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May 27, 2008


Using Games in Public Health (Part 2 of "Let the Games Begin")

This week we are continuing the second part of our two-part series on video games and public health. Last week we spoke with Tina Hoff, Vice President and Director of Entertainment Media Partnerships Exit Disclaimer at the Kaiser Family Foundation, Marguerita Lightfoot Exit Disclaimer of the University of California, San Francisco (UCSF), and David Galiel, an expert on new media with experience in game development.

How can we use video games in public health?

Traditionally, most commercial resources have been devoted to games whose primary purpose is entertainment. There has been little attention to a game's educational value, and "educational games" have been relegated to a niche with little funding and few professional game developers. This has begun to change, however, with the advent of the "Games for Good" movement, which has drawn game developers interested in using the immersive, participatory nature of video games in the public interest.

Marguerita Lightfoot believes there is tremendous potential in using games for public health. As a behavioral scientist, she is interested in using games to change behaviors, as opposed to simply supplying information. She said, "It takes more than information. We have to ask ourselves, how can we use technologies to really change behavior?"

Screen shot of Pos or Not online game

Photo courtesy of Kaiser Family Foundation

Pos or Not online game

In the health arena, games have been used to educate patients about medication and their particular disease or condition. Games have also been used as a form of public education to inform about health risks, to provide basic public health education, and to increase understanding of (and empathy for) individuals suffering from various maladies.

How can we use video games in the fight against HIV/AIDS?

Video games can raise awareness about HIV/AIDS, help change public attitudes, and spark discussion. They can teach about, and encourage, safe behavior through in-game rewards and goals. Most important, they can reach an audience that is increasingly tuning out traditional media (e.g., television and radio). Online games can be a cost-effective way of reaching very large populations without the significant distribution costs associated with offline education.

Screen shot of Pos or Not online game

Photo courtesy of Kaiser Family Foundation

Pos or Not online game

Tina Hoff told us, "Pos or Not Exit Disclaimer is an analogue to the popular online viral game, Hot or Not Exit Disclaimer, and was designed to engage young people in more personal ways about HIV and more specifically about who it affects."

The Kaiser Family Foundation and MTVU Exit Disclaimer, MTV's college network, worked with young people across the U.S. as part of a competition to generate ideas that ultimately led to the development of Pos or Not. Now that the game is live, players are invited to share comments and new ideas for extending its reach. When we asked her about the response to the game so far, Tina said, "In the first 24 hours, we had nearly to 200,000 unique visitors play, and more people keep coming every day to play and offer comments and new ideas."

Challenges and Lessons Learned

Screen shot of Project Light video game

Photo courtesy of Marguerita Lightfoot

Project Light video game

Video games have the potential to raise awareness and change behaviors, but with that potential comes challenges. As we mentioned in a recent post, Marguerita's games have been quite successful, but because she is working with schools and community-based organizations, there are challenges in scaling up her video games to reach larger audiences. She told us, "At this point video games are an emerging field, particularly in HIV. We have some indication that they work. For example, youth who completed my program reported reduced number of sexual encounters, as well as a reduced number of sexual partners. We even saw more condom use. But we're still building the evidence that this stuff works. There's a lot of research being done now on the outcomes, and we'll see more results in the next few years."



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As a gamer myself, I can vouch for the "the immersive, participatory nature of video games." I've tried playing the "Pos or not" game from the link you have in this page, and it's good - for a one-time visit. I can't imagine going back to the site and playing that game again. If you're looking for a one-time exposure to thousands of young people, then it's ok. But if you're looking for young gamers coming back again and again, immersed in the game, absorbing your HIV-AIDS related messages, I'm afraid you have to try harder than that. Maybe a community-building peppered with the messages - it's gotta be more engaging, progressive, etc. Thanks for this thought-provoking post.

Mike thank you for your great comment. Gaming has become a great way to cross generational barriers in recent years. The ability to bring HIV/AIDS awareness through new mediums is definitely an advantage to our cause. Thanks again

Very interesting piece. I like focusing on the positive potential video games still have to offer.

Video games are an entirely new platform by which to reach out to society. The trick for using games as an educational conduit for teens is authenticity. Teens are very entertainment savvy and will not be convinced by poorly positioned messages in games. That being said, the potential is there. We just need to get some talented marketers to figure out how to pull it off!

Thank you for that comment. Do you know of any games that have successfully been able to be entertainment savvy and still deliver a positive message? Do you think that the problem is solely based on marketing?

Well, I think there is tremendous potential in the casual gaming sector. I should qualify that by pointing out that I work for Big Fish Games so my opinion is somewhat 'influenced'. Our games are extremely popular (and gaining momentum quickly) and may serve as a good platform to deliver positive messages. That being said, our core demographic is not teens (yet!). One staple of the casual gaming industry is the absence of gaming violence. Bear in mind, I'm not talking about online Flash gaming...I'm talking about downloadable games.

As time goes by, I suspect core gaming and casual gaming will find a happy medium that will appeal to both adults and teens. This medium will provide new opportunities for marketing groups. The question is, what message do they want to deliver?

To answer your questions, I suspect there are a lot of games that deliver positive messages. Consider Dora the Explorer games. They are wildly popular with young kids and they have an extremely positive message. As far as teens go, I can't think of anything off the top of my head...grrrr.

Can we pin this on marketing? Hmmmm...probably not. I would point the finger at society. As long as their is a demand of something, there will always be a supply. That being said, society has to demand games with a positive message. This might start as a small, grass roots movement, but could grow if organized well. Without demand for such games, the supply will never be there.

Thanks for opportunity to read this article. It inspired us to use videos to rise awareness regarding health of men and boys. A men's health issue is a disease or condition unique to men, more prevalent in men, more serious among men, for which risk factors are different for men or for which different interventions are required for men.


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