Investigating the Potential of Interactive Media to Encourage Engagement with Type 1 Diabetes Management

Proceedings of the Seventh Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2014), Auckland, New Zealand Investigating the potential of Interactive Media to Encourage Engagement with Type 1 Diabetes Management ALEXANDER S. BORSBOOM1 1 Department of Software Engineering The University of Auckland, Private Bag 92019, Auckland, New Zealand, Email: [email protected] Abstract (Hiss 1996). Unfortunately, Diabetes is very common and thus the large number of sufferers to whom The effective management of type 1 diabetes is very assistance must be provided directly impacts the vi- challenging for a number of people. Improving the ability of many proposed diabetes treatment plans. management skills of those suffering with the disease One solution which remains unhindered by the vol- is even more so due to the sheer number of Type 1 di- ume of diabetes patients is video games. A video abetes sufferers. We believe that a serious video game game can be replicated many times and thus is suit- which targets diabetes education has the potential to able for distribution amongst large numbers of peo- significantly improve the management of Type 1 Di- ple. Video games can also be designed in such a way abetes. In light of this we have developed a series of that they are able to dynamically reconstruct content game mechanics which are able to represent Type 1 in response to a number of user specified properties, Diabetes management in a video game. We have de- thus allowing the gameplay experience to change to veloped a prototype video game to demonstrate the represent the circumstances and specific issues facing effectiveness of these game mechanics, and we have a player (Booth 2009). This report details the con- identified potential areas of future development in this struction of a prototype video game "proof of con- field. cept" which demonstrates the feasibility of creating a serious video game to teach people about effective Keywords: Video Game; Serious Video Game; Dia- diabetes management. The report also outlines a set betes; Medical Video Games of game mechanics which can be used as an effective representation of Type 1 Diabetes in a video game. 1 Introduction The video game proof of concept was produced using the Unity 3D engine. Diabetes is a serious medical condition with far reaching consequences on the lives of those living 2 Serious Video Games, Educational Games with the disease and their friends and family. Ef- and Gamification fective management of diabetes requires the management of many interrelating systems such as diet Traditionally, a video game consists of a rule based management, exercise management and medication system with which the user interacts for their own en- management (Hanas 2007). Failure to effectively joyment. These rules which make up the core video manage the symptoms of diabetes can lead to se- game interactions are referred to as game mechanics. rious health consequences: Hyperglycemic episodes The focus of the video game is entirely placed upon can lead to blindness and organ failure, while hypo- the user's enjoyment, which usually is achieved by glycemic episodes can lead to fainting, mood swings, overcoming challenges, although more recently some anxiety and dizzyness. Effective management of dia- video games have achieved this by allowing the player betes symptoms is challenging and an area of inter- some form of self expression, such as the extremely est to many. Better symptom management has been popular video game Minecraft, in which players build shown to reduce the long term health impact of di- their own worlds, buildings, mining systems and in- abetes on patnts lives (Norris, Lau, Smith, Schmid dustries. & Engelgau 2002)(Norris, Engelgau & Narayan 2001) Educational video games have existed since the (Deakin, McShane, Cade & Williams 2005), as well as advent of video games themselves. We use the term reducing the financial burden the disease places upon "Educational Game" here to refer to a specific style of New Zealand as a whole (Wagner, Sandhu, Newton, video game common to early educational video games McCulloch, Ramsey & Grothaus 2001). Additionally, and children's learning games. We define the term it is known that tailored healthcare which accurately as a game where the rule based system which forms represents and deals with the issues facing individu- the core of the video game relates to knowledge. For als and their circumstances is significantly more ef- example, there is geographic knowledge in the core fective at improving healthcare outcomes when com- of the popular Where in the world is Carmen San pared to non-tailored solutions (Mensing & Norris Deigo? series, or there is skill based knowledge, such 2003) (Rickheim, Weaver, Flader & Kendall 2002) as algebra or mathematical skills, in other children's Copyright 2014, Australian Computer Society, Inc. This paper games. Users must complete challenges using these appeared at the Australasian Workshop on Health Informatics skills, thus the