Games for Health Research Papers (original) (raw)

This article is concerned with attempts to pose videogames as solutions to systemic racism. The mobile app, Everyday Racism, is one such game. Its method is to directly address players as subjects of racism interpellating them as victims of racist language and behaviour within Australian society, implicating the impact of racism on mental health and wellbeing. While the game has politically laudable goals, its effectiveness is undermined by several issues themselves attributable to the dynamics of race and games. This paper will spell out those issues by addressing three separate facets of the game: the problematic relationship between the player and their elected avatar; the pedagogic compromises that are made in modelling racism as a game; finally, the superliminal narrative that attempts to transcend the limited diegetic world of the game.

- by and +1
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- Game studies, Serious Games, Race and Racism, Video Games and Learning

This article reviews research in the fields of psychology, literature, communication, human-computer interaction, public health, and consumer behavior on narrative and its potential relationships with videogames and story immersion. It also reviews a narrative's role in complementing behavioral change theories and the potential of story immersion for health promotion through videogames. Videogames have potential for health promotion and may be especially promising when attempting to reach youth. An understudied characteristic of videogames is that many contain a narrative, or story. Story immersion (transportation) is a mechanism through which a narrative influences players' cognition, affect, and, potentially, health behavior. Immersion promotes the suspension of disbelief and the reduction of counterarguments, enables the story experience as a personal experience, and creates the player's deep affection for narrative protagonists. Story immersion complements behavioral change theories, including the Theory of Planned Behavior, Social Cognitive Theory, and Self-Determination Theory. Systematic investigations are needed to realize the powerful potential of interactive narratives within theory-driven research.

- by Tom Baranowski
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- Health Promotion, Games for Health, Digital Story Telling

Können,Computerspiele,für,junge, Menschen,identitätsstiftend,sein?,, Der Heros verlässt die Welt der gemeinen Tage und sucht einen Bereich übernatürlicher Wunder auf, besteht dort fabelartige Mächte und erringt einen entscheidenden Sieg, dann kehrt er mit der Kraft, seine Mitmenschen mit Segnungen zu versehen, von seiner geheimniserfüllten Fahrt zurück. (Campbell 1999, S.36) Adoleszenz,>,der,"Identitäts>Findungs>Höhepunkt"., Die Adoleszenz ist jene Entwicklungsphase im menschlichen Leben, die am stärksten von der Suche nach Identität geprägt ist. Es gilt sich aus der Position des Kindes seiner Eltern hin zu einem eigenständigen Individuum mit besonderen Fähigkeiten, Zielen und Möglichkeiten zu entwickeln. Der Weg ist ein mitunter harter und auch schmerzlicher. "Die psychische Arbeit, die dabei jeweils geleistet werden muss, besteht zunächst in Abschied und Trauer, des Weiteren in der Fähigkeit, Bestehendes infrage zu stellen und die damit verbundenen Ängste und Schuldgefühle auszuhalten, und schließlich darin, aus den vorhandenen Ressourcen Vergangenes und Gegenwärtiges zu einem neuen Lebensentwurf zu verknüpfen." (King 2009, S.135) Um diesen schwierigen Job zu meistern, ist es notwendig sich Rahmenbedingungen zu schaffen, die jene Prozesse begünstigen. Und genau das tun Jugendliche. Sie sind unglaublich "…erfinderisch, eine Umwelt zu schaffen oder zu suchen, die andersartige Lösungen als die der infantilen Entwicklungsphase möglich macht." (Bohleber 1996, S.16) Sie erschaffen sich Lebenswelten, die eine Abgrenzung von der Herkunftsfamilie ermöglichen, sie suchen sich Interaktionsparter/innen, mit denen sie -oft in einer Art geschütztem Raum, oder wie Gee in Anlehnung an Erikson sagt: in einem psychosozialen Moratorium (Gee 2008) -reife Interaktion erproben können. Selbsterkenntnis als jener Vorgang Kenntnis zu erlangen über sich selbst, über seine Möglichkeiten und Ressourcen -über das einzigartige so-Sein im zeitlichen Kontinuum ist untrennbar verwoben mit dem Prozess der Selbstgestaltung, der auf Ziele ausgerichtet ist. (vgl.Oerter & Montada 2002, S.292) Gemeinsam sind dies die beiden Kräfte, die bewirken, dass -im günstigen Fall -ein Gefühl von Identität oder aber -im ungünstigen Fall -eines von Identitätsdiffusion vorherrscht. (vgl.Erikson 1973)

- by Katharina Mittlböck
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- Game studies, Education, Social Work, Teacher Education

Objective: This study investigates games intended for use with an upper-limb exoskeleton robot operated unilaterally and bilaterally. Games are evaluated in terms of usability and preference for stroke survivors. Game design considerations relating to the human to machine interface, are also discussed. Subjects and Methods: Ten hemiparetic stroke survivors completed 12 90-minute sessions using an upper-limb robotic exoskeleton unilaterally and bilaterally. During the sessions subjects played seven different games designed for rehabilitation. At the conclusion of their sessions subjects completed an 83-question survey. Results: Subjects preferred static games to dynamic games. Preferred games elicited greater effort. Conclusions: Intermediate goals in addition to ultimate goals should be set with both static and dynamic games such that even with the patient's limited range of motion, speed, or coordination, the game should be playable and provide a sense of accomplishment to the patient. Marking the games' ultimate goals that can be accomplished only by healthy subjects, such as range of motion and workspace, provide references and encouragement to the patient for improving motor control and performance through the process of playing the game.

