scholarly journals Archetypes of Gamification: Analysis of mHealth Apps

10.2196/19280 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e19280
Author(s):  
Manuel Schmidt-Kraepelin ◽  
Philipp A Toussaint ◽  
Scott Thiebes ◽  
Juho Hamari ◽  
Ali Sunyaev
Keyword(s):  
Best Practices ◽  
Health Behavior ◽  
Health Behaviors ◽  
Mobile Health ◽  
Positive Reinforcement ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Future Research ◽  
Research Approach ◽  
Health Related

Background Nowadays, numerous health-related mobile apps implement gamification in an attempt to draw on the motivational potential of video games and thereby increase user engagement or foster certain health behaviors. However, research on effective gamification is still in its infancy and researchers increasingly recognize methodological shortcomings of existing studies. What we actually know about the phenomenon today stems from fragmented pieces of knowledge, and a variety of different perspectives. Existing research primarily draws on conceptual knowledge that is gained from research prototypes, and isolated from industry best practices. We still lack knowledge on how gamification has been successfully designed and implemented within the industry and whether certain gamification approaches have shown to be particularly suitable for certain health behaviors. Objective We address this lack of knowledge concerning best practices in the design and implementation of gamification for health-related mobile apps by identifying archetypes of gamification approaches that have emerged in pertinent health-related mobile apps and analyzing to what extent those gamification approaches are influenced by the underlying desired health-related outcomes. Methods A 3-step research approach is employed. As a first step, a database of 143 pertinent gamified health-related mobile apps from the Apple App Store and Google Play Store is set up. Second, the gamification approach of each app within the database is classified based on an established taxonomy for gamification in health-related apps. Finally, a 2-step cluster analysis is conducted in order to identify archetypes of the most dominant gamification approaches in pertinent gamified health-related mobile apps. Results Eight archetypes of gamification emerged from the analysis of health-related mobile apps: (1) competition and collaboration, (2) pursuing self-set goals without rewards, (3) episodical compliance tracking, (4) inherent gamification for external goals, (5) internal rewards for self-set goals, (6) continuous assistance through positive reinforcement, (7) positive and negative reinforcement without rewards, and (8) progressive gamification for health professionals. The results indicate a close relationship between the identified archetypes and the actual health behavior that is being targeted. Conclusions By unveiling salient best practices and discussing their relationship to targeted health behaviors, this study contributes to a more profound understanding of gamification in mobile health. The results can serve as a foundation for future research that advances the knowledge on how gamification may positively influence health behavior change and guide practitioners in the design and development of highly motivating and effective health-related mobile health apps.

scholarly journals Archetypes of Gamification: Analysis of mHealth Apps (Preprint)

2020 ◽  
Author(s):  
Manuel Schmidt-Kraepelin ◽  
Philipp A. Toussaint ◽  
Scott Thiebes ◽  
Juho Hamari ◽  
Ali Sunyaev
Keyword(s):  
Best Practices ◽  
Health Behavior ◽  
Health Behaviors ◽  
Mobile Health ◽  
Positive Reinforcement ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Future Research ◽  
Research Approach ◽  
Health Related

