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Research

Studies about the use of the Common Practice game Hello (and its predecessor, My Gift of Grace) have been published in several peer-reviewed research journals and have utilized mixed methods (i.e. both quantitative and qualitative sources of data). Research about the game is conducted by independent researchers with no financial links with Common Practice. Following is a summary of the research so far.

Research question: Does playing the game lead to behavior change?

Note: All published studies referred to below include only gameplay as the intervention – no follow-up materials or other interventions were provided to participants.

  • All published studies demonstrated high rates of subsequent Advance Care Planning behaviors within 3 months of playing the game. (58%-88%).2,6,7,8
  • Among patients with chronic illness and their loved ones, 74% completed an ACP behavior after gameplay.6,8
  • In a study of volunteers with unknown health status, 78% completed an ACP behavior within 3 months of gameplay and 73% of participants reported increased readiness to perform ACP behaviors.2
  • In a study of patients with chronic illness and their loved ones, there was a significant increase in ratings of self efficacy to perform ACP behaviors.6
  • In a population of South Asian Indian Americans, significant increases in all measured aspects of ACP Engagement were reported within 3 months of gameplay.5

Research question: Will people enjoy playing a game about living and dying?

  • In post-game focus groups, all studied cohorts (including patients and caregivers) across diverse demographics and cultures reported that the game was enjoyable and a good method for talking about end-of-life issues.5,6,8
  • In a study of South Asian Indian Americans, participants described the game as fun, thought-provoking and applicable to any culture.5
  • In a study of the game’s mechanics, patients with advanced chronic illness and their caregivers described the use of Thank-you chips as fun and engaging. No participants reported negative responses to the chips.
  • None of the 236 focus group participants conducted in these studies reported the game to be psychologically burdensome or difficult to play.

Research Question: Is the game an effective tool in a community setting?

  • In a study conducted at 12 community events (at public libraries, senior centers, retirement communities, churches, and private organizations), both quantitative behavior surveys and qualitative focus groups found that the game was a “well-received, positive experience for participants” and that 75% of participants performed ACP three months post-intervention.8

Research question: Is the game a useful tool for training healthcare staff?

  • A study of healthcare chaplains showed that playing the game improved participants confidence in having end-of-life conversations with their peers and with patients.7
  • Healthcare chaplains in this study also reported the game to be a positive experience and a useful educational tool.7

Research question: What do people talk about during the game?

  • A large qualitative analysis of the game conversations found that the participants addressed clinically relevant topics related to ACP and that the discussions were well-aligned with expert consensus on key ACP topics.3

About the lead researcher

Research on Common Practice’s conversation games is led by Lauren Jodi Van Scoy, M.D., (click here for CV) a pulmonary and critical care doctor at the Penn State Milton S. Hershey Medical Center and Assistant Professor of Medicine and Humanities at the Penn State College of Medicine.

Dr. Van Scoy has been awarded a Parker B. Francis Foundation grant from the American Thoracic Society to study the effects of the game in a larger, randomized controlled trial.

Dr. Van Scoy can be reached by email at [email protected].


1Van Scoy, LJ, Scott, AM, Reading, JM, Chuang, CH, Chinchilli, VM, Levi, BH, Green, MJ. From theory to practice: measuring end-of-life communication quality using multiple goals theory. Patient Education and Counseling. 2017 May; 100 (5): 909-918. PMID: 28011081

2Van Scoy, LJ, Reading, JM, Scott, AM, Chuang, CH, Green, MJ, Levi, BH. Can playing an end-of-life conversation game motivate people to engage in advance care planning? Am J Pall Hospice Med. 2016 Jul 12. pii: 1049909116656353. [Epub ahead of print] PMID: 27406696

3Van Scoy, LJ, Reading, JM, Scott, AM, Chuang, CH, Levi, BH, Green, MJ. Exploring the topics discussed during a conversation card game about death and dying: a content analysis. J Pain Symptom Manage. 2016 Nov;52(5):655-662. PMID: 27650010

4Van Scoy, LJ, Reading, JM, Scott, AM, Green, MJ, Levi BH. Conversation game effectively engages groups of individuals in discussions about death and dying: a feasibility study. Journal of Palliative Medicine, Jun;19(6):661-7. PMID: 27022862

5Radhakrishnan, K, Van Scoy, LJ, Jillapalli, R, Saxena, S, Kim, M. Community-based Game Day intervention to improve South Asian Indian Americans’ engagement with advance care planning: a pilot study. In Press, Accepted June 2017, Ethnicity and Health.

6Reading, JM, Hopkins, M, Yoo, C, Smith, B, Dillon, J, Green, MJ, Levi, BH, Van Scoy, LJ (2017). Community Game Day: Using an End-of-Life Conversation Game to Engage Patients with Chronic Illness and Their Caregivers in Advance Care Planning. Oral Presentation; Mini Symposium. American Thoracic Society, May 22, 2017; Washington DC.

7Van Scoy, LJ, Watson-Martin, E, Bohr, TA, Levi, BH, Green, MJ. End-of-life conversation game increases confidence for having end-of-life conversations for chaplains-in-training. Accepted July 10, 2017. American Journal of Hospice and Palliative Medicine.

8Van Scoy, LJ, Reading, JM, Hopkins, M, Smith, B, Dillon, J, Green, MJ, Levi BH. Community Game Day: Using an end-of-life conversation game to encourage advance care planning. In Press; Accepted July 17, 2017. Journal of Pain and Symptom Management.