game reinforces gained knowledge and and Knowledge Management (HIKM 2014), Auckland, New encourages education. This form of video game is very Zealand. Conferences in Research and Practice in Information common in the educational space ( sometimes referred Technology (CRPIT), Vol. 153. J. Warren and K. Gray, Eds. to as an edutainment game ) and is distinct from other Reproduction for academic, not-for profit purposes permitted genres of video game. When dealing with diabetes, it provided this text is included. is very challenging to accurately express the informa- 13 CRPIT Volume 153 - Health Informatics and Knowledge Management 2014 tion required for a patient to improve their symptoms the time showed that participants felt more comfort- management in this traditional format. Medication able discussing their diabetes with friends and family and treatment information cannot be reduced to a (DeShazo, Harris & Pratt 2010). series of truisms and maintain its accuracy. Several projects have taken a different approach A serious video game is one that is designed with and attempted to use gamification in conjunction a primary purpose other than the players enjoyment, with blood glucose measurement tools. Didget is and is most commonly found as a simulation game. one such system (Klingensmith, Aisenberg, Kauf- It is sometimes very difficult to distinguish between man, Halvorson, Cruz, Riordan, Varma, Pardo, Vig- a serious video game and a normal video game. Con- giani, Wallace et al. 2011). Consisting of a blood sider the example of SimCity, a popular city simula- glucose monitor which functions as an attachment tion game released by EA in early 2013. SimCity can to the popular Nintendo DS handheld gaming plat- be clearly viewed as a video game yet can potentially form. The Didget device comes with a selection of be employed as an urban planning tool. Other ex- minigames which require that the player to take their amples of game which appear to be both serious and own blood glucose level as a gameplay element. Ad- not include the popular video game ArmA 2 which is ditional minigames can be unlocked as a reward for used by the United States Military for combat train- frequently using their glucose monitoring device. An ing and simulation. The serious game Fold-it is pos- evaluation study carried out in 2011 found that par- sibly the most well known serious game - it allows ticipants who were using the Didget system found it users to experiment with protein folding in a puz- to be motivating and helpful for building good blood zle solving environment. Players are able to deter- monitoring habits (Klingensmith et al. 2011). mine the folding pattern of a key protein involved in Left 4 Dead 2 is not an educational video game. the replication of the HIV virus, which is included It does, however, include a "Director" - an artificial in the video game as a solvable puzzle. Foldit play- intelligence capable of redesigning the game world to ers sometimes outperform state of the art computa- present new and interesting challenges to the player tional algorithms (Khatib, Cooper, Tyka, Xu, Make- (Booth 2009). This can take the form of moving item don, Popović,Baker & Players 2011). Serious games pickups and ammo, to altering the weapons available feature far more complex game mechanics than an to the player. Most importantly, it can change the en- educational game - players are expected to learn to emies the player must fight to create dramatic tension understand the system being modelled by the video at key moments and ensure the player is constantly game through experimentation. engaged with the game. Such a system could easily be extended to dynamically determine the challenges a player faces based upon their own medical history, 3 Related Works allowing a game to be tailored automatically to the This area is not an unexplored one; a large number player's particular medical requirements. of educational video game have been developed, in- cluding a significant number targeting diabetes ed- 4 Advantages of Video Games Over Other ucation. Projects such as the "Escape from Diab" Media aim to encourage those who play video games to exercise more and monitor their food consumption more Video games as a form of interactive medium have closely, while some other research groups are attempt- several significant advantages over other forms of di- ing to introduce gamification into diabetes medica- abetes education. One advantage which can be eas- tion systems (Thompson, Baranowski, Buday, Bara- ily seen and potentially will have the most impact is nowski, Thompson, Jago & Griffith 2010). the easy replication of the product. Tens of thou- In the videogame the "Escape from Diab", the fo- sands of diabetes sufferers can be provided with a cus of the project is to encourage consumption of low copy of a video game for no additional cost. In ad- energy density foodgroups such as fruit and vegeta- dition to this, it is known to researchers that provid- bles and to encourage physical activity amongst obese ing customized and tailored assistance to patients can youth.

Load more