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Data Collection in Games for Health
Tamer Fakhouri, MD
Yale School of Medicine Play2PREVENT Lab
April 6-8, 2014
San Francisco, CA
Annual Conference on Youth + Tech + Health
	
  
•  In 2009, 39% of new HIV infections were among
individuals aged 13-29 years, a 21% increase in
incidence since 2006
•  The majority of cases are in ethnic minority individuals
and due to sexual contact
•  11-14 year olds may be an optimal window of
opportunity for primary HIV prevention
Why a Game About HIV?
•  Touchscreen based
•  RPG-like with over-arching story & persistent player
character that levels up
•  4 Mini games that focus on social skills needed to
avoid risky situations
•  Designed to be played over 12 sessions
•  Aligned closely with health behavior change theory
PlayForward: Elm City Stories
•  Randomized, controlled trial
–  Began February 26th 2013
–  Enrolled 199 teens out of planned 330
–  Players randomly assigned to either PlayForward: Elm City
Stories vs. a set of attention/time control games on iPad
–  Subjects assessed for changes in behaviors/knowledge/
attitudes over time using standardized instruments
Evaluating the Efficacy of PlayForward
•  Document changes in behaviors/knowledge/attitudes
over time using data collected from standardized
assessments
•  Evaluate behavior change and knowledge collected
from in-game experience
•  Explore the question: does behavior in a game reflect
what someone does in real life?
Goals
Game	
  data	
  collec+on	
  
•  Automatic recording of the player’s experience
•  Computer software is used to parse millions of logged
events into a table of discrete variables
Video Game Event Logs – A New Data
Source for Behavior Change Research
00:00 05:00 10:00
024681012
Total Game Time (Hours:Minutes)
TotalScore(Max12)
Levels Beaten Over Time
00:00 05:00 10:00
024681012
Total Game Time (Hours:Minutes)
TotalScore(Max12)
Measuring Game Exposure
Game Progress Correlates with Gains in
Health Knowledge
-50
0
50
100
1 2 3 4 5 6 7 8 9 10 11 12
Stacks beaten
%ChangeInKnowledgeScoreat3Months
Knowledge Score vs. Game Exposure
-50
0
50
100
1 2 3 4 5 6 7 8 9 10 11 12
Stacks beaten
%ChangeInKnowledgeScoreat6Months
Knowledge Score vs. Game Exposure
•  Measuring “exertion”
•  Assessing the efficacy of the aspirational avatar
Future Directions
Tamer Fakhouri, MD
tfakhouri@gmail.com
The	
  play2PREVENT™	
  Lab	
  
Science Side:
Lynn Fiellin, MD
Kimberly Hieftje, PhD
Lindsay Duncan, PhD
Cindy Crusto, PhD
E. Jennifer Edelman, MD
Deepa Camenga, MD
Marjorie Rosenthal, MD
Linda Mayes, MD
David Fiellin, MD
Peter Salovey, PhD
Brian Forsyth, MD
Gail Slap, MD
Tyra Pendergrass, MEM
M. Zachary Rosenthal, PhD
Tamer Fakhouri, MD
The	
  Community	
  Side:	
  
• Farnam	
  Neighborhood	
  	
  House	
  
• LEAP	
  
• Clinton	
  Avenue	
  School	
  
	
  
Game	
  Side:	
  
• Ben	
  Sawyer	
  (Digitalmill)	
  
• Alex	
  Seropian	
  (Industrial	
  Toys)	
  
• Schell	
  Games	
  
Jesse	
  Schell	
  (Founder,	
  CMU)	
  
Bonnie	
  Bogovich	
  (Audio	
  ArLst)	
  
Derek	
  Hetrick	
  (Character	
  ArLst)	
  
Heidi	
  McDonald	
  (Writer)	
  
John	
  Kolencheryl	
  (Game	
  Engineer)	
  
Josh	
  Hendryx	
  (Background	
  ArLst)	
  
Manoj	
  Anand	
  (Producer)	
  
Patrick	
  McKiernan	
  (Art	
  Manager)	
  
Peter	
  Kinney	
  (Design	
  Intern)	
  
Rebecca	
  Cordingley	
  (UI	
  ArLst)	
  
Reagan	
  Heller	
  (Art	
  Director)	
  
Rick	
  MatcheR	
  (Tech	
  Director)	
  
Sabrina	
  Haskell	
  (Project	
  Director)	
  
Samantha	
  Verlihay	
  (UI	
  ArLst)	
  
• Noah	
  Falstein	
  (Google)	
  • McGivney	
  Community	
  Center	
  
• John	
  MarLnez	
  School	
  
• PALS	
  
Supported	
  by	
  the	
  Eunice	
  Kennedy	
  Shriver	
  Na+onal	
  Ins+tute	
  of	
  Child	
  Health	
  and	
  Human	
  Development	
  grant:	
  R01HD062080	
  
play2PREVENT Lab
www.play2PREVENT.org
Lynn Fiellin, MD
Principal Investigator
Kimberly Hieftje, PhD
Project Director
A	
  CollaboraLon	
  Between	
  
