Virtual Worlds and
Social Games for Health
Part of Games Beyond Entertainment Week & Games for Health 2010
Games for Health Pre-Conference Event
May 25, 2010
Boston, MA www.gamesforhealth.org
Virtual worlds, massive multiplayer games, and now, the rise of social network games all share a
core element: combining play with social interactions among large groups of people.
Researchers such as Nicholas Christakis and James Fowler (authors of Connected: The
Surprising Power of Our Social Networks and How They Shape Our Lives) are showing the
power such social networks have on our health & well-being.
As a result, do virtual worlds, massive multiplayer games, and social network games
offer huge potential to help in health & healthcare?
When combined with new cutting edge thinking about how our human social nature can
we create new breakthroughs in the games for health field?
These are some of the conversations which guide Virtual Worlds and Social Games for Health
Day. Attendes will have the chance to discuss the critical strengths and weaknesses of both
social games and virtual worlds by examining their similarities and differences. How do health
practitioners, researchers, and developers sort out these opportunities? That will be the most
critical question of the day.
To attend Virtual Worlds and Social Games for Health you must register for one of the event
packages providing acess to the conference at http://www.regonline.com/gbew2010
To save 10% off the ticket price use the discount code of BOS10 during registration.
Virtual Worlds & Social Games Day, May 25, Boston, MA www.gamesforhealth.org
Full Schedule
Time Speaker Title
9:00-9:30 Parvati Dev, Innovation in Keynote: New Directions for Virtual Worlds for Health
Learning Inc.
9:30-9:55 Jennifer Keelan Using Virtual Focus Groups to Understand Public
University of Toronto Controversies over Chidlhood Vaccination
9:55-10:20 Mellisa E. De Rosier Intelligent social tutoring system for children:
University of North Carolina Implications for game development and health outcomes
10:20-10:40 Break
10:40-11:05 Mette Ter Hoybye Inspiring youths to engage in cancer treatment through a
Visiting Scholar multi-user online environment
Stanford University
11:05-11:30 Nichole Yankelovich Open Wonderland as a Serious Game Platform
Open Wonderland Foundation
11:30-12:30 Panel: Parvati Dev (moderator) The Changing Landscape of Virtual Worlds
Panelists TBA
12:30-1:55 Lunch
1:55-2:20 Judy Shasek Using Social Networks to Create a Huge Community
Healthy Community Development Health Game
2:20-2:45 Jennifer McCabe, Contagion Move It AND Lose It: Hacking Social Networking
Health Dynamics for Microfitness Results
2:45-3:10 Break
3:10-3:35 Celeste DeVaneaux Translating a health club based fitness & nutrition
Club One program into a
virtual world environment
3:35-4:00 Alicia Benjamin Health Tennis: A Facebook Game Designed to Improve
MeYou Health Your Well-Being
4:15-5:15 Panel: Parvati Dev (moderator), Are Social Games The Evolution of Virtual Worlds,
Judy Shasek, Jennifer McCabe, Gaming, Health or All of the Above?
Alicia Benjamin
5:15-5:30 Concluding Remarks
Virtual Worlds & Social Games Day, May 25, Boston, MA www.gamesforhealth.org
Parvati Dev
New Directions for Virtual Worlds for Health
Scenario-based learning, using virtual patients in 3D immersive environments, has been shown to
be effective in changing attitudes and behaviors in medical environments. However ease of use and
ease of access has limited the usage of this tool, while onerous pricing models have deterred
exploration of useful medical applications.
We reviewed the literature as well as verbal and written feedback from learners using our prior
implementations of virtual environments. Negative feedback fell mostly into two categories:
System (lack of adequate graphics computing in the installed base of computers and difficulty of
installing software through a firewall) and Usability (steep learning curve and too many options).
We also examined IT policies at medical institutions, pricing models in use for virtual worlds, and
potential high priority training issues in the health care system.
We will present our findings and discuss possible new directions for virtual worlds in health. We will
then present some of our own work in developing a new 3D, browser-based immersive
environment platform, CliniSpace, in response to the issues above.
