skip to main content
10.1145/3235765.3235789acmotherconferencesArticle/Chapter ViewAbstractPublication PagesfdgConference Proceedingsconference-collections
research-article

Design considerations towards long-term engagement in games for health

Published: 07 August 2018 Publication History

Abstract

While studies point to the positive potential of games for health to increase patient engagement and to a need to consider longer-term perspectives, there is a lack of more tangible knowledge on how to design for long-term engagement in games for health. This paper makes a contribution in this space by drawing a reflective arc across three games for health projects from areas such as rehabilitation, prevention and chronic disease. We discuss the projects using a research through design lens and reflect on user research data and design artifacts from the perspective of the involved game designers. The results are design considerations towards long-term engagement in games for health. These considerations present a body of intermediate-level knowledge [19] oriented towards maximising the potential of the design space in early stages of games for health projects. The considerations are structured into those relevant to gameplay, research design and application context.

References

[1]
Tuomas Alahäivälä and Harri Oinas-Kukkonen. 2016. Understanding persuasion contexts in health gamification: A systematic analysis of gamified health behavior change support systems literature. International journal of medical informatics 96 (2016), 62--70.
[2]
Tom Baranowski, Richard Buday, Debbe Thompson, Elizabeth J Lyons, Amy Shirong Lu, and Janice Baranowski. 2013. Developing games for health behavior change: Getting started. GAMES FOR HEALTH: Research, Development, and Clinical Applications 2, 4 (2013), 183--190.
[3]
Elaine Biddiss and Jennifer Irwin. 2010. Active video games to promote physical activity in children and youth: a systematic review. Archives of pediatrics & adolescent medicine 164, 7 (2010), 664--672.
[4]
Emily Brown and Paul Cairns. 2004. A grounded investigation of game immersion. In CHI'04 extended abstracts on Human factors in computing systems. ACM, 1297--1300.
[5]
A. Burdick. 2003. Design (as) Research. In Design Research: Methods and Perspectives, Brenda Laurel (Ed.). MIT Press.
[6]
Christian Burgers, Allison Eden, Mélisande D van Engelenburg, and Sander Buningh. 2015. How feedback boosts motivation and play in a brain-training game. Computers in Human Behavior 48 (2015), 94--103.
[7]
James William Burke, M DJ McNeill, Darryl K Charles, Philip J Morrow, Jacqui H Crosbie, and Suzanne M McDonough. 2009. Optimising engagement for stroke rehabilitation using serious games. The Visual Computer 25, 12 (2009), 1085--1099.
[8]
Kristin L Carman, Pam Dardess, Maureen Maurer, Shoshanna Sofaer, Karen Adams, Christine Bechtel, and Jennifer Sweeney. 2013. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Affairs 32, 2 (2013), 223--231.
[9]
Colleen Cheek, Theresa Fleming, Mathijs FG Lucassen, Heather Bridgman, Karolina Stasiak, Matthew Shepherd, and Peter Orpin. 2015. Integrating health behavior theory and design elements in serious games. JMIR mental health 2, 2 (2015).
[10]
Victoria Clarke and Virginia Braun. 2014. Thematic analysis. In Encyclopedia of critical psychology. Springer, 1947--1952.
[11]
Brian Cugelman. 2013. Gamification: what it is and why it matters to digital health behavior change developers. JMIR Serious Games 1, 1 (2013).
[12]
Edward L Deci, Richard Koestner, and Richard M Ryan. 1999. A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation.
[13]
Ann DeSmet, Antonio Palmeira, Alicia Beltran, Leah Brand, Vanessa Fernandes Davies, and Debbe Thompson. 2015. The yin and yang of formative research in designing serious (exer-) games. Games for health journal 4, 1 (2015), 63--66.
[14]
J. Dewey. 1938. Logic: The Theory of Inquiry. Southern Illinois University Press, Carbondale.
[15]
Brock Dubbels. 2009. Dance Dance Education and Rites of Passage. International Journal of Gaming and Computer-Mediated Simulations (IJGCMS) 1, 4 (2009), 63--89.
[16]
Pelle Ehn and Jonas Löwgren. 2004. Design {x} research: Essays on interaction design as knowledge. Malmö University, School of Arts and Communication.
[17]
Fitbit. 2016. NBA 2K17 Steps Up its Game with New Fitbit Integration. https://investor.fitbit.com/press/press-releases/press-release-details/2016/NBA-2K17-Steps-Up-its-Game-with-New-Fitbit-Integration/default.aspx
