For all the talk about how video games rot our kids' brains (they've been linked to lower academic performance in college students and a lack of empathy in teens), there's evidence that they can be used for good.
There's mounting data that specially designed video games (known as "serious games") can increase knowledge and change behavior in youth. In particular, they can have a positive influence on the way kids think and act about their health. That's good news because 97 percent of young Americans play computer, Internet, mobile or console games, and 50 percent play daily.
Take Re-Mission, developed to help teens and young adults with cancer. In it, the player controls a "nanobot" and navigates through 3-D environments within the bodies of young cancer patients, killing cancer cells and fighting related infections. Patients who played Re-Mission demonstrated greater knowledge about their cancer medications as well as higher levels of confidence in taking them and actual adherence to them.
Similarly, SPARX, designed to improve depressive symptoms in adolescents, has been shown to work. In the interactive 3-D fantasy game, players choose an avatar and navigate a set of challenges to restore the balance in a fantasy world dominated by GNATs (Gloomy Negative Automatic Thoughts). It is based in cognitive behavioral therapy, known to be effective at treating depression.
Similar games have been developed to address a range of medical conditions in children and teens including HIV/AIDS, asthma, diabetes and cancer. One such game, PlayForward: Elm City Stories, is an iPad game developed by Yale's play2PREVENT Lab for reducing risk and preventing HIV in young teens.
PlayForward is an interactive world in which the young player, using an avatar they have created, "travels" through life, facing challenges and making decisions that bring different risks and benefits. This game aims to work by giving the player the ability to see how their choices affect their life and subsequently are able to move back in time to see how different actions might have led to different outcomes. Players therefore learn skills that translate to real life, equipping them to avoid situations that increase their risk for HIV and other negative health outcomes.
But we still don't know enough about how to design games that actually work. The studies on this subject are sparse and generally of poor quality. And there are the questions we still don't know the answers to. For example, video games that involve exercise don't seem to impact the levels of physical activity in children. Why?
Answering these questions is vital. There is compelling evidence that individuals who acquire new information, motivation and behavioral skills in a virtual environment, then subsequently practice these behaviors within a virtual-reality game, are more likely to act in accordance with the new skills in real life.
And these games could offer us exciting sources of information on teen behavior. For example, the PlayForward collects millions of pieces of data into log files that describe all of the player's behaviors and decision-making. Early analysis from these data show that how players perform in a game is very similar to what they report on surveys. Data collected from video games may also be able to tell us what "dose" of game and how it is delivered is most effective at changing behavior in real life.
The potential is clear, and the possibilities are endless. But we'll never know until we do the research.
Ready, player one?
• Fiellin is associate professor of medicine at Yale University School of Medicine and a practicing HIV physician and addiction medicine provider.