When presented with the choice of escalator or stairs, most of us chose to queue up for the escalator, even though walking up the stairs is better for our health. But what would you do if the staircase was a giant piano? A “fun theory” experiment tried exactly that and found that 66% more commuters opted for the stairs over the escalators, proving that fun can be a motivating factor for improving health.

Changing people’s behaviour for the better is part of what public health aims to achieve. Several health projects are already incorporating fun theory. For example, Unilever is using cartoon characters to get children to wash their hands and to stop the spread of preventable diseases. And in India, the Aids Fighter Pilot and Stop TB Cricket mobile phone games were designed to raise awareness of HIV/Aids and tuberculosis among young people. The games were appreciated by the target group and were found to be an effective, quick and convenient medium for improving health.

It makes sense to incorporate fun theory into programmes aimed at children and young people, but can the approach persuade adults to adopt healthy habits too? Theatre performances, role plays and songs have helped raise awareness on health issues for years. Currently, the #StopEbola song, which originated in Ivory Coast, has gone viral. And a game called Boda-Boda was devised by the Uganda Red Cross and the Engagement Lab to bring down motorcycle taxi accidents. During the game, players compete to earn fares by safely moving passengers from one station to the next. When the inevitable crashes happen, players can help each other by giving first aid.

And it’s not just behaviour change that’s using fun to improve health. In 2011, tens of thousands of online gamers were co-opted to help work out the 3D structures of proteins as part of work to discover the cure for HIV using a game called Foldit. They discovered the structure of a retrovirus enzyme, a task which scientists had failed for more than 10 years to complete.

Gamification is not the only way to encourage behaviour change in health, but it can be a tool for raising awareness on serious issues and helping societies overcome epidemics. Gamification also has potential to help people with chronic diseases to manage their medical regimes.

But there are downsides. Game mechanics are based on extrinsic motivators and can detract from people’s intrinsic motivation. Extrinsic rewards can be a powerful tool to start new behaviours, but too much reliance can actually decrease self-motivation over time. Another downside is that the process of gamification is entirely top down. The designers of the game create the rules and the framework and let no space for improvement or innovation from the users.

A New York City based non-profit Games for Change has devised a toolkit for helping NGOs to create “social impact games”. This a good resource for development organisations who want to make their programmes a bit more fun.

Marie-Christine Boeve is head of communications at the Belgian Development Agency. Follow @BTC_Belgium on Twitter.

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