Nov 122007
 
Gamasutra has reported that the Robert Wood Johnson foundation has launched a new initiative geared towards adapting video games for health purposes. Just two or three years ago this would be almost completely laughable—at that time, only games with large peripherals like Dance Dance Revolution offered a reasonable chance of improving health during play. In that era, a plan like this would either be geared towards developing purpose-built health gaming systems or creating health-education games. It’s possible that some portion of this money will in fact go to the production of cheap flash games based on eating the right number of vegetables. We may even see the long-awaited Salad Master appear. However, the advent of the reasonably-affordable Wii, which has physical activity built into its control system, puts the use of games for health improvement into the home.

But why use games for this purpose? The press announcement includes a key rationale:

Computer and video games are an increasingly powerful medium, providing engaging ways for people to learn, be entertained, and connect and communicate with each other. The industry brings in more than $7.4 billion in annual revenue; nearly 70 percent of American heads of households play computer and video games, the average age of players is 33 and more than 40 percent are women. There is enormous opportunity to apply the power of this interactive medium to pressing health and health care challenges.

There’s a lot of useful information in this little quote that suggests productive avenues. Now, games produced for the PC as yet cannot include a significant amount of real motion without costly purpose-built peripherals. “Health games” for that market will mainly consist of the flash-style games I mentioned earlier. Frankly, in my opinion there is no space in the adult market for health-education games. While I do not disagree that complex and useful information can be conveyed by a game, to effectively communicate health information to an adult audience without making them feel like they are being talked down to is a task to which most interested developers are probably unequal. Health-education messages would have to be sneaked into more mainstream games for this approach to be effective.

Moreover, PC gaming is a mostly sedate experience. You are not moving around, and to create games in this platform runs counter to the overall aim. A more focused and effective approach would be to create games that involve significant amounts of upper/lower body motion for the Wii, or for the XBox and PS3. Some of this program will hopefully go towards developing health-game peripherals for the latter consoles. However, in the near term the best bet is the Wii, for a variety of reasons. First, of course, is the built-in physicality of game control. Also, the lower price-point and the accessibility of this console make it a more attractive choice for gamers with families, which will include many of the gamers in the age bracket targeted above. Additionally the Wii (and the XBox) have a built-in way to distribute simple low-cost games directly (over their respective download systems) without the typical costs associated with game publication. Hopefully the PSN will equalize this factor.

Exercise via Wii should not be assumed to be automatic. Although I am reliably informed that doing so makes one a toolbox, one can play Wii games using only small wrist motions while sitting. This suggests that games intended to produce physical activity should also include compensation to decrease the sensitivity of the Wiimote, forcing more expansive motions.

Some fragment of this “health games” program should be dedicated to developing appropriate accessories. A weighted sheath for the Wiimote, for example, could increase the physicality of a game without interfering with control. Alternately, weighted, reinforced gaming gloves that minimize the coverage of the palm and restriction of the fingers could improve the workout and diminish the incidence of “Wii wrist”. The one thing that’s missing from the Wii is something to do with your feet. One could, however, develop peripherals to deal with this. For instance, one could make a motion-sensing ankle strap (weighted even) with a long cable to reach the Wiimote. I’m not sure there’s any reason why one couldn’t develop a game in which one person uses two Wiimotes with such peripherals to enforce full-body motions. Head-to-head would require 4 wiimotes in that case, however, which starts to increase the expense. Online play to the rescue?

As far as the design of workout games, aside from the typical quality issues, the time required to play should also be taken into account. Typical sports games typically require something like 10 minutes of continuous play. Based on the intensity of the activity, doctors and kinesiologists should calibrate gameplay so that it comes in the right duration—possibly something like 15 minutes for intense play, 30 minutes for light-to-medium intensity. The duration of a gameplay unit should also be calibrated for the intended audience: a 33-year-old father of two probably can’t sit down to play for three hours every night, or even manage that 3 times a week. Games in which 30 minutes to an hour of play are enough to actually achieve something would be optimal; people who have more time can always continue.

A really clever person could also go beyond titles that are explicitly about the activity and exercise to create a title that tells a story and simultaneously achieves a physical end. The pace of the game could be modulated to encourage the right kind of exercise behaviors. For instance, an early part of each game segment could be devoted to motions that encourage stretching, build into motions that constitute the workout, pursue those motions for a calibrated workout period, and use cutscenes and puzzle segments to enforce breaks or a post-workout cooldown. Hack-and-slash adventures or RPGs could be easily adapted to such an approach, or one could use the classic shooter as a model. Using an episodic content download distribution system would keep it fresh for the player, and ensure a continuous revenue stream. Health education could even be incorporated into such a game.

The main point I’m making is that there should be a focus here that goes beyond creating a game that’s “just” exercise. Game designers are some pretty creative people—don’t come to “health gaming” with the idea that all of it has to be Wii Sports or even Rockstar’s Table Tennis. Intense physical activity can also be built into games that tell a story. Doing so might even be an advantage, especially in reaching people who don’t like the idea of working out, or who are very busy but don’t want to have to choose between exercise and entertainment.

Again I’m talking about the Wii mostly, but there’s no reason for the initiative to limit itself to that in the long run. Because it makes use of a two-hand grip, the sixaxis isn’t as conducive to large motions as the Wiimote is, but the existing Playstation Eye could possibly be adapted to exercise use. And, of course, there are always purpose-built peripherals, though these on top of the ~$400 you need for the hi-def consoles may not be as much of a broad-based winner.

Also, of course, dedicated systems for creating exercise games could also work, but I feel they will be less effective. Creating an expensive, purpose-built whole-room video game system that pushes athletic activities may draw in a few people who otherwise wouldn’t join a gym, but mostly such a system will only reach people who are willing to go to a gym anyway. That doesn’t “grow the audience” for exercise. It’s much more important to reach people in their homes, where they feel most comfortable. Also, you don’t want to make people choose between outcomes if it’s not necessary. If you create a conflict between entertainment and exercise there’s a pretty good chance they’ll choose the former. If you create synergy between these possibilities and mix exercise and entertainment in the same machine then your audience grows.

I think an initiative of this kind is a really good idea as long as the administrators don’t tie themselves into archaic or stale game styles. A flash game about colon cancer might be informative, but it probably won’t be enjoyable or entertaining, and besides it will encourage lethargy. A tennis game for Wii might give someone a workout, but hey, they already have one. The effort here needs to be dedicated to ways to make existing games into exercise (by desensitizing the Wiimote, adding weighted accessories) and to develop new modes to make future exercise games better by calibrating their durations and taking the gameplay into directions that aren’t explicitly sports.

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