Health Games. Who Wins?

• by Ted Smith , July 16, 2010

Over the past year, a number of start-ups have formed and a few established businesses have created offerings that package health and wellness in the form of social games and challenges. Can social media create a platform to make us healthier?

Companies in this new race include Contagion Health and Fitfeud in the overall fitness-wellness category and some disease-specific organizations as well. These businesses follow either an employee benefit model or an advertising model.

On the employer-sponsored side, there is a great heritage of human resources-sponsored activities that broadcast or mandate participation in activities designed to place attention on something deemed a "win" for the employee and a "win" for the organization. In health, the targets are typically increasing physical activity, reducing smoking, and improving diet.

On the consumer-driven side where programs often contemplate advertising as a revenue potential, there is much focus on a kind of psychographic contextual targeting opportunity that must certainly be there -- after all, you have a committed person who is actively engaged in something like weight loss -- why not introduce a coupon opportunity for a healthy snack, supplement or maybe some co-morbid pharmaceutical product?

Have technology-mediated games been "game-changers" in health?

The first time I saw an exercise bike connected to a video game in a commercial sports club was the HighCycle in the 1980s, and I thought to myself that health and entertainment were poised to fuse and grow because being healthy is fun now! Nearly three decades have passed since that exercise bike video game and the obesity rate, according to the Centers for Disease Control, has climbed from 25% in 1989 to 40% in 2006 and is still climbing.

The reality is that the track record of adoption of these concepts has been very poor. It would be very fair to say that the technology of the '80s and '90s was not what is needed to be. In the last few years, Nintendo has delivered a consumer health game experience in Wii Fit Plus that was in the hands (and under the feet) of over 12 million people by March 2010. Maybe there is a future in these tech hardware platforms after all?

Gadgets aside, many of the new breed of ventures in health games are using interactive social media like Facebook and Twitter and Twitter-like things to capitalize on the new media habits and support networks that have been developed. There is an expectation in these games that the fun is in the sharing of goals and support. Many of these programs see employers and health plans as part of corporate wellness programs.

And then there is psychology

Having done a fair amount of research into this area, I find it is hard to get past the cheerleading for wellness programs to the issues that truly matter. If you are an employer, you want a program that improves health for everyone. If you are a marketer, you want to reach enough consumers to make it worth your effort. A few things that I hope to see this industry address:

1) Why, behind closed doors, do insurance company executives and human resources managers tell me that those who would benefit the most from these programs participate in them the least? That is to say, wellness programs have an established track record of being most effective for those who are either fit or marginally fit. They don't work so well with people who have a high BMI or other health problems.

2) Several studies (including one I co-authored with Jim Burroughs at the University of Virginia) have shown robust segmentation of those who have chronic conditions based on psychological traits such as self-efficacy. This may be part of the reason wellness programs work best with only part of the overall population. Game designers need to take into account what will appeal to empowered consumers/patients as well as resistant consumers/patients.

Do we need different games for different kinds of people?

This is not a "should we use Facebook or not" question, but a bigger one about the kinds of games that engage different kinds of people. Does everyone respond equally to the thrill of getting on the Dunder Mifflin warehouse scale (obscure reference to an episode of "The Office") for the team weigh-in? Does the idea of "putting it out there" to your Facebook friends that you are really trying not to eat fried food this month double your resolve?

For the sake of the health and wellness of us all, I do sincerely hope that the experimentation continues and above all, that those pioneers share with the rest of us the lessons they learn about how to bring social health games to the level of market penetration promised in the 1980s.