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Fisheye Labs
                                                       751 Holton Road
                                                       Talent, OR 97540
                                      (541) 535-4325                       ewhac@msn.com

                                                                                                                     2/16/2013
Health 2.0, LLC
350 Townsend Street, #403
San Francisco, CA 94107

To Whom It May Concern:

Fisheye Labs is pleased to present The 5th Brain Game proposal for your review. We look forward to partnering with the
Robert Wood Johnson Foundation to provide a cutting edge health application increasing individual and community
health and health care while generating novel citizen-science data. The 5th Brain Game platform design incorporates a
multitude of creative and scale expansion possibilities as the user base grows, making it an ideal application for this
grant’s phased distribution of funds.

Chronic diseases cost the United States 1.6 trillion annually, or 75 cents out of every healthcare dollar, yet a mere 5 cents
per dollar is spent on prevention. Lab research and clinical trials have demonstrated measurable successes in preventing
and even reversing disease by targeting lifestyle levers including attitude, behavior, nutrition, fitness, and social support
and education gaps. The 5th Brain Game particularly focuses on improving adrenal stress and blood sugar deregulation
which underlie 80% of chronic diseases afflicting modern society. The 5th Brain Game addresses the above ‘lifestyle
levers’ and provides a novel patient compliance and willpower training program. This program increases the player’s
‘locus of control’ and reduces the player’s future discount rate with age-progression video morphing and accompanying
cognitive reframing games.

The 5th Brain Game is founded in neurobiology and cognitive psychology research, data from Aligning Forces For Health
(AF4H), County Health Rankings, The 5th Brain Game itself, etc., gamification concepts, and my own 35 years of clinical
experience. The e-Mobile Health 5th Brain gamifies reality, generating patient-centered and extensively contextualized
data through profile questionnaires, augmented self-tracking tools, willpower ‘Challenges’ and external devices. The 5th
Brain Game model incorporates external data-sets for benchmark traditional risk assessments and estimates of achievable
gradual risk reduction goals framed as ‘Challenges’. Data ported internally and externally to Johnson Foundation
databases drives a dynamic system model dedicated to countering daily health concerns and chronic diseases including
obesity, diabetes, cancer, stroke and cardiovascular diseases.

As The 5th Brain Game expands, health practitioners may generate Challenges for patients and benefit from real-time
monitoring of patient compliance and symptoms. At a large scale, this function encourages citizen-scientist collaborations
in large fitness-health-positive psychology trials improving healthcare delivery. Measurable outcomes include reduced
chronic disease, medical expenses and sick days; improved fitness, health and healthcare delivery easily targeted towards
the geographical areas identified as AF4H communities.

We appreciate The Robert Wood Johnson Foundation’s commitment to individual and community health and investment
in cutting edge gamified health applications. We firmly believe The 5th Brain Game is a valuable investment towards
your goals and we are eager to discuss this collaboration opportunity.

Sincerely,

LAC Michael Gandy, CEO
Petr Makagon, CTO
The 5th Brain: Gamification of Integrated Health
The 5th Brain Game, an integrated mobile companion application, empowers players to develop a lifestyle supporting
personal and community health and effective health care. The 5th Brain is an evolving and reflective game, scalable to
individuals, groups and regions, offering a myriad of creative possibilities. Many people struggle to live up to their own
expectations and values, or to complete doctor or health organizations’ recommendations, because they cannot connect
with their future self. A unique and central aspect of The 5th Brain Game is its use of photo-morphing technology
connecting players to how current ‘bad vs. good’ choices negatively or positively affect their future self. The 5th Brain
Game incorporates external data sources such as Aligning Forces For Health (AF4H) and Community Health Rankings,
neurobiology and cognitive psychology research, decades of clinical experience, system modeling, and gamification tools.
The 5th Brain Game generates contextualized player data, initially focused on personal/biographical and geographical
information and patient compliance rates, but expanding its data collection scope and depth with each game iteration. The
5th Brain Game makes strong personal health and willpower ‘fun’ while collecting novel citizen-science generated data
improving community health care approaches and implementation.

The ‘5th Brain’
The Fifth Brain, a technologically enabled systems based program founded on a model of creating individual patterns of
healthy choices, addresses prevalent chronic diseases for greater community health. The application is specifically
designed (especially in the data test version) with both multiple choice and free form feedback for swift adaptation to user
needs. Medical diagnostics built into the interactive 5th Brain Game assists players optimize key functional medicine
meta-patterns and common environmental and lifestyle patterns underlying and contributing to dozens of chronic diseases.
According to the Center for Chronic Disease Prevention and Health Promotion, as much as 80% of chronic diseases
afflicting modern society and over 75% of healthcare dollars are driven by unhealthy lifestyles inducing common
dysfunctions such as adrenal stress and blood sugar dysregulation.

This 5th Brain Game application facilitates the four other brains who sit on an often discordant committee controlling
thoughts, feelings, judgments and actions. Unlike other health apps focusing on isolated details, The 5th Brain Game
coaches the complete ‘Team Brain’ moving a player’s mind, body and purpose towards implementing healthy choices for
a life worth living. The four brains the 5th brain ‘coaches’ are: 1) the basal ganglia focusing on rewardable targets and
delivering delayed gratification; 2) the frontal and prefrontal cortex deciding appropriate and inappropriate behavior; 3)
the limbic system providing emotions, helping prioritize by importance; 4) the sensory association areas stacking
metaphoric morality functions on top of sensory functions, e.g. the wiring for smell provides metaphors appropriate for
that sense such as the moral feeling of pureness in sanctity contrasted with impureness of profanity.

Neurobiological research indicates each brain has different cognitive illusions, biases and blind spots. The 5th Brain
Game creates customized Challenge Events which compensate for these brain system short fallings using extensive
publicly available data such as AF4H or County Health Rankings and internally produced data. These Challenge Events
are customized to the player’s unique health needs and goals and incorporated into the player’s real life. For instance,
Challenge Events may address ‘bad habits’ such as self-medicating consumption of sugary and salty products or tobacco
in an attempt to normalize abnormal physiology and/or stressful internal and external environments. By focusing ‘brain
coaching’ on early functional patterns, players may avoid many unpleasant physical and emotional feelings, a litany of
serious end-stage diseases, and huge health care costs.


Software Design
Framing personal health improvement as a complete lifestyle overhaul appears an unlikely goal. But if each step is made
only as difficult as may be achieved, then the player is engaged in a game of earning success points. For instance, people
are not just willing but excited to run 5 miles in a soccer game, hardly noticing the work they are doing during an
exhilarating game. This eagerness to work during a game is a central tenet of gamifying reality. The 5th Brain Game uses
proven neuropsychological tools and an artful playful interface with vast expansion possibilities, to make Challenge
Events ‘fun’ while also highlighting the future consequences of immediate gratification actions as urgent and vivid. It
deploys a suite of learning approaches with real-time modeling and self-tracking to discover and collect information on
the most potent behavioral change strategies for an individual. The 5th Brain graphically displays the player’s self-
discovery of their unique health stories, goals, values and feelings during specific actions. If the player joins team brain,
the 5th Brain provides the game, coach, ball and bat to play.

The 5th Brain Game develops and suggests individualized Quests with Challenge Events in 6 Subject Area Rings. The
challenge is either a ‘Do’ or a ‘Do Not’. Matching the choice the player makes with the planned action is a satisfying
‘win’. This fun process balances Willpower and Impulse. Challenge Events may be completed as an individual or
(optionally or ideally) as a social exercise. 5th Brain Game social components connect appropriately matched individuals
for activities including hikes, swims or races; shopping for and cooking healthful food; or working on 5th Brain Game
scene writing, photo, music, etc. This virtual and real social interaction develops trust and confidence necessary to accept
larger Health Projects requiring players to: 1) identify their critical health mission, 2) incorporate the appropriate medical
and community information, and 3) form and implement a strategic plan of action. Although goals of these collective
actions and projects differ, the scope of the available data-sets and the core issues common to all, make The 5th Brain
Game easily scalable for groups large and small, rural and urban, young and old.

