GAMES FOR HEALTH JOURNAL: Research, Development, and Clinical Applications Volume 1, Number 6, 2012 ª Mary Ann Liebert, Inc. DOI: 10.1089/g4h.2012.1113

News from the Field

MyBrainSolutions Introduces Games for Children and Parent Toolkit

Exergames Help Students Achieve Physical Activity Recommendations

A collaboration of international scientists, clinicians, and technical professions has developed MyBrainSolutions for parents and PoweringUp.com for children with attention deficit hyperactivity disorder (ADHD). The portals offer games that build children’s cognitive skills and improve attention, concentration, self-control, and emotional resilience. Based on an initial assessment, MyBrainSolutions matches the player’s brain profile to appropriate brain-training games. The company benchmarks it to healthy children and those with ADHD. Parents can monitor their child’s gameplay progress and gain insights for managing ADHD. MyBrainSolutions already offers a variety of games to improve adults’ thinking abilities. More information is available at: http://parents.mybrainsolutions.com/Parents/Default.aspx

Researchers at the University of Montreal, Montreal, Canada, reported in the journal Pediatrics that exergames, such as ‘‘Wii Sports’’ and ‘‘Dance Dance Revolution,’’ can help youngsters get closer to recommended physical activity levels. The team collected self-reported questionnaires from 1,241 grade 10 and 11 students in Montreal, which asked about exergame use, weight, lifestyle, and demographics. About 24% said they exergamed, and 73% played at moderate or vigorous intensity. ‘‘Teenage exergamers—people who play videogames that require physical activity—are most likely females who are stressed about their weight. On average, they play two 50 minute sessions per week,’’ said study author Jennifer O’Loughlin of the university’s Department of Social and Preventative Medicine. More information is available at: www.ncbi.nlm.nih.gov/pubmed/23027171 and www.nouvelles.umontreal.ca/udem-news/news/20121001researchers-identify-a-dance-dance-revolution-in-kids-physicalactivity.html

Study Shows Videogames Can Improve Older Adults’ Balance A study from Queen’s University Belfast and Trinity College Dublin in Ireland found that older adults can improve static and dynamic balance and gait by playing videogames. The Centre for Ageing Research and Development in Ireland (CARDI) funded the research. Forty-four of the 70 participants played four specially developed videogames using the Wii Balance Board. ‘‘This research highlights an engaging way for older people to improve their balance and mobility, helping them to avoid falls and serious injury,’’ said Bob Stout, co-chair of CARDI. ‘‘This brings great personal benefits for older people and financial gains for society as a whole.’’ More information is available at: www.cardi.ie/news/cardilauncha wiibitoffuncanhelppreventfallsinolderpeople and www .cardi.ie/userfiles/Balance%20with%20video%20Research%20 Brief%20(web)(1).pdf The Army Looking to Use Games to Diagnose PTSD, TBI The U.S. Army has contracted with three companies to develop mobile gaming platforms to help identify soldiers with neurocognitive problems, such as posttraumatic stress disorder (PTSD), depression, and traumatic brain injury (TBI). The companies will build a mobile application, which can be used on the soldier’s smartphone, to assess cognitive performance. The games could be used to establish a baseline and then played again to assess for cognitive changes. The games could report results to a central computer, and the Army could use the data to help determine combat readiness. More information is available at: www.wired.com/dangerroom/2012/10/pstdgame/ and http://dodsbir.net/selections/sttr/sttr_2012A.htm

