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2013 | Buch

Games for Health

Proceedings of the 3rd european conference on gaming and playful interaction in health care

herausgegeben von: Ben Schouten, Stephen Fedtke, Tilde Bekker, Marlies Schijven, Alex Gekker

Verlag: Springer Fachmedien Wiesbaden

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Über dieses Buch

Founded in 2004, the Games for Health Project supports community, knowledge and business development efforts to use cutting-edge games and game technologies to improve health and health care. The Games for Health Conference brings together researchers, medical professionals and game developers to share information about the impact of games, playful interaction and game technologies on health, health care and policy. Over two days, more than 400 attendees participate in over 60 sessions provided by an international array of 80+ speakers, cutting across a wide range of activities in health and health care. Topics include exergaming, physical therapy, disease management, health behavior change, biofeedback, rehab, epidemiology, training, cognitive health, nutrition and health education.

Inhaltsverzeichnis

Frontmatter

Research and Validation

Frontmatter
A Serious Game to Inform about HIV Prevention: HInVaders, a Case Study
Abstract
The aim of this research is exploring the possibility of using Serious Games in order to educate the general public, in particular young people, about HIV prevention. We have developed a Facebook-based online game called “HInVaders” as a case study for our research. In the HInVaders game, the player is a HIV virus molecule and his aim is infecting as many people as possible. When the game starts, the molecule has already infected a person and is located inside the infected body. During the gameplay, the player encounters treatments (e.g. antiretroviral therapy) represented using the pill metaphor, and the human immune system (e.g. white blood cells). The player has to avoid the treatments and to attack the immune system in order to increase his score (called viral load). As a side effect (from the virus point of view), the viral load increase cause a decrease in the infected person's health level (as highlighted in the game interface). If the molecule/player goes through the same body too long, he will die with the infected person. Therefore, it is important for the player to explore the possibilities to escape from the infected body by infecting other persons exploiting some events, which occur during the gameplay. We have conducted some preliminary tests to assess the game didactical effectiveness on a small group of adults. The paper presents the game design and some preliminary results from experiment with real users.
Stefania Artioli, Riccardo Berta, Alessandro De Gloria, Andrea Pomicino, Nicola Secco
From KinectTM to anatomically-correct motion modelling: Preliminary results for human application.
Abstract
The KinectTM sensors can be used as cost effective and easy to use Markerless Motion Capture devices. Therefore a wide range of new potential applications are possible. Unfortunately, right now, the stick model skeleton provided by the KinectTM is only composed of 20 points located approximately at the joint level of the subject which movements are being captured by the camera. This relatively limited amount of key points is limiting the use of such devices to relatively crude motion assessment. The field of motion analysis however is requesting more key points in order to represent motion according to clinical conventions based on so-called anatomical planes. To extend the possibility of the KinectTM supplementary data must be added to the available standard skeleton. This paper presents a new Model-Based Approach (MBA) that has been specially developed for KinectTM input based on previous validated anatomical and biomechanical studies performed by the authors. This approach allows real 3D motion analysis of complex movements respecting conventions expected in biomechanics and clinical motion analysis.
B. Bonnechère, V. Sholukha, F. Moiseev, M. Rooze, Jan S. Van Sint
Fear and Happiness in “Re-Mission”: Teasing Out Emotional Gaming Events Responsible for Cancer Risk Perception
Abstract
Improving cancer risk perception among adolescents and young adults is a crucial public health goal that allows the prevention of cancer-initiating behaviors. Digital games can be implemented in health interventions to drive cancer risk perceptions.
This research experimentally examines how a video game called "Re-MissionTM" (HopeLab, Redwood City, CA) may create an environment in which perceived threat from virtual cancer cells can lead to emotional involvement and ultimately induce perceived cancer risk among healthy young adults. In "Re-Mission," players control a nano-robot that fights cancer cells inside cancer patients’ bodies. After baseline survey completion, participants (n = 118) played "Re-Mission" at low or high conflict (i.e., low, or high level of game challenges). Then, participants completed a postexperience survey.
Results from path analyses show that fear when being attacked by virtual cancer cells and happiness when killing cancer cells mediate pathways between conflict manipulation and change in cancer risk perception. These findings suggest that the study of emotions may aid researchers and designers in the identification of in-game events responsible for health outcomes.
Georges E. Khalil