                                                                                                   Graphic I
                                                                                                   Dedicated Subject Area
                                                                                                   Rings orbit the central Self
                                                                                                   Disk where the age morphing
                                                                                                   video connects past, present
                                                                                                   and future self. Events in
                                                                                                   time, such as Challenges, are
                                                                                                   enlargeable displays
                                                                                                   containing practical details
                                                                                                   and reminders such as why
                                                                                                   player chose the Challenge
                                                                                                   and the attitude they intend to
                                                                                                   complete it with and are
                                                                                                   placed into the appropriate
                                                                                                   concentric Ring:
                                                                                                   1) Self Disk
                                                                                                   2) Social Network
                                                                                                   3) Food
                                                                                                   4) Activities
                                                                                                           a) Restful
                                                                                                           b) Active
                                                                                                   5) Feelings
                                                                                                           a) Physical
                                                                                                           b) Emotional
                                                                                                   6) Values


Software Design: Highlight on Age-Progression Morphing
In the famed “Marshmallow Test”, the first measure of future discounting, Stanford University psychologist Walter
Mischel gave four year olds the choice of one marshmallow now or two in fifteen minutes. The longer the kids waited
corresponded with greater academic and social success and lower stress levels a decade later. High future discounting is
associated with riskier behavior: smoking, drug use, drinking to excess, gambling, and other addictions; drunk driving and
unprotected sex; and increased procrastination and depression. Lower future discounting directly correlates to lower stress
and higher health.

Ersner-Hershfield in 2009 studied how close people feel to and identify with their future selves. People with a high future-
self continuity perspective account for financial needs of their future self by delaying gratification, saving more and
accruing less debt. This behavior is the opposite in people who view their future-self as a stranger. Ersner-Hershfield used
age-progression software to show younger adults images of themselves at sixty-five years old. When the younger self
spoke, the ‘older self’ spoke the same words answering questions such as “What is your name?”, “Where are you from?”,
“What is your passion in life?”. After spending time with their morphed future-self, participants added twice the amount
of money into retirement accounts as those who had only looked at themselves in the mirror. This is a robust finding.

Stories matter. The right questions and imagery reframe our future discount rate. The “opportunity loss” effect is more
emotionally powerful than “opportunity gain” effect. By placing a very desirable picture in player’s ‘future’ and
imagining a long-term personal reward in specific ways, players find losing a great future trumps immediate gain. The 5th
Brain Self Disk enables players to create an empathic rapport with their future image, accomplishments and achievements.
Players add extrinsic values and intrinsic values: health, fitness successes, illness prevention, emotional intelligence,
nourishing foodways, enjoyable and beneficial activities, deep friendships, and productive social groups.

The World Health Organization’s Global Strategy on Diet, Physical Activity and Health report stated, “Nutrition is
coming to the fore as a major modifiable determinant of chronic disease... alterations in diet have strong effects, both
positive and negative, on health throughout life... dietary adjustments... may determine whether or not an individual will
develop such diseases as cancer, cardiovascular disease and diabetes much later in life.” Dietary choices are a primary
example of photo-aging technology daily strengthening willpower for massive short and long term cumulative effects.
Increasing exercise willpower and thus frequency offers similar daily benefits. Eighty-nine percent of Americans are
exercise deficient, despite the Center for Disease Control’s statements on exercise controlling weight, reducing
cardiovascular disease, type II diabetes, some cancers, TV hours, smoking, impulsive purchases, alcohol consumption,
procrastination, etc., and being as an effective an antidepressant as Prozac (Nabkasorn, C.N. et al, 2006).

Software Design & Data Collection: The Four Views
(Note tables 1 & 2 containing data collection specifics are attached to the end of the document)
Views generated in The 5th Brain Game empower and inform players differently with varying graphic displays of data to
reorient the player’s perception of their current and future health scenarios. Time is a major character in the 5th Brain
player narrative of beginning, middle and end goals.

The 5D Spiral displays a larger timeline narrative of the actions, values and purpose, past, present and future, of players
and their social network then the Event Timeline View. Challenges, videos, photos, emails, writing, songs, etc., may be
inserted at appropriate points in the 5D Spiral. Gradual change, such as a slow increase in headache frequency over
months or even years, is often perceived as non-urgent and is difficult for humans to remember or appreciate. The 5D
Spiral provides an insistent graphic perspective of gradual changes for both areas of concern and areas of progress. The
5D Spiral is a simple design for visualizing large amounts of data generated by 5th Brain Game self-tracking and the
resulting patterns emerging over time. This is similar to RWJF geographic timeline, or space-time visualization, of disease
incidence across the United States. In this case we are mapping the individual and social networks aspects. There may be
a potential bridge between these two data-sets.

Modern ‘rat-race’ time has physical and mental health consequences. The Event Time View emphasizes achievable
opportunity gain tomorrow instead of risk and opportunity loss today. The trick is to not discounting the future self so
future health matters to the self earlier in their timeline. The Event Time View creates time by choosing, planning
achievable, and facilitating successful, Challenge Events focused on intrinsic values of why you do what you say you will
and do it well. On screen, the “Now” stays immobile while future possibilities and promised events roll toward the player
and the past spirals downwards below the display. Experiences in Event Time are psychologically fuller and less stressful
than chronological time by placing Challenges in context with player’s extrinsic and intrinsic values. The Challenge
Debrief Section helps players capture insights about making Choices: ‘Did you indulge in moral licensing?’ ‘Did you
realize how your choice impacted yourself and others?’ ‘If you messed up, did you schedule a Clean Up Challenge
redeeming your integrity and minimizing health consequences?’ The 5th Brain addresses repeated excuses and complaints
showing as mis-matches and moral licensing to improve player’s emotional intelligence. Positive psychology and
psychoneuroimmunology research demonstrates a clear connection between emotions and health and emotional stress,
inflammation and poor blood sugar control as major adrenal stressors and disablers of willpower and enabler of
impulsiveness. Every Challenge attempted, win or loss, improves player and game emotional intelligence.

Graphic II
                                                                        Profile data for each Ring is gathered as a Ring
                                                                        maximizes into a larger Disk. Profile data is
                                                                        typically slow-to-change historical data and basic
                                                                        personal history: name, birth, locations lived,
                                                                        family, including medical, history, etc. The
                                                                        Feelings Disk-Physical records diagnosed
                                                                        diseases, surgeries, allergies, traumas, etc., and
                                                                        conducts a mental health history. Feeling Profiles
                                                                        contain a health questionnaire gathering data on
                                                                        recurrent symptoms, severity, duration and
                                                                        frequency and generates a list of timed follow-up
                                                                        questions. Social health organizations or doctors
                                                                        may also insert Challenges such as watching
                                                                        health videos and webinars on obesity produced
                                                                        by the Robert Wood Johnson Foundation.

                                                                        Self-tracking data acts as a feedback mirror for the
                                                                        player about the difference between thoughts and
                                                                        feelings and reality. Strong data visualization and
                                                                        video evidence may close the gap and reframe the
                                                                        mismatch between cognitive illusions and pre-
                                                                        judgment beliefs so players better see and then
                                                                        improve actual performance. The 5th Brain Game
                                                                        collects data and shows real-time feedback on
                                                                        progress of programs for nutrition, social
                                                                        connectedness, fitness, sleep, rest, etc., and tracks
                                                                        symptom severity and frequency cross-referenced
                                                                        with adherence to the treatment program
                                                                        (Challenges).

                                                                          The Social Network View enrolls goal and
                                                                          geographically similar players in healthy projects
                                                                          and enables players to conduct their own searches
                                                                          of fellow players within the limits of HIPPA.
                                                                          Researchers at Brigham Young compiled data
                                                                          from 148 studies of 300,000 subjects and
                                                                          demonstrated people with friends, family and
community involvement were 50% less likely to die and added 3.7 years of life during the 7.5 year study period compared
to people with sparse social support. Researchers (Christakis and Fowler, 2007) using Framingham data, however, found
ill health is ‘contagious’, i.e., when a friend became obese, a person’s own risk of obesity increased 171%. The 5th Brain
Game creates and directs healthy social networks.
The Social View defines the nature and health of a network; addresses network concerns or successes; and tracks digitally
emergent network behavior, e.g. the number of 1 to 1 communications. This provides a tool in community health projects’
quantitative analysis. Patients and providers may ask questions, post-answers and share their experiences on the Social
View. This generates detailed data on health care providers which may be combined with AF4H quality of care data-sets.
The Social View provides some data on patient compliance rates and effective methods of compliance improvement. It
also gives health providers an opportunity to contextualize ‘the numbers’, e.g. blood sugar control rates related to
community served or the severity of disease vs. caseload. If a demonstrated need exists, The 5th Brain Game might
support a sub-channel for dedicated doctor-patient conversations and Challenge development and monitoring.

