5) Description of health product/service offering: Re-Mission is a video game developed for young people with cancer (ages 13-29), an overlooked, understudied population at great risk for adverse health-related outcomes. Medical research shows that young people with cancer (ages 13 – 21) have poorer treatment outcomes than other age groups with similar forms of cancer. Re-Mission is designed to address this disparity. The game is available to young people with cancer free of charge through www.re-mission.net, which serves as a broadly accessible distribution mechanism and an online community where young people with cancer share information and support one another. Re-Mission is designed for PCs, commonly used technology worldwide. The game is available in English, Spanish and French.

To be successful, Re-Mission had to be biologically accurate, meaningful to young people with cancer, and fun. HopeLab adopted a highly interactive, rationally engineered development process to create Re-Mission, working with cancer experts, cell biologists, psychologists, game developers, and young people with cancer. The result is an engaging, high-quality game in which players pilot a nanobot, Roxxi, through the bodies of fictional cancer patients to destroy cancer cells, defend against bacterial infections, and grapple with often life-threatening cancer-related side effects and challenges common among young people with cancer.

HopeLab conducted an unprecedented randomized, controlled trial (our Outcomes Study) to test the effect of Re- Mission on key health-related outcomes among adolescents and young adults with cancer. Study results indicate playing Re-Mission produced statistically significant increases in quality of life, self-efficacy, and cancer- related knowledge for adolescents and young adults with cancer. Young people who played Re-Mission also maintained higher blood levels of chemotherapy and showed higher rates of antibiotic utilization, demonstrating that Re- Mission helps patients adhere to cancer therapy regimens.

6) Description of innovation: Re-Mission is the first video game to combine a scientifically robust, rationally designed development process, exciting game play, and rigorous formative and outcomes research to help young people with cancer. It is an edgy, honest video game (rated “T” for Teen) resulting from the collaborative efforts of young people with cancer, researchers, oncologists, cell biologists and game developers. Re-Mission turns entertaining video game technology and artistry into powerful, positive tools for young people with cancer. Re-Mission works – giving young people with cancer a sense of control over their disease.

Re-Mission is the first video game shown to help teens and young adults with cancer improve their quality of life, their sense of control and knowledge about cancer, and maintain adherence to their prescribed treatment regimen. Research on Re-Mission was conducted in much the same way research into new drugs is conducted, with rigorous testing based on established scientific principles. The game was tested in a randomized, controlled trial involving 375 patients in 34 sites across the United States, Canada and Australia. HopeLab believes this to be the first controlled, randomized intervention trial focused exclusively on adolescents and young adults with cancer.

Much has been made of the potential of “serious games” to effect positive change in health settings. By fundamentally incorporating scientific principles and the input of young people living with cancer into the design of a video game and by developing a rigorous research protocol to assess how and to what degree the game has an impact on the young people who play it, HopeLab has validated (1) the feasibility of taking a patient-centered and evidence-based approach to product development and evaluation and (2) shown that video game-based interventions can successfully be designed to be fun and to improve the health and quality of life of young people with cancer.

7) Operational model: HopeLab’s mission is to combine the highest standards of scientific research with innovative solutions to improve the health and quality of life of young people with chronic illness. Re-Mission, developed for young people with cancer, exemplifies this mission and is the result of an innovative model HopeLab has created for targeted philanthropy. This model combines high-quality scientific research and innovation in the development, assessment, and launch of interventions.

Re-Mission bridges socio-economic status, race, gender, age, and some aspects of physical ability. This was achieved by designing the game for use on PCs (commonly used worldwide), leveraging the Internet as a broadly accessible distribution mechanism, and utilizing popular video game technology. The game is available in English, Spanish, and French and is free of charge to any young person with cancer, further reducing barriers to access. Research indicates that Re-Mission was well-received across a cohort of patients that included a diversity of genders, races, ages, ethnicities, diseases, and disease states.

HopeLab works closely with young people with chronic illness to incorporate their critical and ongoing input into product development. This input ensures that outreach to key beneficiaries is an integral part of projects even before the interventions are broadly introduced. In addition, HopeLab is committed to a process of rational engineering and rigorous scientific testing of our interventions to ensure that these products and/or approaches are effective in the real world.

HopeLab intends to apply insights gained from the development and study of Re-Mission to inform our future work in cancer, as well as our work on technology-based approaches that might help young people with other illnesses in which there is significant unmet need and where HopeLab has the potential to have great impact. These illnesses include autism, major depressive disorder, obesity and sickle cell disease.

8) Human resources: HopeLab is a professionally diverse team of 25 full-time employees with expertise in a wide range of disciplines, including research, medical science, psychology, video game technology, language translation, nutrition, communications, health policy and law, and organizational development. Each of our team members has contributed to the success of Re-Mission™.

In addition, HopeLab works closely with young people with chronic illness to incorporate their critical and ongoing input into product development. We also consult a broad array of medical, scientific, and technology experts in an iterative process, to ensure that their expertise both informs, tests and validates our approaches and outcomes.

9) Key operational partnerships: HopeLab’s work with Re-Mission™ has benefited tremendously from the input and collaborative support of partners in the gaming industry, the medical community, non-industry organizations (non-profit foundations, governmental agencies, NGOs, other), and private individuals (most notably, young people with cancer and their families). These partnerships have been key in the development, research, and distribution of the game.