Game Design, Development and Business

Frontmatter
Bias Blaster – Aiding Cognitive Bias Modification- Interpretation through a bubble shooter induced gameflow
Abstract
This paper presents the design and development of Bias Blaster. Bias Blaster is a proof-of-concept integrated bubble-shooter game with an evidence-based therapeutic intervention, i.e., Cognitive Bias Modification Interpretation (CBM-I). The game is tailor-made for patients of the Dutch national mental health organization (GGZ) recovering from a First-Episode Psychosis (FEP). Cognitive Bias Modification- Interpretation treats the self-stigma and its associated interpretation bias as experienced by patients recovering from a FEP. The amount and frequency of CBM-I items and training is regulated by the patient, through an integrated game-mechanic of the modified bubble shooter. The game implements a motivational and reinforcement paradigm, which paves the way for the use of the rigorous and demanding CBM-I therapy. Moreover, Bias Blaster exploits the natural game flow of the bubble shooter to increase resilience and adherence throughout the treatment of FEP patients. This paper presents the design and development process of the game. The lessons learned are summarized in implications for the design of serious games: design for “acceptance“ and as a “serious therapeutic”.
Bard O. Wartena, Hylke W. van Dijk
Attributing Design Decisions in the Evaluation of Game- Based Health Interventions
Abstract
The use of games as interventions in the domain of health care is often paired with evaluating the effects in randomized clinical trials. The iterative design and development process of games usually also involves an evaluation phase, aimed at identifying improvements for subsequent iterations. Since game design theory and theories from associated fields provide no unified framework for designing successful interventions, interpreting evaluation results and formulating improvements is complicated. This case study explores an approach of monitoring design decisions and corresponding theories throughout the design and development cycle, allowing evaluation results to be attributed to design decisions. Such an approach may allow the game design and development process to iterate the game more efficiently towards use in practice.
E.P. Braad, J. Folkerts, N. Jonker
Servitization versus Commoditization: the Business Model Dilemma Confronting Serious Games for Health
Abstract
There is growing interest in the use of Serious Games (SGs) to tackle major health issues. Challenges to their adoption and use includes the cost of development and the need to provide evidence of effectiveness. However, an equally pressing dilemma facing the establishment of a market for SGs is the general commoditization of digital media and erosion (diminution) of economic value. Given the substantial upheaval in the entertainment games, software, music, book publishing, and newspaper industries, it seems unlikely that SGs for health will be immune from such market pressures if they persist in being conceptualized and designed as products. The solution is to switch business strategy by re-conceptualizing and designing SGs for health as networked services. The benefits will include personalization, integration with health administration systems, and importantly, the ability control access and therefore the adoption of pay-per-use revenue models, and ultimately the preservation of value.
Alasdair G Thin, Giusy Fiucci, Angelo Marco Luccini, Michel Rudnianski, Rosa García Sánchez, Jannicke Baalsrud Hauge
IGER: A Game Engine Specifically Tailored to Rehabilitation
Abstract
Exergames for rehabilitation, both in the physical and cognitive fields, have been the target of much research in the last years. Such exergames, however, are often created for a specific impairment and cannot be generalized to other domains. More generally speaking, the lack of shared design and development guidelines for rehabilitation games can be highlighted. The Intelligent Game Engine for Rehabilitation (IGER) described here has been developed with the intent to provide a framework for building rehabilitation exergames that are functional, accessible and entertaining. Several features, mandatory for rehabilitation, have been incorporated: configuration, adaptation, monitoring, data logging and feedback through a virtual therapist. Besides describing how these features have been implemented in IGER, we describe here also a few games we created with it and their rationale.
Michele Pirovano, Pier Luca Lanzi, Renato Mainetti, Nunzio Alberto Borghese
Designing Games for Children with Cerebral Palsy
Abstract
Within recent years the implementation of games as an acknowledged and important part of health care has become increasingly apparent. With positive results of game studies targeting conditions such as cancer, diabetes, and asthma it seems that further research is of great importance to ensure development within the field.
In this paper we will describe the creation of a game that contributes to the realm of health games. Our research, design, and product were directed towards children with Cerebral Palsy (CP) and the game was designed in accordance with the success criteria of socialization, entertainment, and rehabilitation.
By consulting with experts within the area of cerebral palsy, we attempted to create a game that would fulfil the needs of our specific target group and improve their abilities both cognitively and physically.
Kristín Guðmundsdóttir, Astrid Lilja Wille, Alexandru Savu
The Core Mechanic in Battlefood: A Design Journey
Abstract
This research aims to improve the practice of designing educational video games (“learning games”). Specifically, this paper aims to demonstrate need to improve Shelton’s theory of activity-goal alignment, which focuses on the relationship between a player’s activity and the designer’s intended learning goal in any learning game. Using the research method of autoethnography, the data is an account of the evolution of the core mechanic in Battlefood, a learning game research project. While Shelton’s prior findings, that activity-goal alignment theory meets an important need in learning game design practice, are largely confirmed, this research draws two main conclusions: the literature’s typical modality (primarily lengthy text-based discussions) is not a good fit for practising designers, and Shelton’s theory could be more useful if it were made more accessible to practicing designers.
Josh Whitkin
Using Vitruvius as a Framework for Applied Game Design
Abstract
The number of games designed for various applications in healthcare is growing rapidly. However, balancing the needs of an applied game can be a difficult task, especially without a guiding vision or design framework. Here, we propose a philosophical framework inspired by the ancient Roman architect Vitruvius, which can be used as an approach to designing and developing applied games for healthcare and other contexts. Vitruvius believed any well designed artefact should exhibit the three principles of firmitas (soundness or sustainability), utilitas (utility or purpose) and venustas (attractiveness). We describe the Vitruvian approach to applied game design using the design process of Moodbot - a game for mental healthcare - as an example. In this paper, we reflect on the Moodbot project and the application of the Vitruvian triad herein.
Micah Hrehovcsik, Lies van Roessel
‘What Remains?’: A Persuasive Story Telling Game
Abstract
“What Remains?” is a prototype that facilitates the intake of Alzheimer’s disease suffering patients in care homes. The prototype evokes storytelling of the patient using pictorial game-elements and is based on co-creation principles involving the patient, the patient’s family-members, and a caregiver. “What Remains” consists of three interactive consecutive phases. In the first phase, family members of the patient collect pictures which are expected to be of importance for the patient. During the second phase the patient configures and connects the pictures while telling stories about them. In the third phase, the stories are used by the caregiver to enhance understanding about patient’s behavior and to personalize care giving. Additionally, the stories are used by the family members of the patient for remembrance purposes. The present paper describes the “What Remains” prototype, its design process and its evaluation from the perspective of the Persuasive Game Design model.
Alessia Cadamuro, Valentijn Visch

