Re-Mission
Encyclopedia
The Re-Mission video game for teens and young adults with cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 was released by the nonprofit HopeLab
HopeLab
HopeLab is a non-profit organization based in Redwood City, CA that conducts research and develops technology-based products to improve the health and quality of life of young people with chronic illness. HopeLab's work focuses on five diseases: cancer, obesity, sickle cell disease, major...

 on April 3, 2006. The game is a Microsoft Windows
Microsoft Windows
Microsoft Windows is a series of operating systems produced by Microsoft.Microsoft introduced an operating environment named Windows on November 20, 1985 as an add-on to MS-DOS in response to the growing interest in graphical user interfaces . Microsoft Windows came to dominate the world's personal...

 based third-person shooter
Third-person shooter
Third-person shooter is a genre of 3D action games in which the player character is visible on-screen, and the gameplay consists primarily of shooting.-Definition:...

 based in the serious game
Serious game
A serious game is a game designed for a primary purpose other than pure entertainment. The "serious" adjective is generally prepended to refer to products used by industries like defense, education, scientific exploration, health care, emergency management, city planning, engineering, religion,...

s genre. The game was conceived by Pam Omidyar and designed based on HopeLab research, direct input from young cancer patients and oncology doctors and nurses, and game developer Realtime Associates
Realtime Associates
Realtime Associates is an American video game developer and publisher. The company was founded in 1986 by David Warhol and a group of ex Mattel Electronics employees originally to create games for the Intellivision system...

, among others. The game was designed to engage young cancer patients through entertaining game play while impacting specific psychological and behavioral outcomes associated with successful cancer treatment.

Gameplay

In Re-Mission, the player controls an RX5-E ("Roxxi") nanobot
Nanorobotics
Nanorobotics is the emerging technology field of creating machines or robots whose components are at or close to the scale of a nanometer . More specifically, nanorobotics refers to the nanotechnology engineering discipline of designing and building nanorobots, with devices ranging in size from...

 who is designed to be injected into the human body and fight particular types of cancer and related infections such as non-Hodgkin's lymphoma and leukemia, at a cell
Cell (biology)
The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....

ular level. The player must also monitor patient health and report any symptoms back to Dr. West (the in-game doctor and project leader). Each of the 20 level
Level (computer and video games)
A level, map, area, or world in a video game is the total space available to the player during the course of completing a discrete objective...

s is designed to inform the patient on a variety of treatments, how they function, and the importance of maintaining strict adherence to those treatments. Various "weapons" are used, such as the Chemoblaster, Radiation Gun, and antibiotic rocket.

Research

HopeLab conducted an international, multicenter randomized controlled trial to gauge the efficacy of Re-Mission as it relates to compliance
Compliance (medicine)
In medicine, compliance describes the degree to which a patient correctly follows medical advice...

 with prescribed chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

 and antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

 treatments, cancer-related knowledge, and self-efficacy
Self-efficacy
Self-efficacy is a term used in psychology, roughly corresponding to a person's belief in their own competence.It has been defined as the belief that one is capable of performing in a certain manner to attain certain set of goals. It is believed that our personalized ideas of self-efficacy affect...

. The study enrolled 375 cancer patients aged 13–29 at 34 medical centers in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, and Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

. Subjects received either computers pre-loaded with a popular commercial video game (the control group) or computers preloaded with the same control game plus Re-Mission. Study results indicated that playing Re-Mission led to more consistent treatment adherence, faster rate of increase in cancer knowledge, and faster rate of increase in self-efficacy in young cancer patients. These findings were published in August 2008 in the peer-reviewed medical journal Pediatrics
Pediatrics (journal)
Pediatrics is an official peer-reviewed journal of the American Academy of Pediatrics. In the inaugural January 1948 issue, the journal's first editor, Hugh McCulloch, articulated the journal's vision: "The content of the journal is... intended to encompass the needs of the whole child in his...

. Notably, to ascertain treatment compliance, researches used objective blood tests to measure levels of prescribed chemotherapy in the bodies of study participants rather than subjective self-report
Self-report inventory
A self-report inventory is a type of psychological test in which a person fills out a survey or questionnaire with or without the help of an investigator...

 questionnaires, and electronic pill-cap monitors were used to determine utilization of prescribed antibiotics. Researches concluded that a carefully designed video game can have a positive impact on health behavior in young people with chronic illness and that video-game–based interventions may constitute a component of a broader integrative approach to healthcare that synergistically combines rationally targeted biological and behavioral interventions to aid patients in the prevention, detection, treatment, and recovery from disease.

HopeLab is conducting additional research to understand the mechanisms of action that make Re-Mission effective.http://www.hopelab.org/our-research/re-mission-attitudes-study-in-the-brain/ Results of an fMRI study of Re-Mission showing the impact of the game on neurological processes were presented in August 2008 at the 10th International Congress of the Society of Behavioral Medicine.http://www.icbm2008.jp/index.html This research is intended to inform HopeLab's development of the next version of Re-Mission currently underway.

Distribution

HopeLab makes Re-Mission available at no charge to young people with cancer and their families, as well as oncology healthcare workers and institutions around the world. Copies are also distributed at no charge to others, though donations are accepted. The game can be downloaded or ordered at re-mission.net in English
English language
English is a West Germanic language that arose in the Anglo-Saxon kingdoms of England and spread into what was to become south-east Scotland under the influence of the Anglian medieval kingdom of Northumbria...

, Spanish
Spanish language
Spanish , also known as Castilian , is a Romance language in the Ibero-Romance group that evolved from several languages and dialects in central-northern Iberia around the 9th century and gradually spread with the expansion of the Kingdom of Castile into central and southern Iberia during the...

, or French
French language
French is a Romance language spoken as a first language in France, the Romandy region in Switzerland, Wallonia and Brussels in Belgium, Monaco, the regions of Quebec and Acadia in Canada, and by various communities elsewhere. Second-language speakers of French are distributed throughout many parts...

. The Re-Mission website also includes an online community
Online community
An online community is a virtual community that exists online and whose members enable its existence through taking part in membership ritual. An online community can take the form of an information system where anyone can post content, such as a Bulletin board system or one where only a restricted...

 where teens and young adults can share information and support each other.
As of August 2008, more than 126,000 copies of Re-Mission had been distributed in 81 countries. HopeLab engages organizations and individuals worldwide to fasciliate distribution of the game to teens and young adults with cancer. On May 30, 2007, CIGNA HealthCare
CIGNA
Cigna , headquartered in Bloomfield, Connecticut, is a global health services company, owing to its expanding international footprint and the fact that it provides administrative services only to approximately 80 percent of its clients...

 announced a partnership with HopeLab in which CIGNA distributes copies of Re-Mission to its members at no cost.http://newsroom.cigna.com/article_display.cfm?article_id=715 HopeLab has also partnered with Starlight Children's Foundation and the ESA
Entertainment Software Association
The Entertainment Software Association is the trade association of the video game industry in the United States. It was formed in April 1994 as the Interactive Digital Software Association and renamed on July 16, 2003...

Foundation to distribute Re-Mission.

External links


Articles

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