The Purpose Map View displays events at the place they did or as they are planned to occur enabling players to find
where and when they make their best choices, willpower is most engaged, primary off-path impulse moments, happiest,
scariest or best feelings, etc. Corresponding patterns emerge. The Purpose Map facilitates communicating and organizing
with geographically near people for events and activities. The 5th Brain Game adds relevant health related place-time
information from approved sponsors or The 5th Brain Game network. The 5th Brain Game players’ patient experiences
add information to sortable local health links and evaluations of care quality and specializations from AF4H and County
Health Rankings. Health groups might develop strategies tailored to a given community using dynamic system modeling
founded in The 5th Brain Game and AF4H data overlaid over a specific community map. This also has strong potential
for improving health groups’ fundraising successes.

Data Importation
Fish Eye Lab development path goals are met by successive programs expanding the four 5th Brain Views, each
optimized to generate, use and visualize different types of data. Incorporation of external data-sets such as County Health
Rankings, Center for Disease Control, World Health Organization, health.gov, AF4H, etc., are imported and graphically
translated based on the needs of the specified data and relevance to the 5th Brain Game user base. The Purpose Map View
incorporates large quantities of the AF4H county health quality data which is similar to the Roger Wood Johnson
Foundation (RWJF) DataHub. For instance, Purpose Map View contains maps of various scales augmented by categorical
AF4H data with several unfolding options in time. In the first 5th Brain release, the Event Time View directs traffic to the
RWJF DataHub, especially the “Healthier Lifestyles” category. The Event Time View supports evolving willpower in a
player/patient-centered process leading to agency and good judgment in daily activities. It is a novel time-event-value
matrix partially reliant on outside databases. (See Table I below for an elaboration on specific data importation)

Community Deployment
Community deployment strategies target individuals, institutions and providers. An innate market for players is people
actively seeking means to improve their own health and fitness. The game naturally relies on word of mouth, social
networks and targeted marketing in later, larger scale deployment. The 5th Brain Game gains an initial local foothold with
introduction to the AF4H network where stakeholders are invited to customize The 5th Brain by sharing local resources
with the social network. The 5th Brain Game will be introduced to health institutions and providers as mutually beneficial:
the clients/players receive personalized preventative care and improved health/fitness/social lives while providers gain a
missing a window into what happens after patients or clients leave a clinic. Beta test health providers will be able to
assign health Challenges to patients, subsequently benefiting from a game’s power of ‘making it fun’ and closing the gap
between prescription and implementation. For instance, completion of the full course of antibiotic treatment for a
contagious illness is essential, by incorporating The 5th Brain software, providers have a simple means of inspiring and
tracking completion. The 5th Brain Game adoption also offers providers means to quickly respond to adverse effects of
recommendations, e.g. if a client is allergic to prescribed antibiotics. Providers, especially institutions, have an interest in
The 5th Brain’s generation of data reports on patient compliance rates and improvement methods. Beta testers from social
services or community health organizations will find The 5th Brain Game a powerful communication and organization
tool for community project Challenges. A natural game progression given the willpower strengthening focus is future
iterations targeting specific addictions which further expands deployment opportunities.
Conclusion
Ben Franklin famously said “a penny of prevention is worth a pound of cure.” Today, the future return on investments in
disease prevention is far higher. Healthy communities and effective health care are supported by engaged individuals
choosing healthy lifestyles reducing externalized or purposeless health costs. The 5th Brain encourages adoption of new
behaviors consistent with cognitive science’s often counter-intuitive research improving willpower and moderating
impulsiveness while actually increasing appropriate spontaneity, creativity and social interactions. Cutting-edge use of
photo-morphing technology reducing future discount rates and real-time self-tracking empowers players to make lifestyle
shifts in the ‘now’ using their most potent and fun behavioral change strategies. The 5th Brain Game specifically engages
communities in supporting each other in accomplishing personal health goals, improving health metrics. Community
health goals emerge from an informal needs assessment and are oriented by referencing extensive research and data
generated by Aligning Forces, County Health Ranking, healthdata.gov and the Health Indicators Warehouse amongst
others. Research in this theme has never been as thorough or as accessible. The 5th Brain Game mines external and
internal data to develop dynamic system models assessing a player’s health risks and then gamify their personal health
opportunities into engaging Challenge Events. This process creates novel citizen-science interactions capturing a broad
array of contextualized behavioral, physical and mental data.



Game Views for Data Importation & Visualization Utility                                                                      Table I
             Event Time View           Social Network View                                Purpose Map View               5D Spiral View