BACKGROUND Nowadays, numerous health-related mobile apps implement gamification in an attempt to draw on the motivational potential of video games and thereby increase user engagement or foster certain health behaviors. However, research on effective gamification is still in its infancy and researchers increasingly recognize methodological shortcomings of existing studies. What we actually know about the phenomenon today stems from fragmented pieces of knowledge, and a variety of different perspectives. Existing research primarily draws on conceptual knowledge that is gained from research prototypes, and isolated from industry best practices. We still lack knowledge on how gamification has been successfully designed and implemented within the industry and whether certain gamification approaches have shown to be particularly suitable for certain health behaviors. OBJECTIVE We address this lack of knowledge concerning best practices in the design and implementation of gamification for health-related mobile apps by identifying archetypes of gamification approaches that have emerged in pertinent health-related mobile apps and analyzing to what extent those gamification approaches are influenced by the underlying desired health-related outcomes. METHODS A 3-step research approach is employed. As a first step, a database of 143 pertinent gamified health-related mobile apps from the Apple App Store and Google Play Store is set up. Second, the gamification approach of each app within the database is classified based on an established taxonomy for gamification in health-related apps. Finally, a 2-step cluster analysis is conducted in order to identify archetypes of the most dominant gamification approaches in pertinent gamified health-related mobile apps. RESULTS Eight archetypes of gamification emerged from the analysis of health-related mobile apps: (1) competition and collaboration, (2) pursuing self-set goals without rewards, (3) episodical compliance tracking, (4) inherent gamification for external goals, (5) internal rewards for self-set goals, (6) continuous assistance through positive reinforcement, (7) positive and negative reinforcement without rewards, and (8) progressive gamification for health professionals. The results indicate a close relationship between the identified archetypes and the actual health behavior that is being targeted. CONCLUSIONS By unveiling salient best practices and discussing their relationship to targeted health behaviors, this study contributes to a more profound understanding of gamification in mobile health. The results can serve as a foundation for future research that advances the knowledge on how gamification may positively influence health behavior change and guide practitioners in the design and development of highly motivating and effective health-related mobile health apps.

scholarly journals Mobile Apps for Health Behavior Change: Protocol for a Systematic Review (Preprint)

2019 ◽  
Author(s):  
Madison Milne-Ives ◽  
Ching Lam ◽  
Michelle Helena Van Velthoven ◽  
Edward Meinert
Keyword(s):  
Systematic Review ◽  
Health Behavior ◽  
Behavior Change ◽  
Mobile Health ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Mobile App ◽  
Risk Of Bias ◽  
Health Apps ◽  
Mobile Health Apps

BACKGROUND The popularity and ubiquity of mobile apps have rapidly expanded in the past decade. With a growing focus on patient interaction with health management, mobile apps are increasingly used to monitor health and deliver behavioral interventions. The considerable variation in these mobile health apps, from their target patient group to their health behavior, and their behavioral change strategy, has resulted in a large but incohesive body of literature. OBJECTIVE The purpose of this protocol is to provide an overview of the current landscape, theories behind, and effectiveness of mobile apps for health behavior change. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols will be used to structure this protocol. The focus of the systematic review is guided by a population, intervention, comparator, and outcome framework. A systematic search of Medline, EMBASE, CINAHL, and Web of Science will be conducted. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any discrepancies will then be discussed and resolved. One reviewer will extract data into a standardized form, which will be validated by a second reviewer. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool, and a descriptive analysis will summarize the effectiveness of all the apps. RESULTS As of November 2019, the systematic review has been completed and is in peer review for publication. CONCLUSIONS This systematic review will summarize the current mobile app technologies and their effectiveness, usability, and coherence with behavior change theory. It will identify areas of improvement (where there is no evidence of efficacy) and help inform the development of more useful and engaging mobile health apps. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/16931

scholarly journals Mobile Apps for Health Behavior Change: Protocol for a Systematic Review

10.2196/16931 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e16931
Author(s):  
Madison Milne-Ives ◽  
Ching Lam ◽  
Michelle Helena Van Velthoven ◽  
Edward Meinert
Keyword(s):  
Systematic Review ◽  
Health Behavior ◽  
Behavior Change ◽  
Mobile Health ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Mobile App ◽  
Risk Of Bias ◽  
Health Apps ◽  
Mobile Health Apps

Background The popularity and ubiquity of mobile apps have rapidly expanded in the past decade. With a growing focus on patient interaction with health management, mobile apps are increasingly used to monitor health and deliver behavioral interventions. The considerable variation in these mobile health apps, from their target patient group to their health behavior, and their behavioral change strategy, has resulted in a large but incohesive body of literature. Objective The purpose of this protocol is to provide an overview of the current landscape, theories behind, and effectiveness of mobile apps for health behavior change. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols will be used to structure this protocol. The focus of the systematic review is guided by a population, intervention, comparator, and outcome framework. A systematic search of Medline, EMBASE, CINAHL, and Web of Science will be conducted. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any discrepancies will then be discussed and resolved. One reviewer will extract data into a standardized form, which will be validated by a second reviewer. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool, and a descriptive analysis will summarize the effectiveness of all the apps. Results As of November 2019, the systematic review has been completed and is in peer review for publication. Conclusions This systematic review will summarize the current mobile app technologies and their effectiveness, usability, and coherence with behavior change theory. It will identify areas of improvement (where there is no evidence of efficacy) and help inform the development of more useful and engaging mobile health apps. Trial Registration PROSPERO CRD42019155604; https://tinyurl.com/sno4lcu International Registered Report Identifier (IRRID) PRR1-10.2196/16931

scholarly journals Mobile Apps for Health Behavior Change in Physical Activity, Diet, Drug and Alcohol Use, and Mental Health: Systematic Review