Jennifer Keelan
Using Virtual Focus Groups to Understand Public Controversies over Chidlhood
Vaccination
The United States Centers for Disease Control has embraced the idea of reaching out to the
American public to provide them with health information they need, and want to know, in the
media or manner in which they would like to receive it. This has meant exploring a range of social
media platforms including YouTube, and social networking services.
SecondLife (SL) offers a range of new experiential tools and information dissemination strategies
to expand the conventional use of the World Wide Web to disseminate health information and to
encourage healthy behaviours; e.g. an avatar can experience the effects of long-term smoking or
“wear” the symptoms of a disease such as AIDS. Similarly, infectious disease simulations offer
individuals the opportunity to witness the impact of personal health decisions, such as choosing not
to immunize, on a population scale (e.g., watch an outbreak unfold in their army) and they can
experience the consequences of these decisions on their virtual selves over time (have the avatar
suddenly fall sick with influenza if not immunized). Virtual worlds promise a rich environment for
public health and policy makers to experiment with novel communication and consultation
techniques and strategies.
We present the results of a pilot study examining the attitudes of North American parents towards
immunization using focus groups held in SecondLife. We describe both the challenges and
advantages of this platform to reach our target demographics, the logistical challenges of hosting
research in SecondLife and finally we explore the validity of sampling techniques we developed to
recruit people to the research project and how virtual consultation might map onto real-world
attitudes and behaviours. This paper describes a pilot research study examining attitudes towards
immunization using focus groups held in SecondLife. We explore the utility of SecondLife for public
health research, the generalisability of our findings, the connections between virtual world
behaviours of avatars and real-life behaviours and both the limits and advantages of SecondLife as
a public consultation and public health research platform.
Melissa E. DeRosier, Ph.D.
Intelligent social tutoring system for children: Implications for game development and
health outcomes
Experiencing social problems with peers places children at heightened risk for a variety of negative
health outcomes, including obesity, drug abuse, and teen pregnancy. While on the surface learning
social skills via a virtual world appears paradoxical, gaming provides an ideal training ground where
Virtual Worlds & Social Games Day, May 25, Boston, MA www.gamesforhealth.org
children can explore, test out, and practice newly learned social strategies before attempting them
in real situations. Given the potentially high cost of social mistakes in actual peer interactions, a
virtual world offers a safe learning environment without fear of real-world consequences. During
this conference presentation, we will describe a novel game-based intelligent social tutoring system
(ISTS) that provides children with a fun, engaging, interactive means to actively learn and practice
key social problem solving strategies. The ISTS is a Flash-based point-and-click adventure game
based on a scientifically validated, skill-based social skills training intervention. We intentionally
integrated the training strategies of scaffolding, coaching and reinforcement, and practice into
development of the ISTS in order to create an effective interactive social learning environment for
children. We will also present test results from our initial evaluation of the ISTS with children and
parents. Statistically significant relations were found between independent measures of children’s
social skills competencies and ISTS performance indices. Findings from this research provide
considerable support for the construct validity of our instructional content and underscore the
potential value of interactive intelligent software as a social skills training tool. Discussion will
include an examination of our development framework which fostered deep collaboration between
subject matter experts and game designers and the value of this framework for creating interactive
software that can effectively improve health outcomes for children.
Mette Ter Hoybye
Inspiring youths to engage in cancer treatment through a multi-user online environment
Objective of the work
This work proposes to develop a behavioral intervention seeking to increase adherence to cancer
treatment and alleviate social isolation through an immersive online real-time multi-user
environment for adolescents and young adults with cancer.
Significant problem
Development of effective treatment protocols in the past two decades has dramatically reduced
childhood cancer mortality rates to an 80% survival in the first five years. Still, adolescent and
young adults have not shown comparable benefits. Suboptimal treatment adherence is believed to
contribute to this disparity. In a time of developmental transition from child to adult, harsh cancer
treatment regiments deeply challenge the sense of self and body in this group of patients.
