Work in progress: The 2 B PhD concept Research plan

Dear Judith, dear Sandra, dear Huibert,

You didn’t give official feedback yet, but there are already some changes. These still are my first steps on a concept Research plan. The references that I have used at the moment are purely so that a reader can get a better viewpoint on the several issues. They are not scientific references yet.

In the last week four events have triggered an alternation of my research plan:

  1. In his introduction mail Huibert remarked that I still am searching for focus. True! I still am searching, but together with Sandra we are trying to discover if patients with chronic back pains or patients covered by the Onco@Zuyd group are a good group to do this kind of research on. More focus will (and has to follow)
  2. In the previous version a combination of SuperBetter and Elise is suggested. Perhaps choosing for one of them or perhaps even better choosing for the ideas and methodology behind them and searching for a own set up of a game will be more beneficial.
  3. Together with Marsha Bokhorst, our Librarian, I have searched for research on SuperBetter. I found a U Penn research: and am waiting for more statistics on it, but along with it my colleague Miguel van de Laar pointed out something that is going to shift the research into a (slightly (?) different direction): 
  4. Jane McGonigal and SuperBetter have gone different directions, and even worse the company behind SuperBetter has been disbanded. Intellectual property is for sale, and I already have bought a lotery ticket, because that will be the only way to buy it.

You understand that this second version is a little bit different of the first one. And after reading A Guide to Writing the Dissertation Literature Review from Justus J. Randolph of Walden University, there soon will be a third version, 

With kind regards


Concept Research Plan 0.2      

The problem

In the Netherlands (as in other European and North American countries) society is relocating responsibilities from the national government through local governments[1] towards communities and individuals.[2]  This shift in responsibility and current economics en demographics in these regions leave us with a challenge: doing more with less or other resources.

In the field of care and cure of the chronical ill this in effect means more pressure on the patient and his or hers direct environment.  Patients and their social environment have more responsibilities and self-control, but also need to invest more time, energy and money in the process of getting better or adapting to their situation. The empowerment of the patient and the community he or she lives in is a must if we want to keep a high standard of living for patients and their families.

The opportunities

There is a resource, which can be used for our challenge to do more with less or other resources in health care. The gamers! We see that in the same societies there is a big amount of online gameplay[3] and an increase in usage of social media and portable technologies like smart phones, tablets and mini-pc’s. The potential of the gameplaying part of our world, the potential of connectivity through social media and the growth of adaptation of technology gives us some great opportunities to conquer our challenge.

The challenge already begun

The usage of gaming in the domain of health care (of the chronic ill) isn’t new. Since game consoles like the Wii, the X-Box Kinect and the Playstation made exercise games and hardware commercially available, the rise of usage of these games into health care and cure programs increased.[4] Health care takers over the world are convinced that by improving the fun factor into the health program that this will be beneficial to the effort a patient puts into the program.

Most of these games and subsequent health programs are in a setting between therapist/docter and one or several patients which are engaged in a commercially available game. The therapist uses observation, manages the goals and engages patients into the game.

Our main problem is that we want to increase the quality of the health process with less or other resources and therefore we want to increase the involvement of the patient, the relatives and community around the patient.

Let’s research massive multiplayer role playing alternate reality games

Computer games like World of Warcraft are so called MMORPG: Massive Multiplayer Online Role Playing Games. In these type of games the player is challenged in a realm with all kind of roles, races, professions, guilds and groups. Social connections empower players in the quests they encounter and some quests can only be solved in groups with several multi functional players. Research on efficacy and empowerment in such games has been done.

