The Importance of User Design in Games for Health

by Maisha Razzaque

Looking to regulate your sleeping habits? Searching for a way to teach sexual health? There’s an app for that. In today’s web-based world, games for health are rocketing in popularity. These “serious” games are specifically designed to encourage behavior changes to treat a health threat. Naturally, we are inclined to ask about the validity of the games: do they work the way they were designed to work? Can serious games be used to improve health outcomes? However, we may not consider the important role of user experience — how easy and pleasant the game is — factoring into the game’s influence. Paying attention to how a game is designed and what human interaction factors considered during its development may hold the key to the future of health-based games.

Gamification in a Nutshell

Using games to affect change in real life isn’t a new concept. Educational games have been a prominent feature in the integration of technology and grade school learning since the early days of funbrain.com and Mavis Beacon. These games use the theoretical approach of teaching and testing content in small quantities — having student pass a level before moving on to the next one. The late 90s birthed the exergaming (exercise + gaming) industry — utilizing movement tracking and virtual reality to turn movement into play. In 2013, we saw the integration of health metrics, heart rate and a pedometer, into these “exergames” with Nintendo’s Wii consoles. The most visible case of implementing health goals in game design today can be found in trending augmented reality apps like Zombies, Run! and Pokémon GO. One study assessed the walking and sedentary habits of young adults before and after downloading the game Pokémon GO. The GPS-based game requires players to use their phones to search for virtual Pokémon characters as they walk through real-world locations. They found that Pokémon Go was associated with increased walking and decreased sedentary behavior. Some unexpected negative side effects of a semi-virtual game that the experimenters found included the dangers in the environment as the user is walking right into it, too immersed in his/her phone to notice! This is an example of a real-life “bug” that needs to be addressed in these mobile exergames by the developers of the programs. Perhaps the lesson here is that the health benefits of resulting increased physical behavior can only be a priority if the safety of the user in any potential semi-virtual game is accounted for by the designer. After all, what good is an app that raises your heart rate and encourages exercise if the trade-off is mistakenly walking off a cliff?

Psychological Models in Games

Encouraging health-positive behavior and tracking metrics are a great start. However, to delve deeper, we need to start at the conceptual design stage of the game. The question of gamification pivots from “does the existing design work” to “how do we design it to make sure it works?” This is where experts toy with the idea of implementing psychological models of healing in health game design—specifically, the Health Belief Model.

According to the Health Belief model, an individual’s intention to “engage in health behavior” — this includes both positive and negative behavior — can be determined by their perception of their own vulnerability to health threats and consequences. In more technical terms, the user will behave based on self-perceived strengths and weaknesses. So how do you go about using the health belief model in conceptual design: in serious games that use role-playing and sci-fi/action themes to encourage diabetes management, users are rewarded when health landmarks are met.  This offers incentive for health record integration in the game — all to ensure that metric and therapeutic goals are accomplished in the process of playing the game.

Researchers at Johns Hopkins examined design principles of serious games (for patients with chronic illnesses) based on the Health Belief Model and their influence on the games’ effectiveness in health outcomes. Adolescent participants were recruited for user experience evaluation of the games, and they found that implementing the Health Belief Model in healthcare game design increases usability in games, improving the efficacy as a health tools. But that’s just one model. In the context of future experimental design for other chronic illnesses, it’s important to gauge the value of implementing appropriate models when designing games. However, if there’s one thing that can be taken away from this study, it’s that it sets an essential precedent. If our end goal is to improve health outcomes using games, then we need to use professionally developed tools for healing while designing them. The psychological model is an a necessary perspective during the design of health-motivated games.

One Dish, Many Cooks

The idea of different perspectives comes into play (no pun intended) in game design when we talk about the human factors behind health-based gaming. Recent studies have found evidence that may explain the convergences as well as conceptual differences between the different experts. Obviously, game design experts are most sensitive to the mechanics of the game, but they tend to prioritize the player’s autonomy during the experience. They view the integration of gameplay and health behavior in terms of two distinct concepts. On the other hand, health experts interpret player autonomy in the context of health. They are more likely to comment on the “fun” games in contrast to the “serious” games, and they are more likely to discuss game and health concepts less in the context of integration but rather in terms of a causal relationship — game mechanics were to model health behavior. In contrast with these single-discipline groups, games for health experts view content and interaction of the while emphasizing the outcomes and objectives of both the games and health behavior. According to games for health experts, the game mechanics — its own separate entity — are responsible for producing health outcomes. These findings can be applied as conceptual tools during the design process to make sure games are made with the intent to produce desirable health objectives.