[18]
Stefan Göbel, Sandro Hardy, Viktor Wendel, Florian Mehm, and Ralf Steinmetz. 2010. Serious games for health: personalized exergames. In Proceedings of the 18th ACM international conference on Multimedia. ACM, 1663--1666.
[19]
Kristina Höök and Jonas Löwgren. 2012. Strong concepts: Intermediate-level knowledge in interaction design research. ACM Transactions on Computer-Human Interaction (TOCHI) 19, 3 (2012), 23.
[20]
Eva Hornecker. 2010. Creative idea exploration within the structure of a guiding framework: the card brainstorming game. In Proceedings of the fourth international conference on Tangible, embedded, and embodied interaction. ACM, 101--108.
[21]
Katherine Isbister and Florian âĂIJFloydâĂİ Mueller. 2015. Guidelines for the design of movement-based games and their relevance to HCI. Human-Computer Interaction 30, 3--4 (2015), 366--399.
[22]
Daniel Johnson, Sebastian Deterding, Kerri-Ann Kuhn, Aleksandra Staneva, Stoyan Stoyanov, and Leanne Hides. 2016. Gamification for health and wellbeing: A systematic review of the literature. Internet Interventions 6 (2016), 89--106.
[23]
Pamela M Kato. 2010. Video games in health care: Closing the gap. Review of General Psychology 14, 2 (2010), 113.
[24]
Pamela M Kato. 2012. Evaluating efficacy and validating games for health. GAMES FOR HEALTH: Research, Development, and Clinical Applications 1, 1 (2012), 74--76.
[25]
Fares Kayali, Naemi Luckner, Oliver Hödl, Geraldine Fitzpatrick, Peter Purgathofer, Tanja Stamm, Daniela Schlager-Jaschky, and Erika Mosor. 2013. Elements of play for cognitive, physical and social health in older adults. In Human Factors in Computing and Informatics. Springer, 296--313.
[26]
Fares Kayali, Naemi Luckner, and Peter Purgathofer. 2015. Long-time motivation strategies in games for health (lecture). In Games for Health Europe 2015.
[27]
Fares Kayali, Konrad Peters, Jens Kuczwara, Andrea Reithofer, Daniel Martinek, Rebecca Wölfle, Ruth Mateus-Berr, Zsuzsanna Lehner, Marisa Silbernagl, Manuel Sprung, et al. 2015. Participatory game design for the INTERACCT serious game for health. In Joint International Conference on Serious Games. Springer, 13--25.
[28]
Fares Kayali, Konrad Peters, Andrea Reithofer, Ruth Mateus-Berr, Zsuzsanna Lehner, Daniel Martinek, Manuel Sprung, Marisa Silbernagl, Rebecca Woelfle, Anita Lawitschka, et al. 2014. A Participatory Game Design Approach for Children After Cancer Treatment. In Proceedings of the 2014 Workshops on Advances in Computer Entertainment Conference. ACM, 16.
[29]
Fares Kayali, Marisa Silbernagl, Konrad Peters, Ruth Mateus-Berr, Andrea Reithofer, Daniel Martinek, Anita Lawitschka, and Helmut Hlavacs. 2016. Design considerations for a serious game for children after hematopoietic stem cell transplantation. Entertainment Computing 15 (2016), 57--73.
[30]
Christina Kelley, Lauren Wilcox, Wendy Ng, Jade Schiffer, and Jessica Hammer. 2017. Design Features in Games for Health: Disciplinary and Interdisciplinary Expert Perspectives. In Proceedings of the 2017 Conference on Designing Interactive Systems. ACM, 69--81.
[31]
Hadi Kharrazi, Amy Shirong Lu, Fardad Gharghabi, and Whitney Coleman. 2012. A scoping review of health game research: past, present, and future. GAMES FOR HEALTH: Research, Development, and Clinical Applications 1, 2 (2012), 153--164.
[32]
Konami. 1998-present. Dance Dance Revolution (series). Game {Arcade}. Played March 2016.
[33]
Chris Lewis, Noah Wardrip-Fruin, and Jim Whitehead. 2012. Motivational game design patterns of'ville games. In Proceedings of the International Conference on the Foundations of Digital Games. ACM, 172--179.
[34]
William HC Li, Joyce OK Chung, and Eva KY Ho. 2011. The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalised with cancer. Journal of Clinical Nursing 20, 15--16 (2011), 2135--2143.
[35]
Cameron Lister, Joshua H West, Ben Cannon, Tyler Sax, and David Brodegard. 2014. Just a fad? Gamification in health and fitness apps. JMIR serious games 2, 2 (2014).
[36]
Naemi Luckner, Fares Kayali, Oliver Hödl, Peter Purgathofer, Geraldine Fitzpatrick, Erika Mosor, Daniela Schlager-Jaschky, and Tanja Stamm. 2013. From Research to Design-Sketching a Game to Trigger Reminiscence in Older Adults. In Human factors in computing and informatics. Springer, 617--624.
[37]