10.2196/17046 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17046 ◽  
Author(s):  
Madison Milne-Ives ◽  
Ching Lam ◽  
Caroline De Cock ◽  
Michelle Helena Van Velthoven ◽  
Edward Meinert
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Mobile Health ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Risk Of Bias ◽  
Health Apps ◽  
Mobile Health Apps ◽  
Drug And Alcohol Use ◽  
Drug And Alcohol

Background With a growing focus on patient interaction with health management, mobile apps are increasingly used to deliver behavioral health interventions. The large variation in these mobile health apps—their target patient group, health behavior, and behavioral change strategies—has resulted in a large but incohesive body of literature. Objective This systematic review aimed to assess the effectiveness of mobile apps in improving health behaviors and outcomes and to examine the inclusion and effectiveness of behavior change techniques (BCTs) in mobile health apps. Methods PubMed, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behavior change. Two authors independently screened and selected studies according to the eligibility criteria. Data were extracted and the risk of bias was assessed by one reviewer and validated by a second reviewer. Results A total of 52 randomized controlled trials met the inclusion criteria and were included in the analysis—37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive—only one app was rated as less helpful and satisfactory than the control—and the studies that measured engagement and usability found relatively high study completion rates (mean 83%; n=18, N=39) and ease-of-use ratings (3 significantly better than control, 9/15 rated >70%). However, there was little evidence of changed behavior or health outcomes. Conclusions There was no strong evidence in support of the effectiveness of mobile apps in improving health behaviors or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the BCTs that are most effective at promoting behavior change. Improved reporting is necessary to accurately evaluate the mobile health app effectiveness and risk of bias.

scholarly journals Mobile Apps for Health Behavior Change in Physical Activity, Diet, Drug and Alcohol Use, and Mental Health: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Madison Milne-Ives ◽  
Ching Lam ◽  
Caroline De Cock ◽  
Michelle Helena Van Velthoven ◽  
Edward Meinert
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Mobile Health ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Risk Of Bias ◽  
Health Apps ◽  
Mobile Health Apps ◽  
Drug And Alcohol Use ◽  
Drug And Alcohol

BACKGROUND With a growing focus on patient interaction with health management, mobile apps are increasingly used to deliver behavioral health interventions. The large variation in these mobile health apps—their target patient group, health behavior, and behavioral change strategies—has resulted in a large but incohesive body of literature. OBJECTIVE This systematic review aimed to assess the effectiveness of mobile apps in improving health behaviors and outcomes and to examine the inclusion and effectiveness of behavior change techniques (BCTs) in mobile health apps. METHODS PubMed, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behavior change. Two authors independently screened and selected studies according to the eligibility criteria. Data were extracted and the risk of bias was assessed by one reviewer and validated by a second reviewer. RESULTS A total of 52 randomized controlled trials met the inclusion criteria and were included in the analysis—37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive—only one app was rated as less helpful and satisfactory than the control—and the studies that measured engagement and usability found relatively high study completion rates (mean 83%; n=18, N=39) and ease-of-use ratings (3 significantly better than control, 9/15 rated >70%). However, there was little evidence of changed behavior or health outcomes. CONCLUSIONS There was no strong evidence in support of the effectiveness of mobile apps in improving health behaviors or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the BCTs that are most effective at promoting behavior change. Improved reporting is necessary to accurately evaluate the mobile health app effectiveness and risk of bias.

scholarly journals Realist-informed review of motivational interviewing for adolescent health behaviors

