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CS798 | Games for Health Fall 2015

Organizational Meeting/Session 1
Friday September 18 2015 10:00-11:50
Davis Centre 2568

DC2568 is on the second floor of the Davis Centre in the south wing. Go up the stairs by the Tim Horton's Express in the atrium on the ground floor of the Davis Centre. At the top of the stairs, turn right and walk forward through the double doors. DC2568 is in the third hallway down on the left.

Course Staff

Course Description

CS798 Games for Health is a graduate reading seminar and game design course that will review the current major applications of games in healthcare. Readings will cover the major fields in healthcare where games are being used. Case studies will survey a representative set of current health-related games, from best-practices to examples indicating just how far this field has yet to develop.

Course Objectives

By the end of this course students should have a good understanding of the current major topic areas for health-related games, an appreciation for what makes for good "gamification" in healthcare, and the ability to apply good game design principles in healthcare applications.

Recommended Background

There are no formal requirements other than interest in the topic and ability to read and analyze technical material. Some pre-existing knowledge of popular video games would be helpful but is not necessary. Background in other relevant fields (e.g., psychology, health sciences, narrative modeling) will also be useful.

A project team may choose to extend their digital game prototype towards a working implementation for their own interest but no programming is required in the course. Full marks may be obtained for a card game, board game, or other paper prototype of a game. Ideally, Computer Science and students from other disciplines will participate as members of a team.

Non-Computer Science students are welcome to enrol in the course after the first week of classes if there is sufficient space.

You can add your name to the waiting list at:

Auditors are welcome if there are extra seats in the classroom.



Project Guidelines and Course Administrivia


(***NOTE: last updated October 19)


Auditors are welcome if there is sufficient space in the classroom.


All readings are available from this website, or either in hardcopy or electronic versions from University of Waterloo Library Course Reserves or e-journals.

To find the location of a reading, go to the course reserves link on the University of Waterloo's Library web page at:

When you choose our course you will see a list of the titles on reserve. Electronic content can be accessed from anywhere with an Internet connection. Hard copies on reserve will indicate where the copy is located, the loan period, and the call number needed to access it from the Davis Centre Library circulation desk.

Jane McGonigal
Reality is broken: Why games make us better and how they can change the world
Penguin Books, 2011 (multiple copies on reserve)  

S. Arnab, I. Dunwell, and K. Debattista (editors)
Serious games for healthcare: Applications and implications
IGI Global, 2013  

K. Bredl and W. Bosche (editors)
Serious games and virtual worlds in education, professional development, and healthcare IGI Global, 2013  

B. Schouten, S. Fedtke, T. Bekker, M. Schijven, and A. Gekker (editors)
Games for health: Proceedings of the Third European Conference on Gaming and Playful Interaction in Health Care
Springer, 2013  

References on Game Design

Jesse Schell
The art of game design: A book of lenses
CRC Press, second edition, 2015 (multiple copies on reserve)  

Jesse Schell
The art of game design: A deck of lenses
Schell Games, second edition, 2014
(cards to accompany the book) (multiple copies on reserve)  

Other Resources

Games for Health Conference

Game Developers Conference

Serious Play Conference

Jane McGonigal's website:

Course Outline

Session 1: Organizational Meeting/What is a (Serious) Game?

Friday September 18 10:00-11:50 DC2568

Getting Started with an Overview

Games in real life?

The current state of health gaming

Administrivia slides


(last updated September 17)

Background reading

Bill Ferguson, "Videogames: The good, the bad, and the ugly",
Games for Health Journal, February 2013, 2(1): 1-2

Jane McGonigal
Reality is broken: Why games make us better and how they can change the world
Penguin Books, 2011
Chapters 1, 14, Conclusion

Session 1 slides


(***updated significantly September 17***)

Case studies

World Without Oil

Fold It!

