Why Games Matter

A Prescription for Improving Health and Health Care

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Competition Summary

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:

Social Impact:

Sustainability:

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

Entry Stage – July 11 to 6 pm EST September 26, 2007:

Online Review and Judging – September 27 to October 24, 2007:

Voting – October 24 to 6:00 pm EST November 7, 2007:

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

Physical Health: Managing disease and maintaining motor control, biological systems and fitness : Most illnesses involve some loss of control, because the patient has lost strength or range of movement, or because cellular or muscular systems are not working optimally. Games offer an ideal environment for the patient to reassert control over their body, by learning new adaptive ways of managing their illness. Even for less serious situations, such as improving fitness, fun exercises and escapist experiences in a game may deliver better results and keep consumers engaged over the long-run than monotonous activities at the gym.
Emotional Health: Tapping Affect, empathy, imagination, and introspection : Mental and emotional health is important for its own sake, as well as for its effect on physical health. Online environments can provide the shelter of privacy that allow people to name and tackle the source of their struggle, such as peer support groups in online communities to manage chronic illness. Games in particular provide helpful metaphors for people to be simultaneously introspective and engaged.
Cognitive Fitness: Sustaining memory, neurological function, and logical reasoning : Staying fit and agile cognitively is a key driver of overall health. Better than lifelong math homework or expensive drugs with side effects, games can be a natural solution to keeping the brain active. Games that require sharp reasoning and rapid calculations are relatively easy to produce, from crossword puzzles to more sophisticated online brain-teasers. These can be distributed through family doctors and set up at senior centers as social activities.
Community Health: General well-being and awareness of common foundation for information and support: Health is a social phenomenon— not only because diseases spread but also because poor community well-being can undermine safety and security. Innovations in this dimension can increase awareness of human behaviors – personal as well as industrial actions – that undermine well-being. They also can provide information and tools to identify and tackle disease vectors, from poverty to viruses.
Environmental Protection: Protecting natural resources and food supply : As we learn more about how toxins and pollutants can dull even the sharpest of minds, there is increased urgency to prevent environmental upset and contamination. Sustainable living often seems a daunting task and unattainable for the average person. But games that inform and illustrate the impact of specific behaviors can allow people to practice new choices, such as different foods and transportation options. Through practice, they can discover their ability to reduce their environmental footprint, which can instill long-lasting changes in how we live.

Short Descriptions of Mosaic Cases
1. Dance Dance Revolution
  
  Chief Developer: Konami
  Country: Japan
  Website: www.konami.jp/bemani/ddr/na/index.html
  Mosaic Principle: Physical Health
  Mosaic Barrier: Insufficient Evidence that Games Can Improve Health and Management of Chronic Diseases
  Dance Dance Revolution is keeping feet tapping at game arcades across the globe. This music video game challenges players to tap their feet on a dance pad with panels. Players press the panels with their feet in response to the arrows that appear on a screen in front of them. The arrows are synchronized to various song beats and success depends on one’s ability to time and position one’s feet accordingly. Featuring increasing levels of speed and difficulty, this game offers a fun exercise alternative for those whom the monotony of gym routines is a disincentive to working out.
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2. Glucoboy
  
  Chief Developer: Paul Wessell
  Country: USA
  Website: www.myglucoboy.com
  Mosaic Principle: Physical Health
  Mosaic Barrier: Insufficient Evidence that Games Can Improve Health and Management of Chronic Diseases
  For children forced to live with juvenile diabetes, keeping a constant check on blood sugar levels no longer need be a chore. With Glucoboy, diabetes management morphs from a difficult living condition into a thrilling and educational video game. This glucose meter can be inserted into a Nintendo Gameboy. The product operates independently of the video game system but downloads video game programs that are contained within its circuitry into the Gameboy as a reward for maintaining good blood sugar control. With patients being responsible for their own diabetes management, the Glucoboy carries an essential dual role: providing accurate medical diagnosis for the disease as well as an incentive delivery platform which serves as a key portal for obtaining patient-critical medical data.
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3. Hopelab’s Re-Mission
  
