But until recently, we haven’t understood exactly how game-based tools can achieve this.  What are the “active ingredients” in games that can be intentionally designed to elicit specific behaviors?  Over the past several years, HopeLab has been doing some deeper research to tackle this question.

One study conducted with Stanford Business School colleague Jennifer Aaker, PhD showed that even an hour of Re-Mission game play could cause shifts in emotion, knowledge, and perceptions of chemotherapy that might potentially influence downstream behavioral impacts.   We tested that idea again in another way by measuring the activity of brain regions involved in positive motivation, reasoning, and memory.  For this research, we teamed up with another Stanford colleague, neuroscientist Dr. Brian Knutson. We did a study that used functional magnetic resonance imaging (fMRI) (technology that measures neural activity in the brain) to map the brain regions activated when people play Re-Mission, and compare those activations with the patterns observed when people passively watched and heard the same information.  This study, which is being published today in the scientific journal PLoS ONE, showed that playing Re-Mission activates a variety of brain regions, including neural structures involved in emotion and motivation and others involved in learning and memory. You can take a look at this PowerPoint to learn more about the study.  Also, check out this excellent movie that shows the pattern of brain activation among Re-Mission game players:

HopeLab VP for Research and Development Steve Cole had this to say:  “Playing Re-Mission definitely activated brain circuits involved in positive motivation and arousal.  However, one of the most interesting things we discovered was that gameplay also activated a small region of the brain known as the hippocampus, which is involved in learning and memory.  People who showed the strongest activation in the hippocampus also showed more positive cancer-related attitudes – a major target of Re-Mission – when measured immediately after gameplay and again during a surprise one-month follow-up assessment.  That suggests that Re-Mission’s impact on out-of-game outcomes such chemotherapy adherence might potentially be related to the effects of in-game experiences on cancer-related attitudes and their storage in long-term memory.”

So what does it all mean?  In a nutshell, we learned that motivation and emotion appear to be key ways in which playing a serious game differs from watching a movie that contains the same information, and are major active ingredients in serious game effects on behavior and health.   This finding will inform HopeLab’s work as we dive into the development of Re-Mission 2, the next generation version of our cancer game.

We also learned that it’s a good idea to first develop a non-ferrous game controller for use when playing a videogame inside a large magnet.  But that is a blog post for another day…