Support Designers of Games for Health


Serious games for health is an emerging field that use game media to help players attain health-related goals. Game designers play a crucial role in this growing game genre; they face the unique challenge of making their designs accessible and engaging while delivering intended health objectives.

Particularly, this group of designers face a prominent challenge in consolidating the different mindsets and motivations with other stakeholders, especially the subject matter experts. I.e. subject matter experts tended to be narrowly focused on the purposeful goals of the game, while game designers often lacked knowledge about the context in which the game would be played.

Research Outcomes

Understanding games-for-health designers

We interviewed 11 professional games-for-health designers from various studios to explore how they perceived and approached their work. Findings revealed how the participants considered “success” and the challenges of designing games for health; we also identified various methods and tools used in their practice. We found that the interviewees were very user-centric and tended to focus almost equally on the problem and the solution spaces when approaching game design. The designers’ user-centered efforts, however, did not always help with many challenges they met in their work, especially when consolidating interests with the subject matter experts. These insights motivated and guided the rest of this research.

Therapy-centered game design patterns

Design patterns support communication among practitioners in a certain field by providing vocabularies that describe reusable design concepts that have successfully solved recurring problems. It is an important tool in game design (i.e. game design patterns); however, discussion about design patterns in games for health is very limited in the literature.

Through analysis of data about more than 300 therapy sessions in which therapists used various commercial games with patients who have had a brain injury, we generated 25 therapy-centered game design patterns for brain injury therapy games. We then iterated these patterns based on feedback from professional games-for-health designers. These game design patterns were divided into two groups: (1) efficacy-centered patterns that focus on enforcing therapeutic efficacy of the games and (2) experience-centered patterns that focus on fostering in-game experience of patients who have had a brain injury.

An information tool to Support Designers of Games for Health

Design patterns alone do not ensure good design. Research has indicated that presenting patterns in a way that facilitates pattern choosing and context awareness can greatly promote the effectiveness of using the patterns. In addition, game designers of brain injury rehabilitation need to consider other factors such as patients’ abilities, patient preferences, and context of use (e.g. a rehabilitation gym that is shared by many therapists and patients) in order to design appropriate games for target users.

We created a game design tool that streamlines the use of the therapy-centered game design patterns. The tool highlights the inter-relationships among the patterns and supports multiple navigation models for pattern browsing and choosing. The most recent version of the tool can be accessed at

We followed a user-centered approach to create and evaluate this tool through: (1) usability studies to establish the user interaction of the tool and (2) quasi-experimental game design workshops that involved both game designers (including novices and experts) and therapists to further explore the user experience and efficacy of the design tool. During the workshops, the design tool successfully supported exploration of design ideas and effectively facilitated discussion among designers and therapists.

Related Publications (email me if you would like a copy)

  • Cheng, J., Anderson, D., Putnam, C., & Guo, J. (2017). Leveraging Design Patterns to Support Designer-Therapist Collaboration When Ideating Brain Injury Therapy Games. In Proceedings of the 2017 Annual Symposium on Computer-Human Interaction in Play - CHI PLAY ’17 (pp. 291–303). doi:10.1145/3116595.3116600 (Acceptance Rate: 26%; Best Paper Award: Top 5% of accepted papers)
  • Cheng, J., Putnam, C., & Guo, J. (2016). “Always a Tall Order”: Values and Practices of Professional Game Designers of Serious Games for Health. In Proceedings of the 2016 Annual Symposium on Computer-Human Interaction in Play - CHI PLAY ’16 (pp. 217–228). doi:10.1145/2967934.2968081 (Acceptance Rate: 29%)
  • Cheng, J., Putnam, C., & Rusch, D. C. (2015). Towards Efficacy-Centered Game Design Patterns For Brain Injury Rehabilitation: A Data-Driven Approach. In Proceedings of the 17th International ACM SIGACCESS Conference on Computers & Accessibility (pp. 291–299). doi:10.1145/2700648.2809856 (Acceptance Rate: 23%)
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