Video games + behaviour change

Video games don’t normally get a good rap when it comes to the health of young people.

Instinctively, replacing hours of playing outside with friends for hours of solo screen staring or battling with virtual ogres controlled by middle aged men in Shanghai doesn’t seem like a good swap for millions of young people.

At face value, video games have combined with TV watching and internet browsing to spell the death of an active youth. Only around 30% of English children meet recommended daily exercise levels of 60 minutes, while they are spending an average of around 23 hours a week watching TV, using the internet and playing video games.

Similarly, there is plenty of research to suggest that video games have the potential to make players more violent: “playing violent video games can prime aggressive thoughts, increase positive attitudes toward violence, and help create a hostile attribution bias: a tendency to perceive other people’s behaviours as malevolent [1,2,3].”

As well as increase attention deficit and reduce cognitive control: “a growing body of evidence suggests that video games may actually exacerbate attention problems and have harmful effects on some aspects of cognitive control [4].”

Contemporary criticism of gaming is often exaggerated and misleading, as are the lazily recalled scenes of kids playing kick the can for hours in serene streets, watched over by a kind hearted elderly neighbour.

Moreover, there is plenty of research to suggest a series of incidental benefits for moderate users of non-violent games.

For example, if video games are competing with TV and DVDs for screen time then they likely to represent a more positive experience, with an Australian report showing that active screen time (both physically and cognitively active) significantly outweighs the benefits of passive screen time. Furthermore, several studies have shown that video game play can improve a wide range of skills and capabilities, such as visual and spatial skills [5].

But, its becoming clear that we can go further than these subtle, modest benefits and build significant, transformative outcomes into games that are loved and played by massive mainstream audiences, particularly amongst young people.

Compelling video games are incredibly powerful vehicles for positive behaviour change and social progress and, over the next few years, we’re going to see more of this potential realised.

Many of the same trends and influences that make up this positive potential are the same as those that provide the potential for damage: vast and growing amounts of time spent playing them, a uniquely captivating environment and emerging technology that is enabling deeper physical, psychological and social immersion.

On the question of time, it is estimated that 3 billion hours a week of gaming takes place globally and 5-15 year olds in the UK are each contributing an average of 8.7 hours a week to that. Just a small part of that time, every week, throughout childhood, could be harnessed to foster important behaviours and establish habits and capabilities that extrapolate to everyday life and last a lifetime. The 10,000 hours rule of deliberate practice, informed by Anders Ericsson’s research and popularised in Malcolm Gladwell’s Outliers, couldn’t find a much better home than video game playing, particularly if we innovate to embed more progressive regular activities in games.

On the captivating effect of video games, Jane McGonigal, in her wonderful TED talk in 2010, describes the effect of “positive stress”, which engenders an urgent personal motivation that differs from “negative stress”, where we are pushed into something that someone else wants us to do. McGonigal vividly illustrates the effect of this game world, where we become “the best version of ourselves, the most likely to persist, the most likely to help others.” Even without McGonigal’s evangelism, it is clear that the emotional immersion and total concentration that comes with playing a compelling game represents a uniquely powerful environment for introducing new behaviours and habits.

As for emerging immersive technology, there is a lot to choose from.

The motion sensor controls launched by the Nintendo Wii in 2006 provided the starting point for making physical movement a bigger part of more games, with the Microsoft Xbox Kinect allowing the removal of a control completely in some games. This has obvious benefits for physical activity and research suggests that active games, like Dance Dance Revolution can “increase energy expenditure and time spent in physical activity, as well as increase preference for physical activity among players” [6,7].

The growth of live gaming, supported by built-in wifi for consoles and headsets to support live interaction and collaboration, provides the potential for more prosocial benefits. Evidence suggests that when playing prosocial games, there is an increase in prosocial thoughts, enhancements to empathy and a promotion of helping behaviours, which transfer beyond the gaming environment and can be sustained [8,9].

Even more exciting is biofeedback technology. The Xbox One’s sensors can pick up the heart rate of players, building this data back into the game. Although not part of a game as such, the Nike Fuel Band has taken the interaction between heart rate data, GPS data and app tools a huge step forward, all of which is waiting to be harnessed within games.

The mind boggles with the potential to combine a strong social purpose with these billions of hours of human activity, a highly captivating environment and this emerging immersive technology.

Imagine sports games that encourage and reward progress in actual physical health and fitness, building in competitive advantages against opponents.

Imagine large communities of gamers, from all over the world, collaborating on challenging, rewarding tasks in search of ‘epic wins’ that generate data or solutions that contribute to real world problems.

Imagine biofeedback games that respond to players’ stress levels and encourage self control and emotional resilience, rewarding coolness under pressure with more accuracy or better energy levels.

That last one is the subject of our latest R&D project, working in partnership with a group of clever people that bring experience from game development, heart rate variability science, performance management and market research. Over the next few months, we’ll be developing and testing the first of many prototypes that builds the player’s heart rate variability into gameplay, reflecting increased stress and rewarding self control (have a look at the research behind this prototype development if you’d like to know more).

The challenge for this work and partnerships like these emerging all over the place is creating games that are as popular, rewarding and emotionally immersive as mainstream gamers. Not only does generating highly compelling user experiences open up an audience far wider than that looking for overly educational, healthy or socially minded products, but it is also the only way of taking advantage of the unique behavioural environment that video games can provide.


1. Anderson CA, Dill KE. Video games and aggressive thoughts, feelings, and behavior in the laboratory and in life. J Pers Soc Psychol 2000;78:772–90.

2. Funk JB, Baldacci HB, Pasold T, et al. Violence exposure in real-life, video games, television, movies, and the Internet: is there desensitization? J Adolesc 2004;27(1):23–39.

3. Kirsh SJ. Seeing the world through “Mortal Kombat” colored glasses: violent video games and the do1.wawwd.infoelopment of a short-term hostile attribution bias. Childhood 1998;5:177–84

4. Gentile DA, Swing EL, Lim CG, et al. Video game playing, attention problems, and impulsiveness: evidence of bidirectional causality. Psychology of Popular Media Culture 2012;1:62–70.

5. Green CS, Bavelier D. Action video game modifies visual selective attention. Nature 2003;423(6939):534–7 and Green CS, Bavelier D. Effect of action video games on the spatial distribution of visuospatial attention. J Exp Psychol Hum Percept Perform 2006;32(6): 1465–78.

6. Biddiss E, Irwin J. Active video games to promote physical activity in children and youth. Arch Pediatr Adolesc Med 2010;164(7):664–72. 67. Graf DL, Pratt LV, Hester CN, et al. Playing active video games increases energy expenditure in children. Pediatrics 2009;124(2):534–40

7. Mellecker RR, McManus AM. Energy expenditure and cardiovascular responses to seated and active gaming in children. Arch Pediatr Adolesc Med 2008;162(9):886–91
8. Gentile DA, Anderson CA, Yukawa S, et al. The effects of prosocial video games on prosocial behaviors: international evidence from correlational, longitudinal and experimental studies. Pers Soc Psychol Bull 2009;35(6):752–63
9. Narvaez D, Mattan B, MacMichael C, et al. Kill bandits, collect gold or save the dying: the effects of playing a prosocial video game. Media Psychology Review 2008;1(1). Available at:
Image from Rebecca Pollard.

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