EyeWire: A Game to Map the Brain
About EyeWire:

Where to sign up to play the game:

Session 2: Games versus Gamification Panel/Workshop 1

Friday September 25 10:00-11:50 DC2568

Panel session: Neil Randall, Director, Games Institute; Lennart Nacke, Co-Chair Gamification 2013 Conference

Background reading

Bredl and Bosche, Chapter 1, "Concepts behind serious games and computer-based trainings in health care: Immersion, presence, flow"

Thoughts from Games & Gamification Session, 2014 Games for Health Conference,
Speaker: John Ferrara:

"...Too often, people say gamification when they mean games, and sometimes people say games, when they mean the simplicity of gamification. Most often, people are literally confused, thinking that these two words, and their associated practices and traits are one-in-the-same.

Well they’re not.

...the true health experience designer sees games and gamification as mutually inclusive...A common source of trouble on pure gamification implementations is that people often define the experience very narrowly, sacrificing the fundamental appeal that draws people to games in the first place. A broader approach to design, still connected to some of the strengths gamification makes appealing, can lead to better outcomes...[this] session seeks to get at the bigger issue at play when defining experiences as being games or gamified. That issue, simply put, is what works for the user and why?"

Workshop 1: Brainstorming and Team Formation

Objective: One-page project proposal (due next week)

Session 3: Board and Card Games

Friday October 2 10:00-11:50 DC2568


Geoff Kaufman and Mary Flanagan, "Lost in translation: Comparing the impact of an analog and digital version of a public health game on players’ perceptions, attitudes, and cognitions", International Journal of Games and Computer Mediated Simulations, 5(3), 2013, 1-9
Available at:


Presenter: Zeeshan

Case study

POX: A public health game

Game available: Amazon ($US24.95) and App Store (free for iPad)

Flanagan, M., Seidman, M., Belman, J., Punjasthitkul, S., Downs, Z., Ayoob, M., Driscoll, A., and Downs, M., "Preventing a POX among the people? A design case study of a public health game", Proceedings of DiGRA 2011 Conference: Think Design Play, Hilversum, Netherlands
Available at:

Presenters: Xianli

Case study

Monster Appetite


Presenter: Shu

From 2013 Games for Health Conference:

"Monster Appetite addresses the obesity epidemic, one of America’s largest public health challenges, now growing in the rest of the world. In light of efforts to combat the obesity epidemic, Monster Appetite is a game that potentially remediates some aspects of the concern by promoting awareness of the content of food typically consumed by children."

Sessions 4 and 5: Exergaming and Rehabilitation/Workshop 2

Friday October 9 and Friday October 16 10:00-11:50 DC2568

***Session 4: October 9***

Workshop 2: The Design Document

Objective: Description of features of game prototype (initial draft due October 30)

Background reading

Ian Bogost, "The rhetoric of exergaming"

Arnab et al., Chapter 3, "Rehabilitation gaming"

Papers (Exercise)

Deborah L. Feltz, Samuel T. Forlenza, Brian Winn, Norbert L. Kerr, "Cyber buddy is better than no buddy: A test of the Köhler motivation effect in exergames", Games for Health Journal, April 2014, 3(2): 98-105

Presenters: Megan

Traditional game rewards:
Elizabeth J. Lyons, "Cultivating engagement and enjoyment in exergames using feedback, challenge, and rewards", Games for Health Journal, February 2015, 4(1): 12-18

Presenter: Shu

Social exergaming:
Arwen M. Marker, Amanda E. Staiano, "Better together: Outcomes of cooperation versus competition in social exergaming", Games for Health Journal, February 2015, 4(1): 25-30

Presenter: Priyank

Ann E. Maloney, Robin Mellecker, Richard Buday, Zan Gao, Trina Hinkley, Laura Esparza, Shirley Alexander, "Fun, flow, and fitness: Opinions for making more effective active videogames", Games for Health Journal, February 2015, 4(1): 53-57

Presenter: Xinan

Brendl and Bosche, Chapter 1, "Concepts behind serious games and computer-based trainings in health care: Immersion, presence, flow"

Presenter: Dibya

***Session 5: October 16***

Paper (Rehabilitation)

Lauren R. Natbony, Audra Zimmer, Larry S. Ivanco, Stephanie A. Studenski, Samay Jain, "Perceptions of a videogame-based dance exercise program among individuals with Parkinson's Disease", Games for Health Journal, August 2013, 2(4): 235-239

Presenter: Xinan

Case study

Alien Health: A nutrition instruction exergame using the Kinect sensor


M.C. Johnson-Glenberg, C. Savio-Ramos, H. Henry, "Alien Health: A nutrition instruction exergame using the Kinect sensor”, Games for Health Journal, August 2014, 3(4): 241-251

Presenters: Anastasia

Case study: Comparing FitBit to Zombies, Run!