	
  
	
  
www.play2PREVENT.org
Tamer Fakhouri, MD
Research Consultant
tfakhouri@gmail.com

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Data Collection in Games for Health

  • 1. Data Collection in Games for Health Tamer Fakhouri, MD Yale School of Medicine Play2PREVENT Lab April 6-8, 2014 San Francisco, CA Annual Conference on Youth + Tech + Health  
  • 2. •  In 2009, 39% of new HIV infections were among individuals aged 13-29 years, a 21% increase in incidence since 2006 •  The majority of cases are in ethnic minority individuals and due to sexual contact •  11-14 year olds may be an optimal window of opportunity for primary HIV prevention Why a Game About HIV?
  • 3. •  Touchscreen based •  RPG-like with over-arching story & persistent player character that levels up •  4 Mini games that focus on social skills needed to avoid risky situations •  Designed to be played over 12 sessions •  Aligned closely with health behavior change theory PlayForward: Elm City Stories
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11. •  Randomized, controlled trial –  Began February 26th 2013 –  Enrolled 199 teens out of planned 330 –  Players randomly assigned to either PlayForward: Elm City Stories vs. a set of attention/time control games on iPad –  Subjects assessed for changes in behaviors/knowledge/ attitudes over time using standardized instruments Evaluating the Efficacy of PlayForward
  • 12.
  • 13. •  Document changes in behaviors/knowledge/attitudes over time using data collected from standardized assessments •  Evaluate behavior change and knowledge collected from in-game experience •  Explore the question: does behavior in a game reflect what someone does in real life? Goals
  • 15. •  Automatic recording of the player’s experience •  Computer software is used to parse millions of logged events into a table of discrete variables Video Game Event Logs – A New Data Source for Behavior Change Research
  • 16. 00:00 05:00 10:00 024681012 Total Game Time (Hours:Minutes) TotalScore(Max12) Levels Beaten Over Time
  • 17. 00:00 05:00 10:00 024681012 Total Game Time (Hours:Minutes) TotalScore(Max12)
  • 19. Game Progress Correlates with Gains in Health Knowledge
  • 20. -50 0 50 100 1 2 3 4 5 6 7 8 9 10 11 12 Stacks beaten %ChangeInKnowledgeScoreat3Months Knowledge Score vs. Game Exposure
  • 21. -50 0 50 100 1 2 3 4 5 6 7 8 9 10 11 12 Stacks beaten %ChangeInKnowledgeScoreat6Months Knowledge Score vs. Game Exposure
  • 22. •  Measuring “exertion” •  Assessing the ecacy of the aspirational avatar Future Directions
  • 24. The  play2PREVENT™  Lab   Science Side: Lynn Fiellin, MD Kimberly Hieftje, PhD Lindsay Duncan, PhD Cindy Crusto, PhD E. Jennifer Edelman, MD Deepa Camenga, MD Marjorie Rosenthal, MD Linda Mayes, MD David Fiellin, MD Peter Salovey, PhD Brian Forsyth, MD Gail Slap, MD Tyra Pendergrass, MEM M. Zachary Rosenthal, PhD Tamer Fakhouri, MD The  Community  Side:   • Farnam  Neighborhood    House   • LEAP   • Clinton  Avenue  School     Game  Side:   • Ben  Sawyer  (Digitalmill)   • Alex  Seropian  (Industrial  Toys)   • Schell  Games   Jesse  Schell  (Founder,  CMU)   Bonnie  Bogovich  (Audio  ArLst)   Derek  Hetrick  (Character  ArLst)   Heidi  McDonald  (Writer)   John  Kolencheryl  (Game  Engineer)   Josh  Hendryx  (Background  ArLst)   Manoj  Anand  (Producer)   Patrick  McKiernan  (Art  Manager)   Peter  Kinney  (Design  Intern)   Rebecca  Cordingley  (UI  ArLst)   Reagan  Heller  (Art  Director)   Rick  MatcheR  (Tech  Director)   Sabrina  Haskell  (Project  Director)   Samantha  Verlihay  (UI  ArLst)   • Noah  Falstein  (Google)  • McGivney  Community  Center   • John  MarLnez  School   • PALS  
  • 25. Supported  by  the  Eunice  Kennedy  Shriver  Na+onal  Ins+tute  of  Child  Health  and  Human  Development  grant:  R01HD062080   play2PREVENT Lab www.play2PREVENT.org Lynn Fiellin, MD Principal Investigator Kimberly Hieftje, PhD Project Director A  CollaboraLon  Between      
  • 26. www.play2PREVENT.org Tamer Fakhouri, MD Research Consultant tfakhouri@gmail.com