  Chief Developer: Hopelab
  Country: USA
  Website: www.hopelab.org
  Mosaic Principle: Physical Health
  Mosaic Barrier: Dual Stigma about Games Limits Potential Customer Base and Distribution
  Re-Mission, a 3D video game starring a nanobot called Roxie who zooms through the bodies of cancer patients zapping cancer cells, battling infections and managing side effects of cancer and cancer treatments, is aimed at ensuring that teenage victims of cancer understand their condition, internalize the importance of sticking to treatment and adopt behavior designed to improve their health and quality of life. Re-Mission was developed by HopeLabs, US, through a collaborative process that included video game developers, animators, cancer experts, cell biologists, psychologists, and young cancer patients.
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4. Snack Dash
  
  Chief Developer: Pixel-Lab
  Country: UK
  Website: www.schoolfoodtrust.org.uk/
  Mosaic Principle: Physical Health
  Mosaic Barrier: Dual Stigma about Games Limits Potential Customer Base and Distribution
  UK-based School Food Trust just ramped up its efforts to get children to eat healthy by aggressively distributing Snack Dash. The video game is a race to guide sonic character eBee dBee through the school as fast as possible. Along the way, eBee needs to collect health foods to maximize energy, speed and points, and avoid the unhealthy trap of junk foods that will make him fat and slow.
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5. Sonic Invaders
  
  Chief Developer:
  Country: USA
  Website: www.audiogames.net/db.php?action=view
  Mosaic Principle: Physical Health
  Mosaic Barrier: Product Design is Oriented Toward Consumption, Not Application or Learning
  Sonic Invaders, an arcade game played and navigated entirely in audio, is ideal for those with vision impairments. It requires players to “shoot” down extraterrestrials who are invading earth. Gameplay is heavily based on sound positioning in a stereo field and players control the game exclusively through the keyboard and headphones.
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6. Fat World
  
  Chief Developer: Persuasive Games
  Country: USA
  Website: http://www.persuasivegames.com
  Mosaic Principle: Physical Health
  Mosaic Barrier: Product Design is Oriented Toward Consumption, Not Application or Learning
  Fatworld, an online game on the politics of nutrition, works through a mix of empathy and ridicule. Players create a character and then live out his/her life in a veritable consumer paradise where they rule over their empire of restaurants and convenience stores, and enjoy food allergies, diabetes, heart disease, and death! Players’ health outcomes are dependent on the choices they make, for example, that between going in for wheatgrass or fried chicken. The game explores the relationship between obesity, nutrition, and the socio-economics of health in contemporary U.S.A. The game is due for release in Fall 2007.
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7. Brain Age
  
  Chief Developer: Nintendo
  Country: Japan
  Website: www.brainage.com
  Mosaic Principle: Physical Health
  Mosaic Barrier: Narrow Corporate or Public Policy Mission
  Nintendo’s handheld game Brain Age ensures your mind gets the workout it needs to stay in top form. Inspired by the work of prominent Japanese neuroscientist Dr. Ryuta Kawashima, Brain Age features activities designed to stimulate and exercise different parts of the brain. Solving simple math problems, counting people going in and out of a house simultaneously, drawing pictures on the Nintendo DS touch screen, and playing Sudoku are some of the ways in which the brain is massaged. With its potential for ratcheting up cerebral activities, the game may have a profound impact on staving off and/or arresting the onset of diseases like Alzheimer’s.
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8. ID the Creep
  
  Chief Developer: NCMEC
  Country: USA
  Website: www.idthecreep.com
  Mosaic Principle: Emotional Health
  Mosaic Barrier: Dual Stigma about Games Limits Potential Customer Base and Distribution
  ID The Creep is an online game designed to help young girls practice identifying pedophiles online. The game is a part of the “Think Before You Post” campaign from the Department of Justice, the Ad Council, and the National Center for Missing and Exploited Children (NCMEC) and is aimed at making teenage girls aware of the dangers of posting personal information on social networking sites. The game lets players search mock emails, instant messages, and chat rooms and pick out the potential pervert. The game challenges young people who think they would be able to identify a predator to play along and see how they score. It allows players to engage in simulated chat, e-mail, and IM situations and choose from several statements as they reply to others. It serves both as a sobering wake-up call to teens who realize they are not quite as creep-savvy as they think.
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9. IntroSpection
  