One of the first steps to translate this empowerment from games into the real world are made by the Lydians, at least thats what Jane McGonigal states in ‘Reality is Broken’. As a game developer she researched game principles used in real world settings. So a real world proces made into a game. This is called an ARG, alternate reality game. She has worked on a multiplayer ARG to improve the health process called SuperBetter. SuperBetter[5]  is a online game for patients coping with a broad range of problems. In the words of the development team SuperBetterLabs: “SuperBetter helps you achieve your health goals — or recover from an illness or injury — by increasing your personal resilience. Resilience means staying curious, optimistic and motivated even in the face of the toughest challenges.”[6] The basis of the game is to improve four types of resilience: Mental, Emotional, Physical and Social.[7] You can improve on these resilience types by learning how to set goals and achieving them.[8] Through Social Media your social environment can be involved in this game.[9]

Family centered care or community centered care[11] gets a lot of support at the moment. Researchers, governments and care companies are interested in tools and methods which will support the change from nationally organized care into community organized care. The combination of a game and a both online and offline social community which is connected to other communites-a-like has great potential for coping our challenges of: doing more with less or other resources (within the field of the chronic ill) Creating a game where the social environment of the patient is more engaged in the health process of that patient will improve efficacy of that patient and empowerment of that patient (and its social environment).

 Research Question

It is still too early (for me) to formulate a great research question out of this all. But I can try to describe what I want to research:

Questions that I hope to find answers on are:

  • Can we improve involvement/engagement of the social environment by making the health care process a game?
  • Can we improve effectiveness of communication between health caretakers and patient by making the health care process a game?
  • Can we improve the effort and energy that a patient puts into his health care process by making the health care process a game?
  • Can we improve the knowledge exchange between the patient and other patients, between the social environments of a patient with type of illness and between specialized health caretakers of one type of illness by making the health care process a game?
  • Can we do all this by using a MMRPARG in a setting where the patient has a chronic illness? Or do we need a combination of ideas from SuperBetter and Elise to get a tool that enables community based and self-managed care.

No formulation for the main research question yet!

[1] Reference to: “ De drie decentralisaties” zoals ze door de VNG genoemd worden

[2] Reference to:  Een van de wijkgerichte zorg projecten zoals ze nu door Gemeenten worden opgepakt

[3] This can be illustrated by research, starting point: Reality is Broken

[4] Reference to: Scoping Review of Exergames

[6] In a personal (Dutch) blog: SuperBetter is explained. This blog is supported by video explanations by Jane McGonigal in English. Reference to the U Penn research on SuperBetter ( A Randomized Controlled Trial: The Effects of SuperBetter on Depression) should be made.

[7] In a personal (Dutch) blog: and the resiliences are explained and supported by video explanations by Jane McGonigal in English.

[8] In a personal (Dutch) blog: the goalsetting and questing is explained. The explanation is supported by video explanation by Jane McGonigal in English

[9] In a personal (Dutch) blog: the Allies ares explained. The explanation is supported by video explanation by Jane McGonigal in English

[10] Trademark of Mediaan (

[11] Reference to: the research of Barbara Piskur on Family centered care/cure and Ruth Dalemans on ‘Eigen Kracht’

[12] We are especially interested what is called in Dutch: “Eerste lijns hulp”. Your local doctor, physical therapist, etc.

Geplaatst op 23 september 2013, in 2 B PhD JAMS, English Jam, SuperBetter. Markeer de permalink als favoriet. 1 reactie.

  1. Judith van Hooijdonk

    Nu je voor de 2e keer om feedback vraagt zal ik dat proberen te doen. Wel in het Nederlands. If you don’t mind 😉

    Met je onderzoek sluit je wel mooi aan bij wat onze Koning tijdens Prinsjesdag verwoordde: dat we door lokale samenwerkingsverbanden transformeren naar een participatiesamenleving! Zijn steun heb je al.

    Wat superjammer dat het einde oefening van Superbetter is, hopelijk is het lot je gunstig gestemd. Ik kan me voorstellen dat Sandra je adviseert je meer op de methoden van jouw voorkeur games te focussen ipv op deze games zelf. En misschien zijn er nog wel superbettere games waarvan je nu het bestaan nog niet weet. Of die ga je nu gewoon zelf maken!

    Ik weet niet wat je allemaal al gelezen hebt, maar ik wil je nog even op 2 blogpost van mij over gaming attenderen J over game-deskundige David Nieborg en op de infographic staan ook nog verwijzingen naar literatuur waar je misschien nog iets mee kunt.

    En als ik nog wat tegenkom dan meld ik me wel, dat weet je 😉

    In je vragen heb je het nog over Elise terwijl je die in je inleiding niet meer noemt (betekent ook dat noot 10 verwijderd moet worden).

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