Ralph Maddison, Louise Foley, Cliona Ni Mhurchu, Yannan Jiang, Andrew Jull, Harry Prapavessis, Maea Hohepa, and Anthony Rodgers. 2011. Effects of active video games on body composition: a randomized controlled trial. The American journal of clinical nutrition 94, 1 (2011), 156--163.
[38]
Kristine A Madsen, Sophia Yen, Lidya Wlasiuk, Thomas B Newman, and Robert Lustig. 2007. Feasibility of a dance videogame to promote weight loss among overweight children and adolescents. Archives of pediatrics & adolescent medicine 161, 1 (2007), 105--107.
[39]
Susan Michie, Stefanie Ashford, Falko F Sniehotta, Stephan U Dombrowski, Alex Bishop, and David P French. 2011. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychology & health 26, 11 (2011), 1479--1498.
[40]
Erika Mosor and Daniela Schlager-Jaschky. 2013. Web of Life - Lebensnetz" Occupational therapists' contribution to the development of a serious game for older adults in the context of dementia prevention and Treatment by creating a catalog of requirements (master thesis). In University of Applied Science Campus Vienna.
[41]
Michele Pirovano, Pier Luca Lanzi, Renato Mainetti, and Nunzio Alberto Borghese. 2013. IGER: A game engine specifically tailored to rehabilitation. In Games for Health. Springer, 85--98.
[42]
Brian A Primack, Mary V Carroll, Megan McNamara, Mary Lou Klem, Brandy King, Michael Rich, Chun W Chan, and Smita Nayak. 2012. Role of video games in improving health-related outcomes: a systematic review. American journal of preventive medicine 42, 6 (2012), 630--638.
[43]
Esmaeel Rahmani and Suzanne Austin Boren. 2012. Videogames and health improvement: a literature review of randomized controlled trials. GAMES FOR HEALTH: Research, Development, and Clinical Applications 1, 5 (2012), 331--341.
[44]
Scott Rigby and Richard M Ryan. 2011. Glued to games: How video games draw us in and hold us spellbound: How video games draw us in and hold us spellbound. ABC-CLIO.
[45]
Cornelia M. Ruland, Justin Starren, and Torun M. Vatne. 2008. Participatory design with children in the development of a support system for patient-centered care in pediatric oncology. Journal of Biomedical Informatics 41, 4 (2008), 624--635.
[46]
Richard M Ryan and Edward L Deci. 2000. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American psychologist 55, 1 (2000), 68.
[47]
Donald A Schön. 1983. The Reflective Practitioner: How Professionals Think in Action. Vol. 1. Basic Books. 374 pages.
[48]
Katie Seaborn and Deborah I Fels. 2015. Gamification in theory and action: A survey. International Journal of human-computer studies 74 (2015), 14--31.
[49]
Richard S Shames, Paul Sharek, Michelle Mayer, Thomas N Robinson, Elisabeth G Hoyte, Frances Gonzalez-Hensley, David A Bergman, and Dale T Umetsu. 2004. Effectiveness of a multicomponent self-management program in at-risk, school-aged children with asthma. Annals of Allergy, Asthma & Immunology 92, 6 (2004), 611--618.
[50]
Miguel Sicart. 2014. Play matters. MIT Press.
[51]
Monique Simons, Lex Opdam, and Pepijn van Empelen. 2013. Feasibility of an active game program in a Dutch pre-vocational high school setting. GAMES FOR HEALTH: Research, Development, and Clinical Applications 2, 6 (2013), 332--340.
[52]
A. J. Stapleton. 2005. Research as Design-Design as Research. In Proceedings of the DiGRA 2005 Conference - Changing Views: Worlds in Play.
[53]
Stephen Uzor and Lynne Baillie. 2014. Investigating the long-term use of ex-ergames in the home with elderly fallers. In Proceedings of the 32nd annual ACM conference on Human factors in computing systems. ACM, 2813--2822.
[54]
Visual Concepts. 2016. NBA 2K17. Game {Playstation 4}. Played April 2017.
[55]
Carolyn Watters, Sageev Oore, Michael Shepherd, Azza Abouzied, Anthony Cox, Melanie Kellar, Hadi Kharrazi, Fengan Liu, and Anthony Otley. 2006. Extending the use of games in health care. In System Sciences, 2006. HICSS'06. Proceedings of the 39th Annual Hawaii International Conference on, Vol. 5. IEEE, 88b--88b.
[56]
Nick Yee. 2006. Motivations for play in online games. CyberPsychology & behavior 9, 6 (2006), 772--775.
[57]
José P Zagal, Staffan Björk, and Chris Lewis. 2013. Dark patterns in the design of games. In Foundations of Digital Games 2013.
[58]
John Zimmerman, Jodi Forlizzi, and Shelley Evenson. 2007. Research through design as a method for interaction design research in HCI. In Proceedings of the SIGCHI conference on Human factors in computing systems. ACM, 493--502.