- by Nancy Byl and +1
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- Games for Health, Communication and media Studies, Games Culture

This paper presents analysis of relationship between change in the player’s behavior to performance of a fighting game AI for health promotion. The AI was developed for balancing use of body segments of the player for preventing muscle... more

- by Pujana Paliyawan and +1
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- Artificial Intelligence, Health Promotion, Video Games, Games for Health

Stroke is the main cause of disability in adulthood. Recent advances in virtual reality (VR) technologies have led to its increased use in the rehabilitation of stroke patients. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effectiveness of game-based reality on upper limb (UL) motor function and quality of life after stroke. In March 2018, a search of the following databases was performed: PubMed, PEDro, Web of Science, Scopus, The Cochrane Library, and Medline at EBSCO. The selection criteria were all RCTs published in English or Spanish during the past 10 years. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 20 clinical trials were included in the systemic review, of which 15 contributed information to the meta-analysis. Favorable results were found for VR interventions on UL motor function (Fugl-Meyer Assessment for upper extremity, standardized mean difference [SMD] = 1.53, 95% CI [0.51-2.54]) and quality of life (functional independence measure, SMD = 0.77, 95% CI [0.05-1.49]). The results demonstrate the potential benefits of VR interventions on the recovery of UL motor function and on quality of life after stroke.

- by Alejandro Salazar
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- Games for Health

This paper presents a design of a non-player character (AI) for promoting balancedness in use of body segments when engaging in full-body motion gaming. In our experiment, we settle a battle between the proposed AI and a player by using FightingICE, a fighting game platform for AI development. A middleware called UKI is used to allow the player to control the game by using body motion instead of the keyboard and mouse. During gameplay, the proposed AI analyze health states of the player; it determines its next action by predicting how each candidate action, recommended by a Monte-Carlo tree search algorithm, will induce the player to move, and how the player' health tends to be affected. Our result demonstrates successful improvement in balancedness in use of body segments on all five subjects.

- by Pujana Paliyawan and +3
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- Artificial Intelligence, Health Promotion, Video Games, Games for Health

Media Literacy als eine Schlüsselkompetenz für Life Long Learning setzt sich aus verschiedenen Teilkompetenzen zusammen, die nur in ihrem Zusammenspiel einen konstruktiven und unbeschadeten Umgang mit digitalen Medien erlauben. Im vorliegenden Artikel, der Einblick in ein laufendes Dissertationsprojekt gibt, wird der Blick auf psychodynamische Aspekte von Media Literacy gerichtet. Es wird das Experiment gewagt, Prozesse, die im Rahmen von psychoanalytischer Psychotherapie stattfinden können, mit solchen zu vergleichen, die auch beim Spielen von Digital Role Playing Games (DRPG) zum Tragen kommen. Dabei wird dargestellt, inwiefern sowohl die Psychoanalyse, als auch DRPGs ein günstiger Rahmen für potentielle Persönlichkeitsentwicklungsräume sein können.

- by Katharina Mittlböck
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- Psychoanalysis, Game studies, Games for Health, Games for Change

Games provide an attractive venue for engaging participants and increasing nutrition-related knowledge and dietary behavior change, but no review has appeared devoted to this literature. A scoping review of nutrition education and dietary behavior change videogames or interactive games was conducted. A systematic search was made of PubMed, Agricola, and Google Scholar. Information was abstracted from 22 publications. To be included, the publication had to include a videogame or interactive experience involving games (a videogame alone, minigames inserted into a larger multimedia experience, or game as part of a human-delivered intervention); game's design objective was to influence dietary behavior, a psychosocial determinant of a dietary behavior, or nutrition knowledge (hereinafter referred to as diet-related); must have been reported in English and must have appeared in a professional publication, including some report of outcomes or results (thereby passing some peer review). This review was restricted to the diet-related information in the selected games. Diversity in targeted dietary knowledge and intake behaviors, targeted populations/audiences, game mechanics, behavioral theories, research designs, and findings was revealed. The diversity and quality of the research in general was poor, precluding a meta-analysis or systematic review. All but one of the studies reported some positive outcome from playing the game(s). One reported that a web-based education program resulted in more change than the game-based intervention. Studies of games may have been missed; a number of dietary/nutrition games are known for which no evaluation is known; and the data presented on the games and research were limited and inconsistent. Conclusions and Implications: A firmer research base is needed to establish the efficacy and effectiveness of nutrition education and dietary behavior change games.

