The nonprofit recommends parking patients in front of a video game. HopeLab, however, is trying to reinvent that sedentary pastime as a powerful means to improve the health habits of young people.

The organization developed its first game, Re-Mission, to motivate young cancer patients to stay on their medicine. Now it's designing a game to spur children to play actively, so they won't join the rising number of seriously overweight kids.

Dr. Steve Cole, HopeLab's vice president of research, said such games could someday become prescribed elements of a treatment plan covered by medical insurance. "Insurance companies, health maintenance organizations, the government, all are interested in how to prevent disease in large numbers of people at low cost," he said.

HopeLab was founded in 2001 by Pam Omidyar, the wife of eBay founder Pierre Omidyar, to develop video games for more than just entertainment. The group participates in the Serious Games Initiative, a consortium of game producers trying to achieve everything from better disaster management to world peace.

If video games are ever to become a mass market health tool, however, developers will have to prove their worth to big medical insurance outfits with the money to buy them, Cole said. Individual consumers are less likely to pay for such preventive products, he said.

So HopeLab tested Re-Mission very much the way pharmaceutical companies test their drugs - in a randomized, controlled clinical trial with hundreds of subjects. The results, published in the scientific journal Pediatrics today, were encouraging.

Re-Mission singles out cancer patients about 13 to 30 years old, who often fail to take their medicines regularly. That may mean a higher rate of relapse or death, scientists fear.

The HopeLab game follows a Nanobot named Roxxi on a journey inside the body as she annihilates cancer cells threatening to multiply. The game shows players the serious consequences of skipping even a single one of their chemotherapy pills, their antibiotics to ward off infections or their anti-constipation drugs that prevent bowel ruptures.

The scenes mix fun with sober information. Roxxi uses a blaster gun to blow up intestinal blockages of poop, said HopeLab chief executive Pat Christen. "Anything that has to do with poop, kids love," she said.

The clinical trial in 375 subjects showed that Re-Mission players were more likely to take their drugs regularly than a control group that played a commercial video game. Re-Mission's positive influence varied, however, depending on the drug and the patient subgroup. HopeLab is studying those differences for clues to better game design. The nonprofit is even scanning the brain to see which parts activate during game play. The goal is to provide a scientific "recipe" that game developers can use to change behavior, Cole said.

It was HopeLab's scientific approach that persuaded CIGNA HealthCare to help distribute 125,000 free copies of Re-Mission, said CIGNA marketing executive Michael Rosenfield. The partnership inspired CIGNA's own in-house exploration of the game medium. "Culture is changing, and we need to change along with it," Rosenfield said.

Both Rosenfield and Kaiser Permanente executive Ray Baxter said their companies will consider licensing or reimbursing for commercial video games proven to enhance health. In September, Kaiser introduced its own free video game titled the Incredible Adventures of the Amazing Food Detective to teach kids about healthy eating. Kaiser also helped HopeLab with its idea competition, Ruckus Nation, which solicited concepts for a game to prevent obesity.

Serious Games Initiative co-founder Ben Sawyer said the Re-Mission clinical trial proved that games can help tackle real-world problems. "Clearly, Re-Mission shows you can embed messaging and elements for behavior change in a game and create a compelling experience around it to achieve certain results," Sawyer said.

E-mail the writers at btansey@sfchronicle.com and rkim@sfchronicle.com.

This article appeared on page D - 1 of the San Francisco Chronicle