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Dartmouth Study Shows That Playing Games Can Shift Attitudes

May 14, 2015

A Dartmouth research laboratory is working to quantify the effects of playing games. In a study published online last month by the Games for Health Journal, Professor Mary Flanagan and her team found that attitudes toward public health issues shift to be more accepting and understanding after playing a game they developed called RePlay Health.

“Sales of games have been steadily increasing for several years,” says Flanagan, the Sherman Fairchild Distinguished Professor in Digital Humanities at Dartmouth and the director of the Tiltfactor laboratory.  “So economically, we have measured their impact, and now it’s time to measure their ability to change behaviors and attitudes.”

RePlay Health is a role-playing sport that requires players to assume different identities and carry out various activities to improve their health. The backdrop of the game is a fictional health care system, and the players learn how personal behaviors, workplace productivity, insurance (or lack of it), and all related health care costs are woven together within the system. Each player is presented with opportunities to not only improve their own health, but also the health of their community through policy initiatives that they vote on.

“We showed how active engagement with the game’s characters and events was crucial to the game’s ability to shift players’ mindsets and attitudes about health and health policy,” says Geoff Kaufman, a co-author of the study and Tiltfactor’s post-doctoral researcher in psychology.

The researchers asked a group of young adults to complete an online questionnaire two weeks prior to playing RePlay Health and again within a week after playing the game. Flanagan says that the results indicate that the game has the potential to have a lasting impact on the players.

RePlay Health was developed in collaboration with The Dartmouth Center for Healthcare Delivery Science and the Rippel Foundation. The game is part of a broad initiative to promote learning about public health policies and spending priorities. Flanagan and her team envision college students, medical students, doctors, local council leaders, government officials, and any other people interested broadly in public health playing the game to digest the issues and find ideas that resonate. “It’s not just students and public officials who can play this game, or benefit from playing,” says Flanagan.

RePlay Health is just one game developed by the Tiltfactor laboratory being studied for its ability to shift attitudes and behaviors. Several additional games have been created to address issues of bias, racism, and prejudice. For example, preliminary research involving Awkward Moment, a party card game for middle school-age kids and older, suggests strengthened associations between women and STEM and inspires greater assertiveness in confronting social bias after playing. Data from experimental studies involving Buffalo, a fast-paced party card game for adults and families, suggests reduced prejudice and greater inclusiveness in players’ representations of social identity groups.

Professor Flanagan can be reached directly via email at:

Last Updated: 5/12/15