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Erica Naccarato ◽  
Jen Rouse ◽  
Caitlin Davey ◽  
Kelly McShane
Keyword(s):  
Systematic Review ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Motivational Interviewing ◽  
Adolescent Health ◽  
School Setting ◽  
Health Behavior Change ◽  
Effective Intervention ◽  
Future Research

Background Clinical research investigating effective intervention strategies for adolescents to improve health behaviors has shifted to the application of motivational interviewing (MI). Evidence indicates that MI is an effective intervention for improving health behaviors as related to diet, exercise, and diabetes among adolescents. However, there is a lack of understanding about the mechanisms through which MI works and the contextual factors impacting MI effectiveness. The purpose of this review was to understand how, for whom, and under what circumstances MI works for adolescent health behavior change, which will inform future implementation of this intervention. To provide this in-depth understanding, a realist-informed systematic review was conducted in order to synthesize the evidence on the use of MI for health behaviors. Self-determination theory (SDT) was chosen as the candidate theory for testing in the present review. Methods Databases including PsycINFO, Healthstar, Cochrane, and PubMed were searched for articles published until March 2017. The search strategy included studies that examined or reviewed the effectiveness or efficacy of MI to change health behaviors among adolescent populations. The search identified 185 abstracts, of which 28 were included in the review. The literature was synthesized qualitatively (immersion/crystallization) and tested SDT as the candidate theory. Results Based on SDT, three mechanisms were found within reviewed studies, including competence, relatedness, and autonomy. The following contexts were found to impact mechanisms: school setting, clinician MI proficiency, parental involvement, and peer involvement. Conclusions This realist-informed systematic review provides advances in understanding the mechanisms involved in MI for adolescent health behavior change. Additionally, it provides important practical information as to which contexts create the conditions for these mechanisms to occur, leading to health behavior change. The results can inform future MI interventions for adolescent health behavior change. Future research should continue to test this realist theory and also examine mechanism variables not extensively documented in order to improve our understanding of MI in this population.

scholarly journals Realist-informed review of motivational interviewing for adolescent health behaviors

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Erica Naccarato ◽  
Jen Rouse ◽  
Caitlin Davey ◽  
Kelly McShane
Keyword(s):  
Systematic Review ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Motivational Interviewing ◽  
Adolescent Health ◽  
School Setting ◽  
Health Behavior Change ◽  
Effective Intervention ◽  
Future Research

Background Clinical research investigating effective intervention strategies for adolescents to improve health behaviors has shifted to the application of motivational interviewing (MI). Evidence indicates that MI is an effective intervention for improving health behaviors as related to diet, exercise, and diabetes among adolescents. However, there is a lack of understanding about the mechanisms through which MI works and the contextual factors impacting MI effectiveness. The purpose of this review was to understand how, for whom, and under what circumstances MI works for adolescent health behavior change, which will inform future implementation of this intervention. To provide this in-depth understanding, a realist-informed systematic review was conducted in order to synthesize the evidence on the use of MI for health behaviors. Self-determination theory (SDT) was chosen as the candidate theory for testing in the present review. Methods Databases including PsycINFO, Healthstar, Cochrane, and PubMed were searched for articles published until March 2017. The search strategy included studies that examined or reviewed the effectiveness or efficacy of MI to change health behaviors among adolescent populations. The search identified 185 abstracts, of which 28 were included in the review. The literature was synthesized qualitatively (immersion/crystallization) and tested SDT as the candidate theory. Results Based on SDT, three mechanisms were found within reviewed studies, including competence, relatedness, and autonomy. The following contexts were found to impact mechanisms: school setting, clinician MI proficiency, parental involvement, and peer involvement. Conclusions This realist-informed systematic review provides advances in understanding the mechanisms involved in MI for adolescent health behavior change. Additionally, it provides important practical information as to which contexts create the conditions for these mechanisms to occur, leading to health behavior change. The results can inform future MI interventions for adolescent health behavior change. Future research should continue to test this realist theory and also examine mechanism variables not extensively documented in order to improve our understanding of MI in this population.

scholarly journals Utilizing Participatory Research to Engage Underserved Populations to Improve Health-Related Outcomes in Delaware