Professional Education

Frontmatter
Serious game based on Clinical cases: A multidisciplinary Approach for Self-assesssment in Dental Education
Abstract
Serious games have taken up an important place in the field of health. The aim of this work was to design and to develop a serious game for students in Dental Education.
The interest is to perform a multidiscip1inary approach of patients. Several clinical cases are available online and each of them concerns patients treated by students in Dental Hospitals. After choosing the e-patient, the serious gamer progresses in the game step by step. The game-play simulates the similar methodology as a dental practitioner in clinical reality. E-learners have to make a diagnosis in a limited time. Finally, the goal is to treat the e-patient deciding the ideal treatment plan.
The collaborative network between students and teacher(s) achieves an interactive learning and improves the quality of undergraduate Dental Education. The perspective is to promulgate dental education and to train young practitioners giving better dental care to patients after dental studies.
Céline Brunot-Gohin, Alexandre Augeard, André Aoun, Jean-Yves Plantec
A serious game to improve situation awareness in laparoscopic surgery
Abstract
Safety analyses show that errors in surgery are more frequently caused by misperceptions and misjudgments than from technical failure of the surgeons. The adaptive coupling between humans and their environment, based on the perception and comprehension of signs and signals when performing a complex task, is referred to as situation awareness (SA). To date, no off-site training methods are offered to improve SA in surgical trainees. To aid the improvement of SA in minimally invasive surgery (MIS), a serious game was designed for surgical trainees. This serious game teaches surgical trainees to deal with major and minor problems in the minimallyinvasive surgical theatre that originate outside of the direct line of sight. Serious games are instructional methods that allow serious skills training in a challenging environment. This paper discusses insights on design, development and evaluation of a game-based educational program for surgical residents.
Maurits Graafland, Marlies P. Schijven

