This game was designed for Purdue Extension's Be Heart Smart Program. The goal was to encourage participation in the program and raise awareness of heart health for all age groups. While the traditional methods tend to be less exciting (e.g. slide show), the game provides a solution that combines both education and entertainment.
This work resulted in a highly educational and fun card game. This game simulates the fundamentals of heart health and is very easy to pick up. Each turn, players will experience random life events, make decisions, and regulate their blood pressure and cholesterol in order to stay healthy.
Q: Why does the program need younger audiences?
The average age of attendees of the program is higher than desired. Compared with elderlies, middle-age adults have a greater opportunity to manage their risk factors to prevent heart problems. In order to maximize the effectiveness of the program, educators need to reach younger audiences.
"It's always important for everyone to learn about heart health, to take care of themselves and their loved ones."
Create a highly educational game that can be played in small groups for 30 minute sessions.
Make the game simple enough for new players to pick up, while keeping it fun for adults that may have little interest in games.
Throughout this project, the game went through multiple iterations, evolving and taking shape over time. Earlier versions of the game featured greater complexity that exemplified roleplaying. Later on they were adapted and simplified into more natural gameplay.
To start off we will take a look at the beginning of the brainstorming phase. I experimented and affinity diagramed the educational content until it would fit into logical game systems. These game systems were presented, discussed and prototyped. The notes in this section layout design process of game elements.
As the sole designer of the project, I spent months working with the program lead and educators to create and test this game. My work involved designing the art and gameplay, iterating various versions of the game and play-testing with educators and peers.
The stakeholders presented the project requirements, expectations and provided all of the teaching material their curriculum covers. From here I had the goal of making a fun and simple game that could effectively educate on heart health.
I began familiarizing myself with the material, asking clarification questions from the educators, and used affinity diagramming to populate and categorize the content that could be used in the game. With this content, I created a concept map to comprehend the logical flow and relationships between concepts.
Topics extracted from the learning material with the intent to teach through gameplay.
Managing blood pressure and cholesterolHeart problemsHealthy dietary lifestylesHealthcare provider interactionBehavioral traitsUncontrollable risk factors
Additionally, based on the stakeholders target market age determined to be 30-55 years and with some descriptors of their typical attendees allowed me to create basic personas to help understand who I was designing this game for.
Young to Middle-Age Adults
The youngest end of the target demographic involves young adults reaching mid-age. Individuals at this age are starting to feel the effects of growing old and may start to regret some of their unhealthy lifestyles. Being caught up in fast moving life, young-adults may not realize they should be learning how to take better care of themselves before it's too late.
Older Adults
The older end of the target audience pertains to individuals that may be more aware of the dangers of an unhealthy heart. As they experience their loved ones and peers under-go the trauma of heart issues, they may be more willing to make healthy changes in their life.
Increase program participation with younger audiences; raising awareness of heart health and furthering prevention of heart issues.
This gamified solution was modified and the content was refined through discussion and playtesting until something enjoyable emerged. Playtesting involved in-house testing and occasional usability tests with the program lead and a few educators that worked closely throughout the project. The design conversation with project leads was an ongoing one, and the struggle to maximize educational value, entertainment and usability proved to be a significant challenge. However, through hard work, the game showed an ability to be balanced and simplified for our target audience.
In order for adult players to engage with an educational game, the game should have a balance of relevance and complexity.
In order to actualize the above concepts into a functional game system, designs had to be ideated and fleshed out. Some aspects ideal for the game were obvious such as monitoring blood pressure, while others seemed out of place for a game, like teaching healthy decision-making.
For monitoring blood pressure, there was an opportunity to utilize realistic metrics of heart health which would not only be beneficial, but crucial to an accurate educational portrayal.
While dealing with incorporating healthy decision-making, would be much more difficult, as no player will ever choose something that hurts them. However, that is not true in reality, due to something we call vices. It was only through forcing the indulgence in bad behaviors and unhealthy habits that players would have to really face the reality of an unhealthy lifestyle and learn what it takes to counteract it.So in order to simulate the mechanisms of heart health in life, the gameplay needs to allow players:
These major elements provide the building blocks of the game experience.
The design moving forward could be categorized as a routine management game with simulation of daily life and heart-health.
Many of these saw significant changes throughout evaluation. A few were iterated on but removed completely later on in favor of simplification, such as the character cards. However, the majority were refined and made it into the final version of the game in a more simplified fashion. Since fun was not the primary goal, but rather creating something educational, I always had to prioritize usability and engagement, instead of creating a game that is the most fun. Here are these original gameplay elements that evolved into the final version later on.
The early prototype was inspired from traditional RPG games. Usually, players begin with initial stats (e.g. health, endurance) and traits (long term effects). Throughout the adventure, players will experience random events that could affect their stats. They can also spend resources/currency to purchase positive effects or remove negative effects on their stats.
