The Development of a Gamified System for Health Activism as a Graduate Student Project

The Development of a Gamified System for Health Activism as a Graduate Student Project

David Kirschner (Georgia Gwinnett College, USA)
Copyright: © 2017 |Pages: 22
DOI: 10.4018/978-1-5225-0513-6.ch018


This chapter presents a case of the development, implementation, and iteration of a gamified, graduate-student-driven, collaborative class project about community health activism. The project was founded on three principles: (1) people define, interpret, and modify the meanings of health and wellbeing based on past experiences and in diverse contexts; (2) both learning and iterative design are adaptations to problems; and (3) knowledge is created through the transformation of experience. Prior to the class project, the researchers designed a web-based platform for people to publicly recognize and motivate one another for being healthcaring, exhibiting positive attitudes and behaviors toward the health and wellbeing of themselves and others. This chapter shows how students, researchers, and the community refined a definition of healthcaring while trying to change people's health attitudes and behaviors through gamification. After contextualizing the project and discussing its foundations, the chapter offers a discussion on its four phases and results.
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Health activism is action on behalf of health-related causes that goes above and beyond the norm (Martin, 2007), often challenging those perceived as responsible for social injustice or health inequality in the process. Obstacles that health activists face include individualism, unsupportive political environments, and commercial and corporate interests (Laverack, 2012). The need for health activism today is obvious. Structural strains such as food deserts (Walker, Keane, & Burke, 2010) and long work hours (Virtanen et al., 2012) intersect with personal health behaviors such as lack of exercise to act against healthy lifestyle choices and outcomes, leading to escalating rates of chronic diseases and conditions, including heart disease, obesity, and diabetes (Centers for Disease Control and Prevention [CDC], 2015). Additionally, these factors intersect with other social structures. For example, governments play a key role in protecting public health and safety (Frieden, 2013) through programs like implementing city-wide nutrition standards (Lederer, Curtis, Silver, & Angell, 2014) and mandating that fast food menus show calorie information (Dumanovsky, Huang, Bassett, & Silver, 2010). Such top-down approaches to health promotion aim to uniformly benefit large numbers of people, although the national data highlighting significant health disparities and inequalities among race, class, and other groups indicate that many are left out (CDC, 2013). Other people object to top-down approaches on philosophical grounds by arguing against perceived government intrusion in their lives and liberties (Harsayani, 2007). Purveyors of unhealthy food products employ flavorists to maximize consumers’ favorable responses to artificial tastes and smells (Schlosser, 2001), and fast food advertising all but ensures that people, especially kids, develop a relationship to the food and the companies selling it. Fast food restaurants spent $4.6 billion on advertising in 2012, almost half of that specifically targeting children, while in the same year McDonald’s demonstrated its market dominance by spending 2.7 times as much to advertise its products than all bottled water, milk, fruit, and vegetable advertisers combined (Yale Rudd Center, 2013). It is no wonder that changing people’s health behaviors is hard; they experience structural inequalities, exhibit individual resistance, and face the challenge of shrugging off corporate socialization efforts, not to mention the fact that, to many, unhealthy food tastes good and routine is easy, even preferable to change. The point: top-down approaches to health promotion are confronted with opposition due to various factors and face the difficulties inherent in employing blanket solutions. Top-down approaches are typically divorced from everyday health activism.

Bottom-up approaches to attitudinal and behavioral health change are more closely intertwined with health activism in forms similar to grassroots environmentalism (see Bullard, 1993, 2000). These “people-centered” (Biehl & Petryna, 2013) approaches are positioned to avoid top-down pitfalls and can subvert the interests of oppositional corporate and political voices on local levels (Zoller, 2005). Additionally, innovative approaches to effecting health change are likely to be developed from the bottom up because bottom-up innovation is often apart from or in direct opposition to the dominant healthcare culture. To the extent that innovative ideas are perceived as threats by the dominant health, political, financial, or other institutional culture, they are unlikely to receive funding or attention, pushing them further away from the mainstream and toward the local level (Bergman, Markusson, Connor, Middlemiss, & Ricci, 2010), where they are more likely to become embedded in people’s everyday lives.

Key Terms in this Chapter

Symbolic Interaction: A microsociological perspective foregrounding meaning-making in everyday life. We act toward things based on the meanings those things hold for us; meanings arise through interaction with others; and meanings may be modified through an interpretive process.

Healthcaring: Exhibiting positive attitudes and behaviors toward the health and wellbeing of oneself and others. Healthcaring has three key features: embodiment (internalizing healthcaring), facilitation (awareness of and helping others reach health goals), and selflessness (working for the good of the community).

Experiential Learning: Learning by doing; hands-on learning; getting one’s hands dirty through practice.

Linguistic Relativism: Language shapes thought and thought guides behavior. For example, if people accept the metaphor, “love is a collaborative work of art,” then they are likely to think of love in terms of hard work, beauty, and creativity, as opposed to entailments of the metaphor, “love is war,” such as fighting, winning or losing, and surrendering.

Behavioral Definition: A word or phrase that is designed to cue behavior for social good. Examples include designated driver, secondhand smoke, and healthcaring.

Health Activism: Advocating for equality in health contexts; spreading awareness about health knowledge and practices; working to promote improved health and wellbeing in a population.

Gamification: The practice of applying game design to contexts so as to purposefully increase user motivation, fun, and engagement.

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