Why Do I Care? Why Should You?

I’m nearing the end of my master’s program for applied cognition and neuroscience, and I’ve been spending its duration performing cognitive tests (testing memory and attention) on volunteer participants during a cognitive training regimen. What is the cognitive training in question? Any guesses?

If you thought “games,” you thought right. And since taking a special interest in human-computer interaction theory during my undergrad years, I can’t help but speculate on the relationship between the user experience of the games that we use for cognitive training and the behavioral and neurological effects that we investigate.

Are games the future of cognitive and physical health? I can’t definitively say that for sure, but I can be pretty confident that digitizing and gamifying health is and will continue to be an important tool in a holistic approach to manage health. The studies I mentioned earlier make it evident that the technological component of health games is not only important in terms of validity but also usability. If we plan to continue implementing games into behavioral health and cognitive training as aids in metrics, management, and even enhancement (in the terms of cognitive training), we have to pay attention to the multiple factors that go into designing the games themselves. At the risk of sounding corny, I feel like the conclusion I drew from this little investigation could be summed up in a little phrase: better game design allows for better user health.

References

Digital Emotes

Using​ ​Biofeedback​ ​and​ ​Facial​ ​Tracking​ Technologies to Abstract Emotions.

In his 2018 Master’s Thesis, Aaron Tate details his project to “create​​ an artistic ​visualization ​​that ​​would ​​use both electroencephalogram ​and ​​facial ​​tracking technologies ​​as ​​input​​ devices driving creative compositions in a digital interface. ” Taking influences form data visualization, cognitive science, art, and aesthetics, Digital Emotes is an interesting look at the integration of artistic visualization and neuroimaging to produce a visual reflection of current emotional state.

There Is An App For That!

by Maisha Razzaque

“Noom isn’t just your average dieting app. It’s goal-oriented psychotherapy that helps you think critically about the food you’re eating.” I heard this pitch a few weeks ago during a radio ad, and I thought: wow, I like that way of looking at food tracking. I’d totally use this app.

Except I already have.

Here is a comprehensive list of apps I have used, am using, or have downloaded with the idea of future usage in order to regulate and maybe even improve my productivity, diet, and overall physical and emotional health: Noom (food and exercise tracking), Clue (period and ovulation tracker), doc.ai (personalized health data), Calm (mood tracking), Sayana (mood tracking), 30 Day Fitness (exercise tracking), Lifesum (Macro Tracker), Flora (habit tracking), Reflectly (anxiety tracking), Focus Keeper (time management)— I’ll stop here. You get the point; there are a lot.

Reading a book, going for a run, eating a meal, and relaxing are all supposed to be pretty uncomplicated activities for most people. Yet, I — and I suspect an alarming number of others — have overcomplicated it to a point of chaos. The question remains: why did I convince myself that I need a billion apps to regulate my life?

Six years of being in school has taught me to look to the research. According to the Health and Wellness Foundation, 60 million people in the United States are using some sort of mobile health app. And, as studies indicate, a majority of those users are female millennials. The promise of these apps basically can be boiled down to something called the Health Belief Model. Developed in the 1950s, the Health Belief Model is a systemic method that identifies health behavior; the main gist of it is that an individual’s intention to “engage in health behavior” (positive or negative) is directly related to how vulnerable to health threats they believe themselves to be. The user will act according to his/her own perceived strengths and weaknesses. Health apps enable self-monitoring which, in theory, should lead to some positive effects. Mobile health apps are essentially a user-friendly tracking journal on your phone, and for the most part you don’t have to analyze your own data because the app does it for you. It can even be helpful to bring this sort of data to your healthcare provider if you’re trying to manage a chronic condition (e.g. blood sugar, blood pressure, heart rate, etc).

When it’s put that way, it doesn’t sound so bad, so what could go wrong? It turns out, a lot.