  Chief Developer: Stephen Wilson (Art Department, San Francisco State University)
  Country: USA
  Website: www.userwww.sfsu.edu/~swilson/
  Mosaic Principle: Physical Health
  Mosaic Barrier: Dual Stigma about Games Limits Potential Customer Base and Distribution
  Presented as an art installation, visitors to IntroSpection interact with microorganisms and cells derived from their own body in a non-invasive way when they surrender a cell sample from their own mouth onto a microscope slide. The slide is then submitted to Nikon's automated Coolscope which allows telemicroscopy control for the computer orchestrating the multi-media event. Visitors can then engage in a number of games: Exploration demystifies biological research where players undertake a mini-study of their own body; in another game, visitors try to identify what place in their cell sample is the origin of a blown up mystery image. Viewers end up reflecting on the changing nature of identity when so much cultural attention is focused on the microbiological level.
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10. Personal Investigator
  
  Chief Developer: Media Labs Europe
  Country: Ireland
  Website: www.medialabeurope.org
  Mosaic Principle: Emotional Health
  Mosaic Barrier: Product Design is Oriented Towards Consumption, Not Application or Learning
  Personal Investigator (PI) is an online 3D detective game designed to help teens overcome mental health problems and engage with traditional mental health care services. It combines the goal-orientation of gaming with the Brief Solution Focused Therapy (BSFT) model of goal-oriented psychological therapy, and serves to reach out to teenagers, a group that therapists often have difficulty getting through to. Players take on the role of Solution Detectives in a Detective Academy. As they move through the academy they are set a series of tasks that are rewarded. The tasks and dialogues implement the therapy model and by achieving the goals set by the game, teenagers learn to understand their problem, convert it to a goal, and identify the resources they have to help them achieve this goal.
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11. Paint Affects
  
  Chief Developer: Mind Games
  Country: USA
  Website: www.medialabeurope.org/mindgames/projects/paintAffects/projectPaintAffects.htm
  Mosaic Principle: Emotional Health
  Mosaic Barrier: Product Design is Oriented Towards Consumption, Not Application or Learning
  Mind Games’ Paint Affects allows you to, quite literally, paint with your emotions. This multi-modal installation gives users creative control over a large virtual canvas and a digital palette that is influenced by their biometric state. The user paints by gesturing with a pressure controlled orb. Simultaneously, the system reads his/her biometric measurements and the resultant swathes of color on the canvas are a direct result of the painter’s emotions as the paint particles adopt characteristics synonymous with his/her biometric state. The game has tremendous potential for application in art therapy, for example, with autistic children.
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12. mtvU
  
  Country: USE
  Website: www.mtvu.com
  Mosaic Principle: Emotional Health
  Mosaic Barrier: Narrow Corporate or Public Policy Mission
  mtvU, MTV’s 24-hour college TV network is promoting game development around social issues through global online competitions. The channel throws open “challenges” to gamers, activists and students to create innovative video games aimed at making the world a better place by raising awareness and the promotion of personal action. While the competitions offer prize money, the real incentive offered up by mtv is that it helps gamers to develop and market the game. The widely acclaimed Darfur is Dying was one such game that was surfaced through their competition, and then launched by them.
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13. Phantom Limb
  
  Chief Developer: University of Manchester
  Country: UK
  Website: www.psych-sci.manchester.ac.uk
  Mosaic Principle: Cognitive Health
  Mosaic Barrier: Insufficient Evidence that Games Can Improve Health and Management of Chronic Diseases
  Virtual reality is providing welcome relief to Phantom limb pain or PLP—the discomfort felt by a person in an amputated limb. Drawing on research that prove that when a person's brain is 'tricked' into believing they can see and move a 'phantom limb,' pain can decrease, researchers at UK’s University of Manchester’s Schools of Psychological Sciences and Computer Science are using 3D computer graphics to combat the pain suffered by amputees with remarkable results. By putting on a headset patients enter a life-sized virtual world, where they see themselves with two limbs. They can control the movements of their purely computer-generated limb using their remaining physical one.
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14. Journey into the Brain
  
  Chief Developer: Morphonix
  Country: USA
  Website: www.morphonix.com
  Mosaic Principle: Cognitive Health
  Mosaic Barrier: Product Design is Oriented Toward Consumption, Not Application or Learning
  Weaving the key concepts of brain structure into the very fabric of game play, Journey into the Brain is an award-winning mystery-adventure game for children ages 7-11. The game’s developer, Morphonix, has come up with a series of video games that make abstract concepts of brain science fun and comprehensible to children and teens. While many software games stimulate children to use their brains, this is the first series of video games that also teaches them the science of their brains including information on neuroscience and a whole slew of brain facts.
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15. Cognitive Lab’s Free Brain Games
  