Game available: App Store, Google Play, Windows Store

Tester/Presenter: Asma

Zombies, Run!

Game available: App Store and Google Play

Tester/Presenter: Winnie

Session 6: Cognitive and Mental Health

Friday October 23 10:00-11:50 DC2568

Background reading

Schouten et al., "A taxonomy of serious games for dementia", pp219-232

Kelli N. Dunlap, "Integration of game design and theory into group psychotherapy with veterans with severe/chronic mental illness", Games for Health Journal, April 2013, 2(2): 109-112

Case study


Game available: iPhone

Background reading

Ann Marie Roepke, Sara R. Jaffee, Olivia M. Riffle, Jane McGonigal, Rose Broome, Bez Maxwell, "Randomized controlled trial of SuperBetter, a smartphone-based/Internet-based self-help tool to reduce depressive symptoms", Games for Health Journal, June 2015, 4(3): 235-246


Presenters: Xianli, Zeeshan

Case study

Depression Quest

Follow the history at:

Game available: Steam

Presenter: Asma

Case study

MoodHacker: A mobile app for depression self-management

Background reading

Presenter: Yuqing, Junyi

From 2013 Games for Health Conference:

"...ORCAS [producer of MoodHacker] is applying gamification, personal user recommendations, and persuasive design to address challenges of user experience and engagement...The goal of ORCAS is to demonstrate long-term behavior change through evidence based outcomes. The result is improved health for individuals, which can drive down individual costs and costs to organizations when adopted by health care systems."

Session 7: Games for Children and Youth

Friday October 30 10:00-11:50 DC2568

***Initial Draft of Design Document due***

Background: Google TechTalk, July 11, 2013

PlayForward: Using Games to Improve Adolescent Health
Video (approx one hour):


Peter J. Chung, Douglas L. Vanderbilt, Neelkamal S. Soares, "Social behaviors and active videogame play in children with autism spectrum disorder", Games for Health Journal, June 2015, 4(3): 225-234

Presenter: Xu, Dibya (demos)

Cerebral palsy
Lian Ting Ni, Darcy Fehlings, Elaine Biddiss, "Design and evaluation of virtual reality–based therapy games with dual focus on therapeutic relevance and user experience for children with cerebral palsy", Games for Health Journal, June 2014, 3(3): 162-171

Presenters: Megan

Case study


Food Focus: Fruits
Available on iTunes US Store

Presenters: Zijin, Jamie

From 2014 Games for Health Conference,
Speaker: Catherine Frederico, President, Frederico Arts, Creator of "Food Focus: Fruits"

"Food Focus: Fruits is a game designed to educate users about the wide variety of available healthy fruit options in a fun and engaging way. The game challenges players' fruit recognition capabilities and nutrient content knowledge..."

Case study



Game available: Browser-based version currently available. Mobile version planned.

Presenters: Xu, Ivens

From 2014 Games for Health Conference,
Speaker: Jeff Orkin, Co-Founder, Giant Otter, Creator of "SchoolLife"

"SchoolLife is a social role-playing game that teaches and assesses social skills to combat the bullying epidemic....The technology platform underlying SchoolLife builds on over 10 years of research from the Harvard Graduate School of Education and the MIT Media Lab — research which has proven that walking in another’s shoes virtually improves relationships, and has demonstrated automating conversational characters with crowdsourced data."

