These games target COVID-19 misinformation. But do they work?

Rozita Singh and her colleagues at the U.N. Development Programme’s Accelerator Lab in New Delhi developed a scenario-based game called CoronaChampion during India’s first national lockdown in 2020. The rules of the game are simple. Players are asked to swipe right if they think a statement — such as whether rinsing one’s nose with saline would prevent COVID-19 — is true, and left if false.

At that time, most information on COVID-19 was inaccessible, provided in few languages, or difficult to consume, Singh, head of solutions mapping at the lab, told Devex.

“So, you know, the idea was that, can we actually just make it a little bit more fun to give this information? Because obviously, people are going through the stress already during a pandemic. So can we reduce their stress? Can we like, gamify the information?” she said.

Organizations have tried different ways to debunk fake news and misinformation, and games are a more lighthearted alternative to news fact checks, or videos of scientists explaining why garlic won’t protect people from getting COVID-19. 

In speaking with game developers, Devex learned that the extent to which these games can change people’s attitudes, behaviors, and beliefs about COVID-19 is unclear, or can be limited. But there are ways to reinforce the message games impart, and they can still be a useful additional tool in health promotion for COVID-19 and other diseases.

Wide reach, impact uncertain

A second version of CoronaChampion launched in September 2020, and included scenarios on the impact of COVID-19 on women. UNDP matched that with a three-week-long campaign on Facebook and Instagram to promote the game, but also to know who was playing it. At the end of the campaign, they generated over 27 million impressions on both social media platforms. They also found the game reached individuals in their late 30s to early 40s across different states in India, and that more men clicked on the game than women.

Learning that more men expressed interest in the game inspired the team to launch a month-long digital initiative in December 2020 targeted at men and boys, to increase their acceptance and responsibility toward unpaid caregiving, Singh said.

As for the game itself, Singh said it likely sowed some initial change, but it was a challenge for the team to gather information on how it changed behaviors in real life.

A complementary intervention

Nevertheless, it appears games can help complement health interventions on the ground.

The COVID Challenge game is an iteration of a game Médecins Sans Frontières developed during the 10th Ebola outbreak in the Democratic Republic of Congo that ended in June 2020. That game was developed to fight misconceptions among communities — for instance, that Ebola treatment centers were places where people die.

There was a similar if not wider misunderstanding happening around COVID-19, and MSF saw the need to develop a COVID-19-focused game, said Dr. Abiy Tamrat, medical technology  coordinator for MSF in Geneva.

The game is scenario-based, where players are asked to choose an action based on a situation. For example, if someone in the family is suspected to have COVID-19, should the player ask the family member to “stay only on the sofa” or “air out the house”?

MSF has yet to evaluate both games’ behavioral impact. But for COVID Challenge, Tamrat said the difficulty is in differentiating whether people’s knowledge were gained from the game itself, or health messages from other organizations or the media.

MSF plans to add information on vaccinations, given the scramble globally for doses and the challenge of vaccine hesitancy. But he added that such game-based applications “shouldn't be done in a vacuum.”

“There should be a way to link it with the general health promotion activities that we do. So they go hand in hand,” he said.

Learning as prevention technique

Debunking is not the only way games are fighting misinformation. There is also prebunking, or preempting fake news. Go Viral!, for example, is an interactive game that gives players a glimpse on how fake news goes viral.

Before Go Viral! was launched, Jon Roozenbeek, a postdoctoral fellow of psychology at the University of Cambridge, and colleagues had developed Bad News, a game that trains people to recognize manipulation techniques online. They also developed Harmony Square, which teaches players how information is weaponized to sow discord and polarization.

The games don’t dictate what’s right or wrong, but they train people on how information is misused and spread online, in the hopes that it will help people become more discerning in consuming information. Efforts for fact checking and debunking are helpful but can be useless if people don’t trust the information, Roozenbeek told Devex.

”We're not trying to tell anyone what is and what isn't real. But rather we're trying to make it easier for people to decide for themselves, ‘OK, I think … this looks manipulative to me. I'll think twice before believing this or sharing this with others,” he said.

But in the studies they’ve done evaluating the impact of the games, the team found a player will require a regular reminder or, in vaccine speak, “booster shot” so they don’t forget.

With Bad News for instance, they found that participants who were tested in their ability to discern the reliability of news headlines several times after playing the game were still able to determine manipulative social media posts after 13 weeks compared to a control group that only played Tetris. But in another study where participants didn’t undergo multiple tests, they found the effect of the game mostly dissipated after nine weeks.

A separate study for Go Viral! showed that participants were able to spot manipulative content about COVID-19 one week after playing the game. But that was in December 2020, and Roozenbeek is doubtful whether the lessons stick six months later.

“It's like with a regular vaccine. The immunity doesn't last forever,” he said. “It's the same with psychological immunity, because people tend to forget the things that they learn if they don't repeat them.”

Such reminders, or booster shots, can come in the form of a new game, like Bad News version 2.0 which the team is currently developing, with other multimedia like infographics or short videos that explain how manipulative content is made.

Roozenbeek’s team recently collaborated with Jigsaw, a tech incubator under Google, to develop videos exposing how manipulation techniques work. The team found the videos also helped participants to discern misinformation, Roozenbeek said, although the full study has yet to be published.

He said such videos can be played as advertisements on social media platforms like YouTube or Twitter, where people can check them out while scrolling through their feeds. That’s another way to help inform people how content manipulation works.

“One of the limitations of the game, of any game, is not everyone is going to sit down and play it,” he added.

This coverage, presented by the Bay Area Global Health Alliance, explores the intersection between technology, innovation, and health. How are tech, innovation, and cross-sector partnerships being leveraged to accelerate equitable access to health care?