Zombies, run! A case study

Physical activity is associated with a host of positive health outcomes, including reduced risk of cardiovascular disease, several cancers and all-cause mortality. 1 - 3 Unfortunately, the average American adult is active for only 4 percent of their day, 4 and most do not meet physical activity recommendations. The National Health and Nutrition Examination Survey (NHANES) estimates that as many as 34 percent of Americans have metabolic syndrome, a compilation of risk factors that include high blood pressure, high “bad” and low “good” cholesterol, high blood fat levels and abdominal obesity. 5 Each of these risk factors can be lowered by regular exercise 6, however, even within otherwise highly effective behavioral weight-loss interventions, physical activity levels decrease sharply over time. 7 Innovative methods for encouraging physical activity are clearly required to increase motivation to begin and sustain an active lifestyle. It is difficult to find the time to engage in a monotonous and un-engaging activity, but something as important as maintaining a healthy and active lifestyle requires a commitment. Your chopper crash lands and a sea of zombies surround you, providing ample motivation to run (for your life) while playing Zombies, Run!, an epic narrative adventure app available for iOS and Android mobile devices. Naomi Aider-man, the game’s head writer and co-creator with Six to Start, recalls that she had just joined a running group when the idea came to her. She asked the members why they had joined; some wanted to lose weight, others hoped to get fit, and one person exclaimed, “To escape the zombie apocalypse.” In a keynote presentation at the 2013 Games for Health conference, Alderman and Six to Start CEO Adrian Hon summed up the purpose of the game: “Not everyone wants to run, but everybody wants to want to run, and that is the gap that we fill.” 8 For many, running is simply not a very exciting activity, but playing a game certainly is. If running were a metaphor for life, world-renowned game designer and best-selling author Jane McGonigal says that it “Just doesn’t offer up as easily the carefully designed pleasures, the thrilling challenges, and the powerful social bonding afforded by virtual environments.” 9 While Zombies, Run! is not the typical virtual environment one would associate with a fitness video game, it is a conduit for arguably the most important aspect of a game: fun. Fun and enjoyment 104of exercise-related games are associated with behavioral and physiological changes, 10 and this game appears to truly resonate with its users.