HopeLab is actively pursuing partnerships to support ongoing work with Re-Mission and other HopeLab initiatives as a central part of our strategy. Potential partners in HopeLab initiatives may come from industry/corporations, non-industry organizations (non-profit foundations, governmental agencies, NGOs, other), and private individuals. HopeLab enters into partnerships at various stages of a project: early in the process, during the research phase, during development of the innovation, in marketing and/or distribution. Points of collaboration between HopeLab and its partners include funding, products, and/or services. Longer-term, strategic partners may participate with HopeLab in any number of initiatives; shorter-term, tactical partners may join a HopeLab initiative for only a single instance.

10) Financial Sustainability

          • Fees charged to clients?: No

          • How do you assure affordability?: No. Re-Mission™ is available to young people with cancer free of charge.

          • Earned incomes as a percentage of operating costs: 0

          • Other funding sources: To help offset the costs of making Re-Mission™ available free to young people with cancer, HopeLab suggests a donation of $20 from others who wish to order a copy of Re- Mission.

Since its inception, HopeLab has benefited from the generous financial support of founder and Board Chair Pam Omidyar. That support continues and has been supplemented with a number of smaller donations by individuals, organizations, and families of those young people participating in the development and testing of Re- Mission. HopeLab also enjoys both in-kind and financial support from a wide range of individuals, organizations, and institutions (e.g. free tech support/video conferencing, pro-bono legal assistance, office space).

          • Strategy for long-term sustainability: HopeLab intends to continue internal funding for core operational infrastructure and research through the financial support of founder Pam Omidyar, while seeking external partners to contribute to deployment of products and innovative solutions developed by HopeLab, including Re-Mission™.

Potential partners in HopeLab initiatives may come from industry/corporations, non-industry organizations (non- profit foundations, governmental agencies, NGOs, other), and private individuals. Points of collaboration between HopeLab and its partners include funding, products, and/or services that provide resources for ongoing work with Re- Mission and other HopeLab initiatives.

11) Current and Future Impact

          • Total number of clients: approx. 3600

          • Clients in the past year: approx. 3600

          • Percentage of low-income clients: -

          • Impact: In the six weeks following the introduction of Re-Mission™ on April 3, 2006, HopeLab has distributed approximately 3,600 copies of the game to individuals in 30 countries. Young people with cancer, Re-Mission’s primary audience, represent an overlooked, understudied population, as the majority of research and treatment options are focused on the needs of younger children and adults. Research conducted by HopeLab shows that playing Re-Mission improved quality of life, self-efficacy, and cancer- related knowledge for adolescents and young adults with cancer. In addition, young people who played Re-Mission maintained higher blood levels of chemotherapy and showed higher rates of antibiotic utilization, demonstrating that Re-Mission helps patients maintain adherence to cancer therapy regimens.

          • Overall "market": Re-Mission was developed for young people with cancer (ages 13-29), and HopeLab is committed to making the game available to them free of charge. According to the National Cancer Institute’s SEER (Surveillance, Epidemiology, and End Results) data, the prevalence numbers for cancer among young people as of January 2002 were as follows:

• Persons 10-19 years of age: 66,293 • Persons 20-29 years of age: 128,154

These SEER data are calculated based on estimates in the United States alone. The global population of young people with cancer and the number of individuals who might potentially benefit from Re-Mission is even larger.

12) Scaling up strategy

          • Stage of the initiative: Scaling Up stage.

          • Expansion plan: HopeLab’s goal is to make Re-Mission™ available to as wide an audience of young people with cancer (ages 13-29) as possible. HopeLab is actively exploring partnership opportunities to support this goal. In addition, HopeLab is exploring the possibility of next-generation development of Re-Mission, as well as intervention strategies to address autism, major depressive disorder, obesity and sickle cell disease among young people.

13) Policy change: Medical research shows that young people with cancer (ages 13-21 years) have poorer treatment outcomes than do people in younger or older age groups with similar forms of cancer. Little is understood about how to tailor effective interventions to the specific needs of this understudied population. Dedicating resources to support formative and outcomes research that would lead to insights into the unique challenges these young people confront – including understanding their sense of self, the ways they communicate, and how they utilize technology to connect with others – could significantly stimulate and accelerate innovation, lead to the development of rationally engineered interventions that incorporate these insights and are specifically tailored to them and ultimately improve their health-related outcomes.

14) Origin of the initiative: Early in her career, HopeLab’s founder, Pam Omidyar, worked as a researcher in an immunology lab. As a video game enthusiast, she had the idea that a video game for teenagers with cancer might play a positive role in helping them fight their disease. Pam determined that involving the direct input of young people throughout the development process and conducting high-quality research to test the game and its impact on health-related outcomes would be critical to its success. In 2001, Pam founded HopeLab to make this vision reality. A review of available research suggested that harnessing the power of video game technology to fully engage young people with cancer about their disease held promise, and work on Re-Mission™ began. The game is the product of her vision and perseverance and was made possible by her commitment and continued generosity.

Contact Information:
Richard  Tate
Communications Director
HopeLab (IRS listing as HopeLab Foundation Inc.)
(Non-profit foundation (501c3))
101 University Avenue, Suite 220, Palo Alto, CA 94301-1638
United States
Tel: (650) 853-5507
Fax: (650) 853-5501
Email: rtate@hopelab.org
Website: www.hopelab.org