- by Amy S. Lu
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- Nutrition and Dietetics, Obesity, Video Games and Learning, Games for Health

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: This special supplement, " Children, Adolescents and Screens: What We Know and What We Need to Learn, " was made possible through the financial support of Children and Screens: Institute of Digital Media and Child Development. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. Obesity is one of the best-documented outcomes of screen media exposure. Many observational studies find relationships between screen media exposure and increased risks of obesity. Randomized controlled trials of reducing screen time in community settings have reduced weight gain in children, demonstrating a cause and effect relationship. Current evidence suggests that screen media exposure leads to obesity in children and adolescents through increased eating while viewing; exposure to high-calorie, low-nutrient food and beverage marketing that influences children's preferences, purchase requests, consumption habits; and reduced sleep duration. Some evidence also suggests promise for using interactive media to improve eating and physical activity behaviors to prevent or reduce obesity. Future interdisciplinary research is needed to examine the effects of newer mobile and other digital media exposures on obesity; to examine the effectiveness of additional interventions to mitigate the adverse effects of media exposures on obesity and possible moderators and mediators of intervention effects; to effectively use digital media interventions to prevent and reduce obesity; and to uncover the mechanisms underlying the causal relationships and interactions between obesity-related outcomes and media content, characteristics, and context.

- by Amy S. Lu
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- New Media, Digital Media, Video Games, Childhood Obesity

- by Sandra Calvert
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- Pediatrics, New Media, Digital Media, Obesity

There has been a debate about whether entertainment videogames should incorporate story or narrative. A concern has been whether story cut scenes break game immersion, and thereby minimize the fun of gameplay. Alternatively, games for health (G4H) have an agenda that goes beyond just having fun. The possible role of story in G4H has not been thoroughly addressed. We have assembled a group of experts who have worked with stories in G4H, and asked some pointed questions.

- by Amy S. Lu
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- Narrative, Video Games, Games for Health

This chapter will situate academia in relation to serious games commercial production and contextual adoption, and vice-versa. As a researcher it is critical to recognize that academic research of serious games does not occur in a vacuum. Direct partnerships between universities and commercial organizations are increasingly common, as well as between research institutes and the contexts that their serious games are deployed in. Commercial production of serious games and their increased adoption in non-commercial contexts will influence academic research through emerging impact pathways and funding opportunities. Adding further complexity is the emergence of commercial organizations that undertake their own research, and research institutes that have in-house commercial arms. To conclude, we explore how these issues affect the individual researcher , and offer considerations for future academic and industry serious games projects. Keywords: serious games · applied games · educational games · games for health · academia · commercial games · games for change · application domains · academic partnerships · research evaluation

- by TJ Matthews
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- Serious Games, Games for Health, Research evaluation, Academia

Specific psychodynamic qualities are a precondition for lifelong personality development. Further development of the human psyche is always happening in a kind of virtual space or as D.W. Winnicott calls it: in an intermediate area. In this article challenges of deep immersion into this intermediate area are mentioned and the parallels and differences between early and later intermediate areas are discussed. The first intermediate areas in the development of an individual are co-constructed in early infancy by “psychological parents” and their child. Later on situations like psychoanalytic therapy or while playing a digital role playing game facilitate the co-construction of intermediate areas as “developmental spaces”. The article focuses on a bundle of competencies of a sane psychic structure that mutually interact. Referring to psychoanalytic theories these four competencies are secondary symbol formation, co-construction of intermediate areas for collaborative playing, back and forth motion of immersion and reflection and strategies to “tame” chaos. The following article will show some aspects how these abilities can be advanced by the act of playing digital role playing games.

Obsessive-Compulsive Disorder (OCD) is a chronic disease stated by United Nations as one of the 10 most disabling illnesses and key factor in decreased quality of life. It affects millions of people around the world, reaching a population equivalent of countries like Germany or Mexico. One of most used and effective treatment is Cognitive-Behavioral Therapy (CBT) but, its failure rate can be as high as 30%. Games have been greatly incorporated to everyday lives of millions of people, and because of that, are becoming a useful tool to help in healthcare-becoming what is called Games for Health (GfH). This literature review seeks to research academic papers that demonstrate the use of games to treat OCD-as games standalone or in conjunction with CBT. The main objectives of this literature review are to summarize the previous published works and to gather base knowledge in the area for future research developments.

