On July 16, 2016, Pokemon Go had been in release for 10 days and it was already more popular than Twitter and Tinder on mobile devices. Those with the app spent more time on it than on Facebook. It became the most downloaded mobile game in U.S. history. So what does this have to do with health? Pokemon Go is a game, but it is also a health and wellness app. And it’s making people move, a lot. Because unlike the thousands of “gamified” health and wellness apps created over the last decade, Pokemon Go is a healthified game. The game comes first. That turns out to be the smarter path to actually engage large numbers of people to be active, and it is showing a world of possibility. Self-reports and early data from tracking devices reveal a massive jump in walking, almost certainly tens of billions of additional steps in just one week. Over the course of the game, trillions of steps could be walked that would not have been otherwise. What can we learn from this?
Start with the experience. Gamified health and wellness apps or tools have been around for years. And they have been largely ineffectual, because nobody really enjoyed them. Yes, some of us do get briefly pulled in to one app or another; even things as simple as step trackers can get some people to make behavior changes for a time, but nothing has really been able to move the needle at a population health level. In contrast, the developers of Pokemon Go (Nintendo partnered with a Google spinoff called Niantic) had learned from millions of hours of playing time on other games what people actually enjoy, and asked themselves a simple question: how can we immerse them in an augmented version of the real world and make them get out and explore it while they play?
One of the tricks Pokemon Go uses is intermittent reinforcement. One of the oldest and strongest findings in experimental psychology is that intermittent reinforcement elicits a more persistent response than highly predictable reinforcement. A mouse presented with the prize of cheese from hitting a lever will hit the lever more times when it can’t predict which hit will bring the cheese, and it might come at any time. If I know I will get a prize with a small effort, like one press, I do the small effort and get sated. If I know it will be a huge effort, like 1,000 presses, I only make that effort when necessary (like if I need to avoid starvation). But if I don’t know how many presses it will take, suddenly the act of pressing the lever becomes more interesting because of the uncertainty and anticipation, and reward centers of the brain are engaged much longer. Las Vegas was built on intermittent reinforcement, along with some other quirks of human psychology, like our propensity to misjudge the likelihood of highly unlikely events. But unlike gambling, finding pocket monsters is not a zero sum game.
Another trick Pokemon Go uses is that the goals are open-ended (there is always more to do: another new challenge to accept, a Pokemon to find, a level to gain) and they are framed as in-game objectives rather than health objectives, by and large. While there is a badge for walking 10 kilometers, you aren’t aiming for a specific step goal and then stopping when you reach it. People, especially adults, are exercising more than they have in months or years without even realizing it, until they can no longer ignore the pain in their feet or legs.
One of the remarkable things about Pokemon Go is that it is able to inspire such high levels of participation without any monetary incentive. No one is getting paid to lose weight, or walk 10,000 steps a day, or keep their cholesterol low. If the engagement level in Pokemon Go can be replicated by other games (and surely it will be) this could have big implications for corporate wellness programs, which have tended to myopically focus on financial incentives to change behavior. This may turn out to be unnecessary. As developers create more engaging wellness games that don’t require financial payouts, it could substantially reduce the cost of such programs, or eliminate a reason to create them entirely (though the latter is unlikely).
The world is the playground. This is not the first iteration of healthy gaming for Nintendo. For the Wii console, Nintendo made what was, at the time, the best integration of motion sensitive controls and game play. Millions of people were flailing their arms to hit virtual tennis balls (and sometimes throwing their controllers into their TV screens), and shifting their legs on the “balance board” to move around in ways that made their onscreen avatars mimic them. But with the Wii you had to stay in your living room, and if you were using the board for a real workout, you had to stay on a very small platform. The same limitation applies to Microsoft XboX’s Kinect sensor that allows you to move and interact with the video game…as long as you stay right in front of the sensor’s view. As promising as Oculus Rift and immersive virtual reality gaming is, it has a similar limitation to the Wii, Xbox and other traditional gaming devices. You had better not walk out into a real street with it, but stay in the safety of your room (or even better, a room in which objects you might bump into are carefully removed).
The room, let alone couch, is a limitation that Pokemon Go just doesn’t have. The world is opening up to gaming. Pokemon Go and its ilk are not virtual reality, but augmented reality. Game destinations are added to a real map of the real world. Once you arrive at the right place, you use your Android or iOS device to “see” and “catch” the creatures around you, with their images superimposed on images your camera takes.
The pleasure of the game has another dimension that has only begun to be tapped: it’s social. Real people, of all ages, races and walks of life, are congregating in the same places pursuing the same goals in a way that isn’t zero-sum. And they’re smiling, amused at being thrown together doing something silly, casual and serious all at the same time. Right now the game hasn’t given these people a very deep experience at interacting, cooperating or battling, and so mostly they are just co-existing and feeling the comraderie of fellow-travelers.
After the fad. Is Pokemon Go a fad? Of course it is. But it’s a fad that opens a door to unimaginably many other fads and enduring games that will change the face of both gaming and health and wellness tools generally.
Take social engagement. Crowds of people are mingling around the world at hot spots for the little pocket monsters, and smiling in recognition of their fellow human who made it to the same spot on the same quest. But deeper social engagement already exists in another app from Niantic, on which Pokemon Go was partly based, Ingress. In that game, players must form teams and conduct elaborate strategies at real world sites of significance (like museums and monuments) to advance. That’s right, games now are giving people history lessons and showing them parts of town they had never visited before. How long will it be before some spawn of Pokemon Go and OK Cupid gets people to walk around town on quests, imaginatively participate in the history of their locale, and hook up with a potential partner?
On the other end of the spectrum, augmented reality could also be used in shooter games. I have two young children, and recently played laser tag for the first time in almost 30 years. As primitive as it was, with cumbersome gear needed to register a “hit,” I had a blast. It was perhaps the best cardio workout I’ve had all year (pathetic, I know, but we lazy people are legion, and we are the ones who need these kinds of games). Augmented reality could create an engaging backstory, and use special goggles to take a real world obstacle course or city park and add to it virtual monsters and robots, or alter how other players look, to take first-person shooter games like Call of Duty or Halo and make people actually run, duck and dive for victory. The question at this point isn’t whether such games will be created, but how long before the first killer app that is good enough to have millions scrambling for cover.
And soon some clever game designers will figure out how to make socially-interactive apps that not only encourage movement, but other healthy behaviors like good nutrition, in an immersive and fun experience. If the effects on childhood nutrition are large enough, we may even want to rethink the use of games in school settings. For some of the good behaviors learned will likely stick long after kids have stopped playing a particular game, and the public health benefits may be worth giving in a little on how we think kids, especially younger ones, should be spending their time in school. But first there has to be a game, a fun one, and not just a wellness tracking tool with a game-like veneer on top.
Jonathan Halvorson is new economy editor for THCB.