Healthy Gaming - Video Game Design to promote Health.

BACKGROUND: There is an increasing interest in health games including simulation tools, games for specific conditions, persuasive games to promote a healthy life style or exergames where physical exercise is used to control the game.
OBJECTIVE: The objective of the article is to review current literature about available health games and the impact related to game design principles as well as some educational theory aspects.
METHODS: Literature from the big databases and known sites with games for health has been searched to find articles about games for health purposes. The focus has been on educational games, persuasive games and exergames as well as articles describing game design principles.
RESULTS: The medical objectives can either be a part of the game theme (intrinsic) or be totally dispatched (extrinsic), and particularly persuasive games seem to use extrinsic game design. Peer support is important, but there is only limited research on multiplayer health games. Evaluation of health games can be both medical and technical, and the focus will depend on the game purpose.
CONCLUSION: There is still not enough evidence to conclude which design principles work for what purposes since most of the literature in health serious games does not specify design methodologies, but it seems that extrinsic methods work in persuasion. However, when designing health care games it is important to define both the target group and main objective, and then design a game accordingly using sound game design principles, but also utilizing design elements to enhance learning and persuasion. A collaboration with health professionals from an early design stage is necessary both to ensure that the content is valid and to have the game validated from a clinical viewpoint. Patients need to be involved, especially to improve usability. More research should be done on social aspects in health games, both related to learning and persuasion.