  Chief Developer: University of Manchester
  Country: UK
  Website: www.cognitivelabs.com
  Mosaic Principle: Cognitive Health
  Mosaic Barrier: Narrow Corporate or Public Policy Mission
  Research shows that speed games are a highly effective form of brain exercise with measurable impact on improved cognitive performance years into the future. Focused on helping people of all ages in improving their brainpower and tracking their brain, Cognitive Labs is developing and marketing cognitive testing software that is delivered as a web service on the Internet and through strategic partners. The company’s goal is to provide the widest variety and selection of cognitive games anywhere—both developed by them as well as by independent game developers. The free-of-charge games fit with regular test taking and exercising and with players’ other online activities including searching, reading news, and checking email.
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16. Stop Disasters!
  
  Chief Developer: PlayerThree
  Country: USA
  Website: www.stopdisastersgame.org
  Mosaic Principle: Community Health
  Mosaic Barrier: Insufficient Evidence that Games Can Improve Health and Management of Chronic Diseases
  Sponsored by the UN International Strategy for Disaster Reduction, Stop Disasters! is a disaster simulation strategy game that tackles the very real issue of saving lives and reducing the financial impact that natural hazards cause when they turn into disasters. The game aims to raise awareness of how disasters affect people and how even simple measures can save lives. Aimed primarily at secondary level students—a young yet influential audience—the game will soon be translated into the UN's five major languages to broaden its reach.
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17. Outbreak at Water’s Edge
  
  Chief Developer: Midwest Center for Life-Long-Learning in Public Health (MCLPH); University of Minnesota School of Public Health, Centers for Public Health Education and Outreach; and Popular Front Interactive
  Country: USA
  Website: www.mclph.umn.edu/watersedge/index.html
  Mosaic Principle: Community Health
  Mosaic Barrier: Insufficient Evidence that Games Can Improve Health and Management of Chronic Diseases
  The need to recruit the next generation of public health professionals has never been greater: Outbreak at Watersedge, an interactive game, introduces players to the domain of public health. Players are challenged to discover the source of the outbreak that has hit the small community of Watersedge and to stop it before more residents fall ill. The learnings from the game include discovering how public health professionals investigate disease outbreaks and their role in promoting health and preventing illness. By introducing players to various professional roles within the field of public health, the game is helpful for those seeking a career in health to identify specific jobs within this field. The game is also available in a CD format.
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18. Squeezed
  
  Chief Developer: University of Denver
  Country: USA
  Website: www.du.edu
  Mosaic Principle: Community Health
  Mosaic Barrier: Dual Stigma about Games Limits Potential Customer Base and Distribution
  Squeezed, an online game developed by students and faculty at the University of Denver, is designed to make players empathize with the struggles of migrant farm workers. The common gaming figure of the first-person shooter appears here as first person picker who must pick fruit in order to obtain juice, which is used as currency. Part of the juice gets shipped away. The player must decide how to allocate the little that remains between multiple, competing demands including her family’s needs in her homeland, her own needs, etc. There’s a strong emotional element to the game that reinforces the player’s empathy with migrant workers even as s/he learns about their tough everyday realities.
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19. Darfur is Dying
  
  Chief Developer: University of Southern California
  Country: USA
  Website: www.darfurisdying.com
  Mosaic Principle: Community Health
  Mosaic Barrier: Product Design is Oriented Toward Consumption, Not Application or Learning
  Darfur is Dying, a free online interactive video game, affords players an insight of what it is like to be a refugee in the genocide-affected Darfur region of Sudan. Players take on the role of refugees searching for water, food, shelter, and safety, while at the same time, hiding from the government-sponsored marauding Janjaweed militia. The third and last “level” of the game makes a conceptual leap in allowing players to together rebuild devastated villages. Created by a team of University of Southern California students lead by Susan Ruiz and Ashley York— staunch believers in multiplayer online game activism—the game hopes to facilitate an immediate call to action as it stirs the conscience of players.
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20. Ayiti: The Cost of Life
  
