Exergames, video game systems that require exertion and interaction, have been rising in popularity in the past years. However, research on popular exergames shows mixed health benefits, potentially due to minimal energy expenditure and decreasing use over time. This paper presents a 2x2 experimental study (N = 44), using a popular exergame, where we vary the framing of intention (i.e., “Gameplay” or “Exercise”) and feedback (i.e., “Health” or “No health”) to explore their single and interactive impacts on perceived exertion, objectively measured energy expenditure, affect, and duration of usage in a single session. Our study showed that participants primed with exercise used the system significantly longer than those primed with game play (M = 49.2 ±2.0 min versus M = 39.3 ±2.0 min). We discuss our results and possible design implications based on our single-session experiment. We conclude with a discussion on the potential impact of focusing on “healthifying” exergames—highlighting an exergames’ dual purpose as both a game and exercise—as opposed to gamifying health behaviors. A presentation given by Frank Chen at CHI 2014. Co-Authors: Eric Hekler, Abby King. The paper accompanying this presentation can be found: http://j.mp/1og3kkY

1. WHAT IF…
You could become healthier by changing
ONLY your thoughts?

2. EXERGAME!
DEFN A video game that
is also a form of exercise
Wikipedia

3. “HEALTHIFYING” EXERGAMES: IMPROVING HEALTH
OUTCOMES THROUGH INTENTIONAL PRIMING
Frank Chen
Abby C. King
Eric B. Hekler

4. TAKEAWAY
It's the little details that are vital.
Little things make big things happen.
John Wooden

5. HOW ARE EXERGAMES TYPICALLY PLAYED?!
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6. LIKE THIS?!
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Photo
credit:
examiner.com

7. LIKE THIS?!
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Photo
credit:
nintendo.com

8. MORE LIKE THIS?!
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Photo
credit:
nintendo.com

9. ACTUALLY PROBABLY LIKE THIS!
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Photo
credit:
42green.com

10. DOES EXERGAME USE →!
RECOMMENDED 150 MINS MVPA?!
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ACSM. 2008. Physical Activity Guidelines
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credit:
flickr.com/bass_nroll

11. EXERGAMES!
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Photo
credit:
flickr.com/dcmaster

12. EXERGAMES!
Most experiences are “gamifying”
Points, tokens, badges as feedback
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Baranowski,T., et al. 2008. Playing for real…

13. EXERGAMES!
Wii-fit Usage over three months
decreased for eight families
No significant health change
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Owens, S. G., et al. 2011. Changes over three months…

14. EXERGAMES!
Exergames may be a gateway…
Either towards vigorous exercise or other games
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Schwanda,V., et al. 2011. Side effects and 'gateway' tools

15. PRIMING!
Priming is the visual, audio, or other sensory
cues that provide a subtle shift in attitude,
believes or behavior.
Prior work has shown explicit intention has
an impact on behavior and sustained
engagement.
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16. PRIMING!
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Crum,A. J. Langer, E. J. 2007. Mind - set matters
Photo
credit:
istockphoto.com/asiseeit

17. PRIMING!
N = 84 hotel maids. 4 weeks.
66.6% no regular PA
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Crum,A. J. Langer, E. J. 2007. Mind - set matters
Photo
credit:
istockphoto.com/asiseeit

18. PRIMING!
N = 84 hotel maids. 4 weeks
66.6% no regular PA
Improved BMI, body fat %,
blood pressure
No reported behavior change
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Crum,A. J. Langer, E. J. 2007. Mind - set matters
Photo
credit:
istockphoto.com/asiseeit

19. HYPOTHESES!
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Photo
credit:
flickr.com/shuGerhack

20. HYPOTHESES!
Exercise:
More intense; shorter; decreased positive affect
Gaming:
Less intense; longer; increased positive affect
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Dishman, R.K., et. al. 1985.The determinants of physical activity and exercise.