- by Bruno Oliveira and +1
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- Cognitive Behavioral Therapy, Serious Games, Video Games, Obsessive-Compulsive Disorder

The use of videogames in healthcare interventions is gaining popularity, but there is still a gap in the understanding on how these types of interventions are used for the management of diabetes. The purpose of this review is to examine published research on the use of videogames for diabetes management. With the increased use of mobile technology, the review was expanded to understand whether games, gamification, and virtual environments can be used for diabetes self-management. Out of the 307 articles identified, only 10 articles met the inclusion criteria of the study. The duration of most studies was short, with small sample sizes. All interventions targeted behavioral changes examining risk reduction of diabetes-related risk and promotion of healthy behavior among study participants. Videogames appeared to be helpful tools for education in some interventions, whereas gamification and virtual environments increased extrinsic motivation and provided positive reinforcement. This review concludes by discussing the potential of using videogames and gamification for the self-management of diabetes.

- by Jason Wen Yau Lee
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- Health Communication, Games for Health, Diabetes self-management

Background: Interactive systems are being developed with the intention to help in the engagement of patients on various therapies. Amid the recent technological advances, KinectÔ from Microsoft (Redmond, WA) has helped pave the way on how user interaction technology facilitates and complements many clinical applications. In order to examine the actual status of Kinect developments for rehabilitation, this article presents a systematic review of articles that involve interactive, evaluative, and technical advances related to motor rehabilitation. Materials and Methods: Systematic research was performed in the IEEE Xplore and PubMed databases using the key word combination ''Kinect AND rehabilitation'' with the following inclusion criteria: (1) English language, (2) page number > 4, (3) Kinect system for assistive interaction or clinical evaluation, or (4) Kinect system for improvement or evaluation of the sensor tracking or movement recognition. Quality assessment was performed by QualSyst standards. Results: In total, 109 articles were found in the database research, from which 31 were included in the review: 13 were focused on the development of assistive systems for rehabilitation, 3 in evaluation, 3 in the applicability category, 7 on validation of Kinect anatomic and clinical evaluation, and 5 on improvement techniques. Quality analysis of all included articles is also presented with their respective QualSyst checklist scores. Conclusions: Research and development possibilities and future works with the Kinect for rehabilitation application are extensive. Methodological improvements when performing studies on this area need to be further investigated.

- by Veronica Teichrieb
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- Video Games, Games for Health, Exercise therapy, Movement
- by Amanda Staiano
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- Financial management, Games for Health, Health Services Research, Research
- by Maged N Kamel Boulos
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- Games for Health

The world population is expected to grow until the year 2100. Also, the number of senior individuals is expected to surpass the number of children and teens in the population. This growth in the raw number and number of seniors creates huge challenges for countries-especially in cost terms. It's well known that preventive healthcare could smooth those impacts through preventing disease. One of the most effective and easy to implement tools healthcare programs of this scope use is exercise. However, many individuals lack the motivation for practice. Since gaming is one of the most used entertainment forms, it seems a good way to attract and maintain people into exercise routines. Games of this type, that require the user movement as part of playing, are called 'Exergames'. This paper is a consequence of larger research towards game design methods for this specific type. Since initial surveys showed some lack of information about this subject, the need for this project emerged. A problem found along the research development was which device would be used to conduct further testing with design methodologies. Therefore, this paper shows the process of using maker movement assets to create an open-source device capable of transforming body movement through cycling into command input to a platform game.

- by Bruno Oliveira and +1
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- Serious Games, Game Design, Computer Games Technology, Video Games

Im Spiel herrschen andere Regeln als im Leben außerhalb des Spielraumes, der hier in Bezug auf digitale Rollenspiele in den Blick genommen wird. Er stellt einen geschützten Handlungsraum und damit Möglichkeitsraum dar, Handlungsmuster, die einem Wiederholungszwang und somit einem gewissen Leidensdruck unterliegen, durch spielerisches Ausprobieren zu durchbrechen. Wie und warum dies denkbar ist, soll im folgenden Beitrag erörtert werden.

- by Katharina Mittlböck
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- Psychoanalysis, Game studies, Games for Health

This article reviews research in the fields of psychology, literature, communication, human–computer interaction, public health, and consumer behavior on narrative and its potential relationships with videogames and story immersion. It also reviews a narrative's role in complementing behavioral change theories and the potential of story immersion for health promotion through videogames. Videogames have potential for health promotion and may be especially promising when attempting to reach youth. An understudied characteristic of videogames is that many contain a narrative, or story. Story immersion (transportation) is a mechanism through which a narrative influences players' cognition, affect, and, potentially, health behavior. Immersion promotes the suspension of disbelief and the reduction of counterarguments, enables the story experience as a personal experience, and creates the player's deep affection for narrative protagonists. Story immersion complements behavioral change theories, including the Theory of Planned Behavior, Social Cognitive Theory, and Self-Determination Theory. Systematic investigations are needed to realize the powerful potential of interactive narratives within theory-driven research.

