In this session from the recent Games For Health conference in Baltimore, academic Cynthia Bates from the University of California, Santa Barbara discussed the ways in which academic theory and research can be used to design effective games for health, referencing a variety of different methods that are yet to be used.
"Theory is not a dirty word," opened Bates. "It's used colloquially as 'something that could be real, but isn't.' In good research, though, theory is a foundation, a way to test things in a valid way. It helps explain and predict events, so you can prove your game is effective and why."
"It improves design: It helps you set goals and advance your future games. It lets you point to other things and ask 'Why does this work?' It let's us give better evidence."
"Education theories have been used in commercial/educational video games," continued Bates. "Like The Oregon Trail
or the constructivist learning in SimCity
. But what do we use for health games? Education is not enough to make someone do a behaviour. Telling them what they should do is a minimum, but it's not enough."
Bates went into detail on some methods that have been used in games for health, including "social-cognitive theory and self-efficacy" (where factual knowledge isn't all that's required but the player has to feel capable of performing the behavior).
In addition, she covered "social support theory", where social interaction increases support and improves health -- in particular helping people talk about problems, which is "a strong predictor of improved health."
However, Bates felt there were clearly many more theories that could be used as methods for games for health:
- Social norms theory: A method used to enforces safe norms: "Misstaken perceptions influence behaviors," Bates explained, "College kids think drinking is ubiquitous, for example, reinforcing the behavior, and sexual health issues are similar."
- Social exchange theory: A method that takes into account economic perspective, looking at gains and losses, why people form bonds and sever connections. "Games can make it easier and 'cheaper' to connect with people," said Bates, "like social networking sites."
- Health belief model: "Find out who the target audience is, find out what they think the barriers and benefits are for a behavior, and when you create game, use the theory from the start, so when you test, you know what you're looking for. Then you can look at literature and try and figure out what happened."
Virtual reality for phobias is an example of this, Bates explained, and she gave some other examples -- the Super Nintendo title Rex Ronan: Experimental Surgeon
gave players "vivid examples of why they shouldn't smoke and the benefits of not smoking" and biofeedback can be used with ADHD/ADD children to show them how it feels to be focused, by giving them external reward when they focus.
Using new methods for games for health "will be easier to fund if we can show how/why games were effective in past," concluded Bates. "We all believe it, but to carry to next level, it's important to establish and use theories to really inform game design, analysis and discussion."