Texas Students Win Award for Health Videogame Three students in the Digital & Interactive Media class at Pflugerville High School in Pflugerville, TX, won the Healthivores Video Game Contest sponsored by Green Ribbon Schools. Jessica Page, Monica Moltz, and Joel Barrow’s ‘‘Food Pyramid Expedition’’ game features a character that explores the five levels of the food pyramid before Junk Food Bandits interfere. The game teaches people about the health benefits of eating well. The students worked on the project for about 20–25 hours and documented their process as they worked through all the phases of the software development life cycle: research and analysis, design, development, testing, and implementation. Green Ribbon Schools received nearly 400 entries from 42 schools. More information is available at: http://cms.pflugervilleisd.net/site/default.aspx?PageType = 3&ModuleInstanceID = 844&ViewID = 047E6BE3-6D87-41308424-D8E4E9ED6C2A&RenderLoc = 0&FlexDataID = 3894& PageID = 1 and www.greenribbonschools.org/activity-detail .php?id = 1307&resId = 2019 ‘‘Just Dance 4’’ Released in Europe and the United States Ubisoft has released ‘‘Just Dance 4.’’ A brightly dressed onscreen avatar dancer leads players in the routines, and the game virtually takes them to nightclubs and other fun places. In Battle Mode, two players can compete with each other while dancing to five rounds of choreographed songs, while Dance Quests players compete on specific objectives. The

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392 game includes a Just Sweat feature, with a calorie counter and intensity tracker, to track progress during fitness routines. The game contains 40 sound tracks with hits, including Flo Rida’s ‘‘Good Feeling,’’ One Direction’s ‘‘What Makes You Beautiful,’’ Stevie Wonder’s ‘‘Superstition,’’ and Barry White’s ‘‘You’re The First, The Last, My Everything.’’ More information is available at: http://just-dance-thegame.ubi .com/jd-portal/en-gb/home/index.aspx and www.digitalspy .com/gaming/review/a429250/just-dance-4-review-xbox360-another-fun-dance-floor-filler.html truth Launches Anti-Tobacco Game The smoking prevention campaign, truth, has introduced ‘‘Flavor Monsters,’’ a videogame in which players fight flavored tobacco products, using a blend of shooting and tower defense. It is part of a youth smoking prevention campaign. The game educates young people about smoking and tobacco companies’ use of flavorings in a fun way. The game features five skill levels, each featuring a different colorful flavor monster to defeat. truth took the game on a tour this summer, and its crew of young adults talked to participants about the health effects, addictiveness, and social consequences associated with tobacco use. Sabertooth Interactive of Venice, CA, developed the game, which is available for free for Apple and Android devices. More information is available at: www .thetruth.com/games/play/flavor-monsters/ and www.inside flavormonsters.com/uploads/2/0/4/0/2040236/truth_releases_ five_new_levels_for_the_flavor_monsters_mobile_game.pdf Peoria Physicians to Study Exergame Effects on Youth The RiverPlex Recreation & Wellness Center, a joint project between the Peoria Park District and OSF Saint Francis Medical Center, in Peoria, IL, is conducting a research study to compare the results of a 10-week exergaming weightmanagement program with more traditional nutrition-based classes for overweight children, 8–12 years old. To enroll, children had to have a body mass index of 85% or greater. The researchers will randomly assign the youngsters to the intervention and control groups in a 2:1 ratio. The 2-hour intervention sessions include five hour-long classes by a dietician, five classes about psychosocial aspects of overweight, five hour-long exergaming sessions, and five hour-long exergaming and traditional exercise sessions. The children will attend four monthly maintenance meetings, and they must commit to participate for 6 months and in a 1-year follow-up evaluation. The researchers plan to enroll seven groups of 140 participants and are continuing to accrue youngsters. More information is available at: https://www.riverplex .org/exergaming-for-health