- by Amy S. Lu
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- Health Promotion, Games for Health, Digital Story Telling
- by Brenda K Wiederhold
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- Games for Health

Objective: Stroke is one of the leading causes of serious long-term disability. However, home exercise programs given at rehabilitation often lack in motivational aspects. The purposes of this pilot study were (1) create individualized virtual reality (VR) games and (2) determine the effectiveness of VR games for improving movement in upper extremities in a 6-week home therapy intervention for persons with stroke. Subjects and Methods: Participants were two individuals with upper extremity hemiparesis following a stroke. VR games were created using the Looking Glass programming language and modified based on personal interests, goals, and abilities. Participants were asked to play 1 hour each day for 6 weeks. Assessments measured upper extremity movement (range of motion and Action Research Arm Test [ARAT]) and performance in functional skills (Canadian Occupational Performance Measure [COPM] and Motor Activity Log [MAL]). Results: Three VR games were created by a supervised occupational therapist student. The participants played approximately four to six times a week and performed over 100 repetitions of movements each day. Participants showed improvement in upper extremity movement and participation in functional tasks based on results from the COPM, ARAT, and MAL. Conclusions: Further development in the programming environment is needed to be plausible in a rehabilitation setting. Suggestions include graded-level support and continuation of creating a natural programming language, which will increase the ability to use the program in a rehabilitation setting. However, the VR games were shown to be effective as a home therapy intervention for persons with stroke. VR has the potential to advance therapy services by creating a more motivating home-based therapy service.

- by Jack Engsberg
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- Games for Health

Ubiquitous computing and ambient assisted living environments offer promising solutions to meet the demographic change. An example are serious games for health care: Regular exercises mediated through games increase health, well-being, and autonomy of the residents whilst at the same time reducing the costs for caregiving. To understand which factors contribute to an increased acceptance of such exercise games in ambient assisted living environments, a prototypic game was evaluated with 32 younger and 32 older players. Game performance is influenced by age, need for achievement, and also gender. Acceptance and projected use are related to the believe in making the game a habit, current gaming frequency, and social influences. Notably, the game increased the perceived health of the subjects, which is an important issue. This article concludes with guidelines to successfully introduce serious exercise games into health care and future ideas to realize social inclusion in game design.

- by Philipp Brauner and +1
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- Health Psychology, Information Technology, Serious Games, Ubiquitous Computing
- by Tom Baranowski
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- Games for Health

Virtual reality (VR) techniques have proved effective in distracting patients from perceived pain in a variety of studies. These results, partly due to the visual impact and immersion achieved, encourage investigating the purposeful design of games for deployment in a variety of dentist treatments. In fact, a large group of patients, particularly youngsters, experience a strong resistance or even aversion to visiting a dentist's practice, often due to previous distressing and painful experiences. We argue that, to solve such situations, distracting a patient with just an attractive virtual environment is less efficient than with an interactive game expressly designed for this context and purpose. This paper presents the first results of a pilot project in this direction. We discuss the various requirements gathered throughout the project, and describe several technological challenges, involving e.g. user experience, interaction, content, graphics, which we faced throughout the game design and development phases. Although the project is still ongoing, the preliminary results of the prototype game evaluation in a controlled environment were very encouraging.

- by Rafael Bidarra
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- Games for Health

This article reviews research in the fields of psychology, literature, communication, human–computer interaction, public health, and consumer behavior on narrative and its potential relationships with video games and story immersion. It also reviews narrative's role in complementing behavior change theories and the potential of story immersion for health promotion through video games. Video games have potential for health promotion and may be especially promising when attempting to reach youth. An understudied characteristic of video games is that many contain a narrative, or story. Story immersion (transportation) is a mechanism through which a narrative influences players' cognition, affect, and, potentially, health behavior. Immersion promotes the suspension of disbelief and the reduction of counterarguments, enables the story experience as a personal experience, and creates the player's deep affection for narrative protagonists. Story immersion complements behavioral change theories, including the Theory of Planned Behavior, Social Cognitive Theory, and Self-Determination Theory. Systematic investigations are needed to realize the powerful potential of interactive narratives within theory-driven research.

- by Amy S. Lu
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- Transportation, Video Game, Games for Health, Narratives

This paper presents a design of a non-player character (AI) for promoting balancedness in use of body segments when engaging in full-body motion gaming. In our experiment, we settle a battle between the proposed AI and a player by using FightingICE, a fighting game platform for AI development. A middleware called UKI is used to allow the player to control the game by using body motion instead of the keyboard and mouse. During gameplay, the proposed AI analyze health states of the player; it determines its next action by predicting how each candidate action, recommended by a Monte-Carlo tree search algorithm, will induce the player to move, and how the player's health tends to be affected. Our result demonstrates successful improvement in balancedness in use of body segments on 4 out of 5 subjects.