Session 8: Social and Virtual Reality Games/Workshop 3

Friday November 6 10:00-11:50 DC2568

Workshop 3: Review of Prototype Design

Objective: Individual feedback on game prototype design

Note: Class poster session Thursday November 26 at Games Institute

Case study

Second Life: A 3D virtual world for eHealth


Presenter: Hemant, Haiyu

Case study

SimCoach: A virtual human support agent for PTSD


Short video overview:

CBC Radio Article and Audio Program (approx 30 minutes):

Albert Rizzo, Eric Forbell, Belinda Lange, John Galen Buckwalter, Josh Williams, Kenji Sagae, David Traum, "SimCoach: An online intelligent virtual agent system for breaking down barriers to care for service members and veterans", Chapter in Healing war trauma: A handbook of creative approaches, Routledge, 2012.

Available at:

Presenters: Haiyu, Hemant

Session 9: Games for the Elderly/Chronic Disease Management

Friday November 13 10:00-11:50 DC2568

Games for Chronic Disease Management



Meveshni Govender, Randy C. Bowen, Massiell L. German, Grzegorz Bulaj, Carol S. Bruggers, "Clinical and neurobiological perspectives of empowering pediatric cancer patients using videogames" Games for Health Journal, October 2015, 4(5), 362-374

Free-access available at:

Presenter: Winnie

Case study

GeckoCap: A gamified asthma inhaler


From 2013 Games for Health Conference

Asthma is the most common chronic disease and one of the leading causes of hospitalization for American children. Nearly ten million – or one in seven – kids are affected by asthma. Worrisome for children and parents alike, asthma is also a pressing public health issue, costing the U.S. over $15 billion annually.
GeckoCap has developed mobile, digital, and smart tools that empower children as well as their parents and doctors to better manage asthma medication. GeckoCap’s glowing reminder system helps children build healthy habits and motivates them to take control of their health. With inhaler tracking, GeckoCap can also use inhaler activity to drive game-based experiences that can support managing asthma a collaborative effort, allowing parents and doctors to use games to drive adherence and behavior change in Asthma."

Presenters: Gustavo, Terence

Paper and Case study

Diabetes: InsuOnline

Leandro Arthur Diehl, Rodrigo Martins Souza, Juliano Barbosa Alves, Pedro Alejandro Gordan, Roberto Zonato Esteves, Maria Lúcia Silva Germano Jorge, Izabel Cristina Meister Coelho, "InsuOnline, a serious game to teach insulin therapy to primary care physicians: Design of the game and a randomized controlled trial for educational validation", JMIR Research Protocols, 2(1), 2013

Paper download and YouTube video available at:

Further background reading: Pilot evaluation

Leandro Arthur Diehl, Rodrigo Martins de Souza, Pedro Alejandro Gordon, Roberto Zonato Esteves, and Izabel Cristina Meister Coelho, "User assessment of “InsuOnLine,” a game to fight clinical inertia in diabetes: A pilot study", Games for Health Journal October 2015, Special Issue on Games in Diabetes, 4(5): 335-343

Now available on our online course reserves

Presenters: Junyi, Jamie

Games for the Elderly


K. Gerling, I. Livingston, L. Nacke, and R. Mandryk, "Full-body motion-based game interaction for older adults", Proceedings of the SIGCHI Conference on Human Factors in Computer Science, 2012, 1873-1882

Available at:

Presenter: Rina, Ivens

Virtual Reality Games for Health

SimCoach revisited: SimSensei

Presenters: Haiyu, Hemant

Session 10: Narrative and Storytelling in Games

Friday November 20 10:00-11:50 DC2568


Amy Shirong Lu, "Narrative in exergames: Thoughts on procedure, mechanism, and others", Games for Health Journal, February 2015, 4(1): 19-24

Presenter: Priyank


Topic: Personalization in serious games

Presenter: Gustavo

Case study


Game available: App Store and Google Play

Presenters: Yuqing, Justin

From 2014 Games for Health Conference,
Miriam Verburg, Bloom Digital Media, Producer, "LongStory"
Elysse Zarek, Bloom Digital Media, Co-Producer, "LongStory"

"LongStory is a dating and adventure game that helps pre-teens sandbox healthy relationships and sexuality. It deals with issues such as consent, bullying, being different, fitting in and learning how to ask for what you really want.