Cited By

View all
  • (2024)Self-Determination Theory and HCI Games Research: Unfulfilled Promises and Unquestioned ParadigmsACM Transactions on Computer-Human Interaction10.1145/367323031:3(1-74)Online publication date: 15-Jun-2024
  • (2024)Long-Term Gamification: A SurveyHCI in Games10.1007/978-3-031-60692-2_3(32-43)Online publication date: 29-Jun-2024
  • (2023)A Virtual Reality Serious Game for the Rehabilitation of Hand and Finger Function: Iterative Development and Suitability Study (Preprint)JMIR Serious Games10.2196/54193Online publication date: 1-Nov-2023
  • Show More Cited By

Recommendations

Comments

Information & Contributors

Information

Published In

cover image ACM Other conferences
FDG '18: Proceedings of the 13th International Conference on the Foundations of Digital Games
August 2018
503 pages
Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

Publisher

Association for Computing Machinery

New York, NY, United States

Publication History

Published: 07 August 2018

Permissions

Request permissions for this article.

Check for updates

Author Tags

  1. design as research
  2. game design
  3. games for health
  4. long-term engagement

Qualifiers

  • Research-article

Conference

FDG '18
FDG '18: Foundations of Digital Games 2018
August 7 - 10, 2018
Malmö, Sweden

Acceptance Rates

FDG '18 Paper Acceptance Rate 39 of 95 submissions, 41%;
Overall Acceptance Rate 152 of 415 submissions, 37%

Contributors

Other Metrics

Bibliometrics & Citations

Bibliometrics

Article Metrics

  • Downloads (Last 12 months)64
  • Downloads (Last 6 weeks)5
Reflects downloads up to 13 Feb 2025

Other Metrics

Citations

Cited By

View all
  • (2024)Self-Determination Theory and HCI Games Research: Unfulfilled Promises and Unquestioned ParadigmsACM Transactions on Computer-Human Interaction10.1145/367323031:3(1-74)Online publication date: 15-Jun-2024
  • (2024)Long-Term Gamification: A SurveyHCI in Games10.1007/978-3-031-60692-2_3(32-43)Online publication date: 29-Jun-2024
  • (2023)A Virtual Reality Serious Game for the Rehabilitation of Hand and Finger Function: Iterative Development and Suitability Study (Preprint)JMIR Serious Games10.2196/54193Online publication date: 1-Nov-2023
  • (2023)An Examination of Motivation in Physical Therapy Through the Lens of Self-Determination Theory: Implications for Game DesignProceedings of the 2023 CHI Conference on Human Factors in Computing Systems10.1145/3544548.3581171(1-16)Online publication date: 19-Apr-2023
  • (2022)Designing Spellcasters from Clinician Perspectives: A Customizable Gesture-Based Immersive Virtual Reality Game for Stroke RehabilitationACM Transactions on Accessible Computing10.1145/353082015:3(1-25)Online publication date: 19-Aug-2022
  • (2022)A Game of Dark Patterns: Designing Healthy, Highly-Engaging Mobile GamesExtended Abstracts of the 2022 CHI Conference on Human Factors in Computing Systems10.1145/3491101.3519837(1-8)Online publication date: 27-Apr-2022
  • (2022)Genius - Brain Training Mobile Application for the Elderly2022 IEEE Bombay Section Signature Conference (IBSSC)10.1109/IBSSC56953.2022.10037433(1-6)Online publication date: 8-Dec-2022
  • (2021)Respawn, Reload, RelateProceedings of the ACM on Human-Computer Interaction10.1145/34746905:CHI PLAY(1-31)Online publication date: 6-Oct-2021
  • (2021)Dive DeeperProceedings of the ACM on Human-Computer Interaction10.1145/34746635:CHI PLAY(1-25)Online publication date: 6-Oct-2021
  • (2021)Homecoming: Exploring Returns to Long-Term Single Player GamesProceedings of the 2021 CHI Conference on Human Factors in Computing Systems10.1145/3411764.3445357(1-13)Online publication date: 6-May-2021
  • Show More Cited By

View Options

Login options

View options

PDF

View or Download as a PDF file.

PDF

eReader

View online with eReader.

eReader

Figures

Tables

Media

Share

Share

Share this Publication link

Share on social media