Making a chore into a game is a fairly obvious way to make it seem less tedious and get more people to participate. A lot of health technology tools have tried taking a game-like tack: Fitbit’s badges, for example, apply a gamified reward system to physical activity (albeit one that becomes less rewarding the more you use it). Almost any health app will incorporate at least some game elements like badges, leveling up, or social competition. Yet, they clearly have not solved public health issues like chronic obesity.
An interesting area to explore gamified public health interventions is in a natural social setting, rather than a more private 1:1 between an individual and an app or program. There have been some promising attempts to carve behavior change mechanisms into the physical or social environment to gently nudge people’s behavior toward the good, often done in partnership with people from urban planning or civil engineering backgrounds. I’ve collected a few examples (not including the running path on Toronto’s Waterfront, which I loved).
Vote With Your Butts
Hubbub has several concurrent initiatives to create cleaner streets in London by pairing prosocial behaviors with game elements. Check them out here. For example, Hubbub created a cigarette disposal device that lets fans use their extinguished butts to vote between two choices. In one example, stubbed cigarettes become votes for smokers’ preferred footballer, Lionel Messi or Cristiano Renaldo:
Now, you could argue that having the extinguished cigarette be the ballot encourages smoking (not a good public health goal), and I’d be hard pressed to argue back. But hey, at least the smokers aren’t littering anymore? And proper sanitation is a public health good.
Getting people to walk up stairs instead of taking an escalator is a more clear-cut example of a social good. A now-famous example of reinforcing healthy behavior using game elements is the piano stairs in the Odenplan subway station in Stockholm, Sweden:
The stairs were installed through an initiative called The Fun Theory, funded by Volkswagen. Like Hubbub, The Fun Theory is also concerned with the environment and has several projects specifically encouraging the appropriate disposal of garbage, all of which can be seen on their website.
A third and very different example of gamification applied to public health is a joint initiative between the Red Cross in Uganda and the Engagement Lab at Emerson College in Boston called “Boda-boda.” This is a motorcycle safety course taught via an interactive ball game; graduates get a special jacket they can wear to signify their safe driver status.
Does it have to be a game?
No! Creating environmental guardrails to nudge people toward healthier behaviors doesn’t necessarily need to incorporate game elements. Sometimes giving people appealing resources for healthy behavior helps, as I saw in Hongzhou, China last fall. Hongzhou’s extensive system of protected bike and motorcycle lanes encourages citizens not to drive more polluting automobiles, while well-maintained and equipped public exercise blocks throughout the city help people get physical activity.
Whether it’s through gamified interventions or simply creating an environment that encourages healthier behaviors, urban planners and civil engineers have an important role to play in public health. I think it’s exciting to imagine what collaborations with these experts might bring for behavior change.