Health care is one of life’s most basic needs. It’s so simple. In recent years, though, the subject of health care has also served to polarize our nation. We all need it, but who’s responsible for making sure we get it? How do we ensure it’s safe, high-quality care? What about cost? Vocal, contentious debate over the answers to these questions—and many more—continues unabated in the United States. Meanwhile, in my work as a volunteer nurse at a clinic for the uninsured, I see patients who continue to lack the means to get even the most basic of care, who struggle with chronic disease in a system that seems to throw up obstacles at every turn.

That’s the bad news.

Here’s the good news: Amidst the unproductive noise, countless innovators from all walks of life are quietly going about the work of solving some of the most intractable problems in health and health care. 

Amanda E. Staiano, PhD, MPP, Research Fellow, Pennington Biomedical Research Center

Can video games help kids move more and even lose weight?  Long blamed for promoting an unhealthy, sedentary lifestyle, video games are gaining a new reputation—by offering opportunities for enhanced physical activity.

Exergames, which are video games that require physical exertion, are popular among children and adults alike. The Children’s Digital Media Center at Georgetown University received a grant from Health Games Research, a national program of the Robert Wood Johnson Foundation, to investigate the game design principles that might make exergames effective physical activity and weight loss tools. Professor Sandra Calvert of the Department of Psychology at Georgetown University served as the principal investigator and was joined by myself and Dr. Anisha Abraham of Georgetown University Medical Center as co-investigators.  The exciting results were recently published online in the journal Obesity.

Forty years ago, smallpox still existed. We hadn’t heard the acronyms HIV or AIDS. The Nixon administration had declared war on cancer and was about to introduce America to the health maintenance organization, aka HMO. Meanwhile, a couple of paramedics on a TV show called “Emergency!” and a new philanthropy, the Robert Wood Johnson Foundation, were introducing the nation to the life-saving concept of 911 and another acronym: EMS (emergency medical services).

Four decades later, the Robert Wood Johnson Foundation is the nation’s largest philanthropy devoted exclusively to health and health care, and we are still in the business of searching for solutions that will improve the health and health care of millions. As the Foundation marks its 40th anniversary this week, we remain committed not only to proven, evidence-based strategies, but also to new ideas that push boundaries.

As we re-launch the Robert Wood Johnson Foundation’s website and the Pioneering Ideas blog, it is a good time to pause and take stock of Pioneer’s role--and, a question we get asked often: What is a pioneering idea?

Most of what the Robert Wood Johnson Foundation does is sharply focused on four targeted issues—childhood obesity, the quality and equality of health care, public health, and access to health care insurance—and two critical population groups—vulnerable populations and human capital.

The Pioneer Portfolio has a unique, but complementary, mandate. We seek to identify and explore new ideas and approaches that help shape the future of health and health care. We are dedicated to finding the next new idea – whether it is a game-changer that accelerates a breakthrough or an initial exploration into a new area. So what makes the cut? Why do we fund the ideas we do, and where do we go to find them?

In July, five grantees of the Health Games Research national program have published peer-reviewed research articles in the Journal of Diabetes Science and Technology, in a special issue symposium called “Serious Games for Diabetes, Obesity, and Healthy Lifestyle.”  Their research has discovered innovative ways to improve the design and effectiveness of active video games that require physical exertion in order to play.

The studies have identified, for example, evidence-based game design strategies that motivate college students to increase their physical activity; insights into the benefits of cooperative game play that can motivate overweight and obese adolescents to put more effort into active games; and new approaches to using teamwork in active games to increase player effort and exertion.  The studies used Wii Active and Wii Fit games, stationary bikes with video screens enabling virtual tours and racing games, a motion sensor game, and an alternate reality game.  I served as a guest co-editor of the special issue symposium along with guest co-editor Deborah Thompson, PhD, an associate professor of pediatrics at Baylor College of Medicine and a USDA/ARS scientist/nutritionist.