Sparx game combats depression among youth

By: Aditi Pai | Jun 28, 2013        

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SPARXAlthough depression hits youth of all ages, a large percentage of young people are left untreated, CEO of LinkedWellness David Burt said during a talk at the Games For Health event in Boston this week. Causes that he cited included stigma, inconvenience of therapy appointments, fear of drug side effects and cost of drugs and therapy. While searching for a solution to this problem, Burt and his team came across New Zealand-based Sparx, a video game to help youth cope with depression that was created by University of Auckland Associate Professor Sally Merry. She and her team were grappling with the same predicament as Burt.

“This is the question Sally Merry asked herself six or seven years ago,” Burt said. “She’s trying to fix adolescent depression in New Zealand and all these people are playing video games, so her question was ‘What does Grand Theft Auto have that we do not have?’ Obviously it’s an immersive video game.”

The object of Sparx is for the player to rid him or herself of negative thoughts and aim to reach ‘hope’. Within the game, the avatars that a patient can play as have New Zealand accents, which Burt believes will add to the fantasy of the game for an American audience. Burt also sees this is a possible treatment option for the influx of patients that hospitals will receive after the Affordable Care Act fully takes effect.

“Games like this involve self efficacy,” Burt said. “The player develops his or her avatar and walks through the fantasy world shooting down negative, automatic thoughts which can cause and perpetuate depression [while] developing skills — skills that are sustainable. This is not taking a pill and waiting for something to happen to your brain.”

After conducting a clinical trial with 94 participants, some of which were indigenous Maori people, Merry’s results were published in the British Medical Journal. Burt plans on launching the product in the fall and then running a clinical trial with an American audience soon afterwards.


Video games can keep seniors moving, but only if they play them

By: Jonah Comstock | Jun 28, 2013        

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ExergameStudies have shown that exercise video games, or exergames, can benefit elderly people who sometimes have trouble getting enough daily physical activity. But few studies have dealt with the question of how to get older people to engage with video games in the first place.

“I can give you a stationary bike, but if you don’t bike it, I doubt that you will get any benefits from it,” said Annerieke Heuvelink, a researcher with Dutch research firm TNO, at the Games For Health conference this week in Boston. “And [recent] studies were all done in very structured settings. People either came into a lab, doing something three times a week, or they would go to a certain senior place regularly, and they all did it because they were told to do it.”

Working with the Mayo Clinic at their Healthy Living Lab in Rochester, Minnesota, Heuvelink recently led a pilot of 19 seniors where they were given training and unstructured access to exergames. Although the sample size was very small, the study did yield some insights about what factors are correlated with engagement in exercise games for older people.

All the participants were shown how to play the game in two initial sessions during a three-week orientation period. Researchers also helped half of the participants to build a personalized avatar. The others were given default avatars. Then the games were made available to study participants for 12 weeks in a special room at the Charter House independent living facility. The study offered five different Kinect titles including sports and adventure games. Some didn’t play at all after the initial orientation, while others played weekly and even continued to play after the study was over. Ultimately about half of the participants played on a regular basis.

The study found that the top predictor of participation was frequency of already playing computer games — even if the computer games in question were, in Heuvelink’s words, “basically Freecell and Freecell.” The next biggest predictor was engagement with games in general, not just video games but also board games.

“My hunch is it’s more about people that think their time is worth playing games. They have enough time and they want to spend it playing games because they enjoy it,” she said.

The other three statistically significant predictors were how outgoing or social the person was, how good the person believed themselves to be at the games, and their score on a short physical performance battery — that is, people who were already fit were more likely to play the games. There was no statistically significant difference due to age, gender, BMI or cognitive function (although conditions like Alzheimer’s and dementia were exclusionary criteria for the study).

Anecdotally, Heuvelink found that many older people resonated with particular games from their past. One man who boxed on his college team became attached to Kinect boxing, even though it was one of the more strenuous games offered in the pilot. Heuvelink stressed that older people in the study chose to play these games, even though they weren’t designed for them. She hopes that if a company tackles designing an exergame just for seniors, developers will draw from the data in this small pilot study.