- by Pujana Paliyawan
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- Computer Science, Artificial Intelligence, Health Promotion, Video Games

Objective: This study documented the prevalence of active screen time (i.e., screen time that includes active games, exercise or dance videos, or TV exercise programs) and identified characteristics associated with it among youth 9-18 years of age. Subjects and Methods: This cross-sectional study was conducted on a convenience sample of 1,165 youth using the 2009 Styles Surveys; data were weighted to approximate the Current Population Survey. We calculated descriptive statistics and conducted multivariable logistic regression to identify characteristics associated with active screen time by estimating adjusted odds ratio (aOR) and 95 percent confidence intervals (CIs). Results: The sample comprised 51.4 percent boys, and almost 60 percent were non-Hispanic white. The prevalence of active screen time q1 hour/day was 31.2 percent on a typical school day and 41.6 percent on a typical weekend day. Logistic regression revealed youth with physical activity of 3-5 days/week had higher odds of active screen time q1 hour/day compared with youth with no physical activity (aOR school day = 2.8, 95 percent CI 1.5-5.2; aOR weekend day = 2.3, 95 percent CI 1.4-3.9). Certain characteristics (i.e., sex, age group, race/ethnicity, income, and sedentary screen time) were significantly associated with active screen time q1 hour/day, but associations were inconsistent for school and weekend days. Conclusions: Three in 10 youth are engaging in at least 1 hour of active screen time on school days, and about 4 in 10 youth are engaging in at least one hour on weekend days. Understanding the use of active screen time and associated characteristics are important for developing interventions addressing screen time and physical activity.

- by Sohyun Park
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- Games for Health

This paper announces the “Games Against Health” (GAH) research agenda, a criticism of, and response to, the cultural imperialism of the “Games for Health” paradigm. Committed to player-centric design ethics, GAH seeks to dismantle the “games for health” myth as neo-liberal elitist diktat. We acknowledge the values, tastes and pleasures of billions of game players worldwide. We argue that game designers should engage more efficiently in the disimprovement of player health and wellbeing in order to cater to those players’ existing preferences. We hope the paper can serve as a convenient reference for those designing psychotic, sociopathic or antisocial games.

- by Sabine Harrer
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- Cultural Studies, Game Design, Games for Health, Public Health

Exergames são um tipo de jogo para saúde (game for health) que
usa o movimento do corpo do jogador para fins de atividades
físicas – seja para exercícios de melhoria da saúde (fitness) como
também no auxílio em tratamentos de reabilitação. Neste trabalho
são apresentadas as pesquisas para a confecção de um protótipo de
bicicleta para exergames. Para tanto, são apresentadas pesquisas
sobre os dispositivos usados para exergames com foco no uso de
tecnologias do movimento maker como uma alternativa viável
para o desenvolvimento do protótipo

- by Sergio Nesteriuk
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- Video Games, Games for Health, Videogames, Games

This paper proposes a motion-gaming AI for health promotion that can adapt to the player's behavior change in an effective manner. Through modeling of the player's behavior and predicting of their counteraction, this AI learns how its actions can induce its opponent player to move. The proposed AI aims at suppressing health risks associated with motion gaming, by improving balancedness in use of body segments, as well as at increasing the level of calories consumption.

- by Pujana Paliyawan
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- Artificial Intelligence, Games for Health, Motion Detection, Exergaming

Adherence is a significant problem when managing chronic illness. There is some evidence that video games and/or interactive multimedia tools can help to improve health-related behaviors in pediatric populations, but conclusions from... more

- by Pamela Kato
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- Serious Games, Video Games and Learning, Cancer, Medication Adherence

Abstract Health game research has flourished over the last decade. The number of peer-reviewed scientific publications has surged as the clinical application of health games has diversified. In response to this growth, several past literature reviews have assessed the effectiveness of health games in specific clinical subdomains. The past literature reviews, however, have not provided a general scope of health games independent of clinical context. The present systematic review identified 149 publications.

- by Amy S. Lu
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- Games for Health, Systematic Reviews

Objective: Mild cognitive impairment (MCI) is a broad term for people at a stage between normal age-related cognitive decline and dementia, where cognitive problems are present but do not impair activities of daily living. This study aimed at evaluating the effectiveness of a virtual reality (VR)-based rehabilitation program on cognitive functions in MCI. Materials and Methods: Sixty-one older adults (25 men, 36 women) with MCI were randomized to the intervention group (n = 30; 70.12-2.57 years) or control (n = 31; 70.30-2.73 years) group. The intervention group received a VR (computer-generated interactive environments) intervention in addition to a conventional cognitive rehabilitation (CR) intervention, whereas the control group received only the CR intervention. Cognitive functions were assessed in both groups before and after the 12-week interventions by using the Loewenstein Occupational Therapy Cognitive Assessment-Geriatric. Results: Between-group comparisons revealed significantly greater improvements in orientation, visual-spatial perception, visuomotor organization, thinking operation, and attention/concentration functions in the VR group than in the control group (P < 0.001 for all). Conclusion: Our results showed that 12 weeks of VR-based rehabilitation enhanced cognitive functions in older adults with MCI. Using VR applications in CR is recommended to improve cognitive functions of older adults with MCI.

