CAMPUSCRAFT: USING SERIOUS HEALTH GAMES TO

ENGAGE COLLEGE STUDENTS

WisdomTools• Based in Bloomington, Indiana• Offer expertise in the areas of using serious games and other

immersive learning technologies, and social media to reach children and young adults in the K-20 education market. • Developing a health games division over past two years.

Projects include:• CampusCraft, a serious health game targeting college students.• InSight Rehab, in partnership with Dr. Jill Bolte Taylor, author of My

Stroke of Insight.• Paper Kingdom, under the leadership of the New England Research

Institutes (NERI)

Background• Health care costs are driving trends in consumer-oriented

health.• Patients need the knowledge, skills, as well as the tools and

technologies to enable and encourage informed decisions about their health.• College campuses emerging as ideal environment to “connect”

with future health care consumers. • Nearly 9,000 PHR accounts created on the Indiana University,

Bloomington campus.• Interest in using online tools such as health trackers.• Lack context & relevance with regard to own health.

Snapshot of Target Population

• 18.2 million college students on nearly 4,500 campuses nationwide.• 45% of binge drink.• 33% are either obese or overweight• 66% carry at least one (1) risk factor for metabolic syndrome (i.e., high

blood pressure, excessive abdominal fat, high cholesterol).• 20% currently receiving some form of behavioral counseling (vs. 9.7% of

gen. pop.) for depression, stress, anxiety, suicidal ideation, etc.• 14.2% report taking psychotropic meds (vs. 7.7% of gen. pop.)• 25% of females will be sexually assaulted at one time during their

academic career.• 50% of cases associated with alcohol;• 80% of cases committed by an acquaintance.

Emerging Set of Trends• Growing shift in responsibility to consumers in costs and

behaviors/lifestyle choices.• Growing set of information and tools available to consumers via

the internet, mobile applications, patient portals, PHRs, etc.• Significant health concerns on college campuses mirroring

those occurring nationally.• College campuses represent an opportunity to inform, educate,

and prepare future health care consumers.

Our Approach• Traditional methods of informing students how they should

behave or live their lives are not working.• Mandated programs on alcohol or sexual assault education are

largely ignored by target population.• You cannot preach or promote a specific lifestyle.• We must connect with their lifestyles and behaviors with what

they already tend to do through games.

CampusCraft • Funded by a Small Business Innovation Research (SBIR) grant

with the NIH’s National Center for Research Resources.• Phase 1 completed and prototype design developed & tested.• Currently awaiting Phase 2 award.

• Address four (4) overarching learning objectives :• What are my health risks (personal, family, environmental, social, etc.)?• How do my behaviors & lifestyle impact my health?• What resources & skills are needed or available to optimize my health?• Do I have control over my life and understand the skills, resources, and

tools I need to thrive in college and beyond.

Phase 1 Prototype Objectives• Address two (2) health issues relating to the combination of

sexual health and binge drinking:• Negotiating sexual consent• Negotiating condom use

• Create a virtual environment that offer a combination of player characters and non-player characters interacting within realistic scenarios depicting life on a college campus.• Incorporate game play elements such as quests, mini-games,

point & reward system, and feedback to enhance experience. • Enable an environment in which students can enter to explore

or experience the good, the bad, and the ugly of college life;

Designing CampusCraft• With input from the target audience, health educators, and

subject matter experts (SMEs), we iteratively designed, developed, and researched this prototype: • 11 interviews with SMEs in sexual health, alcohol consumption, and stress

to better understand issues affecting students.• 8 focus groups with students to address content, game design, and game

mechanics. Groups included ongoing discussion with • Undergraduate-level Health Seminar in Gender, Communication, Sexuality and

Health (12 students);• Masters’ level class on Human-Computer Interaction (20 students).

• 2 participatory design workshops (12 students), we iteratively designed and developed the CampusCraft prototype.

The Challenge of Finding Right Balance: Learning vs. Fun

• We can create a game that teaches, but will anyone want to play it?

• We can create a game that’s fun, but will anyone learn anything?

• Students won’t be forced to play, so how do we create a game that students will actually seek out, play, and take something away?

• What will attract them to return to the game?

• What will want them to invite their friends to play?

CampusCraft’s Working Game Theme• Scenario: You’re a new student, free from the chains of

parents, curfews, bed times, and eating your vegetables. The problem is that you’ve never really been on your own and, worse, you’re broke!• Solution: You begin taking on some jobs to make some extra

cash, while learning your way around campus, meeting new friends, and creating new experiences.• Strategy: As part of your job, you have to explore and get close

to potential culprits. The objective is to get information that will help you crack the case, but not get caught. You’ll have to navigate some pretty delicate situations. Are you up for it?