NEWS FROM THE FIELD exam room or equipment. It takes about 30 minutes to play. Users advance to the next of three levels as they earn points. The government thought the game would be an enjoyable way to get the message of privacy across to small practices that often lack the resources for other types of training. More information is available at: www.healthit.gov/providersprofessionals/privacy-security-training-games Exergame Players More Likely to Exercise in Other Ways A pilot study of 120 people by researchers at the University of Bedfordshire, Bedford and Luton, United Kingdom, found that participants who played interactive videogames were likely to take part in other physical activity, such as going for walks or playing sports, as well. Those playing exergames also reported more positive mood and felt people have control over their exercise levels. The investigators measured mood and beliefs before and after the participants were asked to either play or observe Nintendo Wii or XBox Kinect games. The team presented the results of their study at the Psychological Society’s Division of Health Psychology Annual Conference in Liverpool, UK. More information is available at: www.lutontoday.co.uk/news/local/university-studyshows-that-playing-video-games-can-be-good-exercise-1-4299708 Game and Activity Meter Boost Children’s Activity Level A study from HopeLab, maker of Zamzee, a pocket-sized activity meter that connects to a motivational game-based Web site, increased moderate to vigorous physical activity levels in middle-school-aged teens by 59% during a 6-month period and reduced biological risk factors for heart disease and diabetes. The researchers enrolled 448 middle-school aged students from urban, suburban, and rural communities in the United States and randomly assigned them to one of two groups. The intervention cohort used Zamzee, uploaded information about their movement gleaned from an accelerometer they wore, and could track their progress on a motivational game-based Web site. The control group received a Zamzee activity meter and uploaded data, but they had no access to the motivational Web site. The increase of about 45 additional minutes of physical activity per week in the intervention group persisted throughout the 6-month study period. The Robert Wood Johnson Foundation co-sponsored the study, and the findings were presented at the 2012 Obesity Society Annual Meeting in San Antonio, TX. More information is available at: www.prweb.com/releases/2012/ 9/prweb9932554.htm United’s ‘‘Baby Blocks’’ Encourages Preventive Visits

HHS Releases Privacy and Security Training Games The U.S. Department of Health and Human Services’ (HHS’) Office of the National Coordinator for Health Information Technology’s Office of the Chief Privacy Officer has released a free, Web-based security-training module. ‘‘CyberSecure: Your Medical Practice’’ uses a game format in which players respond to privacy and security challenges found in small medical practices. Correct responses help players earn points to grow their virtual practice, and wrong decisions can hurt their virtual practices, such as losing an

United Healthcare encourages pregnant women on Medicaid to attend prenatal and then well-child physician visits through the first 15 months of life. The free game allows the participants to unlock blocks every time they keep a doctor’s appointment, and they receive a gift, such as diapers or something else for the baby or the mom. Just for signing up, the woman earns a $20 Old Navy gift card or a diaperchanging pad. The result of the pilot game has been more patients keeping their visits. More information is available at: http://medcitynews.com/2012/10/how-an-avid-gamer-

