scholarly journals Creating a Theoretically Grounded, Gamified Health App: Lessons From Developing the Cigbreak Smoking Cessation Mobile Phone Game (Preprint)

2018 ◽  
Author(s):  
Elizabeth A Edwards ◽  
Hope Caton ◽  
Jim Lumsden ◽  
Carol Rivas ◽  
Liz Steed ◽  
...  

BACKGROUND Gaming techniques are increasingly recognized as effective methods for changing behavior and increasing user engagement with mobile phone apps. The rapid uptake of mobile phone games provides an unprecedented opportunity to reach large numbers of people and to influence a wide range of health-related behaviors. However, digital interventions are still nascent in the field of health care, and optimum gamified methods of achieving health behavior change are still being investigated. There is currently a lack of worked methodologies that app developers and health care professionals can follow to facilitate theoretically informed design of gamified health apps. OBJECTIVE This study aimed to present a series of steps undertaken during the development of Cigbreak, a gamified smoking cessation health app. METHODS A systematic and iterative approach was adopted by (1) forming an expert multidisciplinary design team, (2) defining the problem and establishing user preferences, (3) incorporating the evidence base, (4) integrating gamification, (5) adding behavior change techniques, (6) forming a logic model, and (7) user testing. A total of 10 focus groups were conducted with 73 smokers. RESULTS Users found the app an engaging and motivating way to gain smoking cessation advice and a helpful distraction from smoking; 84% (62/73) of smokers said they would play again and recommend it to a friend. CONCLUSIONS A dedicated gamified app to promote smoking cessation has the potential to modify smoking behavior and to deliver effective smoking cessation advice. Iterative, collaborative development using evidence-based behavior change techniques and gamification may help to make the game engaging and potentially effective. Gamified health apps developed in this way may have the potential to provide effective and low-cost health interventions in a wide range of clinical settings.

2021 ◽  
Author(s):  
Rui Moreira ◽  
Nuno Durão ◽  
Rita Maria Cabral ◽  
Jessica Lourenço ◽  
Augusta Silveira ◽  
...  

BACKGROUND Our modern way of life, health and well-being depend on the individual's health behaviors. Motivation is a major factor of health behaviour change, and intrinsically motivated behavior change is desirable as it is both sustained and directly contributes to well-being. This raises the immediate question about what kind of interventions are best positioned to intrinsically motivate health behavior change. OBJECTIVE With this study we wanted to analyse the presence and efficiency of gamification mechanisms in oral healthcare-themed digital games and apps on promoting user engagement to comply with prevention policies. METHODS The search query was based on the electronic database PubMed. Applying exclusion and inclusion criteria, this study is focused on scholar work reporting original research of the value of gamification on oral healthcare. The final pool of data was scrutinized for the gamification features, evidence-based oral health and behavior change techniques. RESULTS Apps with high quality evidence-based educational content for oral self-care, employing gamification features and behavior change techniques, provide excellent results in functionality, effectiveness, efficiency and satisfaction. However, some authors highlighted issues such as the need to improve engagement, aesthetics, evidence-based information content, behavior change taxonomies, psychological needs, evaluation, validation, quality assessment and professional regulation of the oral healthcare apps. CONCLUSIONS In this systematic review, we did not find any app that included all the segments for learning, performing, and maintaining proper oral health care. Evidence-based oral healthcare gamification features represent potential new approaches for health care providers to change behavior in the form of learning, performing and maintaining proper oral hygiene. Evaluation, validation, quality assurance, best practice standards and guidelines are needed for improving app use.


2019 ◽  
Author(s):  
Ann DeSmet ◽  
Ilse De Bourdeaudhuij ◽  
Sebastien Chastin ◽  
Geert Crombez ◽  
Ralph Maddison ◽  
...  