By incorporating these concepts, below are the basic features created for the game:
[*] = Features Removed from final design
[*] Traits (Habits/Vices)
They were assigned from character you chose or purchased during player's turn using Resources. - Good Habits can defend you from negative effects - Bad Vices can amplify negative effects
Resources
The currency cards in players' hands.These cards feature three categories of living: Mental, Physical and Nutrition. Players can spend the resources to obtain habits or remove vices.
*This feature was later refactored into the behavior combos system in final version
Life Events
Each turn, player draws a random life event card that can cause a variety of positive and negative effects.
[*] Character Cards
The narrative and role-playing aspect of gameplay.Players would start with a character card, providing a brief backstory, existing stats (blood pressure, cholesterol) and traits (habits, vices). This feature determined players' risk level.
Q: Why were Traits (Habits/Vices) and Character Cards removed from the final version?
The main goal of this game was always about maximizing education and engagement and making it simple enough that learning the game doesn't detract from the educational component.
We found that the traits (habits/vices) and character cards combined together overcomplicate the gameplay. Despite the possibility to role-play with various background and health risk-factors, It was removed in favor of simplicity and flexibility.
(For more details, please refer to the Evaluation section)
The early version game flow includes many complex decision making, such as fulfilling event requirements, purchasing habits and removing vices. The habits and vices features brought role-playing element to the flow. However, players had to spend much more time to learn about the game flow.
What you can expect from the final version are:
Staying out of the danger zone could become challenging, and players may experience how their risk can compound. Below are a look at some of the cards and features that make up the Be Heart Smart Game.
Behaviors cards
Choices we make and the urges we succumb to
Behavior cards combo system
Behavioral opportunities that players can choose to act on (in combos)
Version Comparison
This feature was adapted from traits system. In early version, players use behavior cards to gain heathy habits or lose vices. In final version, we removed the concept of habits/vices, and reduced it to simply pairing behaviors for immediate outcomes.
Blood Pressure
A primary gauge of health risk that must be monitored and kept under control. The risk level indicates the severity of potential health events.
Cholesterol
A secondary gauge of health risk that leads to atherosclerosis, harming players further.
Events
Random life events that happen to us out of our control
Version Comparison
Early versions had trouble providing fair effects and adjusting to reflect players' risk level. Later versions facilitated a categorization of risk level based on current BP levels and presence of atherosclerosis.
Compared with the early version, the game flow of final version is more simplified and automated. Most decision making are based on simple conditions for deciding behavior cards combo, as the flow chart below.
The game was evaluated on a weekly basis by educators and peers along with feedback provided by the stakeholders.
I really like it and I know that participants enjoy it as well. It is a great, unique way to engage with our audiences and to help them learn.
- Purdue Extension Program Leader
2 educators, 1 program lead, (many unknown educators)
Sep 2018 - Oct 2018
Weekly basis
Across state (IN)
I held small pilot tests with the 3 stakeholders every week. Then these stakeholders would go across the state to observe and conduct focus groups with the educators conducting pilot tests and their participants. Feedback was gathered and observations were reported along with their suggestions based on the experience.
I really like the colors of the cards, they look new and bright. The game helps show the difference that can be made in health with resources.
- Pilot Test Participant
Game is practical and uses real life examples. It reinforced concepts we learned from educational content. I really enjoyed it!!
- Pilot Test Participant
One of the latest pilot tests was conducted by me, with all of the members on the project there to help me conduct a full usability evaluation during the pilot test with all the educators present. This large group of diverse educators met at Purdue University to test this matured game. They were there to provide as much feedback as they could.
24 educators, and 6 assistants/observers
Oct 2018
Once
Across state (IN)
The educators were presented the latest version of the game along with full instructions. Educators formed 6 groups of 4, and we had enough staff familiar with the game that they could conduct each group. The staff, including myself, observed and took notes, recording feedback and observations about players experiences, noting the circumstances of issues that came up while identifying pain points and confusion.
The BHS educators are stakeholders for the game's success as they will have to teach this game and use it to educate people around the nation about heart health for years to come. They were passionate about making an effective and enjoyable game and were critical on keeping it easy enough to learn quickly.
The feedback and outcome of all these pilot tests included many clear improvements and brought awareness to issues that could be easily solved, such as changes to the instructions, tweaks to gameplay, and lots of recommendations such as graphic changes to aid visual comprehension and improving clarity of game state. Feedback was collected from the educators play tests and their feedback was sent to me in the form of consolidated notes. Many changes were made leading up to and following the final pilot and user testing.
Much of the feedback regarded confusion about gameplay rules. In earlier versions, many features such as the exchange of resource cards for controllable risk factors was a concept difficult to grasp by older players. Changes of the game flow includes:
Game flow (old v.s new)
Realism represents how much player can relate the game elements to real life, also the accuracy of experiencing heart issues. Regard to user feedback, realism was improved and addressed by the changes below:
BP tracking system (old v.s new)
Changes were made to improve the clarity of game elements and the player state, helping simplify decision making and reduce the cognitive load on players. Changes included:
Life Events (old v.s new)
