Why Games Matter: A Prescription for Improving Health and Health Care

Why Games Matter

A Prescription for Improving Health and Health Care

Competition Information

Competition News

Changemakers, in partnership with the Robert Wood Johnson Foundation (RWJF), is proud to announce the three winners for the Why Games Matter competition. The winners will each receive US $5,000 and all finalists will attend the Changemakers Change Summit at the RWJF-sponsored Games for Health Conference in Baltimore, MD in May 2008.

You may continue to read and comment on all entries; we welcome your feedback.

Welcome Letter from Robert Wood Johnson Foundation

Dear Changemakers Community,

We invite you to participate in “Why Games Matter: A Prescription for Improving Health and Health Care”—an online collaborative competition running now through September 26, 2007. This competition is the third in a series sponsored by the Pioneer Portfolio of the Robert Wood Johnson Foundation (RWJF) and Ashoka’s Changemakers initiative.

The Changemakers open source competition model has helped RWJF this year to access a broad, exciting array of new ideas and approaches through two competitions addressing important challenges—ending intimate partner violence and finding disruptive innovations in health and health care. We’re now looking to stimulate similarly diverse and creative solutions that merge two distinct but increasingly interconnected worlds—computer and video games and health and health care.

Computer and video games have captivated the hearts and minds of millions of people around the world. Games today, in fact, are the fastest growing media form. People are interacting with them in arcades, at home, in schools, online, and on the go, using portable game players and mobile phones. No longer do they only constitute sedentary activity. Innovations like Nintendo’s Wii wireless console get people on their feet and playing the game with their whole bodies, and several games are being used in physical rehabilitation exercises with patients.

RWJF’s Pioneer Portfolio has supported work in this area for a couple of years now, and we have tapped a groundswell of interest in moving games beyond the entertainment realm to help them become powerful tools that help people learn about, manage, and improve their health. The sophisticated graphics and technologies that go into such games also provide a wealth of opportunity for helping doctors and nurses, public health officials, emergency responders, researchers, and others to deliver better care.

We hope that you will submit an entry and become part of a larger dialogue on how best to encourage and facilitate the connections between games and health. In sponsoring this competition, Pioneer Portfolio seeks to bring forth provocative ideas that demonstrate the imaginative and therapeutic ways that games can be used as means to improve health and health care.

We also want to better understand today’s health games landscape: who are the players; what kinds of games are under development; how might we invest to advance this unique and growing field of games and health; and, finally, how should the field start to measure the efficacy of games on improving health and health care.

For all its dynamism, the games for health field is still in a nascent stage, generally fragmented, and facing significant barriers to developing into a coherent, widely accepted and understood field. For the past two years, the RWJF’s Pioneer Portfolio has invested in Games for Health, a program under the Serious Games Initiative at the Smithsonian Institution’s Woodrow Wilson International Center for Scholars

One of the major barriers in the development of games for health is the lack of evidence of the efficacy of games in improving health and health care. Through Changemakers’s collaborative competition, we hope to tap the collective wisdom of those on the forefront of game applications in health. We also hope to further build and energize the community of people who see the potential of games for health.

We expect this competition to shake up conventional wisdom about what constitutes a health game, the market for such games, and the approaches one ought to take in designing great health-related games. We anticipate a wide variety of entries (e.g., existing games, research about games, conceptual game designs that are past the programming stage of development, public or private initiatives for game-based approaches to health and health care, etc.).

Some of the games will likely have been specifically and carefully designed to address health conditions. But, we also hope to discover games that were not originally designed or marketed to improve health but whose application to health and health care has been demonstrated or show significant potential. Highly popular commercial games like Konami’s Dance Dance Revolution, for instance, only later became known for their health impact because, as players got better at the game, they burned off more and more calories.

This competition also seeks to showcase the creativity and talent of the video game industry. We invite game developers to bring what they do so well—exciting interactive components, stunning visuals and graphics, and consumer-focused design principles—to this competition, and more importantly, to health and health care.

We hope that you will submit an entry to this competition. In doing so, you will be contributing to this burgeoning field, which promises to make a profound difference in health and health care. As a member of the Changemakers global community, we encourage you to get involved and help RWJF test and refine the ideas surfacing through this competition by using the online review option that accompanies each entry.

Tell us what you’re thinking, how you see the field, where its challenges and opportunities lie. Share your thoughts and reactions throughout the competition. The goal? To catalyze a community of self-identifying “games” changemakers for health who never thought of themselves in that way before and who have a vision—and understanding—of games’ impact for good.

All competition finalists will win the opportunity to go to Baltimore, Maryland, in May 2008, to present their work at the Changemakers Change Summit held in conjunction with the RWJF-sponsored Games for Health Conference. Competition winners will receive a cash prize.

We look forward to participating with you in “Why Games Matter.”

