Bill Sabram has been designing games for a long time and specifically games for health for several years. This talk focuses on cumulative lessons learned from one of the field's most experienced designers. Divided into three parts the talk will cover: 1. The intersection of game design and well-being which will cover the importance of engagement, and small actions that motivate and engage players. 2. Meet Daily Challenge, MeYou Health's well-being improvement product, learn about our clinical trail and hear Bill's design insights. www.dailychallenge.com 3. Learn about the design of Walkadoo, a free walking product that everyone can enjoy. Bill will share what worked and what didn't in building MeYou Health's pedometer program. www.walkadoo.com

1. Bill Sabram
Lead Game Designer
20 June 2014
Games for Health Conference
Engagement is the first metric:
How game design enriches
5 well-being products
bill@meyouhealth.com@billsabram

2. Gamification is the use of game
thinking and game mechanics in
non-game contexts to engage users in
solving problems.
Game-if-a-what?
Marketing & beyond
Conferences, workshops and certifications
Loyalty Programs
1979 1st frequent flyer program
Crowd sourcing
2011 retroviral protease in 10 days?!

3. 19 years of professional game design
Industrial Design at Carnegie Mellon
University. An incredible journey from
museum /exhibit design -> game design
-> contract design -> behavior change
design at a healthcare start up.
About me
Board, dice, card games
Buffy the Vampire Slayer, Pokémon + more
Social games
iPhone , Facebook, pedometers
Hand-held electronic games
Talking games for preschoolers + beyond

4. In 2009, Healthways re-imagined online
health and well-being interventions.
MeYou Health develops and delivers
next generation wellness and well-being
solutions.
About us
Open social design
Interventions for all your social connections
Person-centered design
Realistic, convenient, immediate, genuine
Privacy + engagement
Protect PHI while enabling engagement
across social networks, email and SMS.

5. A conversation in three parts:
1. Gamifying Well-Being
2. Daily Challenge
3. Walkadoo
structure
Research + my insights Failures + your ideas
What are these programs? What is success?

6. Small healthy actions.
Health improvement is inherently long-
term. Sustained engagement is a success.
Gamifying
Well-being
90+ Day Retention
Percentage of users who return to the
DC sight at 90 days and beyond:
3 types of touches:
1. Visit website, 2. Complete a challenge or
3. Read a challenge email or reminder.
70.7%

7. Begin by defining the core action.
Why? It is a question of time.
Design for engagement
Do the action
Press the Done button
How much time do you
expect a typical user to spend with
your app? Craft an experience to
this time window. Then halve it!
Complete your card
Walk and offload your steps
Find your 200
Eat 200 less calories today

8. More social more impact
• Pragmatic
Randomized
Control Trial
• 1,502 individuals
recruited and
randomized
• Well-being assessed
at enrollment, 30
and 90 days
• Control = Weekly e-
newsletter
Results published in The American Journal of Preventive Medicine.

9. Points. Levels. Badges.
These are standard in gamification.
When done well, they are very powerful.
Show progress
Stamps + Badges
They are a visual road map.
Levels
Own your achievements and gain status.
Points are feedback.
They are just like any other motivational
message. But they are also currency!

10. I built four separate systems
around basic actions for similar
point events.
Large point events denote large
challenge. High levels convey
status.
An economy
of points
A hunch
Validated
Balance your point economies
across multiple products. One of
our customers uses participant
levels to quickly assess how
engaged users are in Daily
Challenge and Walkadoo.

11. Daily challenge
• Small actions
delivered daily.
• Multiple tracks of
content across all
the elements of
well-being
• Gamified elements
of exploration,
achievement,
socializing and mild
competition.
• Optimized for
mobile web and an
iPhone app.

12. Your daily action
• Small actions
delivered daily.
• Multiple tracks of
content across all
the elements of
well-being
• Gamified elements
of exploration,
achievement,
socializing and mild
competition.
• Optimized for
mobile web and an
iPhone app.
7 am
email
4pm
reminder

13. 50+ tracks from all domains of well-being
Cycle into 28 days of specialized challenges
Tracks for everyone
Freemium
Join for free, earn
premium content
Build the minimum viable
solution. Deploy it. Your clients will
request smart improvements.
Virtual Currency
Points -> tokens -> keys -> tracks
The method to this madness!
Unlock Tracks
You hold the key!
(earned, given or gifted)

14. What is success?
How do you know if you’ve succeeded?
Establish mutually agreed upon terms.
We chose engagement
• Unique visitors
• Return visits
• Sustained engagement

15. Something new
Unheard of numbers
Hard to believe. But true.
Unexplained behavior
The Others
The reason?
We suspect it’s the light
touch

16. My favorite:
5-Day pacts
My story
Max 25 day streak ballooned to
125 day streak with 5-day pacts
It felt really good
I was astonished. Bursts of
engagement with all my friends!
However…
I found that giant streaks
corrupt. It wants to live!
Empower the
relationships between
your users.

17. Walkadoo
• Receive realistic,
custom, daily step
goals. Walkadoo adapts
to your walking!
• Create derbies with
friends to race and
compete.
• Supports the
Walkadoo Pebble,
Fitbit, Jawbone UP and
Moves app.

18. Make it social
• Answer the daily
Walkie Talkie and get
the conversation going.
• Learn some fun facts
about walking.
• Allow genuine stories
to emerge around the
walking theme.
• Notice the different
card! All or Nothing
step cards are rare and
worth double points.

19. Your daily email + SMS
• Learn today’s card.
• Call to Action (CTA)
for today’s Walkie
Talkie.
• Recap of yesterday.
• Mobile technology
amplifies the
power and ease of
today’s healthy
action.

20. Build experiences
Walkadoo is not about pedometers.
We are building awareness, validating
people’s movement, and motivating
them to engage.
Keep a book of your
big ideas. Then simplify
them mercilessly. “Fail fast”
as you build weekly sprints.
“I have not failed. I've just
found 10,000 ways that
won't work.”
― Thomas Edison

21. What is success?
We chose card completions
• “The algorithm is the intervention.”
– Nat Cob, M.D., MYH Chief Medical Officer
• Pilots with control group later this year!
Measure your core actions.
Design for a future clinical trial.

22. Give ‘em what they want… Kinda
• Eureka moment from
our research: People
walk about the same
each week.
• This made step
competitions
demoralizing; we
wanted to allow folks
with different activity
levels to compete in a
light and playful way.
• The Point Derby was
born! Games, rules and
“luck of the draw” lets
people fail gracefully.

23. Some examples of our epic failures.
Information design is difficult and other
blunders from the world of gamification.
Walka-fail
Daily prompts
The expiration date
problem.
Chips!
Bonus spins often feel
desperate.

24. Too.
Much.
Awesome.
Too.
Fast.
“Bill, please.
Simplify!”
-Michael
Stratmann,
Industrial
Design
Professor
Moar Walka-fail

25. Core experience + time = end game
Define your end game before your super
users go over the cliff. Plan now, not later.
What’s it all mean?
Daily Challenge
Complete challenges. Earn points. Grow a tree.
Over and over. Until it’s golden.
Walkadoo
Complete cards. Earn points. Answer Walkie
Talkies. Earn levels. Then what?
?

26. Walkadoo has an outback journey look + feel.
What could you experience as you progress
through the product? Support theme + core.
Progression Recycle when possible!
Social game reused
My art will go on?

27. Bill Sabram
Lead Game Designer
bill@meyouhealth.com@billsabram
Thank you!
20 June 2014
Games for Health Conference
Engagement is the first metric:
How game design enriches
5 well-being products