View’s Prime    Events/Will Challenges X             People X Role/ Relationship X        All Locations X markers of     All Time Scales X Purpose
Data            Subject Area X Time                  markers of Value/Importance          Value/Importance               Path X markers of
Visualization                                                                                                            Value/Importance
Program         5B core subject areas & adrenal      Support community project            Locations impacted-school,     Display Change in selected
Area (PA)       stress/blood sugar model             organizing, i.e., affordable         residential, work              network over time
Childhood       functions: food, exercise. link to   quality healthcare/ food/activity
                RWJF                                 centers, predatory ads
Obesity
PA Coverage     RWJF link                            State organizing project logistics   How locations are effected     Coverage change over time
                                                                                          differently, pressure points   for different networks
PA Pioneers     AF4H FYI link, download              Organize around inspirational        Put Ideas on the map           Show ideas as memes that
                events/ news                         idea                                                                grow, wither, evolve
PA Public       5B core functions prevention,        Science-citizen projects,            Where is there need, where     Impact of public health
Health          adrenal stress/blood sugar           organize to change funding           & what resources available     initiatives over time
                regulation, <risky impulsive         priorities
                behavior, > will & healthy
                behaviors
PA Quality/     Search RWJF site personal            5B Pt-Doc Clear communication        Use AF4H County Health         Healthcare quality &
Equality,       health based on 5B Profile Dx,       game. Tool for player to             Excel Data to Map where        equality over time
AF4H            Pt Hx. Or Healthier Lifestyles by    organize their social network:       problems are, relative to
                Subject.                             e.g. quality healthcare delivery     where player, augment
                                                     in community, workplace.             with quality metrics
PA              Core 5B mission affordable           Social network project               Distinguish where how &        Visualize history of
Vulnerable      support overcoming common            organizing for the right change      why a population is            communities over time,
Populations     unhealthy patterns                   at right time with right             vulnerable                     strategies the did and didn’t
                                                     connections                                                         work
RWJF Data       Data informs 1) 5B Chronic           Social project research. Data        Data displayed according to    Longitudinal studies
Center          Disease Risk Assessment, 2) 5B       sources visualized as nodes in a     where the study was            displayed over time
                Opportunity for Health Link          SORTABLE network, e.g.               conducted, X for what X
                RWJF for specific health             dependency types- reference,         who
                searches                             collaborators, competitors, map      Map of the Data Hub as an
                                                     citation network                     Information Universe.
RWJF            Link: possibly preload Profile       Is DataHub data granular enough      Map of the Data Hub as an
DataHub         Dx Hx search terms for searches      to resort data beyond allowable      Information Universe.
                                                     DataHub interface?
Software Overview Table
(The first column is the indexed data field that connects the Software Overview Table & Data Production Table)                                                                  Table II
 #    SOFTWARE OVERVIEW
 0    Name                         View         Object                                                   Function             Goal
 1    Subject Rings Max & Min      Event Time   Subject Area Ring Maximized to Disk function             Story Profile Game   Display events in time by subject area
 2    Biographical Profile         Event Time   #1 Self Center Disk                                      Profile              Capture Biographical profile information
 3    Fire Health Risk             Event Time   #1 Self Center Disk + Maximized Health Risk/ Health      Game Model           Display chronic disease health risk. Emphasize health opportunity GOAL. B
      Maximized in Self-Disk                    Opportunity Dashboard Instrument                         Profile              healthy future.
 4    Bet on Better/               Event Time   #1 Self Disk + “Bet on Better” Game + Health             Game                 Bet on ability to improve health is fun & gets “skin in the game”.
      Outsource financials.                     Opportunity Dashboard +Challenge
 5    Social Tracking              Social Net   #2 Social Disk +                                         Tracking             Determine degree & type of connectedness
 6    Social Challenge             Social Net   #2 Social Disk + Accept Challenge +                      Challenge            Take on a Social Challenge
 7    “What’s Next Coach?”         Event Time   #2 Social Disk +Will Challenge Bar                       Challenge Story      Subject Area Coaches & Doctors give & track player Challenges
 8    Social Family Profile        Event Time   #2 Social Disk +                                         Profile              Gather family biographical health history. Map Relationships
                                                                                                                               within social network
 9    Back on Track                Social Net   #2 Social Disk +                                         Tracking             Author of Challenge notified real-time of Player non-compliance
                                                                                                                              for follow-up
 1    Challenge Each Other         Social Net   #2 Social Disk +                                         Event                Players enroll others in a group challenge
 12   Let’s Do It Together         Event Time   #2 Social Disk + Other Subject Disks                     Event                Players set up meet-ups
 13   Need a Han                   Social Ne    #2 Social Disk +                                         Story                Player or Proxy organizes social network to support Player in health
                                                                                                                               emergency
 20   Morph Future Face            Event Time   #1 Self Disk + Values Disk + Future Counts-Video-        Game Story           With rapport with our future self we value future self.
                                   Social Net   Morph Game+ Time slider instrument.
 21   Morph Future Face            Event Time   #1 Self Disk + video-Morph Game + Time slider            Game Story           Player watches how their choices change their future towards health or
      by (un)Healthy Judgment      Social Net   instrument.                                                                   illness & aging,
 23   Outsourced Food              Event Time   #3 Food Drink Disk                                       Tracking             Outsource Food Tracking to FitBit
      Tracking
 24   In-house Food Tracking       Event Time   #3 Food Drink Disk + Photo Record Food H&/Plate          Tracking Game        Self-tracking Game & aid to estimate what & how much you are eating
                                                Size Portion Volume Estimate Game+ Q&A pop-up                                 & drinking
                                                box
 25   Food Profile                 Event Time   #3 Food Drink Disk                                       Profile              Profile information regarding past food & beverages
 26   Food Guide Challenge         Event Time   #3 Food Drink Disk + Food Ring Will Challenge            Model Challenge      Take on healthy food or beverage Challenge
                                                Schedule + Will Impulse
 31   Activities- Quiet Profile    Event Time   #4 Activities yin Quiet Disk                             Profile              Gather past information about sleep, rest, yoga, etc.
 32   Activities- Quiet Tracking   Event Time   #4 Activities yin Quiet Disk+ Q&A pop-up box             Tracking             Gather real-time information about sleep, rest, etc
 33   Activities- Quiet            Event Time   #4 Activities yin Quiet Disk + Accept Challenge          Challenge            Take on a Quiet Activity Challenge
      Challenge
 34   Activities- Quiet HRV        Event Time   #4 Activities yin Quiet Disk + HRV Device + Chill Pill   Tracking Game        Parasympathetic switch Heart Rate Variability biofeedback external
                                                Button                                                                        Device
 35   Activities- Quiet Breath     Event Time   #4 Activities yin Quiet Disk + Chill Pill Button         Game                 breath patterns calm, focus, or relax as needed
 36   Activities- Take 10 Chill    Event Time   #4 Activities yin Quiet Disk+ Chill Pill Button          Game                 Get space & time between player & temptation
      Pill
 37   Activities- Active Profile   Event Time   #5 Activities yang Active Disk                           Profile              Gather past information exercise, physical work, etc.
 38   Activities- Active           Event Time   #5 Activities yang Active Disk+ Q&A pop-up box           Tracking             Real-time information exercise, physical work, etc.
      Tracking
 39   Activities- Active           Event Time   #5 Activities yang Active Disk+ Accept Challenge +       Challenge            Take on a Active Challenge
      Challenge
 40   Sport Meet-up                Event Time   #5 Activities yang Active Disk+#2 Social Network+        Event                Sport Meet-up for a challenge or safety in numbers
                                                Map
 41   Feelings-physical Profile    Event Time   #6 Feelings-physical Disk                                Profile              Gather past information about sensations, symptoms
 42   Feelings-physical            Event Time   #6 Feelings-physical Disk +Q&A pop-up box                Tracking             Current information physical sensations & symptoms
      Tracking
 43   Feel-physical Challenge      Event Time   #6 Feelings-physical Disk +Accept Challenge +            Challenge            Take on a physical feeling Challenge
 0    Name                         View         Object                                                   Function             Goal
 44   Feelings-emotional           Event Time   #7 Feelings’-emotional Disk                              Profile              Gather past information about emotional state
      Profile
 45   Feelings-emotional Track     Event Time   #7 Feelings’-emotional Disk+Q&A pop-up box               Tracking             Gather current information about emotional state
 46   Emotion to motion            Event Time   #7 Feelings’-emotional Disk+Accept Challenge +           Challenge            Take on an emotional Challenge
 47   e-IQ Free the Birds          Event Time   #7 Feelings’-emotional Disk+                             Story                Identify emotions & thought behind feelings. Repeat.
 49   Value Profile:               Event Time   #8 Values Disk                                           Profile              Use Scenario planning, dilemmas, paradox, Q&A
 50   Value Tracking:              Event Time   #8 Values Disk +Q&A pop-up box                           Tracking             How motivating is the value tied to challenge?
 51   Value Challenge              Event Time   #8 Values Disk +Accept Challenge +                       Challenge            Take on a values challenge
52   Dear Abby value           Event Time   #8 Values Disk                                       Story              “Dear Abby” letters as value dilemmas. Prioritize
      dilemmas
 54   Why do it?                Event Time   #8 Values Disk                                       Story              Associate values with all Challenge events
 55   I know why, why do you?   Social Net   #8 Values Ring                                       Story              Share values associated with Challenge events
 56   Coach Tryouts             Event Time   Future Will Challenge Prep Area                      Challenge Game     Pick your Attitude Coach Avatar
                                                                                                  Story
 57   Visualize Game Plan Win   Event Time   Future Will Challenge Prep Area                      Challenge Game     POVTOON (ver.1.0) prompt to visualize success
                                                                                                  Story
 58   Now Choose!               Event Time   Now Choose! Challenge Area +(Mis)Match               Challenge Game     DO/DON’T buttons, If choice Matches Challenge Game Plan Will
                                             Counters/Ratio + Bet on Better                       Story              power counters increase
 59   Game Match License?       Event Time   Past Will Debrief Area+Y/N Moral License Let         Challenge Game     After Match Moral Licensing danger >, do you feel entitled to do what
                                             Go+Time Capsule                                      Story              you wouldn’t normally?
 60   Moral or Stress Mess Up   Event Time   Past Will Debrief Area +Y/N Act on Moral License     Challenge Game     record on video rationalizations after Match moral licensing or
      License Time Capsule                   +TimeCapsule                                         Story              Mis-Match Stress Licensing
 61   Poor Entitled King        Event Time   Recent Past Will Debrief Area +Time Capsule +Poor-   Challenge Game     Aftermath of licensed actions. Feel & deal with the consequences.
                                             Rich Meter+Off Purpose Path+Social Perception+       Story              Schedule CUMUC. ASAP
 62   Mis-Match Wake up Call    Event Time   Now Choose! Challenge Area +(Mis)Match               Challenge Game     DO/DON’T buttons. If choice is a Challenge Game Plan Mismatch
                                             Counter/Ratio +Wake up Call Bet                      Story              Impulse counter increases
 63   Post-Game Mis-Match       Event Time   Recent Past Will Debrief Area + Y/N Stress Mess Up   Challenge Game     After Mis-match >danger of Mess Up Stress Licensing, do you feel
      Stress License?                        License? Let if Go + Time Capsule                    Story               entitled to do what you wouldn’t normally?
 64   CUMUC Clean Up Mess       Event Time   Redemption checklist + Schedule extra challenge +    Challenge Game     Clean Up Mess Up Challenge after Screw up, need to get back in
      Up Challenge                           POVTOON + Time Capsule                               Story               integrity with self & others.