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2353
Author(s):  
Shannon M. Robson ◽  
Samantha M. Rex ◽  
Katie Greenawalt ◽  
P. Michael Peterson ◽  
Elizabeth Orsega-Smith
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Health Behaviors ◽  
Participatory Research ◽  
Cooperative Extension ◽  
Underserved Populations ◽  
Community Outreach ◽  
Outreach Program ◽  
Health Related ◽  
Improve Health

Cooperative Extension is a community outreach program. Despite its large reach, there is a need for the evaluation of changes in health-related outcomes for individuals engaged with Cooperative Extension. A team-based challenge was developed using community-engaged participatory research integrated with Cooperative Extension to encourage healthy eating and physical activity behaviors through Cooperative Extension programming. Thus, the primary purpose of this secondary analysis was to (1) evaluate changes in anthropometric outcomes and (2) evaluate changes in health behavior outcomes. Associations of anthropometric changes and health behavior changes with engagement in the three-month team-based challenge were explored. Anthropometrics were measured using standard procedures, and intake of fruits and vegetables and physical activity were self-reported. Of the 145 participants in the community-engaged participatory research portion of the study, 52.4% (n = 76) had complete anthropometrics before and after the team-based challenge and were included in this study. At 3 months, there was a significant reduction in body mass index (−0.3 kg/m2, p = 0.024) and no significant change in waist circumference (p = 0.781). Fruit and vegetable intake significantly increased (+0.44 servings/day, p = 0.018). Physical activity did not significantly change based on (1) the number of days 30 or more minutes of physical activity was conducted (p = 0.765) and (2) Godin Leisure-Time Exercise Questionnaire scores (p = 0.612). Changes in anthropometrics and health behaviors were not associated with engagement in the team-based challenge. Using community-engaged participatory research with community outreach programs, such as Cooperative Extension, can improve health-related outcomes in underserved populations. However, despite a participatory approach, changes in anthropometrics and health behaviors were not associated with engagement in the developed team-based challenge.

The Disconnected Values Model: Intervention Strategies for Exercise Behavior Change

2008 ◽  
Vol 2 (4) ◽  
pp. 357-380 ◽  
Author(s):  
Mark H. Anshel
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Exercise Program ◽  
Health Behavior Change ◽  
Exercise Behavior ◽  
Future Research ◽  
Behavioral Strategies ◽  
Values And Beliefs ◽  
Long Term Consequences

This article proposes a new approach to health behavior change, the disconnected values (intervention) model (DVM). The DVM consists of predetermined cognitive-behavioral strategies for initiating and maintaining changes in health behavior, such as the implementation of an exercise program. The model consists of helping clients (a) examine the benefits, in contrast to the costs and long-term consequences, of the habit they most want to change; (b) identify their deepest values and beliefs (e.g., health, family, faith, integrity); (c) detect a “disconnect” between the negative habit and the identified values; and (d) conclude whether the disconnect is acceptable, given its costs and long-term consequences. The client’s conclusion that the disconnect is unacceptable creates incentive and commitment for health behavior change. The theoretical foundations of the DVM are explained, and its specific application for exercise behavior change is described. Three outcome studies also are reported, as well as a brief case study. Implications for practitioners and suggestions for future research are provided.

Heat-Health Behavior Change During Summer 2020 in African American Alabama Residents

2021 ◽  
Vol 111 (8) ◽  
pp. 1443-1447
Author(s):  
Suwei Wang ◽  
Ethel Johnson ◽  
Sheila Tyson ◽  
Julia M. Gohlke
Keyword(s):  
African American ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Health Behavior Change ◽  
Public Spaces ◽  
Police Brutality ◽  
Telephone Surveys ◽  
Safety Concerns

To investigate how heat-health behaviors changed in summer 2020 compared with previous summers, our community–academic partnership conducted telephone surveys to collect data on cooling behaviors, safety concerns, and preferences for cooling alternatives for 101 participants living in Alabama. Participants indicating they would visit cooling centers declined from 23% in previous summers to 10% in summer 2020. The use of cooling centers and other public spaces may be less effective in reducing heat-related illness because of safety concerns amid the COVID-19 pandemic and police brutality.

Sign in / Sign up

Export Citation Format

Share Document