21. METHODS!
N = 44. Stanford students, staff, post-docs
70% reported regular exercise
Measurements: RPE, EE, Duration, PA
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22. METHODS!
Used Dance Central
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23. FACTORS: PRIMING X FEEDBACK!
Priming
“You’re exercising”
“You’re playing”
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24. FACTORS: PRIMING X FEEDBACK!
Priming
“You’re exercising”
“You’re playing”
“Workout” mode
“Perform It” mode
Feedback
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25. FACTORS: FEEDBACK!
“Perform It” mode
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Photo
credit:
ign.com

26. FACTORS: FEEDBACK!
“Workout” mode
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Photo
credit:
ign.com

27. FACTORS: PRIMING!
(Default)
“You’re playing”
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28. FACTORS: PRIMING!
“You’re exercising”
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29. DESIGN!
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Recruit
“Kinect as Stress Reliever”

30. DESIGN!
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Recruit
Pre-randomized

31. DESIGN!
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Recruit
Pre-randomized
Instrumented

32. DESIGN!
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Recruit
Pre-randomized
Pre-Survey
Instrumented

33. DESIGN!
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Recruit
Pre-randomized
Priming
“Please play”
“Please exercise”
Pre-Survey
Instrumented

34. DESIGN!
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Recruit
Pre-randomized
Feedback
“Perform”
“Workout”
Priming
“Please play”
“Please exercise”
Pre-Survey
Instrumented

35. “Break it down”
DESIGN!
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Recruit
Pre-randomized
Feedback
“Perform”
“Workout”
Priming
“Please play”
“Please exercise”
Pre-survey
Instrumented

36. “Break it down” Post-survey / interview
DESIGN!
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Recruit
Pre-randomized
Feedback
“Perform”
“Workout”
Priming
“Please play”
“Please exercise”
Pre-survey
Instrumented

37. RESULTS!
People “exercised” about 25% longer in a
single session
0
20
40
60
Game
prime
Exercise
prime
Dura%on
of
Use
(minutes)
Gaming
feedback
Exercise
feedback
M = 39.3 ± 3.0 min M = 49.2 ± 2.0 min
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38. FACTORS: PRIMING X FEEDBACK!
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Priming
“You’re exercising”
“You’re playing”
“Workout” mode
“Perform It” mode
Feedback

39. FACTORS: PRIMING X FEEDBACK!
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+25%
duraLon
Priming
“You’re exercising”
“You’re playing”
“Workout” mode
“Perform It” mode
Feedback

40. “TELL US ABOUT YOUR SESSION”!
“I played through many songs […] I really liked and had a
lot of fun. I found myself becoming very competitive, more
than I had imagined I would [because I do not play a lot of
games]. M, G×nH
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41. “TELL US ABOUT YOUR SESSION”!
“This could be one of the things I do to train.What you see a
lot on dance teams is it’s difficult to learn new routines due
to lack of feedback on what I’m actually doing…” F,
E×nH
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42. DUAL BENEFITS!
“I think this is a great game. I typically run and do strength
training and burn about 360 calories at the gym per session.
You could have used a different game… It’s still not as
efficient as a workout at the gym.” M, E×nH
• Eight in exercise priming; three in gaming priming
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43. “GAMIFICATION” !
HEALTH FEEDBACK IN EXERGAMES!
No participants mentioned health feedback
as particularly insightful or motivating
“I did not use the feedback […] I play sports. I
don’t run or lift weights. Exercise is boring,
rather than doing something monotonous I like
to play games.” F, E×H
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44. ADDED BENEFIT !
WITH PRIOR EXPERIENCE!
Excellent as learning cues
“This could be one of the things I do to
train.What you see a lot on dance teams
it’s difficult to learn new routines due to
the lack of feedback on what I’m actually
doing.” F, E×nH
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45. RESULTS!
Exertion = 4.5 MET ~ MVPA
We saw no significant effect on RPE,
EE, or PA
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46. LIMITATIONS!
Single session
70.4% of our participants
reported regular activity
48.4% for the rest of the US
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CDC. 2011. Health, United States.

47. HEALTHIFICATION!
Gamification is not enough without embedding
this activity deeply in the activity. Cannot be
“bolted on”
Healthifying = Emphasizing dual benefits of the
activity so it's more engaging to the individual
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48. “HEALTHIFYING” EXERGAMES!
@frankc
Intentional priming emphasized the dual purpose of Dance
Central
Framed a strong game as exercise and increased duration of use
by 25%
Gamification might be too blunt of an instrument. Psychology
offers a rich set of tools and principles that lead to long-term
healthful impact.
@ehekler