Data Production Table                                                                                                                                                    Table III
 #    5B New Data Generation                                                                       #      5B New Data Generation
 2    Biographical profile & contact information, name, DOB, address/time, email,                  39     Physical activity behavior modification with defined Challenges
      marital status, number of children, etc.
 3    Risk Assessment instrument Q&A/ Risk Assessment instrument results                           40     Data on solo v group exercise
 4    Relate gambling approaches & motivation                                                      41     Memory & available medical history of Dx, Sx
 5    Real-time information on type & quantity of interpersonal communications                     42     Gather real-time information on physical feelings
 6    Data on social flexibility                                                                   43     Physical sensation modification with defined Challenges
 7    Hypothesis tested challenges                                                                 44     Memory reports of emotional & mental health history
 8    Family biographical health history. Map relationships within social network                  45     Gather real-time information on perceived emotions
 9    Real time compliance & symptom data                                                          46     Emotional IQ modification with defined Challenges
 11   Data on intra-group support                                                                  47     Efficacy of emotional cognitive reframe of amygdale stored events
 12   Data on social health behavior                                                               49     Memory report of what player has cared about
 13   Data on patient coordinated social support networks                                          50     Real-time success data on player valuation of will power Challenge
 20   Relationship of intrinsic values, future discounting, will & health metrics.                 51     Data on iterative re-evaluation tied to Challenges
 21   Relationship of empathy & choice when future consequences valued                             52     Data on narrative dilemmas to elicit learned values
 23   External device data on food & exercise from Fitbit                                          54     Data on operationally potent values increasing will power success
 24   Reliable tracked food quality & quantity of consumption estimates                            55     Data on emergent network will power & shared values
 25   Memory report of past food & beverage consumption history                                    56     Data on effective matching of player character & coaching styles
 26   Data on eating behavior modification with defined Challenge interventions                    57     Data on visual value symbols & exercise of will power
 31   Memory report of past sleep & rest history                                                   58     Relationship between will power, valued plan & impulse.
 32   Tracking data parasympathetic activities, i.e. sleep, rest, breath, etc.                     59     Data on perceived win & susceptibility to moral licensing
 33   Rest & sleep behavior modification with defined Challenges                                   60     Effects of videos of self-rationalization of moral licensed behavior
 34   External HRV device parasympathetic status in broad health data context                      61     Relationship of videos, unhealthy choice, consequences & judgment
 35   Data on breath control, stress reduction & compliance                                        62     Relationship between impulse, & motivation of a valued plan
 38   Gather real-time information on defined physical activities                                  63     Relationship between stress, impulse & valued plan.
 36   Data on guided 10 min. movement away from risky impulse                                      64     Taking responsibility, reconciliation, distinguish guilt & shame
 37   Memory report of exercise & physical activities.

