Developing and Sustaining Health Games—A Losing Battle?

We welcome Melanie Lazarus as part of our guest blogger series.  

Melanie M. Lazarus, MPH is the Director of Marketing for Archimage, a serious game developer with titles including Escape From Diab and Nanoswarm: Invasion from Inner Space. She is also editor of healthGAMERS, a blog designed to educate the public about the games for health field, and author of Monster’s Blog, the corporate blog for Playnormous Health Games. Melanie has a B.S. degree in Microbiology from UT-Austin and an MPH in Health Promotion and Behavioral Science from The University of Texas Health Science Center at Houston.

The video game industry is an influential one -- $13.5 billion influential. Improving the health of children through a messaging medium this big seems like an obvious idea. Unfortunately, as a developer in this space for several years, we’ve found that obvious does not always translate into easy.

Archimage began work in 2003 on two National Institutes of Health-funded video games for the prevention of obesity and type 2 diabetes in children: Escape from Diab and Nanowswarm: Invasion from Inner Space. Since then we have moved into the relatively unexplored area of online casual games for health with our subsidiary Playnormous Health Games. From our perspective, there are three significant barriers to the proliferation of health video games in today’s marketplace. I’m sure there are many more challenges to choose from, but the following have been the biggest we’ve faced.

Getting funded

Although there is strong interest in exploring video games for health among government funding agencies like the National Institutes of Health, many grant reviewers are not as committed. Video games for health use entertainment to deliver its medicine. The words “fun” and “games” are not universally appreciated in the medical and scientific research academies. We have been literally told (though the trend now seems to be on the decline) not to use those words in association with serious topics like “health” and “disease.” The press is full of negative comments about video games as both the cause and effect of teenage violence. Similar sentiments can be found in the hearts and minds of some grant reviewers. Getting funding for the creation and research of video games for health may be an uphill battle for some time.

Sustaining funds

As Director of Marketing for a serious game design firm, I always find it interesting to talk with decision makers about the health games market. More often than not I’m told, “Market? What market? No one can make money on these things. Why don’t you just try to get on Oprah? I bet she’d like health games.”

Indeed, Oprah probably would. But a market beyond grant-based video game research is a topic worth discussing in the business community too. No question about it, an economic foundation beyond grants must be found to sustain the video games for health movement. A working commercial model is also needed to provide the researchers and developers with health game experience with the means to produce ever more effective games. There can be huge funding gaps between formative research, product development, and the clinical trials required to get a video game tested and ready for market. This industry needs a commercial basis and viable distribution models. On a positive note, investors such as health insurance companies, pharmaceuticals, and the food industry giants are starting to look beyond the feel-good messages health games can provide. Unfortunately, that’s not the same as viewing video games for health as critical influencers on the lives of their patients, customers, and constituents.

Knowing what works, and why

The literature on how and why video games for health work is rather thin. Clinical efficacy trials are few and far between. There is no real history to give game developers the X + Y = Z formula needed to develop medically and cost effective health games. Some research has been conducted on how the brain reacts to violent games versus non-violent games via functional MRI studies, but what about other aspects of health games? Very little research has been done on what is fun, let alone how fun translates into positive health change. I hate to sound like a researcher, but more research needs to be done on this. And research takes funding.

Light at the end of the research tunnel

Investigators are starting to report their data on the effectiveness of health games, including Diab and Nanoswarm, which should be available in the next few months.  An increase in positive evidence for health games in the literature could underpin new rounds of funding, commercial interest, and venture capital support.  Furthermore, it is encouraging to see large institutions like the Robert Wood Johnson Foundation and the Joan Ganz Cooney Center showing an interest in the use of technology for the improvement of child health. The days of health games sitting on researcher back shelves may soon be over. Let’s move beyond initial formative research and start getting these games to market.