Game on,


Chinwe Onyekere
Program Officer, Robert Wood Johnson Foundation


Welcome to the Changemakers “Why Games Matter: A Prescription for Improving Health and Health Care” Collaborative Competition, which aims to find innovative solutions and catalyze a community of changemakers around two increasingly interconnected worlds—computer and video games and health and health care.

The competition description and timeline are as follows:

Eligibility Criteria
The competition will be open to all types of organizations (charitable organizations, private companies, or public entities) from all countries. We consider all entries that:

    • Reflect the theme of the competition: Why Games Matter. The goal of the competition is to identify computer and video games that are able to transform health and health care. Entries are invited from organizations in all countries and proposed solutions should inform work being done in the U.S and around the world. To learn about how The Robert Wood Johnson Foundation conceptualizes games please visit (link will be posted shortly).
    • We are looking for games that are beyond the stage of programming.
    • Are submitted in English or in Spanish and are complete

Assessment Criteria
The winners of this Changemakers Collaborative Competition will be those entries that best meet the following criteria:
    • Innovation: This is the knock-out test. The blueprint must clearly describe how the innovation reflects the ability to systemically transform health and health care by focusing on greater simplicity, lower cost, and enhanced convenience of services to more powerful, informed consumers. Does it enable more consumers in that market to afford and/or have the skill to use the product or service?
    • Social Impact: It is important that the innovation has already begun to have an impact on the field it addresses. Some innovations will have proven success at a small level, while others will have scaled to engage millions of people. Regardless of the level of demonstrated impact, it is important to see that the innovation has the ability to affect the world and not just one village. This will be judged by considering the scale strategy, ability to be replicated, clear how-tos, and a map to reach the big goals.
    • Sustainability: For an innovation to be truly effective it must have a plan for how it will acquire financial and other bases of support for the long-term. Entries should describe not only how they are currently financing their work, but how they plan to finance their work in the future. Go beyond describing whether you charge or not for your services, and describe your business plan. Is there a clear financial plan in place?

Competition Deadlines, Procedures, and Rules
There are three main phases in the competition:

    Entry Stage – July 11 to 6 pm EST September 26, 2007: Entries can be submitted until 6 pm Eastern US time on September 26, 2007. Online review and discussion can go on during this entire entry period. Entrants are strongly encouraged to consider feedback and edit and revise their blueprint throughout the entry period.
    • Online Review and Judging – September 27 to October 24, 2007: Online review and discussion continues. The Why Games Matter judging panel will select 7 to 15 finalists from the entry pool.
    • Voting – October 24 to 6:00 pm EST November 7, 2007: The Changemakers community votes online to select the three award winners from the field of finalists. The Changemakers Collaborative Competition winners, the three finalists that receive the most votes, will be announced on November 8, 2007 and will receive a cash prize of US$5,000.

Participating in the competition provides the chance to receive feedback on your blueprint from fellow entrants, Changemakers staff, judges and the Changemakers community. Showcasing your blueprint and the challenges involved in creating social impact advises potential investors about how best to change funding/investing patterns for the sector and to maximize the strategic impact and effectiveness of their future investments.

Disclaimer—Compliance with Legal Restrictions
Ashoka complies fully with all U.S. laws and regulations, including Office of Foreign Assets Control regulations, export control, and anti-money laundering laws. All grants will be awarded subject to compliance with such laws. Ashoka will not make any grant if it finds that to do so would be unlawful. This may prohibit awards in certain countries and/or to certain individuals or entities. All recipients will comply with these laws to the extent they are applicable to such recipients. No recipient will take any action that would cause Ashoka to violate any laws. Additionally, Ashoka will not make any grant to a company involved in the promotion of tobacco use.

For more information, contact gamesmatter@changemakers.net.

Discovery Framework

Games for Health:

A Prescription for Improving Health and Health Care


Games are an ideal way to engage people in activities that promote healthy lifestyles and tackle their health problems head-on. Accessing these activities through games can make them more attractive and effective because games are designed to be fun, easy to access, and give players a sense of control and safety that is sometimes lacking in more traditional health services and products. The field of Games for Health is at a take-off point. We present this mosaic of solutions for Games for Health at this critical time to promote such innovative approaches that improve health.

Consider what’s in a game: A strong interactive computer or video game provides a serious challenge that players must overcome to reach a goal, usually with fun and some learning along the way. At their best, games for health create experiential scenarios that channel what players learn during the game into smarter choices outside the game. Superb graphics and clever storytelling, applied to high-stakes issues such as cancer remission and natural disaster preparedness, make games for health anything but kids’ play. Though games for health are serious, they only work when they’re fun. Sometimes, they surprise you without intending to, like the calorie-burning benefits of playing Nintendo’s Wii or Konami’s Dance Dance Revolution.

Games for health, like the best social enterprises, have tremendous potential for profit and behavior change. Additional research into games for health can only prime and improve the marketplace for the next generation of ideas and products.