What starts out as helpful information from well-intentioned apps can turn into data overload. As a result, this can exacerbate health anxiety — a phenomenon in which a person has an irrational preoccupation with possible health threats. For people with certain proclivities to obsess over calorie/exercise tracking, these apps can actually be enablers of unhealthy behaviors. There is also the question of validity. Many mobile health products are self-report models. What if you don’t know the exact calorie count in a home-made meal or the “intensity level” — something a version of MyFitnessPal has asked users to report — of your cardio exercise? Without valid data, the analysis provided by these apps is not useful to managing health at all!

Last of all, we have to look at the money.

In 2019, the mobile health app industry made $3 billion in sales. A lot of this money is coming from advertising, but what the average user might not know about is the amount of personal data being harvested and sold to third party companies. In 2018, several period app companies including Glow and Flo got into hot water because they were selling personal data about people’s menstrual cycles to companies that were, in turn, using them to create targeted ads. Suddenly, aggressive online ads for baby clothes and cribs would coincide with a missed period. But is hot water the right way to describe the backlash? There were no legal consequences; In fact, most of these apps have tiny, tiny print stating that you’re allowing them to do whatever they want with your health data the moment you tap “install.”

But surely, you’re thinking, there are some legal standards to protect people from this kind of predatory data mining.

That’s just the thing. Mobile health apps have taken the market by storm and seemingly transforming how people are looking at health management overnight. The legislation has simply not had the time to catch up. The sheer vastness of the mobile health market makes it hard for the average user to judge quality. The FDA’s oversight of mobile health products has been met with a lot of handwringing. Pushback from the industry has been hanging on the argument that overregulation could hamper growth and innovation. Nathan Cortez, a law professor at the Southern Methodist University, has suggested broadening the FDA’s jurisdiction. In a 2014 article about FDA regulation of mobile health apps, he argues that the existing legislation that limits the FDA’s involvement is bad for doctors and dangerous for health app users. He proposes that Congress should consider allowing a professional third-party to evaluate the algorithm and quality safeguards outlined in an FDA regulatory guides. Since then, a 2017 redraft of the FDA’s regulatory guidelines has tightened regulations of diagnostic apps — ones that physicians use to aid with making clinical diagnoses. The wheels of government regulation turn slowly — so, so slowly — but surely.

What I’m piecing together from this crash course on mobile health products is that these too-good-to-be true apps might not work, may be using my personal data, and aren’t being closely regulated. But why did I convince myself I needed so many of them in the first place? The answer, as you may expect, isn’t quite so simple. It can be broken down into a few pieces. Maybe I may have not been the one doing the convincing. If everyone is touting the newest and best app that’s transforming their lives, it’s natural that I should want in. When my favorite disembodied nutrition podcast host voice tells me to take control of my life by downloading Noom, I just may do it. Perhaps, I — and the aforementioned millions of users — have fallen prey to the phenomenon of “too much data”; it’s very easy to rationalize that somehow having “more” apps is the same thing as having “better” apps. Then before you know it, you’ve used up all your phone storage on six different AI Mindfulness apps. Despite all this, I haven’t reached the conclusion that the apps are bad. After all, people just want to take an active role in their health. Understanding mobile health apps can help us critically think about which ones can better meet our needs and which ones are just unnecessary noise.

Sources:

Local Esports Gaming Hubs!

by Semra Zamurad

As an avid gamer myself, I was drawn to the Esports Cyberathlete Development (ECD) co-design group’s mission: to gain a better understanding of how gaming supports positive social and cognitive growth in cyberathletes. My educational background is rooted in psychology and I am interested in how technology can be used to benefit psychological background and research. To learn more about this, I am lending my expertise in studying human behavior from a biopsychosocial standpoint to the efforts of the ECD team.

As we move forward on our academic journey, we have discovered the necessity of operationally defining the behaviors we seek to understand and making sure that those definitions remain consistent across raters. To operationally define a behavior essentially means to define a behavior in a specific, concrete, and measurable way. This is especially important when more than one researcher will be taking part in an observation. For example, if we were looking for signs of exhaustion, one observer may consider rubbing eyes to be a sign of exhaustion while another observer does not. High levels of inter-rater reliability (referring to how similar the data collection is between the observers) are imperative to the success of study that has key qualitative components. As such, I was tasked with looking into places that the ECD co-design group could practice observing gamers in their natural environment, as well as compiling a list of non-academic resources members could use to supplement their general knowledge of gaming culture.