Previous studies
Computer games may affect and change behavior in children with cancer and alleviate the stressful
experience of cancer. Targeting the problem of treatment adherence a previous randomized study
showed, that playing a video-game specifically designed for adolescent and young adults with
cancer can increase knowledge of cancer and self-efficacy, directly resulting in increased adherence
to cancer treatments.
Studies of internet-based communication further suggest that the web offers a unique platform for
meeting similar others, which creates empowerment in the individual patient, through the social
interaction of a shared story.
Key technologies and innovation in this work
This promises great potential for utilizing new social media and games, which this project seeks to
merge, in psychosocial cancer treatment.
Using the Sirikata platform this work will develop and test an immersive online real-time multi-user
environment for adolecents in cancer treatment that can be embedded in popular media platforms
like Facebook and Twitter, creating ample opportunity for user access.
Virtual Worlds & Social Games Day, May 25, Boston, MA www.gamesforhealth.org
Nicole Yankelovich, Executive Director, Open Wonderland Foundation
Open Wonderland as a Serious Game Platform
Open Wonderland is a free, open source, 100% Java toolkit for creating multi-user, interactive 3D
experiences. Serious game developers can use the toolkit to create highly customized immersive
virtual worlds or multi-user games. For example, one university has used the Wonderland toolkit to
create a virtual hospital to help train nurses in effective communication skills. Another group of
students working with a rehabilitation hospital has created a game for children with Cerebral Palsy
in which children move an avatar by pedaling a bicycle instrumented with sensors and a Wii remote
to find hidden treasure. In this talk, we'll explore what others have done with the toolkit and then
focus on how to create original content.
The Changing Landscape of Virtual Worlds
Parvati Dev (Moderator)
Two years ago they were the definitive "it" of the interactive world. Systems that brought together
multiuser environments, 3D worlds, and rapid content development were slated to be the Next Big
Thing. Since then, a bit of reality (good and bad) has set in, and a recession has gutted some of
the bigger players, not just the small ones. At the same time, Second Life continues to see new
projects launched, and the promise of large-scale virtual environments and what they mean for
health (as well as other needs) has not been wiped complete off the agenda. However, the reality
is that the landscape of virtual worlds has, and still is changing. Given the expertise in the room,
and the need for everyone to adapt with the shifting landscape this panel will explore where things
stand now, and perhaps where they're going. More specifically the discussion will focus on what
that means for building health training, and personal health oriented applications.
Judy Shasek
Using Social Networks to Create a Huge Community Health Game
Currently too much of the healthy game world is a world of one. At best it is a world of a family
with "2.5 kids and a dog". However, we know that for many people health requires a community-
wide intervention. Obesity itself is a community-wide epidemic that is affecting many different
people of age, and background. Social network analysis also shows that people behave similar to
how their friends and colleagues behave as it relates to things like diet and exercise. This means
that to truly improve health for many it requires attacking the entire social network not just the
individual in question.
How then do we bridge the difference between single or household game experiences to larger-
scale communities like school districts, employer groups, senior communities, or entire regions like
upstate New York? Can new types of games that integrate with activity and diet create the
necessary frameworks for community-based interventions? If so, then how?
This talk highlights a specific new effort by a serial games for health entrepreneur to change the
approach for how healthy gaming can work. HCD - Healthy Community Development is working to
think specifically how social network games, active monitoring technologies, and a bevy of
community based partners can create a large-scale wellness meta-game that motivates large
populations of players to improve their health.
During this brief overview the talk will identify the progress in building the plan so far, and identify
the business and social models that are being settled on to drive the service. This includes using
existing proven exercise games as well as activity monitoring systems and virtual currencies to
integrate many forms of health behavior change games and exergames into a larger meta-game
around personal health achievement.
Attendees will be given a chance to offer further advice and reaction to the plan, and use its early
work to imagine how they too can expand and/or integrate their singular or household focused
game for health into something bigger, and potentially better.
