Mobile Technology to Get Us Healthy and Keep Us Well

Alex Gerwer Principal Partner AKN

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The White House: Getting Us Moving

RWJF: Technology to Get Us Moving

Ruckus Nation
A competition to find product ideas to increase physical activity in 11 14 year-old kids

Robert Wood Johnson Foundations Health Games Research initiative

Cosponsored by the Pioneer Portfolio of the

Mobility + Gaming +Social Networking

Click on the titles for full texts.

Benefits of Telehealth
Increased access to healthcare and health-related information, particularly for hard-to-reach populations Improved ability to diagnose and track diseases Timelier, more actionable public health information Expanded access to ongoing medical education and training for health workers
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Target Markets for Telehealth

Consumers Welcome mHealth

Consumers believe that within the next three years mobile health will improve the convenience (46%), cost (52%), and quality (48%) of their healthcare. Consumers expect that mhealth will change the way in which chronic conditions (48%), their medication (48%), and their overall health (49%) are managed. The top three reasons why consumers want to use mHealth are: to have more convenient access to their doctor or healthcare provider (46%), to reduce out-of-pocket healthcare costs (43%), and to take greater control over their health (32%).
Source: Price Waterhouse Coopers; Emerging mHealth: Paths for Growth; 2012
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Technology in mHealth Applications

Source: Vital Wave Consulting

The Evolution of a Convergence

1980

1989
160 x 144 pixels

2004

2008

1997

2003

640x960 pixels

Interactive Gaming

Portable Mobility

Connected Social Networking

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Mobile Health Games: A Perfect Storm

Mobility Wellness

Social Networks

Games for Health

Fitness

Gaming

Health

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Why Mobile Health Games Now?

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Who Cares and Why?

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A Solution to Our Healthcare Crisis: A Unique Collaboration

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Mobile Health Games

What each component does:
Mobile: anywhere, anytime Social Networking: motivation, support Gaming: engagement through interaction

Sectors
Exercise: physical activity Eating: diet Cognitive intervention Disease management Corporate wellness and fitness
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Types of Cognitive Mobile Health Games

Pain management Medication adherence Memory enhancement Addiction treatment
Eating Drug addiction Alcoholism Smoking
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An Emerging Ecosystem
WELLNESS
SELF-HELP CONSUMER WELLNESS EMPLOYEE WELLNESS BRAIN GAMES DISEASE MANAGEMENT MED ADHERENCE ADDICTION RELAPSE

CHRONIC DISEASE

Source: Barbara Feldman

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What is a Serious Game?

A game-based activity that leads the user to obtain: - New knowledge on a serious topic (educate) - Positive changes in behavior (modify behavior) Research and development of serious games are predominantly routed in the history and theory of EduGaming. The ultimate goal of a serious game is to: - Be as engaging as a main-stream leisure game - Lead to new skill set or individual knowledge development - Reinforce new behavior beyond the point of game play
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Serious Games for Health: Cognitive

Jetset TopDoc

Learning

Silverbackers

Freedom BrainAge

eSmart

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Serious Games for Health: Cognitive

Hospital patients are particularly amenable to changing their behaviour to improve their health Examples of the success of hospital interactive educational systems include:
Diabetes (http://spectrum.diabetesjour nals.org/content/14/2/99.full) Stoma management (http://www.springerlink.com /content/20hn3v141j7231pr/)
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Serious Games for Health: Cognitive

Boy genius Murphy discovers a world Tween He brings in favorite foods and activities Junk food and sedentary activities become pervasive Creatures become unhealthy Murphy enlists the student to help him:
Adopt a creature Bring it back to health Learn why the food and activities make it unhealthy Learn how to keep the creature healthy

Set own (student) goals for the real world

Tween
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Serious Games for Health: Cognitive

Virtual Reality Serious Games for Pain Management: Snow World (2008)

Game has proven to be very effective in reducing pain in burns victims

Used during and after treatment

Has been evidence-based through MRI studies in 2010

Problems: - In hospital use only at present. Home Virtual Reality systems still expensive. - Repeated means may lead to decline in therapy outcome over time.
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Serious Games for Health: Cognitive

Games for Mental Health: - ReachOut Central! (aka ROC) & Second Life These modalities claim to assist youth aged 12-25 with depression, anxiety and social fearfulness. ROC is set in a soap opera setting with you being the central character learning how to adjust to a serious of social problems most youth are often faced with. http://www.reachoutcentral.com.au/ Second Life is a Virtual World that does have virtual therapists (!?)
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Serious Games for Health: Cognitive

Biofeedback Games have been found to increase learning and attention.