The following list refers to several locations within the DFW complex that offer gamers and those interested in learning more about Esports a site to gather at and to take part in the experience there.

  • EZ Gaming Café
    • Vibe: minimalistic; snacks and drinks offered from deep freezer, metal shelves
      • Hosts local tournaments
      • Offers PC gaming and consoles (Nintendo Switch, PS4)
  • Nerdvana
    • Vibe: “Games with your coffee” kind of place; café/bar first, with games you can play while eating/drinking
      • Café and board games
      • Bar and videogames
      • Free to play with minimum $10/person purchase
  • Geekletes
    • Vibe: grassroots Esports competitions that serves as a training ground for aspiring gamers
      • Host local tournaments
      • Provide courses on how to navigate and excel in the industry
      • Recruiting and exposure
  • Java Gaming Café
    • Vibe: minimalistic but luxurious
      • Serves drinks to players at their PCs
      • Two floors
      • Hosts local tournaments
      • Offers PC gaming and consoles (PS4, Wii U, Xbox One)
  • PLAYlive Nation at Stonebriar Centre
    • Vibe: social gaming lounge housed in Frisco, powered by Simplicity Esports (merged); high-tech aesthetic (blue neon lights, generally dark, leather seating)
      • Specializes in Xbox One and popular table games (e.g., Magic the Gathering)
      • Offers VR gaming
  • AK PC Gaming Café
    • Vibe: similar look to an office building; identifies as an Internet café
      • PC gaming, web browsing, workstation
      • Offers food and drinks (snacks, soft drinks, coffee, fries)
  • Esports Stadium Arlington Gaming Center
    • Vibe: largest dedicated Esports facility in North America
      • Offers PC gaming and consoles (PS4, Nintendo Switch, Xbox One)
        • Must bring your own controllers and headsets, or rent some from them
      • Hosts local tournaments
      • Offers food, drinks, and merchandise

However, simply being aware of the existence of these places may prove to be insufficient in supplementing our comprehension of gaming culture even if we were to visit. In order to effectively supplement our collective knowledge on Esports and gaming in general, I also put together a list of non-academic resources that are easily accessible and may explain cultural concepts in a simpler fashion. This list includes apps, attractions, and movies to gain a better understanding of Esports’ evolution.

  • WEBTOON: No Scope by ZOYANG
    • A webcomic about a fictional Esports game called PSI BOND and high school players attempting to become pro players
    • Gives insight into player housing, recruiting, team building, basic aspects of Esports, women in Esports, Esports in Korea
  • WEBTOON: Let’s Play by Mongie
    • A webcomic about a game developer whose game is given a bad review by an Internet celebrity (“lets-player”).
    • Gives insight into different types of games and gamers, impact of a gaming-centered career on mental and physical health, skills necessary to excel in a gaming-centered career (mainly game development)

  • BBC documentary: The Supergamers/Rise of the Supergamer
    • Looks into the lives of select teams and players as they train, live together, and learn to play together, striving for the common goal of making it big as a cyberathlete
Preview

  • Netflix documentary: League of Legends Origins
    • Details the rise of the popular MMOBA game League of Legends, its start as a free demo to an Esport game
Trailer

If you or someone you know enjoys visiting any of the aforementioned gaming points or is aware of more non-academic resources that can help explain gaming culture, please feel free to contact the Esports Co-Design Group Project Manager, Lauren Bernal, at Lauren.Bernal@UTDallas.edu.

Franklin Osuagwu transitions out of role of Lab Coordinator

Franklin Osuagwu’s timeline as Lab Coordinator at the ArtSciLab.

Franklin Osuagwu started working at the ArtSciLab in June 2019. After the exit of Kyle, he came in as the new Lab Coordinator. While working at the lab, his major duties were organizing the MOWG meetings, organizing the weekly watering hole events, and finally creating a cybersecurity plan for the Lab. As he steps ahead in his career path moving forward, he conducts a final interview with Alex Topete on his experience and next moves.

What was his first Introduction to the ArtSciLab?

Franklin initially had no prior knowledge about the Lab. Being an electrical engineering major, he had no information about activities going on in ATEC, least of all, the Watering Hole. He found about the lab through the lab coordinator job posting on Handshake last summer.