- by serkan pekçetin
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- Games for Health

Purpose: This study examined differences in energy expenditure and bodily movement among children of different weight status during exergames that varied in mode and intensity. Methods: Fifty-seven 8-to 12-year-old children including overweight/ obesity (n = 28) and normal weight (n = 29) played three 10-minute interval Xbox One exergames (Fruit Ninja, Kung-Fu, and Shape Up) categorized based on predominantly upper-, whole-, or lower-limb movement, respectively. The authors measured bodily movement through accelerometry and obtained energy expenditure and metabolic equivalent (MET) via indirect calorimetry. Results: Energy expended during gameplay was the highest in Shape Up (P < .01) and higher in Kung-Fu than Fruit Ninja (P < .01). Absolute energy expenditure was significantly higher in overweight/obese children (P < .01), but not when controlling for body mass across 3 exergames (P > .05). Based on the MET cut-points, overweight/obese children spent more time at light intensity (<3 METs) for Fruit Ninja (P < .05) and Shape Up (P < .01), but less time at vigorous intensity (≥6 METs) for Kung-Fu (P < .01) and Shape Up (P < .01). Lower-limb movements during Shape Up were less in overweight/obese children (P = .03). Conclusion: Although children in both groups expended similar energy relative to their body mass during gameplay, overweight/obese children spent more time at light intensity but less time at vigorous intensity with fewer movements especially while playing a lower limb-controlled exergame.

- by Amy S. Lu
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- Exercise Physiology, Games for Health, Exercise Science, Exergames

"Jogos sérios" (serious games) é o termo adotado para games utiliza-dos para propósitos que extrapolam o entretenimento, em áreas como a edu-cação, treinamento, simulações e a saúde-objeto de preocupação dos gover-nos e tida como relevante para o bem-estar de uma sociedade. Considerando a presença cada vez mais ubíqua e pervasiva dos computadores e smartphones, o texto parte da premissa que jogos de exercícios (exergames) podem vir a ser um caminho viável para a melhoria de práticas relacionadas à saúde na sociedade contemporânea. Após revisão bibliográfica, fez-se perceber uma carência em métodos e ferramentas para auxílio no design desse tipo de jogo. Desta forma, o presente artigo apresenta os estudos exploratórios iniciais de uma pesquisa sobre metodologias de design pensadas para exergames.

- by Sergio Nesteriuk
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- Serious Games, Game Design, Video Games, Video Game Design

Social health games can drive healthy behaviour. To track social behaviour change in social network games (SNGs), gameplay metrics should quantify socially-engaging gameplay behaviour based on player interactions. We developed social player metrics in a quantitative study of player behaviour in a social health game called Healthseeker (developed by Ayogo Health Inc.). This Facebook game targets people with diabetes to help them manage health goals in real life. Our metrics identify which game mechanics led to more gameplay success, connectedness and virality. We also identified how the behaviour of successful players differs from unsuccessful players in the game. Our results support that game mechanics aiming at social interactions can motivate players to solve more missions, to fulfill more healthy goals and to play the game longer. We conclude that having a well-connected social network can improve player success in solving game missions.

- by Lennart E Nacke
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- Serious Games, Video Games, Human-Computer Interaction for Games, Social Media

Our research indicated that 10–12-year-old children receiving two active Wii™ (Nintendo®; Nintendo of America, Inc., Redmond, WA) console videogames were no more physically active than children receiving two inactive videogames. Research... more

- by Amy S. Lu
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- Health Promotion, Games for Health

Background: Active video games (AVGs) capable of inducing physical activity offer an innovative approach to combating childhood obesity. Unfortunately, children's AVG game play decreases quickly, underscoring the need to identify novel methods for player engagement. Narratives have been demonstrated to influence behaviors. Objective: The objective of this study was to test the hypothesis that a narrative would motivate increased AVG play, though a feasibility study that investigated the motivational effect of adding a previously developed narrative cutscene to an originally nonnarrative AVG, Nintendo Wii Sports Resort: Swordplay Showdown. Methods: A total of 40 overweight and obese 8-to 11-year-olds equally divided by sex played the AVG. Half (n=20) were randomly assigned to a narrative group that watched the narrative cutscene before game play. The other half played the game without watching it. Results: Children in the narrative group had significantly (P<.05) more steps per 10-second period (mean 3.2, SD 0.7) and overall (mean 523, SD 203) during game play compared with the nonnarrative group (10-second period: mean 2.7, SD 0.7; overall: mean 366, SD 172). Conclusions: The AVG with narrative induced increased physical activity. Additional research is needed to understand the mechanisms through which narrative increases physical activity during AVG game play.

