Carnegie Mellon University
January 02, 2019

Can Kids Game Their Way to Better Health?

By Scottie Barsotti

A team of researchers is conducting a global study to determine how mobile-virtual reality gaming might help kids develop a healthier diet and lifestyle habits.

Rema Padman, a professor of management science and healthcare informatics in Carnegie Mellon University's Heinz College of Information Systems and Public Policy, is a key leader of the research.

Her team is working with FriendsLearn, a Silicon Valley-based startup with Chennai presence, and their artificial intelligence-powered app-based game, Fooya. Billed as "The World's Epic Food Fight," the game's aim is to educate and guide players to internalize the symbiotic relationship between food, health and wellness in a fun and immersive way.

"When we compare a group of children who played Fooya to a control group who played a board game, we observe a positive and statistically significant difference in their actual food choices at the end of the game," Padman said.

In the game, players control heroes who use food-based "weapons" to combat villainous robots plotting to destroy the player's health. Players run around the game world to burn calories while dodging unhealthy foods being hurled by enemies, defeating those enemies by throwing food in return.

Fooya is an application of artificial intelligence in the area of non-communicable disease prevention, which is a pioneering category of technology known as "digital vaccines," based on a novel synthesis of neuroscience, cognitive science and immersive mobile-VR technology.

"Disease prevention technology has been focused on vaccines for infectious diseases, but how can we tackle non-communicable diseases? The burden is now shifting toward heart disease, diabetes, cancers linked to diets and mental health issues," said FriendsLearn CEO Bhargav Sri Prakash. "We are now focused on how we can harness the capability of digital technologies as health simulators, to imagine low-risk, low-cost, non-invasive and societal-scale ways of preventing these diseases."

Padman said the aim is for players to get the hang of the game quickly and revisit it often to reinforce learning.

"The idea is to think of it almost as a prescription, as part of a treatment plan. Just like a patient taking a vitamin every day - it's a similar approach, only they're playing a game instead," Padman said. "We think it is a powerful push forward in disease prevention technology."

The game is enabled by breakthrough innovations in machine learning and deep learning techniques, able to personalize the experience for each child depending on their unique demographics. For example, details in the gameplay can change to reflect the child's individual needs, health-risk for being undernourished or overweight, location and even seasonal changes in the food the child might encounter. The team emphasizes that Fooya has undergone substantial ethical review, including information security concerns.

Research has shown that playing various types of games including video games can have emotional, intellectual, creative and many other benefits for young players. One study found that playing video games — in conjunction with fitness coaching and a step tracker — helped overweight children lose weight, lower blood pressure and increase their physical activity, among other benefits.

FriendsLearn recently partnered with the Bloomberg School of Public Health at Johns Hopkins University; the Center for Communication and Change — India; and Professor Padman's team, which includes CMU alumnus Dr. Yi-Chin Lin of Hofstra University and a number of current Heinz College graduate students, to conduct an experiment in Chennai, India, to test the game's effectiveness and its association with food choices.

Padman and her team are examining behavioral data generated by users clicking within the game to look for patterns that indicate how children engage with the game and what patterns of clicking may point to healthier food choices.

"We're seeing some interesting patterns in game mechanics and dynamics, such as variations in the number of levels, features played, and range of actions at each level, and associations between those variations and the kids' actual food choices," Lin said.

Padman added that the team observed that simply being exposed to the game generated some awareness in the children to make better food choices. She noted that further longitudinal studies involving more participants will help to solidify these observations.

Padman and FriendsLearn are expanding the application of the technology and its analytics platform in partnership with UPMC Children's Hospital of Pittsburgh (CHP) to assess their impact within a pediatric population of type 1 diabetes patients.

The CHP clinical team includes Dr. Srinivasan Suresh, emergency physician and chief medical information officer; Dr. Heba Ismail, until recently the clinical director of the Diabetes Program and a professor of pediatrics and pediatric endocrinology; Dr. Radhika Mazumdar, chief of Endocrinology; and Dr. Ingrid Libman, director of the Diabetes Program. Together, they are studying the longitudinal impact on glycemic events and other biomarkers of risk.

Even the most chronic diabetes patients only spend about 1 percent of their time at the hospital, according to Suresh. Feedback from games like Fooya can give clinicians a window into what's happening during the other 99 percent.

"The game can help us know more about the disease, about compliance with medications, and other general information so that we can provide better care," Suresh said.

Ismail notes there is a gap between health education and the habits of today's youth.

"Food is really important, especially for kids with Type I diabetes. They get a lot of teaching about food, they have to change how they eat, they have learn to monitor insulin, etc." she said. Ismail noted that current education methods tend to be didactic (ie. lecturing) — retention of the information suffers as a result, and many patients fall back into old habits.

"Since most kids already play games, we thought why not have them do that in a way that is educational? Hopefully we will be able to change their habits and positively impact their diet," Ismail said. In addition to providing education on healthy dietary choices, Fooya also addresses critical subject matter like ketones and insulin management.