Virtual Worlds & Social Games Day, May 25, Boston, MA www.gamesforhealth.org
Jen McCabe
Move It AND Lose It: Hacking Social Networking Dynamics for Microfitness Results
Can 'random' acts of microfitness be contagious?
Are you more likely to exercise when the 'challenge' comes from friends and family?
Can Twitter be the Rx for weight loss and other 'lifestyle' conditions?
Current health game design largely mirrors videogame design, but perhaps we're making things
too difficult.
Simple social games that hack users' existing relationship graphs may have a bigger impact than a
flashy ORPG by working at the daily 'microchoice' level, plugging in support from friends when you
need it most - BEFORE you decide to do something 'healthy' like take the stairs or hit the gym.
The good news: You don't have to rebuild a new community to get folks to #getupandmove.
The bad news: Your best single-player game design - snazzy visuals and all - may not be enough to
make a daily difference in the life of your users.
We'll explode assumptions we're currently making about 'gamer behavior' and 'user psychology'
and how this is limiting what gaming for health is able to achieve.
Using case studies (with choice quotes from real, live "guammies") we'll work from the ground up
using behavioral economics to explore how 'healthy' choices actually get made, and how to code a
game that provides the feedback most likely to drive repeated healthier decision-making.
Celeste DeVaneaux
Translating a health club based fitness & nutrition program into a
virtual world environment
This presentation focuses on a case study of Club One Island. The goal of this project was to take
a successful weight-loss challenge program implemented at a commercial health club and corporate
health facility management firm and translate it into a sophisticated online experience.
Combining digital media and social networking with what is conventionally known about cognitive
and gaming theory, we have successfully motivated members of our pilot program to live healthy
and fulfill their desires through an interactive and fun environment.
The session will detail the development of the virtual experience, built in Second Life, and the first
three-months of the pilot program detailing results, feedback, and critical analysis of the effort.
The session will focus on how virtual worlds have allowed Club One to build an experience that
goes beyond typical web-based community experiences including how people experience their
physical self online.
Alicia Benjanim
Health Tennis: A Facebook Game Designed to Improve Your Well-Being
This session features a case-study of the design of Health Tennis by Me You Health. Health Tennis
is a Facebook-based title that connects you with your friends through small daily actions.
Are Social Games The Evolution of Virtual Worlds, Gaming, Health or All of the Above?
Parvati Dev (Moderator)
In 2009, the momentum in virtual worlds slowed while social network games gained ascendency.
Virtual Worlds & Social Games Day, May 25, Boston, MA www.gamesforhealth.org
Games like Farmville, Scrabulous, Mob Wars, and Cafe World have become huge online brands
being accessed by millions of players globally. To some extent social network platforms have
achieved what virtual worlds have not - they provide strong audience numbers and peer-to-peer
interactions. At the same time, the games built on top of them while sometimes compelling, are in
many cases simpler then the types of applications built on top of leading virtual world platforms
like Second Life, or the now discontinued Metaplace.
If you think of virtual worlds as being communities and the interactions between their members,
then social networking systems and games are incredible virtual worlds. However, if you look at
most of the games built for them, they're are at times fairly unworldly - offering little interaction
beyond swapping small virtual goods and skinner-box-like gameplay. Yet the market has certainly
voted in favor of one vs. the other -- for the moment.
During this panel we will examine the large force that is social network gaming. We will examine
how social network games are filling voids that virtual worlds failed at serving and how social
network games are still very much an embryonic work in progress. Is there a merger between the
two that will bring the best of both or are they each a platform headed in their own independent
trajectories?
After understanding the relationship between virtual worlds and social network games the panel
will then turn its attention to the future and attempt to offer some thought leadership about not
only where social network gaming is going in general, but how specifically this powerful force in
games and the Internet in general can be used in unique ways to solve problems in health and
healthcare that other games for health projects have yet to do.
Virtual world discussion today can benefit from hindsight. Ideally what can that hindsight tell us
about the fast-moving but still uncertain nature of the Next Big Thing: Social Network Games...
Virtual Worlds & Social Games Day, May 25, Boston, MA www.gamesforhealth.org