- by Richard Buday
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- Psychology, Behavioral Sciences, Narrative, Childhood Obesity

Objective: Lower limb amputation is common in war combat and armed conflict as well as in traumatic settings and presents a challenge for health care providers. The incorporation of advanced technologies, particularly virtual reality, presents an opportunity to address the main consequences of amputation, principally balance and gait. The aim of this study was to investigate the additional effect of virtual reality with a traditional rehabilitation exercise program on balance and gait in unilateral, traumatic lower limb amputees. Materials and Methods: Thirty-two traumatic lower limb amputees, fulfilling a postfitting rehabilitation program at least 6 months ago, were recruited and randomly assigned into two identically sized groups; group C (control group) experiencing the traditional exercise program and group VR (virtual reality group) experiencing an addition of a virtual reality training. The intervention was conducted over 6 weeks at a rate of three sessions per week. Outcome measures assessed before and after 6 weeks were the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, Dynamic Gait Index (DGI), and 6-minute walk test (6 MWT). Results: Both interventions induced improvement in all measured parameters (P < 0.05); however, virtual reality demonstrated significant superior effects only on the balance markers, TUG test, DGI, and BBS (P < 0.05), but not on the 6 MWT (P > 0.05). Conclusion: Virtual reality is a promising, amusing, and safe intervention for addressing balance and gait in unilateral, traumatic lower limb amputees.

- by Ayman Khatib and +2
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- Games for Health

Persuasive games are more effective if they are personalized to the specific group of users under consideration. This paper presents a personalized persuasive game for motivating risky sexual behaviours in Africa. The arcade-type game simulates various sexual risky behaviours that could lead to contracting STDs and HIV and how to avoid them. It engages players in an interactive manner using various persuasive strategies with the aim of imparting knowledge and skills about safe sexual behaviours/practices and how to avoid risky sexual behaviours. The game uses the engaging concept of the popular ping-pong game and the principles of game-based learning to engage users in the game while subliminally persuading them to refrain from risky sexual be-haviours/practices.

- by Rita Orji
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- Human Computer Interaction, Serious Games, Personalization, Games for Health

Background: Active video games (AVGs) capable of inducing physical activity offer an innovative approach to combating childhood obesity. Unfortunately, children’s AVG game play decreases quickly, underscoring the need to identify novel methods for player engagement. Narratives have been demonstrated to influence behaviors.
Objective: The objective of this study was to test the hypothesis that a narrative would motivate increased AVG play, though a feasibility study that investigated the motivational effect of adding a previously developed narrative cutscene to an originally nonnarrative AVG, Nintendo Wii Sports Resort: Swordplay Showdown.
Methods: A total of 40 overweight and obese 8- to 11-year-olds equally divided by sex played the AVG. Half (n=20) were randomly assigned to a narrative group that watched the narrative cutscene before game play. The other half played the game without watching it.
Results: Children in the narrative group had significantly (P<.05) more steps per 10-second period (mean 3.2, SD 0.7) and overall (mean 523, SD 203) during game play compared with the nonnarrative group (10-second period: mean 2.7, SD 0.7; overall: mean 366, SD 172).
Conclusions: The AVG with narrative induced increased physical activity. Additional research is needed to understand the mechanisms through which narrative increases physical activity during AVG game play.

- by Tom Baranowski and +2
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- Behavioral Sciences, Narrative, Childhood Obesity, Games for Health
- by May O. Lwin
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- Games for Health

Mentalization is a psychological concept that describes the ability to understand mental states of self and others and also to reflect on them. Internalized representations of self and the world are established in early childhood and they underlie a lifelong development. Mentalization is a kind of technique to get in touch with one’s internalized representations in order to modify them. Aim of this contribution is to outline why and in which way DRPGs provide an advantageous possibility space for Mentalization and in which way high level Mentalization abilities contribute to personality development.

- by Katharina Mittlböck
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- Psychoanalysis, Game studies, Games for Health, Games for Change

Emotion regulation (ER) supports multiple individual functions and promotes mental health and wellbeing. Among the tools that may be used to help people in managing their affective states, videogames are reaching attention and are showing positive effects. Yet, little is known about their effectiveness. This study aims to assess the amount and quality of studies investigating the effects and modalities of the use of videogames for ER. A systematic literature search according to PRISMA guidelines was performed. Subsequently, according to expert advice other few studies have been added. Twenty-three studies met the inclusion criteria and were included in the review; they can be categorized into three groups, namely (1) cross-sectional and qualitative studies, (2) experimental studies investigating the effects of videogame experience on ER and (3) ER intervention with serious games. Discussion of the reviewed studies highlights that frequent gaming with commercial games offers more opp...

- by Antonella Marchetti
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- Psychology, Serious Games, Video Games and Learning, Video Games

Our 20-week "Wii Club" intervention for overweight and obese adolescents demonstrated weight loss, increased self-efficacy, and improved peer support from cooperative exergame play. Videogames that require motor activity in a... more

- by Amanda Staiano
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- Bioinformatics, Life Sciences, Games for Health, Biomedical Research