This mosaic highlights some important dimensions of games for health, and we hope it inspires new ideas and new research about play that improves health.

 Innovation Principle:
Create Experiential 
Scenarios to Make  
Smarter Choices 
Outside the Game
Main Barriers to Creating Games for Health:
Insufficient Evidence that Games Can Improve Health and Management of Chronic Diseases
Dual Stigma about Games Limits Potential Customer Base and Distribution
Product Design Is Oriented Toward Consumption, Not Application or Learning
Narrow Corporate or Public Policy Mission
 Physical
Konami’s Dance Dance Revolution

GlucoBoy
Hopelab’s Re-Mission

Snack Dash
Sonic Invaders

Fat World

Nintendo’s Brain Age
 Emotional
 
ID the Creep

Introspection
Personal Investigator

Paint Affects
mtvU
 Cognitive
Phantom Limb


Journey into the Brain
Cognitive Labs’ free brain games
 Community
 
Stop Disasters!

Outbreak at Water’s Edge

Squeezed
(by University of Denver)
Darfur is Dying

Ayiti: The Cost of Life

Food Force
(by UN’s World Food Programme)

CDC in Second Life
 Environmental
 

Archlmage’s NanoSwarm

Water Alert


Sim City

* Ashoka Fellows

• Participate   • Discuss   • Read the Overall Framework of the Competition


Barriers to Building the Games for Health Marketplace:

  • Insufficient Evidence that Games Can Improve Health and Management of Chronic Diseases : Do games for health work? This fundamental question motivates all stages of development. Doctors, as a sort of consumer, need evidence that games for health improve patient compliance and patient management of chronic illness. Corporate and start-up game developers also are more likely to invest in developing games for health if research demonstrates that games can help manage patient health and there is provider acceptance. Day-to-day health management means customers become attached to the product, and loyal customers can provide guaranteed sales. As with developing any health product, early evidence of success invites future research partnerships and investments. But insufficient evidence may reflect a sort of chicken-and-egg problem, in which product development stalls without motivating data, and research can’t advance without new products to evaluate. Innovative players in this field can pair product development and piloting with strong research and evaluation.

  • Games Face a Dual Stigma, Which Limits Their Potential Customer Base and Distribution: Several dynamics inhibit development of the games for health marketplace. Two kinds of stigma limit the traction of games for health. First, old thinking brands electronic games as vacuous, if not harmful to learning. Second, game companies with a loyal youth audience fear they will tarnish their ‘cool’ reputation if their games start to feel overloaded with good-for-you messages. Both approaches do a disservice to games for health, which are not simply games with public service announcements tacked on.

    Confined by this prevailing stigma, entrepreneurs may underestimate the potential customer base and distribution channels for games for health. Some developers assume people are unwilling to pay for a game associated with health, while others think that health games can’t sell in an entertainment store. But these are symptoms of a more fundamental problem: a game with a poorly defined purpose and limited concept of its audience. A well-defined game that addresses a new problem will likely identify a new audience for games. For instance, seniors living in nursing homes are not the typical game consumers. But they may rush to a game that helps them live more independently, and communicate their aches and pains to family members. Similarly, doctors may be new consumers of diagnostic games, and their offices may be new distribution channels to reach patients. Insurers could also speed up patient recovery with games, as CIGNA has done by distributing HopeLab’s cancer awareness game Re-Mission to doctors.

  • Product Design Is Oriented Toward Consumption not Application : Most health care products, like pharmaceuticals, are designed to be consumed – we don’t interact with them or engage with our drugs on anything but a functional level. Similarly, most games are designed to entertain and be used – but not to teach us anything but how to play the game. This one-dimensional sensibility manifests in many companies’ product designs. And such products then have limited applications. But what if games were re-conceptualized -- developed to easily help casual gamers apply what they learned? The challenge, and the brilliance, of games for health is their design to promote learning and change behavior, all while entertaining. To do this successfully, games should be easy to learn, or at least easily engage the player. When a product’s gadgetry frustrates, rather than helps, patients, it loses its purpose and potential customers. Rules and operation should be, at best, subtle background features.

  • Narrow Corporate or Public Policy Mission : New companies often have narrow missions in order to focus on their core business. Game developers focus on entertaining and health sector agencies focus on treating illnesses. But such silos of narrow missions can limit product development, and new applications of existing products. In addition, it can lead to ignoring potential customers and their needs, such as the contingent of aging Baby Boomers, who want independence and control over their health rather than to passively be treated by a doctor. Big game companies like Nintendo have recognized this new market, with brain agility games such as Brain Age. Narrow public policy missions also can miss opportunities to develop games or characters to reach citizens online in the growing social networking and virtual community sites such as myspace or Second Life.


Innovation Principle: Create Experiential Scenarios to Make Smarter Choices Outside the Game

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Competition Links