Cite as: Kamel Boulos MN. On the promises, challenges and risks of Pokémon Go and similar geosocial (location-based) exergames (invited contribution). In: Proceedings of GEOMED 2017: International Conference on Spatial Statistics, Spatial Epidemiology & Spatial Aspects of Public Health, Porto, Portugal, 08 September 2017. Conference URLs: http://www.i3s.up.pt/geomed2017/speakers.html and http://www.i3s.up.pt/geomed2017/scientific_programme.html

1. On the promises, challenges and risks of
Pokémon Go and similar geosocial
(location-based) exergames
Prof. Maged N. Kamel Boulos, MBBCh, PhD, SMIEEE
Chair of Digital Health
University of the Highlands and Islands, Scotland, UK
Founder & Editor-in-Chief, Int J Health Geogr
mnkboulos@ieee.org

2. Agenda
• A quick overview of geosocial (location-based)
games
• Pokémon Go for personal health and well-being
(promotion of physical activity and reduction of
stress)
• Potential misuses or safety and privacy concerns
of Pokémon Go and similar games
• What’s next
• Further reading (pointers)

3. Geosocial (location-based) exergames
• Location-based smartphone games with potential for health promotion were
described in Int J Health Geogr as early as 2013:
• Kamel Boulos MN, Yang SP. Exergames for health and fitness: the roles of GPS and geosocial apps.
International Journal of Health Geographics. 2013;12:18. https://doi.org/10.1186/1476-072X-12-18
• Pokémon Go is not the first of its kind. For example, Ingress, a location-based,
augmented-reality mobile exergame developed by Niantic, was first released for
Android devices in November 2012. The game has a science fiction back story with a
continuous open narrative. It uses the real world as the game world and map.

4. Harnessing the Power of
Gamification and Social, Multi-
player Features for Sustainable
Motivation
(to continue playing/exercising and
not give up/get bored quickly)

5. Personal health and well-being (promotion of physical
activity and reduction of stress)
• Physical activity (in the right amount) is a key ingredient of a
healthy lifestyle. It improves physical and psychological
(mental) well-being, reduces stress, decreases a person’s risk
of developing major diseases, such as type 2 diabetes, heart
disease, stroke and cancer, and lowers the risk of pre-mature
death.
• Introduced in July 2016, Pokémon Go, a mobile location-based
social exergame (digital game involving exercise) with potential
and documented health benefits (e.g., [1-3]), is perhaps the
most popular ever example of a health-related ARGIS
(Augmented Reality GIS) application.
1. Althoff T, White RW, Horvitz E. Influence of Pokémon Go on physical activity: study and implications. J Med Internet Res. 2016;18(12):e315.
doi:https://doi.org/10.2196/jmir.6759.
2. Nigg CR, Mateo DJ, An J. Pokémon GO may increase physical activity and decrease sedentary behaviors. Am J Public Health. 2017;107(1):37–8.
doi:https://doi.org/10.2105/AJPH.2016.303532.
3. Tateno M, Skokauskas N, Kato TA, Teo AR, Guerrero AP. New game software (Pokémon Go) may help youth with severe social withdrawal, hikikomori.
Psychiatry Res. 2016;246:848–9. doi:https://doi.org/10.1016/j.psychres.2016.10.038.

6. Pokémon Go running on an Android smartphone. Note the
cartoon-style map of the user’s real world location. Nearby
Pokémon creatures, PokeStops (where the player can
collect in-game items, such as Eggs and Poké Balls [used to
catch Pokémon creatures]) and Pokémon Go Gyms (battle
arenas of the Pokémon world) are overlaid on the map.
Players are expected to walk or run towards these
creatures and points of interest to interact with them, while
competing with one another and in teams. (All players at a
given location and time see the same creatures and points
of interest around them.)
In AR (Augmented Reality) mode, the game uses the
smartphone’s camera to overlay Pokémon creatures (as
they are being caught by the player) onto real-world
scenery.
Different types of Pokemons can be found near relevant
locations, e.g., water type Pokemons near rivers, lakes,
canals, harbours, etc. (a clever design feature that makes
good use of map data).