Webinar: Digital Health Midyear Review is today

By: Brian Dolan | Jun 27, 2013        

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Brian Dolan, Editor, MobiHealthNewsThis afternoon at 2PM ET (11AM PT) we’ll be kicking off our midyear review webinar — a look at the biggest news stories that MobiHealthNews covered during the first six months of 2013 — along with some of their implications.

As of this morning we are honing in on 1,000 registered attendees for this afternoon’s presentations and lively question-and-answer period. If you haven’t already, be sure to sign up right here — it’s free.

Two questions we always get — yes, the webinar will be available on demand for those who register, but it usually takes a few days for that to be up and running. Attending live, of course, means you get to participate in the Q&A. The other question — will slides be available for download? Yes, mine will be and I’m happy to share with attendees.

Looking forward to a great discussion later today — last chance to register! Talk to you all at 2ET this afternoon.

Medicaid plans in 20 states roll out Voxiva SMS health services

By: Brian Dolan | Jun 27, 2013        

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Tracfone SafeLinkMedicaid health plans in more than 20 states are rolling out mobile health services thanks to a new partnership between mobile health company Voxiva and mobile operator TracFone Wireless. The partnership will see the launch of SafeLink Health Solutions. The program is something of an offshoot of the federal Lifeline mobile phone program, which can trace its roots to a Reagan-era landline phone program, but is sometimes referred to as “Obamaphones” by critics.

SafeLink Health Solutions aims to help Medicaid health plans help members take a more active role in their health, increase member satisfaction, increase re-enrollment rates, and improve quality measures. SafeLink Health will equip members with a free mobile phone, free monthly service with 250 calling minutes and unlimited minutes to designated member services numbers. The program also includes free enrollment to Voxiva’s text message-based health services and unlimited text messaging.

Voxiva’s services include reminders for exams, screenings, vaccinations, and more via SMS.

Voxiva, founded in 2001, is perhaps best known as the enabling technology behind the Text4Baby program. Just a few weeks ago Harvard Pilgrim tapped Voxiva for text-based diabetes management programs for its members and in 2011 Alere inked a deal with the company for exclusive rights to its smoking cessation program, Text2Quit.

In 2011 healthcare benefit services provider Medagate announced a similar partnership to the one Voxiva and TracFone announced this week. Medagate and ReadyWireless inked a deal to offer free Lifeline phones to Medicaid members on Medagate’s OTCMedicaid card platform. Medagate offers prepaid cards under their OTCNetwork that Medicaid members can use on eligible items in pharmacies and stores.

That partnership also included health alerts sent to members via their Lifeline phones.

iPad game PlayForward aims to prevent HIV infection

By: Aditi Pai | Jun 27, 2013        

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PlayForwardIn 2009, 39 percent of new HIV infections were among individuals aged 13 to 29, which was a 21 percent increase since 2006, according to Associate Research Scientist Dr. Kim Hieftje. In her talk at Games for Health in Boston this week Hieftje discussed her new HIV prevention iPad game, PlayForward: Elm City Stories, which tests kids in socially compromising simulations to see if her game affects the way they approach safe sex and other moral questions.

“We know there’s this optimal window in which we think we can really inform and engage adolescents before they start having sex,” Hieftje said. “So we really wanted to focus on that window right before they start engaging in sexual activity so we are looking at ages 10 to 14. This age is really active in playing video games as well.”

When Associate Professor of Medicine Dr. Lynn Fiellin acquired NIH funding to work on a project to help at-risk youth avoid behaviors that lead to HIV infection and ultimately delay of sexual initiation, she, Hieftje and their team formed play2Prevent, an initiative that would work to reach Fiellin and Hieftje’s goals. PlayForward is play2Prevent’s first big undertaking.

PlayForward is a role-playing game where every student builds an avatar, created to motivate the students, that they play from seventh grade until high school. This avatar goes through a series of mini games within an overarching storyline of dealing with daily social problems of adolescent youth.