How did Franklin rate his experience at the ArtSciLab?

Franklin loved his time at the ArtSciLab. He always found a chance to speak about how Roger and the rest of his coworkers were. He was able to make new valuable and professional connections. One thing he mentioned he loved mostly the lab was that it also served as his new “chilling spot” in between his classes.

Is there any new skill that Franklin picked up through his experience?

Franklin indicated that his management skills were on an all time high. His constant interaction with people in the lab helped him know how to manage and deal with people in an ideal work environment.

Difficulties while working at the Lab?

Franklin mentioned that one of his major issues was communication. In terms of people responding to emails on timely manner. He further mentioned that he would have loved a better attendance of lab events by its members, more especially the Watering Hole held weekly.

Where is he heading next?

Franklin is currently working as an IT intern at Epsilon. His internship is expected to run from January till December when he graduates. He will still maintain relationships with the Lab, serving as a Lab ambassador.

His final note his former teammates and coworkers are “Be sure to catch me at future watering holes.”

A Spoken Word on Life and Death

Dr. James L. Carter, geoscientist, and associate professor emeritus at the University of Texas at Dallas, passed away on September 21, 2019, in his home at the age of 82. To honor James Carter, ArtSciLab member Ayen Deng has written and performed a spoken word poem in memory of the way he inspired all those who attended his last lecture on September 20, 2019. The slides in this video are from his lecture to accompany the performance.


A Review of Virtual Menageries: Animals as Mediators in Network Cultures

by Michael Warner

Virtual Menageries puts us back in time amongst the collective elites. Berland forms a cohesive genealogy of the “menagerie” to encourage, challenge, and deconstruct our modern perception of non-human animals and their relationship to human meaning and existence. Virtual Menageries looks through the lens of mediation to draw affective and emotional weight to animals as symbolic messengers in the digital era. From the giraffe, to the beaver, virtual art, digital communications, cats, birds and music Berland maps out how animals have become not only the mediators that bridge worlds together for good, but also as the trafficked subjects of terror: tools made to control, methods for silencing, opportunities to proliferate a message, and catalysts in profiteering.
 
The book begins with a question that led to a series of other questions: “Why are there so many cats on the internet?” (Pg. 1) Which then led to thoughts about the roles of animals as symbols and figures in contexts. “How do animals help manage our perception of the Anthropocene? How do they disrupt our own relationship with digital technologies if they are so abundantly apart of them? If they are mediating in new ways, what content are they mediating, and in what context?” (Pg. 1) These are all questions that threw the book and Berland’s project into fruition.    

To read the full review:

ArtSciLab Talkshow: A new series on The Bold Roast

Produced and created by Maisha Razzaque, a new series has launched on The Bold Roast: Student Conversations channel on Creative Disturbance.

The ArtSciLab is home to collaborations between artists and scientists who investigate topics such as experimental publishing, data sonification, data visualization, and the hybridization of art and science. This series is an audio experience that allows the spotlight to fall on its members as they talk to us about their careers, contributions, and passions.

Click here to listen to the first episode of The ArtSciLab Talk Show.

The Voices of Science

Before things were written they were spoken. The Spoken Word has a rich historical basis, especially amongst traditional African societies where culture and knowledge was passed down in the form of riddles, proverbs, stories, poetry, music, and design. Today, spoken word remains a fundamental form of communication, though its limits in academia are rarely challenged. Spoken word poetry is a tool to communicate social issues. Today, it is increasingly popular among the youth with so-called ‘poetry slams’ happening all around the world. Spoken word is appealing as it is impactful and lawless. There are no literary restrictions that define what it is. Instead, it takes a more performative approach, aiming to reach — even interact with — its audience; it is centered on involvement and exchange.This is what makes spoken word, as a type of poetry, powerful: It surpasses communication and creates a participatory audience. Contrastly, scientific phenomena — especially with increasing reliance on technological tools — long ago left the realm of our physical experiences. Consequently, there expands a chasm in intellectual exchange across science and other disciplines that calls for the expertise of a poet. The poet’s role will be to create innovative, metaphorical models in words and to express the often abstract and intangible phenomena in science. The very nomenclature of science, which is often times misleading, could benefit greatly from the collaboration of a poet.

