GDC: Winning the behavior change game – suggestions and success stories

The role of games for promoting, facilitating, an supporting behavior change has been a hot topic at this year’s conference. Below are summaries from two presentations from two separate sessions, both of which stress how games – through their capacity to promote a sense of empowerment, to provide meaningful feedback, and to corral social support – can assist in changing player behaviors (both inside the game and beyond).

Mike Kim (Kairos Labs), who coined “behavior change gaming” at last year’s conference gave an excellent presentation on Tuesday afternoon on how games can apply behavior change psychology and cognitive behavioral psychology, and in doing so he identified “4 key mechanics” for changing behavior:

1. The Fogg Behavior Model – a framework for behavior change developed by Stanford researcher B.J. Fogg (whose work focuses on how technology can persuade behavior and decisions and who presented alongside Kim last year).  The model categorizes behavior into 15 types (one-shot, perpetual, foreign, familiar, start, stop, etc.) and is based on the simple formula of B = M*A*T [translated as behavior is contingent upon motivation, ability, and a trigger for that behavior to occur].  According to the Fogg Model, it is easier to first focus a behavior change design not on an individual’s motivation for an activity, but rather, by simply just making it easier to perform the target behavior. Kim noted some examples of designs in line with this model, including donothingfor2minutes.com (which requires a user to focus on a serene vista for 2 minutes, with the timer resetting if the keyboard or mouse is touched) and Daily Challenge (which triggers users by sending you a daily email at 7am containing directions for a small behavior you can do to improve your health and wellbeing).
2. Timely “A-ha” Feedback Loops – Kim noted that there is currently a lot o buzz about using mobile techs delivering “just-in-time” feedback about user states or behavior.  He was quick to make clear that for this to produce effective behavior change, it needs to include more than just data-tracking and quantified results; it needs to actually provide a context for motivating the user toward a particular behavior. Some interesting examples Kim shared with the audience included Massive Health’s eatery app (in which user upload pictures of what they are eating, which are then rated as relatively good or bad to eat by the community of users, providing first direct and then later vicarious reinforcement even outside of the game), Nike Plus’ “Cheer Me On” feature (in which your run is posted to Facebook and your friends are invited to cheer you as you go, resulting in audible cheers in your headphones), and Zamzee (a pedometer integrated with a gamine portal for winning real and virtual rewards, with reward patterns adapting to individual user behavior patterns).
3. PERMA – standing for “Positive Emotions, Engagement, Relationships, Meaning and purpose, and Accomplishments”, this construct comes directly from  the research of positive psychologist Martin Seligman.  This construct is tied to connection with others and how such a connection can  influence an overall sense of wellbeing, resiliency, and success.  Real world examples cited by Kim include the teamwork strategies found in bike tours, tai chi, and the Hajj pilgrimage in which tens of thousands of Muslims may locally share mediation.   Games seeking to motivate behaviors would do well to similarly tap into this social dynamic.
4. Heroic Narrative – Kim used this label to refer to the process by which games allow us to conceptualize, represent, or realize an “ideal” sense of self

Kim’s presentation served to conceptually list, top-down, these key mechanisms for facilitating changes in behavior.  In contrast, Dr. Rajiv Kumar’s presentation (part of the Health IT session the day before) was a bottom-up account of the behavior change project he’d been working on – ShapeUp – and then the general trends or conclusions his team had made about what worked.

While a medical student in Rhode Island, Kumar was tuned into the obesity explosion over the last 20 years.  In working with patients suffering due to obesity, he noted that the success stories tended to include the patient having leveraged existing social networks – that is, going to gym with buddy, doing a diet with the family, exercising with a group of friends.  Inspired by this, Kumar and others sought to create a social game for health behaviors that focused on such group-based individual behaviors.  Teams competed over 12 weeks, seeing which, as a team, could lose the most weight, exercise the most minutes, take the most steps, etc..

This approach lead to real results, with drops in weight and BMI reduction, as well as high (73%) maintenance of these loses.  Kumar and his team then realized not only that employers were willing to pay more than individuals, but that individuals were more likely to participate if they themselves didn’t have to pay for the opportunity.  In turn, ShapeUp’s current business model is to sell services to large corporate clients (Sprint, Key Bank, others) so that employees can then freely sign up.  As a result, ShapeUp digital service platform has now reached over 700k registered users across 50 clients.

Kumar, not a gamer personally, noted that games are at the center of their behavior change model, relying heavily on the simple but successful mechanic of competition.  Additionally, their platform incorporates social media elements including a social newsfeed, a reward gallery, individual and team progress visualizations,  user-generated challenges, and SMS and mobile tracking.  Together, this produces an experience that results in, on average, 30% user engagement, upped to 50% when including financial incentives (compared to the 6-40% found for other similar employer health-intervention programs).  Those who complete the experience lose, on average, 4.2% of their initial weight, and the amount of weight loss positively correlated with the number of teammates one has.

Kumar noted that as ShapeUp continues to advance, they seek to incorporate real-time rewards within their game platform – most employer incentive systems bundle small reward with base salary or delay delivery; however, Kumar anticipates higher yields would be found if these rewards could be formally separated from salary and presented immediately after specific achievements.  Additionally, ShapeUp seeks to begin incorporating more bio-metric data (which should become easier with the recent surge in cheap sensing tech like Fitbit and GreenGoose), as well as interrogate how one’s role in their social network (being a central “Kevin Bacon” or a peripheral “Steve McQueen”) might be considered so as to further improve results.

Altogether, Kumar believes that games may have the capacity to replace traditional financial incentives for changing health-related behavior.  He reports that the average employer spent $154 per employee on wellness programs in 2010, but spent $430 per employee incentives.  In contrast, he noted that socially-oriented games for health  have the power to potentially solve the engagement problem, provide incentives such as reputation and recognition, promote positive and collaborative behaviors, empower users, and represent a much more sustainable approach to behavior change.

GDC: Winning the behavior change game – suggestions and success stories by Jim Cummings, unless otherwise expressly stated, is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.

One Response to “GDC: Winning the behavior change game – suggestions and success stories”

1. Michael Kim says:

   March 9, 2012 at 4:01 pm

   Thanks for writing a great synopsis of my GDC talk, Jim! I'm glad that most my standup was still comprehensible given my presentation was destroyed seconds before my talk. I'll be posting a do-over video presentation of it shortly.

   We didn't have time to explore this particular issue, but our in-field experimental psychology research at Kairos Labs has also shed light on some of the challenges facing "gamification of corporate Wellness" methods, as opposed to what we call "Behavior-Change Games". Teaser alert: it has to do with the "R" and "M" in PERMA.

   We expound on these and other related topics in the Habit Design Network, a national meetup-oriented community of over 500 companies, non-profits, universities, healthcare organizations, and everyday Muggles focused on #winning in sustainable behavior-change. Habit Design meetups occur in San Francisco and New York with Boston hopefully opening soon (http://www.meetup.com/habitdesign, http://www.meetup.com/habitdesignnyc, http://meetup.com/habitdesignboston). Please feel free to join us and share your insights! We'll also be sharing our first year of amazing shared discoveries from Habit Design at the 2012 Quantified Self Conference in September (http://quantifiedself.com/conference/Palo-Alto-2012/breakout-sessions.php).

   Best,

   Michael Kim
   CEO/Founder, Kairos Labs
   @michaelbkim
   @kairoslabs
   @habitdesign

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