Designing Behavior Change Games

Playing games is the prototypical example for an intrinsically motivating activity and motivation in healthcare is a pivotal issue. Each year, billions of dollars are spent to move our behaviors in a healthier direction to avert crisis such as obesity, diabetes, cardiovascular disease and other costly and painful afflictions. Leveraging the motivational dynamics of gameplay to energize and sustain people through behavior change is a challenging yet profound solution.

Throughout this talk, we'll double-tap into the techniques game designers use to motivate, engage and reward players through a game’s lifecycle combining a playful approach with structured behavior change conventions.

Attendees will learn how to craft a delicate balance of challenge & reward, competition & social support, goal setting & scaffolding, rule definition, interaction patterns, persuasive arguments, meaningful feedback, fun and positive outcomes.

Transcript

1. GETTING A HORSE TO DRINK  
3. h#p://blog.santecenter.com/wordpress/?p=125  
4. h#p://blog.santecenter.com/wordpress/?p=125   MAP FOR TODAY   1.  PRIMER ON BEHAVIOR CHANGE THEORY 2.  GAMES THEORY 3.  PUTTING IT TOGETHER STEP-BY-STEP
5. @DU5TB1N | #BehaviorChangeGames FOGG BEHAVIOR GRID   http://www.behaviorwizard.org
6. @DU5TB1N | #BehaviorChangeGames OR…   BEHAVIOR TIME   NEW   BETTER   DIFFERENTLY   MORE   LESS   STOP   1x   RANGE OF TIME   FROM NOW ON  
7. COM-B MODEL   Michie et al @DU5TB1N | #BehaviorChangeGames
8. Michie et al @DU5TB1N | #BehaviorChangeGames COM-B MODEL  
9. Michie et al @DU5TB1N | #BehaviorChangeGames COM-B MODEL  
10. Michie et al @DU5TB1N | #BehaviorChangeGames COM-B MODEL  
11. SELF-DETERMINATION CONTINUUM   @DU5TB1N | #BehaviorChangeGames
12. @DU5TB1N | #BIGD12 BEHAVIOR CHANGE TECHNI QUES   Goal Setting Action Planning Self-Monitoring Feedback on Performance Skill Development Problem Solving/Barrier I.D. Relevant Content/Information Prompts/Cues/Triggers General Encouragement Social Support Social Comparison Telegraph Consequences Graded Tasks Rewards for Behavior Controlled Practice Stress Management
13. @DU5TB1N | #BehaviorChangeGames THE ROLE OF DESIGNERS  
14. @DU5TB1N | #BehaviorChangeGames THE ROLE OF BEHAVIOR CHANGE GAMES   1.  Create novelty and interest for uninteresting activities 2.  Provide planning, structure, goal-setting and routine 3.  Facilitate feelings of autonomy and intrinsic motivation 4.  Develop & improve necessary skills to enable change 5.  Provide a platform for enhancing feelings of competence 6.  Provide a platform for social support and in uence
15. GETTING A HORSE TO DRINK   TOWARDS A DEFINITION OF “GAME”   @DU5TB1N | #BehaviorChangeGames A voluntary, rules-bound experience of competitive strife towards discrete goals or outcomes.
16. GETTING A HORSE TO DRINK   MINDBLOOM   @DU5TB1N | #BehaviorChangeGames By Aetna Insurance  
17. GETTING A HORSE TO DRINK   HEALTH MONTH   @DU5TB1N | #BehaviorChangeGames By Habit Labs  
18. GETTING A HORSE TO DRINK   GOALPOST.IT   @DU5TB1N | #BehaviorChangeGames By Habit Labs  
19. GETTING A HORSE TO DRINK   REMISSION   @DU5TB1N | #BehaviorChangeGames By Habit Labs  
20. GETTING A HORSE TO DRINK   SUPERBETTER   @DU5TB1N | #BehaviorChangeGames By Habit Labs  
21. GETTING A HORSE TO DRINK   HEALTHRAGEOUS   @DU5TB1N | #BehaviorChangeGames By Habit Labs  
22. GETTING A HORSE TO DRINK   HOTSEAT   @DU5TB1N | #BehaviorChangeGames
23. PUTTING IT TOGETHER @DU5TB1N | #BehaviorChangeGames
24. @DU5TB1N | #BehaviorChangeGames UNDERSTAND BEHAVIORS IN CONTEXT + Identify key speci c behaviors Who needs to do what differently, when, where & how? + Why are the behaviors there? Initiating and maintaining factors: Motivation, habit, physical/social environment, skills + What needs to change for desired behavior to occur? + What core behavior change techniques will be used?
25. CAN IT BE TURNED INTO A GAME? @DU5TB1N | #BehaviorChangeGames IF THE BEHAVIOR BE LEARNED OR MODIFIED IF THE PLAYER’S PROGRESS CAN BE MEASURED IF FEEDBACK CAN BE DELIVERED IN A TIMELY MANNER  
26. @DU5TB1N | #BehaviorChangeGames WHO IS THE GAME FOR?  
27. @DU5TB1N | #BehaviorChangeGames WHO IS THE GAME FOR?   CURRENT “BAD” BEHAVIORS + + + MOTIVATIONAL STATE + + + SKILLS AND ABILITIES + + + FUZZY GOALS + + + BARRIERS TO SUCCESS + + + DEMOGRAPHIC INFO + + +
28. PLAYER LEVEL 01 N00B + Aren't yet challenged by the system. Challenged by learning how to play the game. + Learning how to play the game IS the game for them. + Make onboarding easy. Teach by doing. @DU5TB1N | #BehaviorChangeGames Jessie Schell