It is the ability of a word to transmit meaning from one consciousness to the other that has significance and power. There is a biblical story of people of one language, building a tower with the intention to reach God. Eventually God decides to confuse them by mixing their languages — thus, the place was given the name Babel, meaning a confusion of voices in Hebrew. The sudden shift in communications, one might imagine, would lead to the development of diverse cultures and ideas. Therefore, metaphorically speaking, the growth of the tower was no longer able to be focused on only one dimension.

To a large extent, the language of science is mathematics but supplemented by words, diagrams, or images, each of which acts as a model to communicate reality. Going deeper into the study of science, particularly physics, it becomes impossible to deeply understand, let alone explain, phenomena without mathematics. One can see mathematics, the main language of science, taking a tower-like trajectory; It becomes increasingly complex and eventually, too high for unspecialized populations to reach and interact with. And when things cease to have the capacity to be understood and influenced; then, they lose their power to progress and diverge through otherwise diverse minds.

The word ‘Science’ itself carries heavy cultural connotations. Science could be seen as a dreaded school subject, a subject that is distant for people unexposed to its exciting study. How the scientist sees him/herself depends on their level of experience as a scientist. Personally, science has evolved from a de facto puzzle of a classroom study to one where there is a lot of structured seeking with a lot of room for speculation, interpretation, mistakes, evolution, and a lot of meticulous tedious work and creative planning.

Ideas of scientism stating that science is a closed box, superior to all other modes of intelligence, not only limit but harm our society.

Science affects everyone and exists in all of creation. It is understood in one way by scientists another way by artists, poets, spiritualists and other disciplines. All these distinctions are relevant for practical purposes. They are not laws. Our strength and integrity as a society will be found in open exchange between science and the other disciplines. Such permeabilities are what will allow us progress in multiple degrees of freedom, adding wealth to science studies and how we as a diverse persons view and interact with it.

One of the entry points in which such exchange can occur is our reliance on models to understand and discover new things. The very model for how learning takes place includes formation of new networks of knowledge upon already existing ones. Our minds work like an intricate web making connections in order to understand and develop ideas. In her book Models and Analogies in Science, Mary Hess makes reference to positive, negative, and neutral analogies. Negative analogies being those that we know are unable to fit into a description, positive being those that agree, and neutral being those that are unknown and have the potential to be investigated. This is where spoken word poetry comes in. Poetry would excel at making connections between science principles and unexpected elements of life, juxtaposing vivid imagery which enlivens striking metaphors and narratives — engaging the scientist, science, and everyday life.

For example the verse below:
“Our consciousness , so close, yet so distant, allows us to travel at the speed of light when we fall in love ;(that’s about a 24 times a year for me- twice a month before and after ovulation) But like two ends of the same string, we sink to normality in the greyness and redness of stuff. Though we are made of things that are the substance of light , we can only pulse in inconsistency”
This describes how time dilation, that occurs in general relativity, is the same kind that is experienced by humans when they are focused or feeling intense emotions such as pain or love. One can model traveling at the speed of light to be analogous to being deeply focused or in intense enjoyment where the actual time is moving much faster than the time internally experienced. It also touches on the wave particle duality, and the relationship between physiology and personality.
Spoken word could lead to a plethora of analogies with the potential to be sorted and investigated. Neutral analogy is just one of the pathways that could lead to research investigation, thereby spoken word poetry is a prime example of art as a research method. It can clearly be used in learning. It’s not uncommon for fantastical scenarios such as: “ What if you found yourself in space holding a….” to be used in a classroom question, but it is often not taken further. Though metaphors might shift from their origin, they always find their way back in some form. Vital is the kind of imagery and metaphorical tension existent in engaging spoken word narratives that trigger the mind’s imagination in ways that information in itself could never dream of.

“Imagination is more important than knowledge. Knowledge is limited. Imagination encircles the world,” (Albert Einstein).

Spoken word most importantly holds the power to open room for discourse between unexpected combinations of people.

There seems to me, a great potential to develop scientific spoken word exchanges for the stage, research, learning, creating art, and cultural revolutions.

References

“What is Science” by Sundar Sarukkai
“A review of African Oral traditions and literature”: by Harold Schlub
“Ways of Seeing” by John Berger
“Making science intimate” by Roger Malina
“Science et cetera et cetera for poets et cetera” by John A Moore
“Genesis” Judaic Bible