TRACK 8(1) | DAY 2 - 3 OCT 2017 Elena Bertozzi, Associate Professor of Quinnipiac University (USA) and Aparna Sridhar, Assistant Games for Health Europe 2017

1. Using Games to Collect Public Health Data
2 Case Studies
Elena Bertozzi PhD
Game Design & Development,
Quinnipiac University, Hamden, CT
Aparna Sridhar MD MPH
Division of Obstetrics and Gynecology
University of Los Angeles, California CA

2. Goals
• Two innovative projects
• Funded by Grand
Challenges in Global
Health
• Create compelling game
for target audience
• Collect data during
game play
• Validate tools as means
of instruction and
accurate data collection
• Validate technology

3. Games
Mexico India

4. Hot! Horny! Healthy! -HIV Prevention
Mexico City
Sergio Bautista, Raluca Buzdugan Elena Bertozzi, Zafiro
Andrade-Romo, Laura Chavira-Razo, María Alejandra Cortés,
Tania Aramburo Muro
Conductrr
2014-2016

5. Study objective
To develop and pilot test a game-based
intervention to incentivize 18-35 year old MSM
in Mexico City to:
• Learn about HIV/AIDS
• Engage in safe sexual behaviors
• Get tested for HIV and syphilis.

6. “Become a better lover”
Key mechanics:
Online game
Quizzes/ Trivia
Inviting friends
Points system – for real-world & virtual activities
Rewards – material & non-material (badges)
Competition - leaderboard

7. Game testing
61 MSM participated in the pilot (33 in Arm 1, 28 in Arm 2)
• 7 participants invited friends
• 31 participants answered quizzes
• 89% of quizzes were answered correctly
• 30 participants played the game
• 5 participants (8%) tested for both HIV and syphilis
over 5 weeks
• 80% of men had tested for HIV and 52% for syphilis
in the previous year
• No significant differences in engagement in the
intervention and testing uptake were observed
between the two arms

8. Participant experience
• Participants found the intervention innovative, fun
and relatable
• The content, format and graphics of the quizzes were
well-received
• The quizzes and the game included
• Information about Mexico’s gay culture
• Scenarios similar to real-life situations, which helped them
understand real-life consequences of risky sex.
• The intervention created an opportunity for gay men
in the closet to interact with gay culture and learn
about HIV and STDs in a fun, non-intimidating way

9. Issues and lessons learned
Issues
• Game as peripheral
• Change in scope mid-
project
• Lack of access to target
population
• Technology issues – crashed
server
• Team members had
different goals
Lesson learned
• Game development has to
be central to project
• Limit scope to increase
efficacy
• Manage technology in
house
• Clarity about project goals

10. My Future Family- Family Planning
Karnataka, India
Elena Bertozzi PhD., Aparna Sridhar MD,
Praveen Kulkarni, MD, Tejas Kumar
2016-2017

11. Study objective
To design a game-like tool to identify cultural
norms that influence future family planning
decisions in adolescent school children in
Karnataka, India, which will help improve
contraceptive education.

12. “My future family”
Key mechanics:
• Tablet/phone game
• Collects data about age at milestones
• And who influences decisions
• Minigames teach reproductive anatomy
• Data collected throughout gameplay
• Transmitted to server for analysis

13. Game validation and data collection
• 380 adolescent boys and girls played the game
• 11 schools (both rural and urban)
• Post-game questionnaire for validation

14. Results
Variable Female
(n=135)
Male
(n=146)
P value
Age 15 (15-16) 15 (15-17) 0.652
Age groups 0.277
15 50 (37%) 53 (36.3%)
16 23 (17%) 25 (17.1%)
17 12 (8.9%) 25 (17.1%)
18 3 (2.2%) 5 (3.4%)
>18 18 (13.3%) 11 (7.5%)
Graduation
age
23 (21-25) 23 (21-25) 0.993
Adulthood
age
18 (15-20) 18 (16-
20.8)
0.034
Meeting
spouse age
23 (20-24) 23 (20-25) 0.373
Marriage
age
23 (0-25) 25 (22-26) <0.001
Children
age
25 (22-
26.5)
26 (24-28) <0.001

15. Cultural influences
Variable/
Influencer
Father Mother Friends Religion Teacher
Choosing a
life partner
35% 52% 23% 3% 4%
Marriage 49% 54% 3% 2% 1%
Having
children
26% 55% 2% 4% 1%

16. Participants’ experience
• “In school or house no-one can teach about these topics. So all the
student can learn by playing this game.”
• “There is nothing to improve in this game. It is very useful for interested
students. I think for our age students it is perfect game. Many people
waste their time by other unuseful games. But it is very useful game for
me and all. Thank you so much for giving me so much information, which I
didn't know before. Thank you, thank you very much!”
• “Add some more milestones. Improve game's graphics. Introduce this
game to google game store. Add some more features”
– % of participants either Agreed, or Strongly agreed with:
• “I like playing this Game” : 98
• “My friends should play this game” : 91
• “I want to know more about family planning through health games : 94

17. Next steps
• Phase II application
• Improve interface based on usability tests
• Birth control milestone
• Pregnancy milestone
• How to scale intervention
• How to scale data collection

18. Questions
Contact:
Elena Bertozzi: Elena.bertozzi@qu.edu
Aparna Sridhar: asridhar@mednet.ucla.edu