29. PLAYER LEVEL 02 PLAYER + Get the game and how it works + Have had some successes and failures and are learning how to master the game. + Most of a game's design goes into supporting this group. @DU5TB1N | #BehaviorChangeGames Jessie Schell
30. PLAYER LEVEL 03 ELDER + Have been around and in the system for a long time. + The ‘game’ for them my be played out. In order to keep them around, you can: + Create a more dif cult game + Give them Governance Privileges + Make them Team Captains or Mentors @DU5TB1N | #BehaviorChangeGames Jessie Schell
31. GOALS & THE ULITMATE OBJECTIVE @DU5TB1N | #BehaviorChangeGames
32. GOALS & THE ULITMATE OBJECTIVE @DU5TB1N | #UPA2012 GOOD GAME GOALS 1.  Concrete 2.  Achievable 3.  Rewarding + What must players accomplish in order to reach the ultimate objective? + How can you break the journey up into discrete and satisfying challenges that push your players and help them improve? ONE STEP AT A TIME + Figure out a way to make long-term and short-term goals as exciting and aspirational as possible. DESIRE TO INSPIRE @DU5TB1N | #BehaviorChangeGames
33. RULES & BOUNDARIES WHAT: Actions are moves, tasks and activities that players perform along the way. Brainstorm as many Actions as possible to support each of the key skills we are trying to develop. Think about Scaffolding Actions and how dif culty can be increased as players improve their health, condition, mindfulness, knowledge, etc. @DU5TB1N | #BehaviorChangeGames
34. RULES & BOUNDARIES WHAT: Actions are moves, tasks and activities that players perform along the way. Brainstorm as many Actions as possible to support each of the key skills we are trying to develop. Think about Scaffolding Actions and how dif culty can be increased as players improve their health, condition, mindfulness, knowledge, etc. @DU5TB1N | #BehaviorChangeGames RULES PROVIDE STRUCTURE TO ENABLE PLAY 1.  Be concise and exact 2.  Be rm 3.  Can’t vs. must 4.  Instructions are rules too 5.  Avoid too many special cases 6.  State the game's goal upfront 7.  Tell the rules like a story 8.  Create Scenario Based Examples 9.  Organize play into phases
35. @DU5TB1N | #BehaviorChangeGames MODES OF PLAY  
36. CHALLENGE AND SKILL WHAT CHALLENGES DOES THE GAME PROVIDE THAT BUILDS PLAYER SKILLS? CHALLENGE  TO  BUILD  SKILLS…  SKILLS  TO  IMPROVE  BEHAVIORS.     @DU5TB1N | #BehaviorChangeGames
37. SKILLS. HECK YEAH! KEEP IN MIND: What are the behaviors we are working on? What are we measuring? 1.  Generate a list of all skills necessary to develop in support of the change: Mental Skills, Physical Skills, Social Skills 2.  If possible, identify a core skill that can act as the main method of interaction with the game. 3.  With a list of possible skills in hand, rank them in terms of dif culty & complexity. 4.  Assess skills that have long learning curves and can be developed over longer time frames.
38. ACTIONS! TO DEVELOP SKILLS @DU5TB1N | #BehaviorChangeGames
39. ACTIONS! TO DEVELOP SKILLS @DU5TB1N | #BehaviorChangeGames ON ACTION! + Actions are moves, tasks and activities that players perform throughout the game journey. + Brainstorm as many actions as possible to support each of the key skills for behavior change you are trying to develop. + Start with the Smallest Effective Dose. + Think about how to seamlessly scaffold actions and increase dif culty or intensity as players improve their health, condition, mindfulness, knowledge, etc.
40. @DU5TB1N | #BehaviorChangeGames INPUTS & RESOURCES NEEDED   iHealth Blood Pressure Dock FitBit Striiv ZamZee SmartPhone Withings Scale Withings Blood Pressure Cuff Nike FuelBand Jawbone UP Basis + Inputting and tracking personal health data is currently a barrier for long-term engagement but devices are improving. + Consider what actionable data is most valuable to your players in facilitating change. + How can we collect and display that data? SOME DEVICES TO CONSIDER:
41. LENSES OF RESISTANCE @DU5TB1N | #BehaviorChangeGames
42. LENSES OF RESISTANCE COMPETITION COOPERATION CHANCE TIME PRESSURE LEVELS SOCIAL INFLUENCE REWARDS REAL-WORLD INCENTIVES CURIOSITY PUZZLES NOVELTY SCARCITY Jesse Schell, The Art of Game Design – A Book of Lenses Al e Kohn, Punished by Rewards   @DU5TB1N | #BehaviorChangeGames
43. THE LENS OF CHANCE WHAT Introduces randomness and probability into the system. Lack of chance leads to predictability and boredom. WHY? Once we win or near win, our brain’s pleasure centers light up and try to gure out how that happened and how to make it happen again. Essentially, obsessing over guring it out. TIPS & CONSIDERATIONS: 1.  Pepper the experience with chance strategically to keep things interesting. 2.  What in the game can be truly random? What can be made to feel random? 3.  Does the chance element give players positive feelings of excitement and challenge? 4.  Or does it give them negative feelings of hopelessness and lack of control?
