Re-Mission

The Re-Mission video game for teens and young adults with cancer was released by the nonprofit HopeLab on April 3, 2006. The game is a Microsoft Windows based third-person shooter based in the serious games 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, 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 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 cellular 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 levels 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 with prescribed chemotherapy and antibiotic treatments, cancer-related knowledge, and self-efficacy. The study enrolled 375 cancer patients aged 13–29 at 34 medical centers in the United States, Canada, and Australia. 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. 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 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. 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. 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, Spanish, or French. The Re-Mission website also includes an online community 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, placing it among the most successful serious games to date. 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 announced a partnership with HopeLab in which CIGNA distributes copies of Re-Mission to its members at no cost. HopeLab has also partnered with Starlight Children's Foundation and the ESA Foundation to distribute Re-Mission.

Articles

 * "Games for Health Keynote Speaker Steve W. Cole on ReMission" by Erin Hoffman, Serious Games Source (November, 2006)
 * "Video Games Aim to Hook Children on Better Health" by Christopher Lee, The Washington Post (October 21, 2006)

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