LongStory has based its health strategy on encouraging players to develop empathy through a meaningful and challenging romantic storyline....Games can be interventions for mental health promotion, but the majority of mainstream games don't address the capacity to be emotional sandboxes in a meaningful way."

Case study

QuitIT: Teaching coping strategies for smoking cessation through interactive storytelling


Paul Krebs, Jack E. Burkhalter, Bert Snow, Jeff Fiske, and Jamie S. Ostroff, "Development and alpha testing of QuitIT: An interactive video game to enhance skills for coping with smoking urges", JMIR Research Protocols, Jul-Dec; 2(2), 2013

Published online Sept 11, 2013 at:

Presenters: Justin, Terence

From 2013 Games for Health Conference,
Speaker: Jeff Fiske, Lead Designer,"QuitIT", Muzzy Lane Software

"For decades, the standard behavioral treatment for smoking urges has been behavioral rehearsal, which entails the identification, modeling, and role-playing of diverse cognitive and behavioral coping strategies to identify and manage smoking cues. This treatment promotes skill acquisition, bolsters confidence in coping with smoking cues, and reduces relapse to smoking."

In game vernacular, this skills acquisition approach is called “mastery” and is consistent with a gamer player’s experience as they advance through a variety of game genres such as Role Playing Games (RPGs)....Virtual reality games and simulations provide environments similar to those faced in the real world, which increases personal relevance and learning serve as powerful tools because they encompass many aspects of human learning, such as engagement, problem-solving, receiving corrective feedback, and repetition."

Session 11: Class Poster Session

Friday November 27 10:00-11:50 EC1


Class Poster Session will take place during the Games Institute Annual IMMERSe Project Meeting

Session 12: Public and Global Health/***NEW*** Final Panel Discussion

Friday December 4 10:00-11:50 DC2568

A closing "Mission Statement" for games for health:
(from the 2014 Games for Health Conference, Games for Global Health Meetup roundtable discussion)

"[Games for global health] can include not only opportunities for specific efforts in less-developed regions, but also opportunities to address truly global issues such as pandemic flu, nutrition, and the spread of non-communicable diseases."


Toluwalose A. Okitika, Ruanne V. Barnabas, Tessa Rue, Jordan Weisman, Nathan A. Harris, Walter A. Orenstein, Judith N. Wasserheit, "Polio eradication game may increase public interest in global health", Games for Health Journal, June 2015, 4(3): 195-201

Presenters: Xiao-Bo

Case study

MalariaSpot: Building a global network of virtual malaria hunters through gameplay

Demo and TED talk:

Game available: Android, PC, iPhone

Miguel Angel Luengo-Oroz, Assier Arranz, and John Frean, "Crowdsourcing malaria parasite quantification: An online game for analyzing images of infected thick blood smears", Journal of Medical Internet Research, 2012;14(6):e167

Available from University of Waterloo Library e-journals

Presenters: Zijin, Ahmad

From 2013 Games for Health Conference,
Speaker: Miguel A. Luengo-Oroz, MalariaSpot Founder

"According to the World Health Organization, approximately 216 million cases of malaria occur in the world each year, and the disease kills about 655,000 people annually....Currently, the gold standard for malaria diagnosis worldwide consists of first detecting parasites, and then counting the number of parasites in blood smears by using a microscope....An average of 100 images have to be visually checked by a specialist, a process that can take up to 30 minutes. Confirmation of a negative diagnosis is ultimately dependent on the technician’s expertise....

Thus, we need scalable, fast, ubiquitous, and accurate screening systems...Mobile phone coverage is reaching every corner of the planet and we see the global connectivity as an opportunity to distribute the images all over the Internet.

We believe that there is so much online talent out there that can be used to analyze malaria images (while you play a game!)..."

Closing Panel Discussion: Serious Games for Sensitive Subjects

Suggested background reading

Arnab et al., Chapter 5, "Ethics in the design of serious games for healthcare and medicine."

Bredl and Bosche, pp105-115, "Evaluation of serious games."

Schouten et al., pp75-84, "Servitization and commoditization: The business model dilemma confronting serious games for health."

Panel Members: Ahmad, Anastasia, Gustavo, Rina, Xiao-Bo