Peer group effect
Ayogo's business model is to partner with non-profit organizations and have a pharmaceutical sponsor underwrite the game development.
That allows the games to be given to patients for free, a point of importance for Fergusson. A current project was created
in partnership with the Diabetes Sisters Foundation, an advocacy group for women with diabetes, and funded by Sanofi. Called
SisterMatch, the game was developed for women between the ages of 40 and 60 years old, with type 2 diabetes. "Often these
women feel very isolated," says Fergusson. "Many have developed sophisticated coping skills, with good ways to manage their
condition, and some others have not. What the research tells us and we accept as true is that people who have strong relationships
with other people who have diabetes—strong peer groups—are more successful in staying healthy. The behavior change we want
is for these women to find each other, and to exchange information about their lives and about managing their disease, and
to provide each other with practical and emotional support."
The target group for SisterMatch, unlike teenaged boys, doesn't like to fight and compete; they like to cooperate, says Fergusson.
Thus, the game needed to be built around the dynamic that leads to cooperation within this group.
As it turned out, that dynamic was the telling of embarrassing stories. "Women love to do this, you see them all standing
together, and someone says, 'this really embarrassing thing happened to me.' And they all bond around it," says Fergusson.
"So we built [SisterMatch], an application in the form of a quilt. It's a cooperative game, and together the objective is
to build a quilt, and each square represents a story that's told by someone in the community. Others can comment on the quilt,
and make connections." Squares on the quilt are the game's reward, and there are quizzes that provide additional ways of initiating
new conversations. "We might also give the community a mission, for example, we want them to try going to bed earlier to see
how that affects the way they feel," says Fergusson. "We could just say 'go to bed earlier,' but it's much more effective
if we say, 'go to bed earlier three times this week, and then come back and tell us how it affects your sex life.' That turns
out to really work."
The game also has "an eHarmony-like personality matching system, so that when you visit your quilt, the other people's quilt
squares nearby are people whose personalities most closely match yours. So you're more likely to find people you can relate
to, who have similar interests, and live in similar geographies," says Fergusson. Dunbar's research helped Ayogo determine
the optimal group sizes for cooperation and sharing, which is one reason the game isn't on Facebook, for example. "Facebook
is not a good social network environment for transmitting behaviors of certain types," particularly when the focus is on making
changes around intimate health and medical areas, according to Fergusson.
SisterMatch facilitates social connections between senior women.
Another game called Small Things, also funded by Sanofi, is currently in the beta testing phase and is designed for families
with children diagnosed with type 1 diabetes. It's tough on kids to have to get up and leave the classroom to test their blood
sugar every day, and the real kicker of it, says Fergusson, is that if the child does the right thing, dutifully pricking
a finger and recording the result, nothing happens. Things happen—negative things—when they don't follow the rules. "Our brains
are designed to respond to something, not nothing, even if that thing is negative. Small Things is a smartphone app, and it
works around a Tamagotchi-style game (Tamagotchi is the hand-held digital pet that every kid wanted a few years back) for
the child with diabetes. The app sends an alert when it's time for a blood test, and then results are typed into the app.
The app transmits the data to the child's parents or caregiver, and the next thing that happens, before they leave to go back
to class, is they get a notification announcing some earned game currency. Currency allows them to create little monsters
and then nurture them. The monsters live in a world that the user can customize, and this play—which is only 15 to 20 seconds
after the test—provides an award. Parents get the blood results, but also data on their child's participation in the game
play, through access to a web interface, and they can also get it sent to their phones.