44. ARF! @DU5TB1N | #BehaviorChangeGames
45. DESIGNING FEEDBACK + What do players need to know at this moment? + What do players want to know at this moment? + What do you want your players to feel at this moment? + How can you give feedback that creates this feeling? + What do the players want to feel at this moment? + How can you provide for that feeling? + What is the player's goal at the moment? + What feedback will help him towards that goal? Feedback is our means to know how we are doing   @DU5TB1N | #BehaviorChangeGames
46. DEFINE THE SKILLS CYCLES + Skills Cycle outlines how the game is played. Outlines available options for actions and what feedback will follow on performance of actions. + Like a "round" in a normal game + Actions, Rules, Feedback, Skills, Resources & Resistance. + Depending on the nature of this activity, this period could last one minute or one month. @DU5TB1N | #BehaviorChangeGames
47. TIPS ON CYCLES 1.  Make sure Skills Cycles have an obvious beginning and end – either time based (daily, weekly, monthly) or action based (every 10,000 steps). 2.  The More speci c your actions are the more speci c your feedback should be. 3.  Make sure actions available directly affect their progress in the game. 4.  A wide variety of actions will provide autonomy for players but add complexity quickly. 5.  Does the Skill Cycle provide a steady stream of escalating challenges? 6.  What could change between cycles to ensure that? @DU5TB1N | #BehaviorChangeGames DEFINE THE SKILLS CYCLES
48. PLAYTEST & POLISH! @DU5TB1N | #BehaviorChangeGames
49. 1.  What's working / What isn't? 2.  What have you not considered? 3.  Is the dif culty balanced enough for different skill levels? 4.  Is the game personal enough for your players? 5.  Do they feel that it's tailored to their own unique personality and desires? 6.  Are you tapping into Player Experience needs of Competence & Autonomy? 7.  What is going to keep it interesting in 10 weeks time? In 8 months time? 8.  When players reach the Epic Win, it's time to go back to the drawing board. PLATFORMS ARE NEVER DONE PLAYTEST & POLISH! @DU5TB1N | #BehaviorChangeGames
50. QUESTIONS?
51. Dustin DiTommaso Vice President, Experience Design dustin@madpow.net | @DU5TB1N Portsmouth | Boston | Louisville We deliver research-inspired design aimed at improving the experiences people have with technology, organizations, and each other.
52. REFERENCES: A PATH TO MASTERY Ryan, Deci, The Handbook of Self-Determination Research : Games satisfy intrinsic psychological needs Deci, E. L., Koestner, R., & Ryan, R. M. (1999). A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychological Bulletin, 125, 627–668. Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227–268. Przybylski, A. K., Weinstein, N., Ryan, R. M., & Rigby, C. S. (2009). Having to versus wanting to play: Background and consequences of harmonious versus obsessive engagement in video games. Cyber Psychology & Behavior, 12, 485–492. Sherry, J., & Lucas, K. (2003, May). Video game uses and grati cations as predictors of use and game preference. Yee, N. Motivations for Play in Online Games. Cyber Psychology & Behavior 9, 6 (2006), GAME RESEARCHER
53. REFERENCES: A PATH TO MASTERY Nic Kelman, “Yes, but is it a game?” from Games : Required essay from a not so required book. Raph Koster, A Theory of Fun for Game Design : Fun arises from Learning & Mastery James Paul Gee, What Video Games Have to Teach Us about Learning & Literacy : Pairs nicely with Koster’s book Mihály Csikszentmihályi, Flow – The Psychology of Optimal Experience : Many implications for creating engagement architectures Johan Huizinga, Homo Ludens, A Study of the Play Element in Culture : “All play means something.” Caillois, R. Man, Play, and Games. Builds on Huizinga’s Theories of Play.     GAME THINKER
54. Jesse Schell, The Art of Game Design – A Book of Lenses : Tactical and practical Tracy Fullerton, Game Design Workshop : Techniques for Of ine Prototyping and Testing Hunicke, Leblanc, Zubek, MDA a Formal Process of Game Design : Origin of the Mechanics, Dynamics, Aesthetics framework Bateman, Boon, 21st Century Game Design : Pragmatic approach to Game Design GAME MAKER James Paul Gee, On Video Games & Situated Learning [VIDEO] : http://bit.ly/jpgee The Pac-Man Dossier – A detailed study of every mechanic: http://bit.ly/vzI2QC A mathematical analysis of Candy Land: http://bit.ly/zeos34 BONUS PLAY REFERENCES: A PATH TO MASTERY
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