“When we say behavior change, that means we need to step beyond just teaching kids, giving kids knowledge, teaching them about risk, teaching them about HIV and sex and condoms,” Hieftje said. “We actually have to give them the skills to be able to feel comfortable saying ‘no’, give them clever ways to say ‘no’, avoid peer pressure and get out of situations they don’t want to be in. In order to change behavior we have to focus on increasing their self efficacy, their ability to be able to say ‘no’ or their ability to be able to walk away. We have to correct their social norms.”

Designed with a graphic novel style type and interactive elements, the game forces students to make the wrong decisions and then negotiate their way into the safer choices.

“Kids know the answer…kids know that they want you to say ‘no’,” Hieftje said. “They know that the answer is ‘no’. And they know that if they say the right answer, that’s where they get the most points.”

So far, 54 students have finished playing the game. Hieftje’s team started in January and expect to enroll another 90 to 100 this summer. By the end of the trial, 330 teens will have been enrolled. Of the total group, half play PlayForward and the other half play random games downloaded from the iPad store.

Ayogo is building an adherence game for big pharma

By: Jonah Comstock | Jun 27, 2013        

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Ayogo's Diabestes app for college students.

Health gaming company Ayogo’s CEO Michael Fergusson hinted at this week’s Games for Health event in Boston that the company is working on a new game for a major pharmaceutical company, although he wasn’t able to reveal any details.

“I sure would like to show you this game but I didn’t get clearance to show it. We’re working with one of the five largest pharmaceutical companies in the world to build a game for people with Type 2 diabetes.”

Ayogo has previously worked with Sanofi, Merck, Novartis, Pfizer and Boehringer Ingelheim, according to Fergusson’s presentation and the company’s website.  Fergusson said they’re working on a diabetes application for adults.

“It is a social game designed to be played as a kind of ARG, partly online and partly mobile. It integrates a broad prescription compliance program along with a diet and exercise program,” Fergusson said during the Q&A. “It’s probably the most beautiful thing we’ve ever done.”

“ARG” stands for alternate reality game, which is a game with a narrative that somehow incorporates’ players’ real-life surroundings. ARGs usually involve engaging participants over multiple media.

At the conference, Fergusson spoke about some of Ayogo’s past ventures including kid’s diabetes game Monster Manor, which he also spoke about at December’s mHealth Summit.

He also mentioned that the company is using the Metria patch — a version of BodyMedia’s VUE patch, developed by Avery Dennison — in a health game the company is piloting at British Columbia Children’s Hospital. The game uses Ayogo’s game economy to promote activity among children.

This is not the first time Ayogo has used patch technology in a health game. Back in 2011, Fast Company wrote about a joint project between Ayogo and the Center for Body Computing called I Heart Jellyfish which used a heart-rate monitoring patch.

Fergusson also spoke about Ayogo’s peer-to-peer diabetes adherence support network for college students called Diabesties. Previously based on manual input of blood glucose readings, Fergusson shared that the forthcoming version will incorporate a Bluetooth glucometer.

“We know that at 16, a Type 1 diabetic is typically very adherent. And then when they go away to college, they’re not very adherent at all. Why is that? Well, there’s a number of obvious reasons. You leave all of your routines on which you built your good habits behind, your pediatric endocrinologist is back in your hometown, and your new roommate thinks pizza’s a vegetable.”

Fergusson said that college students don’t play games nearly so much as they message one another, and that instant messaging is a form of play for college students. The platform involves pairing off two college students with diabetes, one more adherent than the other. Fergusson found that students are more likely to check their glucose right after receiving a message.

With all of their products, the company tracks adherence data against game performance. Fergusson said this has led to some interesting insights. For instance, when people elect to challenge their friends to an activity, they are twice as likely to complete that activity themselves. Even more interestingly, the receiver of the challenge is three times as likely to complete the activity.

“Our interpretation was that people who received challenges — even if they never respond to them — were the most engaged people of all,” he said.