NEWS FROM THE FIELD is-helping-unitedhealths-goal-to-rein-in-costs-have-healthiermembers/ and https://www.uhcbabyblocks.com/splash Nexersys Releases Children’s Exergame Platform Nexersys Corp. of Austin, TX, has released a new children’s mode for its Nexersys Home and Pro units, allowing young people to compete with one another in multiplayer competition rounds. The child mode is more intuitive and simpler to use and includes right- and left-handed stances for the 15 cardiotraining videos. Children 14 years of age and younger can compete in Avatar Follow Me, Avatar Sparring, and Multiplayer Competition rounds because the top pads are disconnected. Children can compete with up to three peers in a multiplayer mode. Workouts are saved. ‘‘We are thrilled that this new child mode will make it even easier for the entire family to work out together, making wellness a lifestyle priority,’’ said Terry G. Jones, Chairman and CEO of Nexersys. More information is available at: http://nexersys .com/nexersys-corporation-launches-new-childrens-mode-inlatest-software-platform-release/ British Study Shows Exergames Increase Energy Expenditure Playing ‘‘Dance Center’’ and ‘‘Kinect Sports Boxing’’ increased children’s energy expenditure by 150% and 263%, respectively, compared with resting values, according to a study in Archives of Pediatrics and Adolescent Medicine. Researchers at the University of Chester, Chester, United Kingdom, enrolled 18 schoolchildren, 11–15 years old, in a study to evaluate the response and energy expended while playing active videogames. Participants played the games for 15 minutes, and then the researchers measured heart rate, oxygen uptake, and energy used. They found that participants burned 103% and 194% more calories playing the two exergames than when playing a traditional videogame. That equates to burning up to 172 extra calories per hour compared with when they were sitting and playing the racing videogame. ‘‘While it is unlikely that active gaming can single handedly provide a substitute for traditional outdoor play or sports, these results do suggest that if played regularly, active gaming could prove to be an effective means of bridging the gap in the low physical activity levels currently being observed in children,’’ said Mike Morris, co-author of the study. More information is available at: www.chester.ac.uk/node/ 15482 and http://archpedi.jamanetwork.com/article.aspx? articleid = 1362182 Bacterial Shoot ‘em Up Wins Competition A game called ‘‘Dysbiosis,’’ created by University of Oxford postdoctoral researcher fellow Margherita Coccia with developers Clockwork Cuckoo and Force of Habit, was declared the winner of the Wellcome Trust’s Gamify Your PhD project. Those playing ‘‘Dysbiosis’’ shoot down harmful bacteria in the gastrointestinal tract, during an addictive immunological battle for digestive health. Competitors are given just 2 days to turn their concept game into something playable. The winner receives support to turn it into a releasable game. Gamify Your PhD is part of a wider commitment by the Wellcome Trust to using games and gaming culture as a means of engaging people with science. Daniel Glaser, head of Special Projects at the Wellcome Trust, who

393 chaired the judging panel, said, ‘‘The quality of the games and ideas produced during this short two-day hack is remarkable. And the energy of the teams has been driven by a tangible excitement in the exchange of knowledge. Gamify Your PhD has created an inspiring and innovative collision of popular culture and science, and demonstrated bold new paths for communicating science.’’ More information is available at: www.wellcome.ac.uk/News/Media-office/Press-releases/ 2012/WTVM056292.htm Videogames Shown to Stimulate the Brain University of Utah researchers have found that videogames can capture players’ attention and therapeutic interactive technologies, such as the university’s ‘‘Patient Empowerment Exercise Video Game’’ (PE Game), can turn physical activity into mental empowerment able to help patients psychologically overcome diseases and build resilience to chronic conditions by activating the brain’s reward system and producing positive emotions. Lead author Carol Bruggers, MD, a professor in the university’s Department of Pediatrics and physician at Primary Children’s Medical Center, said she envisions the development of interactive exergames designed to enhance patient empowerment, compliance, and clinical outcomes for specific disease categories. ‘‘Therapeutic video games will push video game design into exciting new directions,’’ said Robert Kessler, director of the university’s Entertainment Arts and Engineering Master’s program. ‘‘Meeting the needs of the competing goals of physical therapy through exercise and patient empowerment is extremely challenging. The PE Game is clearly the first of a whole line of research into therapeutic video games.’’ More information is available at: http://unews.utah.edu/news_releases/videogames-help-patients-and-health-care-providers/ and http:// stm.sciencemag.org/content/4/152/152ps16 Winners Announced in Game Testing Clinicians’ Skills UBM Medica US and Cancer Network have designed the online game ‘‘Diagnostic Champions’ Challenge,’’ to test the knowledge and medical diagnostic skills of physicians and other healthcare professionals. Players answer multiple-choice questions based on diagnosing and assessing different types of cancer. Players have 60 seconds to answer correctly. They compete against one another for the most correct answers and points, culminating with the top physician and non-physician players from the first 4 weeks vying to win the final round. Sumit Sawhney, MD, of Tamarac, FL, and Alex Browns of Texas each won an ounce of gold bullion by placing first in the final round of the 5-week Diagnostic Champions’ Challenge on CancerNetwork. ‘‘Our audience was very receptive to the challenging clinical cases offered by the Challenge on Cancer Network,’’ said Brian Field, executive vice president and managing director of UBM Medica US in Norwalk, CT. ‘‘By offering the Diagnostic Champions’ Challenge to our various healthcare audiences, we’ve seen firsthand how games can be used as an effective learning tool.’’ More information is available at: http:// goforthegold.cancernetwork.com/?cid = PR_GameEnd_201209 AbleGamers Releases Accessibility Guidelines The AbleGamers Foundation, a charity dedicated to bring greater accessibility for the disabled community into the

