1. CampusCraft: Using Serious Health Games to Engage College Students

2. WisdomTools Based in Bloomington, Indiana Offer expertise in the areas of using serious games and other immersive learning technologies, and social media to reach children and young adults in the K-20 education market. Developing a health games division over past two years. Projects include: CampusCraft, a serious health game targeting college students. InSight Rehab, in partnership with Dr. Jill BolteTaylor, author of My Stroke of Insight. Paper Kingdom, under the leadership of the New England Research Institutes (NERI)

3. Background Health care costs are driving trends in consumer-oriented health. Patients need the knowledge, skills, as well as the tools and technologies to enable and encourage informed decisions about their health. College campuses emerging as ideal environment to “connect” with future health care consumers. Nearly 9,000 PHR accounts created on the Indiana University, Bloomington campus. Interest in using online tools such as health trackers. Lack context & relevance with regard to own health.

4. Snapshot of Target Population 18.2 million college students on nearly 4,500 campuses nationwide. 45% of binge drink. 33% are either obese or overweight 66% carry at least one (1) risk factor for metabolic syndrome (i.e., high blood pressure, excessive abdominal fat, high cholesterol). 20% currently receiving some form of behavioral counseling (vs. 9.7% of gen. pop.) for depression, stress, anxiety, suicidal ideation, etc. 14.2% report taking psychotropic meds (vs. 7.7% of gen. pop.) 25% of females will be sexually assaulted at one time during their academic career. 50% of cases associated with alcohol; 80% of cases committed by an acquaintance.

5. Emerging Set of Trends Growing shift in responsibility to consumers in costs and behaviors/lifestyle choices. Growing set of information and tools available to consumers via the internet, mobile applications, patient portals, PHRs, etc. Significant health concerns on college campuses mirroring those occurring nationally. College campuses represent an opportunity to inform, educate, and prepare future health care consumers.

6. Our Approach Traditional methods of informing students how they should behave or live their lives are not working. Mandated programs on alcohol or sexual assault education are largely ignored by target population. You cannot preach or promote a specific lifestyle. We must connect with their lifestyles and behaviors with what they already tend to do through games.

7. CampusCraft Funded by a Small Business Innovation Research (SBIR) grant with the NIH’s National Center for Research Resources. Phase 1 completed and prototype design developed & tested. Currently awaiting Phase 2 award. Address four (4) overarching learning objectives : What are my health risks (personal, family, environmental, social, etc.)? How do my behaviors & lifestyle impact my health? What resources & skills are needed or availableto optimize my health? Do I have control over my life and understand the skills, resources, and tools I need to thrive in college and beyond.

8. Phase 1 Prototype Objectives Address two (2) health issues relating to the combination of sexual health and binge drinking: Negotiating sexual consent Negotiating condom use Create a virtual environment that offer a combination of player characters and non-player characters interacting within realistic scenarios depicting life on a college campus. Incorporate game play elements such as quests, mini-games, point & reward system, and feedback to enhance experience. Enable an environment in which students can enter to explore or experience the good, the bad, and the uglyof college life;

9. Designing CampusCraft With input from the target audience, health educators, and subject matter experts (SMEs), we iteratively designed, developed, and researched this prototype: 11 interviews with SMEsin sexual health, alcohol consumption, and stress to better understand issues affecting students. 8 focus groups with students to address content, game design, and game mechanics. Groups included ongoing discussion with Undergraduate-level Health Seminar in Gender, Communication, Sexuality and Health (12 students); Masters’ level class on Human-Computer Interaction (20 students). 2 participatory design workshops (12 students), we iteratively designed and developed the CampusCraftprototype.

10. The Challenge of Finding Right Balance: Learning vs. Fun We can create a game that teaches, but will anyone want to play it? We can create a game that’s fun, but will anyone learn anything? Students won’t be forced to play,so how do we create a game that students will actually seek out, play, and take something away? What will attract them to return to the game? What will want them to invite their friends to play?

11. CampusCraft’sWorkingGame Theme Scenario: You’re a new student, free from the chains of parents, curfews, bed times, and eating your vegetables. The problem is that you’ve never really been on your own and, worse, you’re broke! Solution: You begin taking on some jobs to make some extra cash, while learning your way around campus, meeting new friends, and creating new experiences. Strategy: As part of your job, you have to explore and get close to potential culprits. The objective is to get information that will help you crack the case,but not get caught. You’ll have to navigate some pretty delicate situations. Are you up for it?

