1.
GAMES FOR HEALTH EUROPE CONFERENCE 2018
Gamification as a life-saving
medicine!
Ting Jiang
Principal, Global Health and Development
Duke University

2.
MAKING PEOPLE
HAPPIER, HEALTHIER, AND WEALTHIER
WITH BEHAVIORAL SCIENCE

3.
It’s yours
if you guess it
right!
Guessing Game: cookiers &
puzzles

4.
This can be
YOURS!Ate 2 cookies
(no radishes)
Ate 2 radishes
(no cookies)
19 min
?

5.
Why?

6.
Takeaway:
We are less
rational than we
think, but our
irrationality is
more predictable
than we think.

7.
What kills us?

8.
European Region African Region
Source: WHO, 2016
-Move more?
-Eat less?
-Relax?
-Save more?
-Drink less?
-Wash?

9.
Why don’t we?

10.
23%

11.
Eat more healthily?

12.
Source: Woolley & Fishbach, 2017
New Year Resolutions - “Which ones last longer?”
Life-changing,
useful, important?
Rewarding,
fun, enjoyable?
but painful,
difficult, non-
gratifying VS.

13.
But not much longer...

14.
The war for attention!

15.
GAMIFICATIONS
Challenge + rewards →
attention-grabbing

16.
Good idea, but
not scalable!

17.
Gamification of
“targeting”

18.
Football: Gamification of running

19.
Do we gamify all healthy
behavior?

20.
vs.
Increased sales by 71%
Wansink (2013)
Make it Easy

21.
Make it Attractive
Immediate System I gratification
substituting long-term rewards!

22.
Make it Social

23.
Make it Timely

24.
Increased nutrition info
awareness, but NO decrease
(even slight increase) in
calories bought.
The American Journal of Preventive
Medicine in 2011

25.
Solution?
KG

26.
Plate size matters - It doesn’t always need attention!

27.
Where can gamification make
the biggest difference for
health?

28.
Game 1: Remember this number...

29.
What is (8x7)+6+6+5?
73

30.
Game: Remember this number...
Your prize:
Cureall

31.
● Heuristics
● Habits
Most daily decisions...
The limited space (that of 7-digit) in System
II are re-written constantly...
Not meant to trigger daily behavior.

32.
System II System I

33.
Game 2

34.
Creating long-lasting
behavioral change:
from “Reward
Substitution”
to “Habit Change”!

35.
● Cue
● Response
● Rewards

36.
Behavioral
Diagnosis
Lack intention
(System II & I)
Intention-behavior gap
(Mostly System I barriers)
Uninformed;
False beliefs
Or,
not in system I
[Not so effortful]
Mindless
(Habitual response)
[Effortful]
Bounded willpower

37.
Our behavior vs. medicines

38.
[Not so effortful]
Mindless
(Habitual response)
[Effortful]
Bounded willpower
Games that help you acquire
healthy habits!
Games that reward directly your
healthy behavior!
Do the right thing for the wrong reason!Habits: cue-response-rewards

39.
Habit formation:
- Stable cue conditioning
- Response rehearsal
- Immediate, variable rewards
Easier in games than in real life...

40.
African RegionDeaths per 100,000 population Source: WHO
1 in 3 die from treatable…
1 in 26 children from diarrhoeal...
“What if you save enough to pay for it…”
What helps one save ahead for heath?

41.
A mobile health wallet just for health

42.
In a game,
PAIN → Stimulating challenge
- Barrier: cashiers don’t have a habit of using
M-TIBA platform → BillThrill

43.
Game of skill! - Flow...

44.
Behavioral Barrier: Forgot to deposit

45.
Savers’ behavioral Barrier: Unfamiliarity of new behavior
But, >4 times?

46.
Cues

47.
Response

48.
Reward

49.
Women Men

50.
Cues

51.
Response

52.
Myopia:
Long-term benefits are invisible…
→ lack response-rewards feedback loop

53.
—> YES, but at the
level of system I or II?

54.
Health Financing Game: Happy Money

55.
Simulated personalized discovery
-Experiential learnings that last.

56.
Life-saving medicines:
Gamified habit change +
Gamified living + the tool of
experimentation

57.
Results:
Compared to control
calendar without
tracking and stories:
30% vs. 17% savers in
the 1st month

58.
Story telling
component

59.
Implementation
intentions
Immediate and
delayed rewards
Personalization

60.
What can Behavioral Science add?
1. Help define the problem
“If I had one hour to save the world, I
would spend 55 minutes defining the
problem and only 5 minutes finding
the solution.”
2. Test & Tweak the treatment

61.
If we use medical
procedure for
behavioral cure...
- Diagnose (system I vs. II)
- Treat (using games)
- Test and tweaks (using
experiments)

62.
Gamification in
your own life?