Games for Care, Cure and Medicine Adherence

Frontmatter
Patient follow-up using Serious Games. A feasibility study on low back pain patients.
Abstract
Low Back Pain (LBP) is one of the most frequent pathologies related to musculoskeletal disorders. Patients suffering from LBP must perform rehabilitation exercises in order to avoid chronic disorder. At the beginning these exercises are performed with physiotherapists during rehabilitation. A major part of the treatment need to be performed at home by the patient himself. Serious Games (SG) could be used to increase patients’ motivation and to be sure that patients are performing these exercises and most important that they are doing it in the right way. A specific SG was created for LBP patients. Motions performed during the game are recorded and parameters (range of motion, speed, coupled motion) are processed. The aim of this feasibility study was to evaluate the intra and inter day reproducibility of this system to evaluate whether or not it can be used in daily practice for following the evolution of the patient and for scoring the severity of disorders.
B. Bonnechére, B. Jansen, L. Omelina, L. Da Silva, D. Mouraux, M. Rooze, Jan S. Van Sint
Designing Kinect games to train motor skills for mixed ability players
Abstract
Children who have special needs when it comes to motor skill development, for instance as a result of developmental coordination disorder or cerebral palsy, need to undergo long bouts of physical therapy. This can often be considered boring, to the detriment of the efficacy of the therapy. One way to improve the engagement of physical therapy is to embed it into a video game, e.g. with the aid of Kinect. However, very little is known scientifically on how to design these serious games for mixed abilities in order to be both fun and efficacious in terms of motor skills development or attitude change. In addition, contemporary entertainment games often revolve around competition based on mastery of skills to be engaging, something special needs children feel left out in. In this position paper we survey the field and propose a number of ways to approach mixed ability game design.
Koen de Greef, Erik D. van der Spek, Tilde Bekker
Gaming at the dentist's – serious game design for pain and discomfort distraction
Abstract
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.
Rafael Bidarra, Dien Gambon, Rob Kooij, Dylan Nagel, Maaike Schutjes, Ioanna Tziouvara

Cognitive and Mental Health

Frontmatter
A Taxonomy of Serious Games for Dementia
Abstract
Serious games for dementia (SG4D) hold their own, unique and significant space within the Games for Health domain. However, the SG4D field still has not been fully mapped out and classified. In this work, we present a generic taxonomy of serious games for dementia, based on the health functions and the health purposes they serve. Firstly, we classify dementia games based on the health function they serve, in: cognitive, physical and social-emotional games. Each of these functions serves a variety of health purposes, leading us to a second, lower level of classification in: preventative, rehabilitative, assessing and educative games. Furthermore, we provide an ex-post evaluation of the proposed taxonomy by exploring whether the existing serious games for dementia can be validly classified, based on the proposed taxonomic characters. To this end, we collect and analyse a set of dementia-related serious games (e.g. WiiSports, Big Brain Academy, Cognifit, MinWii, et al.) by performing a literature review. The results show that the taxonomical system covers a sub-field of “games for health” and indicates areas which are under-explored by current games.
Simon McCallum, Costas Boletsis
BKI: Brain Kinect Interface, a new hybrid BCI for rehabilitation
Abstract
In this paper we propose the creation of a novel hBCI, which combines biomechanical signals acquired by the Kinect sensor with signals from the BCI system Emotiv EPOC through the strategy of selective attention, using SSVEP signals. The combination of these signals (MoCap and EEG-BCI) is used for interaction in a rehabilitation game for patients with motor and/or cognitive impairments. The system, providing a long and fluid interaction time, enables effective data collection that is aimed to objectively describe body movements through software developed for this purpose. The interaction with the BCI system is performed by the SSVEP which allows the user to explode objects in the air, through the controlled focus in a particular visual stimulus; the EEG signals are processed in the OpenVibe software. The Interactive Room for Rehabilitation, a real space plus a digital environment in which patients with neuromotor disabilities interact through their movements and thoughts, allows specialists to perform objective assessments of motor and/or cognitive aspects. Previous results suggest that acute exercise may enhance cognitive control through the management of visual stimulus.
J. Muñoz, O. Henao, J. F. López, J. F. Villada
Development of a theory-based applied game for the treatment of Post-Traumatic Stress Disorder: proof of feasibility
Abstract
Post-traumatic stress disorder is a potentially debilitating psychiatric condition causing severe distress and significant loss of productive employment years. In a recent experiment we developed a therapeutic virtual reality protocol based on already proven successful non-pharmacological theories for treatment of this disorder. The initial immersive virtual-reality sequence was developed on the Computer Assisted Rehabilitation ENvironment (CAREN) and is called 3MDR: military motion-assisted memory desensitization and reprocessing. Furthermore the 3MDR sequence uses principles of cognitive behavioral therapy and eye movement desensitization and reprocessing. After performing a proof of concept the 3MDR-sequence was translated into an applied game called “Achilles Initiative: the Battle for Sector 1”. Central in the applied game is that subjects, prior to playing the game deliver pictures of high emotional affect, that are loaded into the game. As such the game uses principles of augmented virtuality. In the game the participant passes several distinct phases: preparatory, therapeutic and mental cooling down phase. Afterwards a debriefing with the therapist is performed. The game can be run automated, but a therapist is always present. The development process and the feasibility of this game for therapy, based on preliminary patient experiences are discussed.
Agali Mert, Rudolf Buirma, Justin van Luijk, Gor Melkonian, Joeri Pels, Eric Vermetten

