HopeLab Motivation Excitement Memory
- 14. Playing PLOS ONE – March 2012 Re-Mission Attitudes Study #SXSW #games4good @HopeLab Watching Motivation Excitement Memory
- 21. ? … … … … …
- 22. “I want to see the cancer blown up and vaporized!” #SXSW #games4good @HopeLab “I want to watch cancer squirm and suffer!” “Cancer is power hungry. It’s not satisfied with what it’s got, it always wants more.” “[Cancer] sits there and eats and takes from you and does nothing but eat and replicate.”
- 23. #SXSW #games4good @HopeLab Cat God vs. Sun King
- 25. #SXSW #games4good @HopeLab Thank you! .org
Editor's Notes
- Hi there. I’m Fred Dillon, the Director of Product Development at HopeLab, a non-profit research and development organization that works to harness the power of technology to improve health and well-being.
- HopeLab started with an idea. Our founder, Pam Omidyar, wondered: What if you used the power of videogames to help kids fight cancer? What if kids with cancer could actually blast away at their cancer cells? Could that actually have an impact on their health?
- Well we worked to answer that very question. Meet Liz and Nico. Nico was diagnosed with Leukemia when he was 7 years old.
- When he is released from the hospital he is asked to take chemotherapy pills everyday. Actually, a grand total of nearly 1100 pills over 3 years. [6MP (3 years’ worth – prescriptions typically 1-3/day, per Gary Dahl)]
- But if Nico is like most kids, he will miss some doses along the way. Here is what it looks like if he misses 20% of his prescribed treatments. Missing doses can be deadly. Missing 20% of doses can mean a 50% or greater chance of cancer coming back.
- That’s where Re-Mission comes in. How can a videogame change kids’ behaviors and get them to take their medications more regularly?
- In the original Re-Mission, released in 2005, kids pilot a nanobot named Roxxi through the bodies of kids with cancer, blasting cancer cells and helping to manage common side effects.
- And Re-Mission worked. In a randomized controlled trial, kids with cancer who played Re-Mission vs. those who played another game were found to have higher levels of cancer related knowledge.
- But, even more importantly, they had higher levels of self efficacy, the sense that they had a role to play in fighting their cancer and that they could do this.
- And they actually took their medications more regularly.
- We measured the amount of chemotherapy in their blood and the kids who played Re-Mission had higher levels than the control group.
- How is this possible and why did it work?
- We did some follow up studies using functional MRIs to look at that question. What we found is that when young people were playing the game, parts of their brains lit up related to motivation, excitement and memory.
- Other kids who watched video clips of the game play, but were not actually playing the game, did not have the same places lighting up. So the interactivity of the gameplay itself appears to have been key.
- So, what we have found is that Positive Emotions + Self Efficacy + a Shift in Attitudes among those who played the game were all essential ingredients to the recipe. And we then took those ingredients and applied them to the next iteration of the games, Re-Mission 2.
- By 2010, games had evolved since the development of Re-Mission.
- Games were more casual, more mobile.
- They were no longer tied to PCs or consoles.
- Players were enjoying short but powerful experiences, delivered wherever they are.
- In addition, we wanted to test out a new development model. In the more traditional model, someone has an idea and a couple of really creative folks get together and build something out, then they play test with their target audience somewhere around alpha or beta.
- We wanted to do something that honors the creative talents of people in the field, and our own focus on human-centered research Therefore our approach was: To engage with the audience early, understanding their needs, barriers to change, and then work to develop our ideas with them in mind Try something that was less expensive and had a shorter development cycle Leverage already existing fun games Here’s what we did…
- First we spent a lot of time talking to kids with cancer. What does cancer look like to them and what did they want to see in a cancer-fighting game? Insights informed game play style/action/effects. What’s fun for you, what games do you like? With all this in mind, what we did was go out into the space and look for games that were already popular and fun.
- This is Cat God vs. Sun King. It was popular on the flash game hosting site Kongregate. This was a proven game in terms of fun, audience appeal. Approachable game play with mechanics that we could see mapping onto battling cancer. We approached the developer, collaborated on “re-skinning” the game to the cancer-fighting context And what we came up with was Nanobot’s Revenge.
- This clip shows off some of key aspects that were changed: The minions building the tower have become cancer cells building a tumor to reach the bloodstream at the top and metastasize. The attacks have been rebranded and changed visually to be powerful chemo weapons informed by young people with cancer. Other parts haven’t really changed, but naturally map onto cancer treatment. Attacks cost energy, which must be managed. Just like in chemotherapy, you must keep your energy levels up to be able to handle chemo treatments. There are multiple different attacks which need to be used in combination to wipe out the enemy. Again, like in chemo where therapy consists of a cocktail of multiple drugs needed to bring Re-Mission. So by leveraging a pre-existing fun game with mechanics that map onto the behavior change we wanted to achieve, we were able to create 6 modern, accessible, and fun games much cheaper and faster than the original Re-Mission.
- Using this model, we developed 6 games in total, which you can experience (and play!) at ReMission2.org. As you can see from this experience, games can have a powerful impact on health behaviors and outcomes. I believe we are still at the beginning of innovative ways we can use games to improve the lives for millions of people around the world. I am excited to discuss this further later in this session.