Making healthy behavior change fun for youth: games for SBC

Increasing health-seeking in adolescent girls and young women in Zimbabwe with game play.

Client: The Kaizen Company
Project: My Health, My Life (USAID BAA Co-creation)
Location: Zimbabwe


In 2018, USAID/Zimbabwe sought innovative solutions to the challenge of message fatigue for adolescent girls and young women (AGYW) around topics including family planning, gender-based violence, maternal mortality, malaria and TB. Picture Impact was one of three organizations to move forward through this BAA process to co-create, co-design, and collaborate with USAID/Zimbabwe in the development of products aimed to incentivize behavior change among these teen girls and young women.

Our task?

Teens are notorious, even more so than the rest of us, for not wanting to be told what to do. How then, do we encourage adolescents to engage with information they need and use it to make healthier decisions? This was our challenge: spur adolescent girls to engage with and use sexual health information. And can we do this in a way that allows them to learn and practice self efficacy, decision-making, self-advocacy, and confidence?

Positive Youth Development

Young people have a distinct way of approaching and interacting with the world. They are not just undeveloped adults, but have perspectives and strengths unique in each developmental stage. This outlook underlies the Positive Youth Development (PYD) approach, which engages youth as change agents for and within their own communities.

In order to achieve a vision of healthy, productive, and engaged youth, PYD programs or practices work with youth to build their assets, strengthen their agency, recognize contributions, and epower the enabling environments. As experts in their own lives, youth are best positioned to identify ideas and areas for change, as well as to design the corresponding levers and solutions. It is up to practitioners to understand and engage with youth in ways that draw out their strengths and abilities.

While much can be said about adolescence globally, it is also critically important that interventions take into account the diverse age-, culture-, and context-specific needs of youth to create conditions in which youth can thrive (Patton et al., 2016 as cited on In order to be inclusive of and responsive to the diverse experiences and perspectives of young people, PYD must ultimately match the needs of its targeted users: the specific youth themselves.

How we arrived at a game

In order to be effective, PYD interventions and programs should be youth-centered and engaging—a natural place for a well-designed, fun, and maybe a bit challenging game!

Games can be a better way to engage people in learning and the type of thinking and emotional responses needed for the adoption of new behavior than other teaching methods (Vogel, et al., 2006, and Ke, 2009). For youth, games can provide the alternative reality needed to imagine a different future and safe space to practice new skills needed to make that future a reality.

The teen brain is differently structured than the adult brain. Adolescent brains have a heightened response to reward stimuli. This increased response means that teens are pulled toward thrill-seeking and charged, exhilarating situations. While this may lead them to seem (and be) impulsive, it also encourages teens to seek out new surroundings, relations, and social situations—all critical to forging their own identity. This aspect is not a deficit, but actually a vital feature of brain development.

The need for risk need not lead teens into situations that may cause harm or have lifelong consequences. Teens can experience risk in a safe environment, and experience causality (the consequences of actions) without doing harm. Games and game-play can give teens the thrill-seeking situations they desire in a safe, healthy way that, in turn, increases adolescent skills to manage impulses.

Also significant to the teenager’s decision-making process is that the part of the brain responsible for reasoned thinking is not yet fully formed. This means that teenagers access this portion of the brain slower than adults. Games can help teens practice decision making, and through story creation, try on different circumstances—navigating their own identity, actions, and reactions as they play through a wide variety of scenarios.

“Playing a game is a form of PRACTICE for a real-life challenge.” Raph Koster

Games can be an effective way to engage youth in scenario and consequence exploration; build decision-making, communication and social negotiation skills; and develop a sense of confidence and self-efficacy. For these reasons, a game was a good match to help adolescent girls explore the real-life challenge of engaging with sexual health information and using it to navigate social dynamics and individual decision-making.

Building the right game

Now the question was, what game? How would it be played? What would make it fun?

“Create a player experience that’s fun first,” she said. “If the game is about [the content] only, it [won’t] work. If you remove the fun, [players] will feel like they’re being preached to and it’s not a game any more, there’s no agency.” Mary Flanagan (speaking about Games for Change)

To arrive at a game that is fun, relevant, and easily playable, game design needs to be intentional, requiring a depth and breadth of various expertise (psychology, social, behavioral and cognitive science, contextual expertise, content knowledge), a collaborative (co-creative) process, high-quality user-research, visual and written content development, a number of iterations, and a healthy dose of patience.

Learn more about gamification, games and the game design process here.

“Is it?”

Entertain. Surprise. Intrigue your friends. Keep them coming back for another story. If you can imagine it, you can tell it.

“Is it?” is a fun game you can play at home, school, in clubs, or just hanging out with your friends. Play in groups of 5 or more to laugh and try on new freedoms and possibilities, together..

Quick Play

  • To begin play, you’ll need 2 teams, each with 2 storytellers.
  • The audience (anyone who is not a storyteller) judges the play.
  • Deal each team of two storytellers 8 image cards. A judge draws one story-prompt card. Each team can discard and replace 1 or 2 image cards.
  • Teams have 2 minutes to create a story (for the same prompt) using at least 3 (and up to all 8) of their image cards.
  • Teams tell their stories.
  • Each team adds up the points from the image cards they used.
  • Judges award Plot Twist!, Best Fit and Entertainer point cards, adding to each team’s total points.
  • The team with the most points is the winning team of that round!