Journey to the Wild Divine (Biofeedback gaming for ADHD Amon & Campbell, 2008) Scientifically tested over 4 years at Sydney University with ADHD children. - Found to increase attention - Improve memory recall - Promote self-calming - Translate to behaviour improvement without the game being played! As seen on the 7:30 Report June, 2008 http://www.abc.net.au/7.30/content/2 007/s2265178.htm
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Serious Games for Health: Cognitive

Games for Cancer Kids: Re-Mission (2006) by HopeLabs Aims to reduce fear and give empowerment to kids undergoing Cancer Treatment. Power Lies Within
Roxxi the nanobot battles cancer in the bodies of teens

7 cancers 19 patients 20 levels

Study in 2006 found the game did more than empower kids!
http://www.abc.net.au/tv/goodgam e/stories/s2067977.htm

Problem: - Medical Trial Testing

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Serious Games for Health: Cognitive

Emotion/ Motivation Treatment adherence Knowledge

Re-Mission Attitudes Study Jennifer Aaker, Ph.D., Stanford University

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Serious Games for Health: Cognitive

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Serious Games for Health: Cognitive

Interactive play Passive exposure

Caudate

Caudate

Thalamus Hippocampus

Thalamus Hippocampus

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Serious Games for Health: Cognitive

Intervention-targeted knowledge (% correct)

70

p = .034
Re-Mission Control

Cancer-specific self-efficacy (1-7 scale)

Cancer Knowledge

Self-Efficacy
6.2

p = .027
Re-Mission

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6.0 Control 5.8

60

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Baseline Follow-up

5.6
Baseline Follow-up

Antibiotics
p = .008
Total MEMS Cap Events

Chemotherapy: Oral 6MP

3.8
Plasma 6MP (log10)

p = .002 Re-Mission

40 30 20 10 Control 0

3.6 Control 3.4

3.2
In press, Pediatrics Re-Mission Outcomes Study RCT 34 hospitals, 374 AYA with cancer

Baseline

Follow-up

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Serious Games for Health: Diet

Mindless Eating Challenge

OrderUp!

PickChow!

You are what you eat.

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Serious Games for Health: Addiction

Nicot

My Stop Smoking Coach

Lit Rush

Lit Relaxed

Thank you for not smoking.

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Games For Health: Disease Management

Allergies Attack

Colorfall

Peggle

Health games?
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Games for Health: Exercise

TextJab

My Happy Planet

Lifestyle?
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Can Exercise Games Increase Energy Expenditure Enough to Impact Fitness and Obesity?
Wii Fit Wii Sports EA Sports Active Sony Eyetoy PS2 DDR Rockband

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TRS Results

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TRS Results

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TRS Results

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Gaming Added to Traditional Exercise

Presence impacts motivation to play
Presence is the failure to perceive technological mediation the feeling of being there Presence predicts motivation to play a game, and motivation predicts play
(Ryan et al., 2006)

Presence has been found to increase energy expended during exergame play
(Ijsselsteijn et al., 2006)

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Video game activity levels, in METs

Vigorous

Moderate

Light

Sedentary

Lyons, E.J., Tate, D.F., Erickson, K.E., Vaughn, A., & Ward, D.S. (2008). Energy expenditure during Wii Sports minigames in overweight children: comparing data parameter selection. Presented at the Obesity Society Annual National Meeting, October 3-7, Phoenix, AZ. Includes: Borusiak, 2007; Graves, 2007; Lanningham-Foster, 2006; Maddison, 2007; Sell, 2008; Straker, 2007; Unnithan, 2006; Wang, 2006

Conclusions
Exergaming can increase energy expenditure to a level that is considered at least moderate intensity. The level of energy expenditure varies, with boxing related games tending to increase energy expenditure the most. Long term efficacy of exergames to reduce the prevalence of obesity still remains to be seen The continual development of new exciting games that increase energy expenditure is crucial if exergaming will have any long term impacts.
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Family Fit Zone

Insurance-covered 7-wk program Started in 2005 Positive results from pilot studies

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The Future: Sensors, Data & Analytics

Source: Barbara Feldman

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Thank You
Alex Gerwer asg_akn@yahoo.com (562)726-4256 www.linkedin.com/pub/1/264/32b

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