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RWJF Games Challenge

  • 1. Fisheye Labs 751 Holton Road Talent, OR 97540 (541) 535-4325 ewhac@msn.com 2/16/2013 Health 2.0, LLC 350 Townsend Street, #403 San Francisco, CA 94107 To Whom It May Concern: Fisheye Labs is pleased to present The 5th Brain Game proposal for your review. We look forward to partnering with the Robert Wood Johnson Foundation to provide a cutting edge health application increasing individual and community health and health care while generating novel citizen-science data. The 5th Brain Game platform design incorporates a multitude of creative and scale expansion possibilities as the user base grows, making it an ideal application for this grant’s phased distribution of funds. Chronic diseases cost the United States 1.6 trillion annually, or 75 cents out of every healthcare dollar, yet a mere 5 cents per dollar is spent on prevention. Lab research and clinical trials have demonstrated measurable successes in preventing and even reversing disease by targeting lifestyle levers including attitude, behavior, nutrition, fitness, and social support and education gaps. The 5th Brain Game particularly focuses on improving adrenal stress and blood sugar deregulation which underlie 80% of chronic diseases afflicting modern society. The 5th Brain Game addresses the above ‘lifestyle levers’ and provides a novel patient compliance and willpower training program. This program increases the player’s ‘locus of control’ and reduces the player’s future discount rate with age-progression video morphing and accompanying cognitive reframing games. The 5th Brain Game is founded in neurobiology and cognitive psychology research, data from Aligning Forces For Health (AF4H), County Health Rankings, The 5th Brain Game itself, etc., gamification concepts, and my own 35 years of clinical experience. The e-Mobile Health 5th Brain gamifies reality, generating patient-centered and extensively contextualized data through profile questionnaires, augmented self-tracking tools, willpower ‘Challenges’ and external devices. The 5th Brain Game model incorporates external data-sets for benchmark traditional risk assessments and estimates of achievable gradual risk reduction goals framed as ‘Challenges’. Data ported internally and externally to Johnson Foundation databases drives a dynamic system model dedicated to countering daily health concerns and chronic diseases including obesity, diabetes, cancer, stroke and cardiovascular diseases. As The 5th Brain Game expands, health practitioners may generate Challenges for patients and benefit from real-time monitoring of patient compliance and symptoms. At a large scale, this function encourages citizen-scientist collaborations in large fitness-health-positive psychology trials improving healthcare delivery. Measurable outcomes include reduced chronic disease, medical expenses and sick days; improved fitness, health and healthcare delivery easily targeted towards the geographical areas identified as AF4H communities. We appreciate The Robert Wood Johnson Foundation’s commitment to individual and community health and investment in cutting edge gamified health applications. We firmly believe The 5th Brain Game is a valuable investment towards your goals and we are eager to discuss this collaboration opportunity. Sincerely, LAC Michael Gandy, CEO Petr Makagon, CTO
  • 2. The 5th Brain: Gamification of Integrated Health The 5th Brain Game, an integrated mobile companion application, empowers players to develop a lifestyle supporting personal and community health and effective health care. The 5th Brain is an evolving and reflective game, scalable to individuals, groups and regions, offering a myriad of creative possibilities. Many people struggle to live up to their own expectations and values, or to complete doctor or health organizations’ recommendations, because they cannot connect with their future self. A unique and central aspect of The 5th Brain Game is its use of photo-morphing technology connecting players to how current ‘bad vs. good’ choices negatively or positively affect their future self. The 5th Brain Game incorporates external data sources such as Aligning Forces For Health (AF4H) and Community Health Rankings, neurobiology and cognitive psychology research, decades of clinical experience, system modeling, and gamification tools. The 5th Brain Game generates contextualized player data, initially focused on personal/biographical and geographical information and patient compliance rates, but expanding its data collection scope and depth with each game iteration. The 5th Brain Game makes strong personal health and willpower ‘fun’ while collecting novel citizen-science generated data improving community health care approaches and implementation. The ‘5th Brain’ The Fifth Brain, a technologically enabled systems based program founded on a model of creating individual patterns of healthy choices, addresses prevalent chronic diseases for greater community health. The application is specifically designed (especially in the data test version) with both multiple choice and free form feedback for swift adaptation to user needs. Medical diagnostics built into the interactive 5th Brain Game assists players optimize key functional medicine meta-patterns and common environmental and lifestyle patterns underlying and contributing to dozens of chronic diseases. According to the Center for Chronic Disease Prevention and Health Promotion, as much as 80% of chronic diseases afflicting modern society and over 75% of healthcare dollars are driven by unhealthy lifestyles inducing common dysfunctions such as adrenal stress and blood sugar dysregulation. This 5th Brain Game application facilitates the four other brains who sit on an often discordant committee controlling thoughts, feelings, judgments and actions. Unlike other health apps focusing on isolated details, The 5th Brain Game coaches the complete ‘Team Brain’ moving a player’s mind, body and purpose towards implementing healthy choices for a life worth living. The four brains the 5th brain ‘coaches’ are: 1) the basal ganglia focusing on rewardable targets and delivering delayed gratification; 2) the frontal and prefrontal cortex deciding appropriate and inappropriate behavior; 3) the limbic system providing emotions, helping prioritize by importance; 4) the sensory association areas stacking metaphoric morality functions on top of sensory functions, e.g. the wiring for smell provides metaphors appropriate for that sense such as the moral feeling of pureness in sanctity contrasted with impureness of profanity. Neurobiological research indicates each brain has different cognitive illusions, biases and blind spots. The 5th Brain Game creates customized Challenge Events which compensate for these brain system short fallings using extensive publicly available data such as AF4H or County Health Rankings and internally produced data. These Challenge Events are customized to the player’s unique health needs and goals and incorporated into the player’s real life. For instance, Challenge Events may address ‘bad habits’ such as self-medicating consumption of sugary and salty products or tobacco in an attempt to normalize abnormal physiology and/or stressful internal and external environments. By focusing ‘brain coaching’ on early functional patterns, players may avoid many unpleasant physical and emotional feelings, a litany of serious end-stage diseases, and huge health care costs. Software Design Framing personal health improvement as a complete lifestyle overhaul appears an unlikely goal. But if each step is made only as difficult as may be achieved, then the player is engaged in a game of earning success points. For instance, people are not just willing but excited to run 5 miles in a soccer game, hardly noticing the work they are doing during an exhilarating game. This eagerness to work during a game is a central tenet of gamifying reality. The 5th Brain Game uses proven neuropsychological tools and an artful playful interface with vast expansion possibilities, to make Challenge Events ‘fun’ while also highlighting the future consequences of immediate gratification actions as urgent and vivid. It deploys a suite of learning approaches with real-time modeling and self-tracking to discover and collect information on
  • 3. the most potent behavioral change strategies for an individual. The 5th Brain graphically displays the player’s self- discovery of their unique health stories, goals, values and feelings during specific actions. If the player joins team brain, the 5th Brain provides the game, coach, ball and bat to play. The 5th Brain Game develops and suggests individualized Quests with Challenge Events in 6 Subject Area Rings. The challenge is either a ‘Do’ or a ‘Do Not’. Matching the choice the player makes with the planned action is a satisfying ‘win’. This fun process balances Willpower and Impulse. Challenge Events may be completed as an individual or (optionally or ideally) as a social exercise. 5th Brain Game social components connect appropriately matched individuals for activities including hikes, swims or races; shopping for and cooking healthful food; or working on 5th Brain Game scene writing, photo, music, etc. This virtual and real social interaction develops trust and confidence necessary to accept larger Health Projects requiring players to: 1) identify their critical health mission, 2) incorporate the appropriate medical and community information, and 3) form and implement a strategic plan of action. Although goals of these collective actions and projects differ, the scope of the available data-sets and the core issues common to all, make The 5th Brain Game easily scalable for groups large and small, rural and urban, young and old. Graphic I Dedicated Subject Area Rings orbit the central Self Disk where the age morphing video connects past, present and future self. Events in time, such as Challenges, are enlargeable displays containing practical details and reminders such as why player chose the Challenge and the attitude they intend to complete it with and are placed into the appropriate concentric Ring: 1) Self Disk 2) Social Network 3) Food 4) Activities a) Restful b) Active 5) Feelings a) Physical b) Emotional 6) Values Software Design: Highlight on Age-Progression Morphing In the famed “Marshmallow Test”, the first measure of future discounting, Stanford University psychologist Walter Mischel gave four year olds the choice of one marshmallow now or two in fifteen minutes. The longer the kids waited corresponded with greater academic and social success and lower stress levels a decade later. High future discounting is associated with riskier behavior: smoking, drug use, drinking to excess, gambling, and other addictions; drunk driving and
  • 4. unprotected sex; and increased procrastination and depression. Lower future discounting directly correlates to lower stress and higher health. Ersner-Hershfield in 2009 studied how close people feel to and identify with their future selves. People with a high future- self continuity perspective account for financial needs of their future self by delaying gratification, saving more and accruing less debt. This behavior is the opposite in people who view their future-self as a stranger. Ersner-Hershfield used age-progression software to show younger adults images of themselves at sixty-five years old. When the younger self spoke, the ‘older self’ spoke the same words answering questions such as “What is your name?”, “Where are you from?”, “What is your passion in life?”