Children’s Health

Frontmatter
DYSL-X: Design of a tablet game for early risk detection of dyslexia in preschoolers
Abstract
The goal of the DYSL-X project is to develop a tool to predict whether a preschooler (5 yrs) shows high risks for developing dyslexia. This tool is a tablet game that incorporates tests to take specific performance measures that allow for this prediction. The game will thus serve as an assessment tool to be used in school psychology services and clinical diagnostic and rehabilitation centers. In order to design the optimal tablet game for preschoolers, during the first phase of the projects several existing games for preschoolers were evaluated in order to derive design guidelines for games targeted at preschoolers. These design guidelines are presented in this paper and next, we show how these guidelines were used to develop the final game of the DYSL-X project.
Lieven Van den Audenaeren, Véronique Celis, Vero Vanden Abeele, Luc Geurts, Jelle Husson, Pol Ghesquière, Jan Wouters, Leen Loyez, Ann Goeleven
Playfully Conquering Performance Anxiety
Abstract
Despite its significant impact on concentration and learning process, performance anxiety is an under represented topic in today’s primary schools. Even slight extents influence one’s cognitive, behavioural and physiological performance and – if untreated – might manifest and grow into clinical forms for some pupils. We present a serious game prototype for primary schools to introduce this sensitive topic and open discussions with pupil in class. Playing the game raises awareness to the topic and teaches a possible counter strategy in a playful way as a preventive strategy. As such, the game implements a broad base of cognitive psychology research and clinical knowledge in child-oriented way. It was designed in an iterative, user centred design process, using the Serious Games Assessment Framework as a design lens and closely supervised by a psychological therapist. First results of a focus group test are promising and prove accessibility and usability for children. The game seems to fulfill its central purpose, conveying information about performance anxiety and effective counter strategies.
Ralf Schmidt, Patrick Eifler, Maic Masuch
Evidence-based psycholinguistic principles to remediate reading problems applied in the playful app Letterprins: A perspective of quality of healthcare on learning to read.
Abstract
The present study described a new reading game (Letterprins), designed to improve the reading development of children with reading problems. Letterprins contains a series of reading-related tasks, based on previous research, which have been shown to facilitate children’s reading development. In order to ensure treatment fidelity integrity the game is played in collaboration with a parent or caregiver. The parent/caregiver needs to indicate the correctness of the child’s responses. The app adjusts the exercises based on the child’s performance, and thereby optimizes learning. The app addresses reading development at the sound, word, and sentence level, and thereby captures a large range of the stages in early reading development.
Esther G. Steenbeek-Planting, Mirella Boot, Jan C. de Boer, Marco Van de Ven, Nicole M. Swart, Dimme van der Hout
An Active Lifestyle for Youths through Ambient Persuasive Technology. Implementing Activating Concepts in a School Environment
Abstract
The PlayFit project aims to design for a structural reduction in sedentary behavior throughout the day. The challenge is to engage teenagers by connecting to their mainly sedentary lifestyle by playful persuasion. Therefore we defined four design principles: (1) embedded in the context (2) trigger an intrinsic need to play, (3) adapt to a personal playing style and (4) facilitate open-ended and/or emergent play. In the past three years we have been exploring solutions through design research and applied these insights to three new concepts, each tying into a different aspect of a school day. In this paper we share the first insights in applying these design principles and implementing the concepts that help reducing sedentary behavior in schools for vocational education.
R.J.W. Sluis-Thiescheffer, R. Tieben, J. Sturm, M.M. Bekker, B. Schouten
Metadaten
Titel
Games for Health
herausgegeben von
Ben Schouten
Stephen Fedtke
Tilde Bekker
Marlies Schijven
Alex Gekker
Copyright-Jahr
2013
Verlag
Springer Fachmedien Wiesbaden
Electronic ISBN
978-3-658-02897-8
Print ISBN
978-3-658-02896-1
DOI
https://doi.org/10.1007/978-3-658-02897-8