7. https://techcrunch.com/2016/07/22/pokemon-go-actually-does-something-worthwhile/

8. Potential misuses or safety and privacy concerns
• Created by the same experts behind Google Earth, Pokémon Go relies heavily on
the location services of smartphones (GPS [Global Positioning System], Wi-Fi, and
mobile networks) to deliver its multiplayer experience, but not without
documented and potential misuses or safety and privacy concerns [4-7]:
• Electronic cigarette retailers using it for marketing;
• Cheating to progress in-game without performing any physical activity
(betrays the exergame’s health benefits);
• Privacy concerns (as with other GPS/location-based products);
• Drivers and pedestrians’ safety (road traffic accidents);
• Going to places the player is not allowed to visit (e.g., private land), or where her/his life
or health can be put at risk (e.g., exposure to mosquito- or tick-borne diseases);
• etc.
• Successive versions of Pokémon Go have tried to address/mitigate most of the
above issues.
4. Kirkpatrick MG, Cruz TB, Goldenson NI, Allem JP, Chu KH, Pentz MA, Unger JB. Electronic cigarette retailers use Pokémon Go to market products. Tob
Control. 2017 Jan 2. doi:https://doi.org/10.1136/tobaccocontrol-2016-053369 [Epub ahead of print].
5. Oidtman RJ, Christofferson RC, Ten Bosch QA, Espana G, Kraemer MU, Tatem A, Barker CM, Perkins TA. Pokémon Go and exposure to mosquito-borne
diseases: how not to catch ‘Em All. PLoS Curr. 2016 Nov 15. doi:https://doi.org/10.1371/currents.outbreaks.2d885b05c7e06a9f72e4656d56b043cd.
6. Joseph B, Armstrong DG. Potential perils of peri-Pokémon perambulation: the dark reality of augmented reality? Oxf Med Case Reports. 2016, 2016(10):
omw080, eCollection 2016. doi:https://doi.org/10.1093/omcr/omw080.
7. Ayers JW, Leas EC, Dredze M, Allem JP, Grabowski JG, Hill L. Pokémon GO—a new distraction for drivers and pedestrians. JAMA Intern Med.
2016;176(12):1865–6. doi:https://doi.org/10.1001/jamainternmed.2016.6274.

9. Cheating in Pokémon Go. https://www.instagram.com/p/BIR4xdDDZgb/?taken-by=mnkboulos

11. What’s next
• Like very many other games, Pokémon Go’s somewhat fading user
interest and declining user base was to be expected, particularly when
accounting for the initial media hype that drove many people to the
game only temporarily, to satisfy their curiosity.
• Nevertheless, updates to Pokémon Go and merchandise for further
monetisation of the game, such as the Pokémon Go Plus wearable, are
still being released as of 2017.
• But the successive updates of the game have also made it increasingly
“heavier” and bloated, and consequently slower or totally unplayable on
less powerful, low-end devices. For example, while the Apple iPhone 4S
was able to run the earliest versions of Pokémon Go almost flawlessly,
newer versions of the game are unplayable on that handset, crashing
with each attempt to run the game.
• Areas for improvement in future editions of Pokémon Go and similar
games include ‘game loading times’ (need to be faster) and ‘battery
drain’ (needs to be reduced).

12. What’s next
• Games are in some ways like fashion, and many people are now
looking forward to the next geosocial game to follow after Pokémon
Go.
• Most people will get bored of a game at some point, if not after a
couple of months then after 4 or 6 months.
• Furthermore, Pokémon Go has a finite number of levels after which
the player would be considered to have completed it. Most players
will never reach beyond a certain level. They will give up, either as
the game gets much harder or as its monetisation kicks in (when
progression becomes strictly tied to in-game purchases or extremely slow
without them to force players to buy something with real currency).
• But to play an exergame for even such a limited duration of a few
or several months is still beneficial, worthy and commendable
(though some Pokémon Go players were cheating to progress in-
game instead of doing real physical activity—tying future
exergames to heart rate and other relevant body sensors can help
minimise cheating and provide better feedback to players).
Public health stakeholders
need to develop mobile-based
interventions within a framework
that embraces pleasure, rewards,
participation and community.……

13. Further reading
• Wong FY. Influence of Pokémon Go on physical
activity levels of university players: a cross-
sectional study. International Journal of Health
Geographics. 2017;16:8.
https://doi.org/10.1186/s12942-017-0080-1
• Kamel Boulos MN, Lu Z, Guerrero P, Jennett C,
Steed A. From urban planning and emergency
training to Pokémon Go: applications of virtual
reality GIS (VRGIS) and augmented reality GIS
(ARGIS) in personal, public and environmental
health. International Journal of Health
Geographics. 2017;16:7.
https://doi.org/10.1186/s12942-017-0081-0
• More studies from PubMed:
https://www.ncbi.nlm.nih.gov/pubmed/?term=pokemon+go
• My G+ Collection:
https://plus.google.com/collection/UWt9LE