. After spending time with their morphed future-self, participants added twice the amount of money into retirement accounts as those who had only looked at themselves in the mirror. This is a robust finding. Stories matter. The right questions and imagery reframe our future discount rate. The “opportunity loss” effect is more emotionally powerful than “opportunity gain” effect. By placing a very desirable picture in player’s ‘future’ and imagining a long-term personal reward in specific ways, players find losing a great future trumps immediate gain. The 5th Brain Self Disk enables players to create an empathic rapport with their future image, accomplishments and achievements. Players add extrinsic values and intrinsic values: health, fitness successes, illness prevention, emotional intelligence, nourishing foodways, enjoyable and beneficial activities, deep friendships, and productive social groups. The World Health Organization’s Global Strategy on Diet, Physical Activity and Health report stated, “Nutrition is coming to the fore as a major modifiable determinant of chronic disease... alterations in diet have strong effects, both positive and negative, on health throughout life... dietary adjustments... may determine whether or not an individual will develop such diseases as cancer, cardiovascular disease and diabetes much later in life.” Dietary choices are a primary example of photo-aging technology daily strengthening willpower for massive short and long term cumulative effects. Increasing exercise willpower and thus frequency offers similar daily benefits. Eighty-nine percent of Americans are exercise deficient, despite the Center for Disease Control’s statements on exercise controlling weight, reducing cardiovascular disease, type II diabetes, some cancers, TV hours, smoking, impulsive purchases, alcohol consumption, procrastination, etc., and being as an effective an antidepressant as Prozac (Nabkasorn, C.N. et al, 2006). Software Design & Data Collection: The Four Views (Note tables 1 & 2 containing data collection specifics are attached to the end of the document) Views generated in The 5th Brain Game empower and inform players differently with varying graphic displays of data to reorient the player’s perception of their current and future health scenarios. Time is a major character in the 5th Brain player narrative of beginning, middle and end goals. The 5D Spiral displays a larger timeline narrative of the actions, values and purpose, past, present and future, of players and their social network then the Event Timeline View. Challenges, videos, photos, emails, writing, songs, etc., may be inserted at appropriate points in the 5D Spiral. Gradual change, such as a slow increase in headache frequency over months or even years, is often perceived as non-urgent and is difficult for humans to remember or appreciate. The 5D Spiral provides an insistent graphic perspective of gradual changes for both areas of concern and areas of progress. The 5D Spiral is a simple design for visualizing large amounts of data generated by 5th Brain Game self-tracking and the resulting patterns emerging over time. This is similar to RWJF geographic timeline, or space-time visualization, of disease incidence across the United States. In this case we are mapping the individual and social networks aspects. There may be a potential bridge between these two data-sets. Modern ‘rat-race’ time has physical and mental health consequences. The Event Time View emphasizes achievable opportunity gain tomorrow instead of risk and opportunity loss today. The trick is to not discounting the future self so future health matters to the self earlier in their timeline. The Event Time View creates time by choosing, planning achievable, and facilitating successful, Challenge Events focused on intrinsic values of why you do what you say you will and do it well. On screen, the “Now” stays immobile while future possibilities and promised events roll toward the player and the past spirals downwards below the display. Experiences in Event Time are psychologically fuller and less stressful than chronological time by placing Challenges in context with player’s extrinsic and intrinsic values. The Challenge
  • 5. Debrief Section helps players capture insights about making Choices: ‘Did you indulge in moral licensing?’ ‘Did you realize how your choice impacted yourself and others?’ ‘If you messed up, did you schedule a Clean Up Challenge redeeming your integrity and minimizing health consequences?’ The 5th Brain addresses repeated excuses and complaints showing as mis-matches and moral licensing to improve player’s emotional intelligence. Positive psychology and psychoneuroimmunology research demonstrates a clear connection between emotions and health and emotional stress, inflammation and poor blood sugar control as major adrenal stressors and disablers of willpower and enabler of impulsiveness. Every Challenge attempted, win or loss, improves player and game emotional intelligence. Graphic II Profile data for each Ring is gathered as a Ring maximizes into a larger Disk. Profile data is typically slow-to-change historical data and basic personal history: name, birth, locations lived, family, including medical, history, etc. The Feelings Disk-Physical records diagnosed diseases, surgeries, allergies, traumas, etc., and conducts a mental health history. Feeling Profiles contain a health questionnaire gathering data on recurrent symptoms, severity, duration and frequency and generates a list of timed follow-up questions. Social health organizations or doctors may also insert Challenges such as watching health videos and webinars on obesity produced by the Robert Wood Johnson Foundation. Self-tracking data acts as a feedback mirror for the player about the difference between thoughts and feelings and reality. Strong data visualization and video evidence may close the gap and reframe the mismatch between cognitive illusions and pre- judgment beliefs so players better see and then improve actual performance. The 5th Brain Game collects data and shows real-time feedback on progress of programs for nutrition, social connectedness, fitness, sleep, rest, etc., and tracks symptom severity and frequency cross-referenced with adherence to the treatment program (Challenges). The Social Network View enrolls goal and geographically similar players in healthy projects and enables players to conduct their own searches of fellow players within the limits of HIPPA. Researchers at Brigham Young compiled data from 148 studies of 300,000 subjects and demonstrated people with friends, family and community involvement were 50% less likely to die and added 3.7 years of life during the 7.5 year study period compared to people with sparse social support. Researchers (Christakis and Fowler, 2007) using Framingham data, however, found ill health is ‘contagious’, i.e., when a friend became obese, a person’s own risk of obesity increased 171%. The 5th Brain Game creates and directs healthy social networks.
  • 6. The Social View defines the nature and health of a network; addresses network concerns or successes; and tracks digitally emergent network behavior, e.g. the number of 1 to 1 communications. This provides a tool in community health projects’ quantitative analysis. Patients and providers may ask questions, post-answers and share their experiences on the Social View. This generates detailed data on health care providers which may be combined with AF4H quality of care data-sets. The Social View provides some data on patient compliance rates and effective methods of compliance improvement. It also gives health providers an opportunity to contextualize ‘the numbers’, e.g. blood sugar control rates related to community served or the severity of disease vs. caseload. If a demonstrated need exists, The 5th Brain Game might support a sub-channel for dedicated doctor-patient conversations and Challenge development and monitoring. The Purpose Map View displays events at the place they did or as they are planned to occur enabling players to find where and when they make their best choices, willpower is most engaged, primary off-path impulse moments, happiest, scariest or best feelings, etc. Corresponding patterns emerge. The Purpose Map facilitates communicating and organizing with geographically near people for events and activities. The 5th Brain Game adds relevant health related place-time information from approved sponsors or The 5th Brain Game network. The 5th Brain Game players’ patient experiences add information to sortable local health links and evaluations of care quality and specializations from AF4H and County Health Rankings. Health groups might develop strategies tailored to a given community using dynamic system modeling founded in The 5th Brain Game and AF4H data overlaid over a specific community map. This also has strong potential for improving health groups’ fundraising successes. Data Importation Fish Eye Lab development path goals are met by successive programs expanding the four 5th Brain Views, each optimized to generate, use and visualize different types of data. Incorporation of external data-sets such as County Health Rankings, Center for Disease Control, World Health Organization, health.gov, AF4H, etc., are imported and graphically translated based on the needs of the specified data and relevance to the 5th Brain Game user base. The Purpose Map View incorporates large quantities of the AF4H county health quality data which is similar to the Roger Wood Johnson Foundation (RWJF) DataHub. For instance, Purpose Map View contains maps of various scales augmented by categorical AF4H data with several unfolding options in time. In the first 5th Brain release, the Event Time View directs traffic to the RWJF DataHub, especially the “Healthier Lifestyles” category. The Event Time View supports evolving willpower in a player/patient-centered process leading to agency and good judgment in daily activities. It is a novel time-event-value matrix partially reliant on outside databases. (See Table I below for an elaboration on specific data importation) Community Deployment Community deployment strategies target individuals, institutions and providers. An innate market for players is people actively seeking means to improve their own health and fitness. The game naturally relies on word of mouth, social networks and targeted marketing in later, larger scale deployment. The 5th Brain Game gains an initial local foothold with introduction to the AF4H network where stakeholders are invited to customize The 5th Brain by sharing local resources with the social network. The 5th Brain Game will be introduced to health institutions and providers as mutually beneficial: the clients/players receive personalized preventative care and improved health/fitness/social lives while providers gain a missing a window into what happens after patients or clients leave a clinic. Beta test health providers will be able to assign health Challenges to patients, subsequently benefiting from a game’s power of ‘making it fun’ and closing the gap between prescription and implementation. For instance, completion of the full course of antibiotic treatment for a contagious illness is essential, by incorporating The 5th Brain software, providers have a simple means of inspiring and tracking completion. The 5th Brain Game adoption also offers providers means to quickly respond to adverse effects of recommendations, e.g. if a client is allergic to prescribed antibiotics. Providers, especially institutions, have an interest in The 5th Brain’s generation of data reports on patient compliance rates and improvement methods. Beta testers from social services or community health organizations will find The 5th Brain Game a powerful communication and organization tool for community project Challenges. A natural game progression given the willpower strengthening focus is future iterations targeting specific addictions which further expands deployment opportunities.
  • 7. Conclusion Ben Franklin famously said “a penny of prevention is worth a pound of cure.” Today, the future return on investments in disease prevention is far higher. Healthy communities and effective health care are supported by engaged individuals choosing healthy lifestyles reducing externalized or purposeless health costs. The 5th Brain encourages adoption of new behaviors consistent with cognitive science’s often counter-intuitive research improving willpower and moderating impulsiveness while actually increasing appropriate spontaneity, creativity and social interactions. Cutting-edge use of photo-morphing technology reducing future discount rates and real-time self-tracking empowers players to make lifestyle shifts in the ‘now’ using their most potent and fun behavioral change strategies. The 5th Brain Game specifically engages communities in supporting each other in accomplishing personal health goals, improving health metrics. Community health goals emerge from an informal needs assessment and are oriented by referencing extensive research and data generated by Aligning Forces, County Health Ranking, healthdata.gov and the Health Indicators Warehouse amongst others. Research in this theme has never been as thorough or as accessible. The 5th Brain Game mines external and internal data to develop dynamic system models assessing a player’s health risks and then gamify their personal health opportunities into engaging Challenge Events. This process creates novel citizen-science interactions capturing a broad array of contextualized behavioral, physical and mental data. Game Views for Data Importation & Visualization Utility Table I Event Time View Social Network View Purpose Map View 5D Spiral View View’s Prime Events/Will Challenges X People X Role/ Relationship X All Locations X markers of All Time Scales X Purpose Data Subject Area X Time markers of Value/Importance Value/Importance Path X markers of Visualization Value/Importance Program 5B core subject areas & adrenal Support community project Locations impacted-school, Display Change in selected Area (PA) stress/blood