12. A Glimpse at the CampusCraft Prototype & Later Stages Phase 1choices: Gender Name Phase 2 Choices: Gender Name Physical characteristics University/campus Personality Academic ambitions Social ambitions Health status or history Evolving appearance & performance controlled by in-game choices/success. Select an avatar

13. CampusCraft Prototype cont… Meet New People Phase 1 limitations: Handful of NPCs Constrained dialogue Phase 2 changes: More complex dialogue More complex NPCs Richer, more diverse storyline

14. CampusCraft Prototype cont… Explore the Campus Phase 1 Choices: Limited set of locations driven by storyline. Phase 2 choices: Will add new locations so players may explore and discover. Players will be able to visit locations outside of storyline. Locations based on student’s own campus. Incorporate real locations into game play

15. Future Activities Choice of working alone or recruiting a team to complete assignments investigating mysteries occurring on campus. Manage your team of talented students. The better you manage your team, the more effective you are in solving mysteries and earning points/money. Go on daily missions (mini-games) or solve an outbreak to build up your experience, skills and abilities, while blowing off some steam and having fun.

16. CampusCraft Prototype Testing Eleven (11) different sessions involving 149 Indiana University studentsto assess: 52% Male / 48% female. 81% 18-22 years old. Usability of the game prototype and provide feedback on the game design, scenarios, and dialogues. Key concepts, behaviors, and skills addressed in the game. Feasibility of our approach in terms of student engagement & interest, particularly compared to other interventions offered on campus.

17. Feedback on Usability, Game Design Scenarios, and Dialogue Highest rated categories: Content Design of Learning Characters (Non-Player) Story/Activities Lowest rated categories: Game play choices Game play mechanics Graphics

18. Key Concepts, Behaviors, and Skills Introduced Health Attitudes: Health Self-Efficacy Rape Myth Acceptance Sexual Double Standards Token Resistance Pre- and Post-Test Results: Overall attitude changes regarding token resistance. Males had higher mean scores on overall attitudes, rape myth acceptance, sexual double standards, and token resistance. Females had higher mean scores on health self-efficacy.

19. Pilot Test Results & Conclusions Significant differences in learning of health concepts between pre- and post-tests, such that students scored higher on post-tests. Can conclude that the game impacted students learning several key concepts relating to a health topic and impacting attitudes toward a topic of health. Approach of CampusCraft is effective for influencing attitudes towards topics of health. Attitude changes will be further explored in Phase 2. Overall: positive outcomes in terms of usability, health attitude, and health learning.

20. Pilot Test Results & Conclusions Feedback regarding the use of personal health information (PHI) in the game: 83.8% would use PHI to affect Avatar’s characteristics; 82% would use PHI to influence consequences of your choices in the game; 76.6% would use it to affect opportunities available to them in the game.

21. Pilot Test Conclusions cont… Strong interest in CampusCraft from students, health practitioners, and SMEs and want: More actions & activities throughout the game; More flexibility & more control to players in terms of linking to their personal health information; Social networking capabilities through existing platforms (i.e., Facebook) or game play itself; Meaningful links between the virtual and non-virtual world.

22. Random Focus Group Comments “I thought the game was a good way of revealing health information in a fun and entertaining manner.” “Some of the strengths that I specifically enjoyed was how you had a task (solving a mystery) aside of learning the information.” “Overall, I think the idea of the game has the potential to be quite enjoyable and educational at the same time.” “I did like the authenticity of a typical college experience. The activities were easy for me to relate to.” “The fact it is a learning game that doesn't force-feed the player the intended lessons is a huge bonus to its enjoy-ability. If the option was given I would happily play this post production since the gameplay was so entertaining.” “I liked the idea that it was an interactive college lifestyle game. Usually videogames are all about fighting or younger stuff. This is our lives in a video game form.”

23. Questions & Answers Contact Information: Pete Grogg, MHA Hamid Ekbia, PhD pgrogg@wisdomtools.comhekbia@wisdomtools.com