  Chief Developer: Gamelab & Global Kids
  Country: USA
  Website: ayiti.newzcrew.org/ayitiunicef/
  Mosaic Principle: Community Health
  Mosaic Barrier: Product Design is Oriented Toward Consumption, Not Application or Learning
  A free online role-playing game developed by teens for teens, Ayiti: The Cost of Life, exposes players to what it is like to live in poverty, struggling to stay healthy, keep out of debt, and get educated. Players take responsibility for a family of five in rural Haiti. The game spans a 4-year time period spread over 16 seasons, in which season-dependent work roles are given to family members, and where players also guide them in community building and in children’s education.
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21. Food Force
  
  Chief Developer: United Nations World Food Programme
  Country: Italy
  Website: www.food-force.com
  Mosaic Principle: Community Health
  Mosaic Barrier: Narrow Corporate or Public Policy Mission
  Available in ten languages and with over 3 million players worldwide, Food Force is a free educational video game that serves as a classroom tool for teaching 8-13-year-olds about hunger. The game transports players to the imaginary island of Sheylan where a terrible disaster has struck. Each of the game's six missions or mini-games takes players from an initial crisis assessment of the number of survivors and their needs, through to safe delivery of airdropped food packages and properly planned distribution of food aid. Together, the missions provide an overview of how food aid is used in both emergencies and long-term development projects.
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22. CDC in Second Life
  
  Chief Developer: Centers for Disease Control and Prevention (CDC); Second Life
  Country: USA
  Website: www.secondlife.com/
  Mosaic Principle: Community Health
  Mosaic Barrier: Narrow Corporate or Public Policy Mission
  The blended reality aspect of real and virtual worlds can be fascinating. Centers for Disease Control and Prevention is leading trends among Federal agencies by teaming up with Second Life, a 3D online digital world created by its own residents, to disseminate CDC health content via the virtual world. This CDC-Second Life virtual office is focused on merging good health practices in real life with the fun and play of Second Life, making public health a reality, in virtual and actual ways.
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23. Nanoswarm
  
  Chief Developer: Archimago
  Country: USA
  Website: www.archimageonline.com/nanoswarm.cfm
  Mosaic Principle: Environmental Health
  Mosaic Barrier: Dual Stigma about Games Limits Potential Customer Base and Distribution
  Leading healthy lives just got a whole lot more fun for kids with Archimago’s Nanoswarm, a video game. Through the game, players are made to recognize the role that diet and physical activity play in the development of obesity and realize that it’s “cool” to exercise and to eat fruit and veggies. Developed in close collaboration with Children’s Nutrition Research Center of Houston’s Baylor College of Medicine, this action-packed game challenges players to more effectively use information learned during gameplay and incorporate this “virtual experience” into their daily lives through behavior modification designed to prevent diabetes.
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24. Water Alert!
  
  Chief Developer: Tearfund; Water Aid
  Country: USA
  Website: www.unicef.org/voy/explore/wes/explore_1818.html
  Mosaic Principle: Environmental Health
  Mosaic Barrier: Dual Stigma about Games Limits Potential Customer Base and Distribution
  Water Alert! is a free online educational game on water, environment and sanitation where young people are engaged in an adventure of strategy and survival. Available also on CD, the game is designed to work within established standards for learning and comes with content linkages that provide contextual support for classroom use. The goal is to ensure that the people in a fictional drought-challenged village, who are facing a flood threat, have safe drinking water and a clean and healthy school environment. Players are informed of the impending emergencies and made to choose between two “challenges” at the River or School and Pump. The first challenge addresses issues of water contamination and emergency planning in a team situation, while the latter encourages local action in school.
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25. SimCity
  
  Chief Developer: SimCity Societies
  Country: USA
  Website: simcity.ea.com
  Mosaic Principle: Environmental Health
  Mosaic Barrier: Narrow Corporate or Public Policy Mission
  SimCity is a game that allows players to create their own cities and to shape their cultures, societal behaviors and environments. It allows players to mix-and-match and combine, connect and rearrange elements of their city depending on the kind of city one wants: a happy and creative one, an aggressive totalitarian one, or one that leaves an environmental footprint. A revolutionary feature allows players to combine buildings that will produce or consume new kinds of resources called “social energies” such as industry, wealth, obedience, knowledge, devotion, or creativity. The social energy of one’s city will determine the quality of life lived in it.
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