sugar model organizing, i.e., affordable residential, work network over time Childhood functions: food, exercise. link to quality healthcare/ food/activity RWJF centers, predatory ads Obesity PA Coverage RWJF link State organizing project logistics How locations are effected Coverage change over time differently, pressure points for different networks PA Pioneers AF4H FYI link, download Organize around inspirational Put Ideas on the map Show ideas as memes that events/ news idea grow, wither, evolve PA Public 5B core functions prevention, Science-citizen projects, Where is there need, where Impact of public health Health adrenal stress/blood sugar organize to change funding & what resources available initiatives over time regulation, <risky impulsive priorities behavior, > will & healthy behaviors PA Quality/ Search RWJF site personal 5B Pt-Doc Clear communication Use AF4H County Health Healthcare quality & Equality, health based on 5B Profile Dx, game. Tool for player to Excel Data to Map where equality over time AF4H Pt Hx. Or Healthier Lifestyles by organize their social network: problems are, relative to Subject. e.g. quality healthcare delivery where player, augment in community, workplace. with quality metrics PA Core 5B mission affordable Social network project Distinguish where how & Visualize history of Vulnerable support overcoming common organizing for the right change why a population is communities over time, Populations unhealthy patterns at right time with right vulnerable strategies the did and didn’t connections work RWJF Data Data informs 1) 5B Chronic Social project research. Data Data displayed according to Longitudinal studies Center Disease Risk Assessment, 2) 5B sources visualized as nodes in a where the study was displayed over time Opportunity for Health Link SORTABLE network, e.g. conducted, X for what X RWJF for specific health dependency types- reference, who searches collaborators, competitors, map Map of the Data Hub as an citation network Information Universe. RWJF Link: possibly preload Profile Is DataHub data granular enough Map of the Data Hub as an DataHub Dx Hx search terms for searches to resort data beyond allowable Information Universe. DataHub interface?
  • 8. Software Overview Table (The first column is the indexed data field that connects the Software Overview Table & Data Production Table) Table II # SOFTWARE OVERVIEW 0 Name View Object Function Goal 1 Subject Rings Max & Min Event Time Subject Area Ring Maximized to Disk function Story Profile Game Display events in time by subject area 2 Biographical Profile Event Time #1 Self Center Disk Profile Capture Biographical profile information 3 Fire Health Risk Event Time #1 Self Center Disk + Maximized Health Risk/ Health Game Model Display chronic disease health risk. Emphasize health opportunity GOAL. B Maximized in Self-Disk Opportunity Dashboard Instrument Profile healthy future. 4 Bet on Better/ Event Time #1 Self Disk + “Bet on Better” Game + Health Game Bet on ability to improve health is fun & gets “skin in the game”. Outsource financials. Opportunity Dashboard +Challenge 5 Social Tracking Social Net #2 Social Disk + Tracking Determine degree & type of connectedness 6 Social Challenge Social Net #2 Social Disk + Accept Challenge + Challenge Take on a Social Challenge 7 “What’s Next Coach?” Event Time #2 Social Disk +Will Challenge Bar Challenge Story Subject Area Coaches & Doctors give & track player Challenges 8 Social Family Profile Event Time #2 Social Disk + Profile Gather family biographical health history. Map Relationships within social network 9 Back on Track Social Net #2 Social Disk + Tracking Author of Challenge notified real-time of Player non-compliance for follow-up 1 Challenge Each Other Social Net #2 Social Disk + Event Players enroll others in a group challenge 12 Let’s Do It Together Event Time #2 Social Disk + Other Subject Disks Event Players set up meet-ups 13 Need a Han Social Ne #2 Social Disk + Story Player or Proxy organizes social network to support Player in health emergency 20 Morph Future Face Event Time #1 Self Disk + Values Disk + Future Counts-Video- Game Story With rapport with our future self we value future self. Social Net Morph Game+ Time slider instrument. 21 Morph Future Face Event Time #1 Self Disk + video-Morph Game + Time slider Game Story Player watches how their choices change their future towards health or by (un)Healthy Judgment Social Net instrument. illness & aging, 23 Outsourced Food Event Time #3 Food Drink Disk Tracking Outsource Food Tracking to FitBit Tracking 24 In-house Food Tracking Event Time #3 Food Drink Disk + Photo Record Food H&/Plate Tracking Game Self-tracking Game & aid to estimate what & how much you are eating Size Portion Volume Estimate Game+ Q&A pop-up & drinking box 25 Food Profile Event Time #3 Food Drink Disk Profile Profile information regarding past food & beverages 26 Food Guide Challenge Event Time #3 Food Drink Disk + Food Ring Will Challenge Model Challenge Take on healthy food or beverage Challenge Schedule + Will Impulse 31 Activities- Quiet Profile Event Time #4 Activities yin Quiet Disk Profile Gather past information about sleep, rest, yoga, etc. 32 Activities- Quiet Tracking Event Time #4 Activities yin Quiet Disk+ Q&A pop-up box Tracking Gather real-time information about sleep, rest, etc 33 Activities- Quiet Event Time #4 Activities yin Quiet Disk + Accept Challenge Challenge Take on a Quiet Activity Challenge Challenge 34 Activities- Quiet HRV Event Time #4 Activities yin Quiet Disk + HRV Device + Chill Pill Tracking Game Parasympathetic switch Heart Rate Variability biofeedback external Button Device 35 Activities- Quiet Breath Event Time #4 Activities yin Quiet Disk + Chill Pill Button Game breath patterns calm, focus, or relax as needed 36 Activities- Take 10 Chill Event Time #4 Activities yin Quiet Disk+ Chill Pill Button Game Get space & time between player & temptation Pill 37 Activities- Active Profile Event Time #5 Activities yang Active Disk Profile Gather past information exercise, physical work, etc. 38 Activities- Active Event Time #5 Activities yang Active Disk+ Q&A pop-up box Tracking Real-time information exercise, physical work, etc. Tracking 39 Activities- Active Event Time #5 Activities yang Active Disk+ Accept Challenge + Challenge Take on a Active Challenge Challenge 40 Sport Meet-up Event Time #5 Activities yang Active Disk+#2 Social Network+ Event Sport Meet-up for a challenge or safety in numbers Map 41 Feelings-physical Profile Event Time #6 Feelings-physical Disk Profile Gather past information about sensations, symptoms 42 Feelings-physical Event Time #6 Feelings-physical Disk +Q&A pop-up box Tracking Current information physical sensations & symptoms Tracking 43 Feel-physical Challenge Event Time #6 Feelings-physical Disk +Accept Challenge + Challenge Take on a physical feeling Challenge 0 Name View Object Function Goal 44 Feelings-emotional Event Time #7 Feelings’-emotional Disk Profile Gather past information about emotional state Profile 45 Feelings-emotional Track Event Time #7 Feelings’-emotional Disk+Q&A pop-up box Tracking Gather current information about emotional state 46 Emotion to motion Event Time #7 Feelings’-emotional Disk+Accept Challenge + Challenge Take on an emotional Challenge 47 e-IQ Free the Birds Event Time #7 Feelings’-emotional Disk+ Story Identify emotions & thought behind feelings. Repeat. 49 Value Profile: Event Time #8 Values Disk Profile Use Scenario planning, dilemmas, paradox, Q&A 50 Value Tracking: Event Time #8 Values Disk +Q&A pop-up box Tracking How motivating is the value tied to challenge? 51 Value Challenge Event Time #8 Values Disk +Accept Challenge + Challenge Take on a values challenge
  • 9. 52 Dear Abby value Event Time #8 Values Disk Story “Dear Abby” letters as value dilemmas. Prioritize dilemmas 54 Why do it? Event Time #8 Values Disk Story Associate values with all Challenge events 55 I know why, why do you? Social Net #8 Values Ring Story Share values associated with Challenge events 56 Coach Tryouts Event Time Future Will Challenge Prep Area Challenge Game Pick your Attitude Coach Avatar Story 57 Visualize Game Plan Win Event Time Future Will Challenge Prep Area Challenge Game POVTOON (ver.1.0) prompt to visualize success Story 58 Now Choose! Event Time Now Choose! Challenge Area +(Mis)Match Challenge Game DO/DON’T buttons, If choice Matches Challenge Game Plan Will Counters/Ratio + Bet on Better Story power counters increase 59 Game Match License? Event Time Past Will Debrief Area+Y/N Moral License Let Challenge Game After Match Moral Licensing danger >, do you feel entitled to do what Go+Time Capsule Story you wouldn’t normally? 60 Moral or Stress Mess Up Event Time Past Will Debrief Area +Y/N Act on Moral License Challenge Game record on video rationalizations after Match moral licensing or License Time Capsule +TimeCapsule Story Mis-Match Stress Licensing 61 Poor Entitled King Event Time Recent Past Will Debrief Area +Time Capsule +Poor- Challenge Game Aftermath of licensed actions. Feel & deal with the consequences. Rich Meter+Off Purpose Path+Social Perception+ Story Schedule CUMUC. ASAP 62 Mis-Match Wake up Call Event Time Now Choose! Challenge Area +(Mis)Match Challenge Game DO/DON’T buttons. If choice is a Challenge Game Plan Mismatch Counter/Ratio +Wake up Call Bet Story Impulse counter increases 63 Post-Game Mis-Match Event Time Recent Past Will Debrief Area + Y/N Stress Mess Up Challenge Game After Mis-match >danger of Mess Up Stress Licensing, do you feel Stress License? License? Let if Go + Time Capsule Story entitled to do what you wouldn’t normally? 64 CUMUC Clean Up Mess Event Time Redemption checklist + Schedule extra challenge + Challenge Game Clean Up Mess Up Challenge after Screw up, need to get back in Up Challenge POVTOON + Time Capsule Story integrity with self & others. Data Production Table Table III # 5B New Data Generation # 5B New Data Generation 2 Biographical profile & contact information, name, DOB, address/time, email, 39 Physical activity behavior modification with defined Challenges marital status, number of children, etc. 3 Risk Assessment instrument Q&A/ Risk Assessment instrument results 40 Data on solo v group exercise 4 Relate gambling approaches & motivation 41 Memory & available medical history of Dx, Sx 5 Real-time information on type & quantity of interpersonal communications 42 Gather real-time information on physical feelings 6 Data on social flexibility 43 Physical sensation modification with defined Challenges 7 Hypothesis tested challenges 44 Memory reports of emotional & mental health history 8 Family biographical health history. Map relationships within social network 45 Gather real-time information on perceived emotions 9 Real time compliance & symptom data 46 Emotional IQ modification with defined Challenges 11 Data on intra-group support 47 Efficacy of emotional cognitive reframe of amygdale stored events 12 Data on social health behavior 49 Memory report of what player has cared about 13 Data on patient coordinated social support networks 50 Real-time success data on player valuation of will power Challenge 20 Relationship of intrinsic values, future discounting, will & health metrics. 51 Data on iterative re-evaluation tied to Challenges 21 Relationship of empathy & choice when future consequences valued 52 Data on narrative dilemmas to elicit learned values 23 External device data on food & exercise from Fitbit 54 Data on operationally potent values increasing will power success 24 Reliable tracked food quality & quantity of consumption estimates 55 Data on emergent network will power & shared values 25 Memory report of past food & beverage consumption history 56 Data on effective matching of player character & coaching styles 26 Data on eating behavior modification with defined Challenge interventions 57 Data on visual value symbols & exercise of will power 31 Memory report of past sleep & rest history 58 Relationship between will power, valued plan & impulse. 32 Tracking data parasympathetic activities, i.e. sleep, rest, breath, etc. 59 Data on perceived win & susceptibility to moral licensing 33 Rest & sleep behavior modification with defined Challenges 60 Effects of videos of self-rationalization of moral licensed behavior 34 External HRV device parasympathetic status in broad health data context 61 Relationship of videos, unhealthy choice, consequences & judgment 35 Data on breath control, stress reduction & compliance 62 Relationship between impulse, & motivation of a valued plan 38 Gather real-time information on defined physical activities 63 Relationship between stress, impulse & valued plan. 36 Data on guided 10 min. movement away from risky impulse 64 Taking responsibility, reconciliation, distinguish guilt & shame 37 Memory report of exercise & physical activities.