394 digital space, has released accessibility guidelines to help game designers develop games that can be used by people with physical and mental challenges. The organization researched existing literature and, combined with its experience and knowledge, has come up with the guidelines, a 46-page illustrated guide and how-to resource for developers called Includification, and a Web site to access the guidelines and subsequent updates as new technology becomes available. AbleGamers said none of the suggestions will negatively affect game design. More information is available at: www .includification.com/ Dental Association and Games Developer Create Oral Hygiene Game The American Dental Association and PopCap Games, a division of EA, produced the Stop Zombie Mouth campaign, featuring PopCap’s videogame ‘‘Plants vs. Zombies’’ to encourage good oral health among children and adults. The company gave the game away for free, along with gameinspired trading cards and other themed items with suggestions for dental health. The campaign suggested people download printable coupons for ‘‘Plants vs. Zombies’’ and give them out as an alternative to candy on Halloween. ‘‘The ADA and PopCap Games have come up with a fun, clever, and compelling approach,’’ said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest. ‘‘This campaign will help children recognize the relationship between healthy eating and healthy teeth, and provide one of the coolest alternatives to sugary snacks yet.’’ More information is available at: www.stopzombiemouth.com/ Videogames Can Help Train Surgical Skills Researchers from The Netherlands conducted a systematic review of research related to serious games for medical education. They identified 25 articles, discussing 30 games for specific educational purposes and commercial games used to develop medical skills. The team concluded in British Journal of Surgery that serious games and interactive learning may be used to teach surgical capabilities. ‘‘Our review clearly shows that serious games can be used to provide surgeons with

NEWS FROM THE FIELD training in both technical and nontechnical skills,’’ said coauthor Marlies Schijven from the Department of Surgery at the Academic Medical Centre in Amsterdam. ‘‘However, games developed or used to train medical professionals need to be validated before they are integrated into surgical teaching programs.’’ More information is available at: www .bjs.co.uk/details/article/2554281/Systematic-review-ofserious-games-for-medical-education-and-surgical-skillstra.html Irish Mental Health Game Being Used Worldwide Hundreds of therapists and specialists in the United States, United Kingdom, and Ireland have downloaded ‘‘Pesky Gnats,’’ a free computer game developed at the University College Dublin, Ireland, and the University of Bristol, Bristol, United Kingdom, as a tool for therapists to help treat children with anxiety, low self-esteem, and mental health problems. The game is used with children 9–13 years old as part of a cognitive therapy session. Patients fight gnats, which are physical manifestations of negative thoughts that can harm the player. Patients receive a logbook to write their thoughts during play and answer questions in the book. Game characters suggest tasks to do before the next session. More information is available at: www.davidcoyle.org/wordpress/gnats-island/ and www.juvenilementalhealthmatters.com/Welcome.html Stop Smoking iPad Tool Released As part of a stop-smoking competition, a team from the Centre for Tobacco Control Research and a team from the University of Auckland, Auckland, New Zealand, have released ‘‘Stub It Out,’’ a free iPad app for people trying to stop smoking. Players stop products as they move through different game levels and receive points given in accordance with the minutes of life they have gained. The game helps relieve stress while educating players about different tools to help them quit. The game was developed during the Whanau End Smoking Regional Challenge. An iPhone version is in the works. More information is available at: www.wero.me/ node/77 and https://itunes.apple.com/nz/app/stub-it-out/ id551865946?mt = 8&ls = 1