A Glimpse at the CampusCraft Prototype & Later Stages

Select an avatar• Phase 1 choices:• Gender• Name

• Phase 2 Choices:• Gender• Name• Physical characteristics• University/campus• Personality• Academic ambitions• Social ambitions• Health status or history• Evolving appearance &

performance controlled by in-game choices/success.

CampusCraft Prototype cont…

Meet New People

• Phase 1 limitations:• Handful of NPCs• Constrained dialogue

• Phase 2 changes:• More complex dialogue• More complex NPCs• Richer, more diverse storyline

CampusCraft Prototype cont…

Explore the Campus

• Phase 1 Choices:• Limited set of locations driven by

storyline.• Phase 2 choices:• Will add new locations so players

may explore and discover.• Players will be able to visit

locations outside of storyline.• Locations based on student’s own

campus.• Incorporate real locations into

game play

Future Activities• Choice of working alone or recruiting a team to complete

assignments investigating mysteries occurring on campus.• Manage your team of talented students. The better you

manage your team, the more effective you are in solving mysteries and earning points/money. • Go on daily missions (mini-games) or solve an outbreak to build

up your experience, skills and abilities, while blowing off some steam and having fun.

CampusCraft Prototype Testing• Eleven (11) different sessions involving 149 Indiana University

students to assess:• 52% Male / 48% female.• 81% 18-22 years old.• Usability of the game prototype and provide feedback on the game

design, scenarios, and dialogues.• Key concepts, behaviors, and skills addressed in the game.• Feasibility of our approach in terms of student engagement & interest,

particularly compared to other interventions offered on campus.

Feedback on Usability, Game Design Scenarios, and Dialogue

• Highest rated categories:• Content• Design of Learning• Characters (Non-Player)• Story/Activities

• Lowest rated categories:• Game play choices• Game play mechanics• Graphics

Key Concepts, Behaviors, and Skills Introduced

• Health Attitudes:• Health Self-Efficacy• Rape Myth Acceptance• Sexual Double Standards• Token Resistance

• Pre- and Post-Test Results:• Overall attitude changes regarding token resistance.• Males had higher mean scores on overall attitudes, rape myth

acceptance, sexual double standards, and token resistance.• Females had higher mean scores on health self-efficacy.

Pilot Test Results & Conclusions• Significant differences in learning of health concepts between

pre- and post-tests, such that students scored higher on post-tests.• Can conclude that the game impacted students learning several key

concepts relating to a health topic and impacting attitudes toward a topic of health.

• Approach of CampusCraft is effective for influencing attitudes towards topics of health.• Attitude changes will be further explored in Phase 2.

• Overall: positive outcomes in terms of usability, health attitude, and health learning.

Pilot Test Results & Conclusions• Feedback regarding the use of personal health

information (PHI) in the game:• 83.8% would use PHI to affect Avatar’s characteristics;• 82% would use PHI to influence consequences of your choices

in the game;• 76.6% would use it to affect opportunities available to them

in the game.

Pilot Test Conclusions cont…• Strong interest in CampusCraft from students, health

practitioners, and SMEs and want:• More actions & activities throughout the game;• More flexibility & more control to players in terms of linking

to their personal health information;• Social networking capabilities through existing platforms

(i.e., Facebook) or game play itself;• Meaningful links between the virtual and non-virtual world.

Random Focus Group Comments• “I thought the game was a good way of revealing health information in

a fun and entertaining manner.”• “Some of the strengths that I specifically enjoyed was how you had a

task (solving a mystery) aside of learning the information.”• “Overall, I think the idea of the game has the potential to be quite

enjoyable and educational at the same time.”• “I did like the authenticity of a typical college experience. The activities were

easy for me to relate to.”• “The fact it is a learning game that doesn't force-feed the player the intended

lessons is a huge bonus to its enjoy-ability. If the option was given I would happily play this post production since the gameplay was so entertaining.”

• “I liked the idea that it was an interactive college lifestyle game. Usually videogames are all about fighting or younger stuff. This is our lives in a video game form.”

QUESTIONS & ANSWERSContact Information:

Pete Grogg, MHA Hamid Ekbia, PhDpgrogg@wisdomtools.com hekbia@wisdomtools.com