BACKGROUND There is a limited understanding of components that should be included in digital interventions for 24-hour movement behaviors (physical activity [PA], sleep, and sedentary behavior [SB]). For intervention effectiveness, user engagement is important. This can be enhanced by a user-centered design to, for example, explore and integrate user preferences for intervention techniques and features. OBJECTIVE This study aimed to examine adult users’ preferences for techniques and features in mobile apps for 24-hour movement behaviors. METHODS A total of 86 participants (mean age 37.4 years [SD 9.2]; 49/86, 57% female) completed a Web-based survey. Behavior change techniques (BCTs) were based on a validated taxonomy v2 by Abraham and Michie, and engagement features were based on a list extracted from the literature. Behavioral data were collected using Fitbit trackers. Correlations, (repeated measures) analysis of variance, and independent sample <italic>t</italic> tests were used to examine associations and differences between and within users by the type of health domain and users’ behavioral intention and adoption. RESULTS Preferences were generally the highest for information on the health consequences of movement behavior self-monitoring, behavioral feedback, insight into healthy lifestyles, and tips and instructions. Although the same ranking was found for techniques across behaviors, preferences were stronger for all but one BCT for PA in comparison to the other two health behaviors. Although techniques fit user preferences for addressing PA well, supplemental techniques may be able to address preferences for sleep and SB in a better manner. In addition to what is commonly included in apps, sleep apps should consider providing tips for sleep. SB apps may wish to include more self-regulation and goal-setting techniques. Few differences were found by users’ intentions or adoption to change a particular behavior. Apps should provide more self-monitoring (<italic>P</italic>=.03), information on behavior health outcome (<italic>P</italic>=.048), and feedback (<italic>P</italic>=.04) and incorporate social support (<italic>P</italic>=.048) to help those who are further removed from healthy sleep. A virtual coach (<italic>P</italic><.001) and video modeling (<italic>P</italic>=.004) may provide appreciated support to those who are physically less active. PA self-monitoring appealed more to those with an intention to change PA (<italic>P</italic>=.03). Social comparison and support features are not high on users’ agenda and may not be needed from an engagement point of view. Engagement features may not be very relevant for user engagement but should be examined in future research with a less reflective method. CONCLUSIONS The findings of this study provide guidance for the design of digital 24-hour movement behavior interventions. As 24-hour movement guidelines are increasingly being adopted in several countries, our study findings are timely to support the design of interventions to meet these guidelines.


10.2196/18021 ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. e18021
Author(s):  
Mohammad Owaise Sharif ◽  
Jonathon Timothy Newton ◽  
Susan J Cunningham

Background Orthodontic treatment is a common health care intervention; treatment duration can be lengthy (2-3 years on average), and adherence to treatment advice is therefore essential for successful outcomes. It has been reported that up to 43% of patients fail to complete treatment, and there are currently no useful predictors of noncompletion. Given that the National Health Service England annual expenditure on primary-care orthodontic treatment is in excess of £200 million (US $267 million), noncompletion of treatment represents a significant inefficient use of public resources. Improving adherence to treatment is therefore essential. This necessitates behavior change, and interventions that improve adherence and are designed to elicit behavioral change must address an individual’s capability, opportunity, and motivation. Mobile phones are potentially an invaluable tool in this regard, as they are readily available and can be used in a number of ways to address an individual’s capability, opportunity, and motivation. Objective This study will assess the effectiveness and acceptability of a personalized mobile phone app in improving adherence to orthodontic treatment advice by way of a randomized controlled trial. Methods This study will be conducted in 2 phases at the Eastman Dental Hospital, University College London Hospitals Foundation Trust. Phase 1 is feasibility testing of the My Braces app. Participants will be asked to complete the user version of the Mobile Application Rating Scale. The app will be amended following analysis of the responses, if appropriate. Phase 2 is a randomized controlled trial to test the effectiveness and acceptability of the My Braces app. Results This study was approved by the London – Bloomsbury Research Ethics Committee on November 5, 2019 (reference 19/LO/1555). No patients have been recruited to date. The anticipated start date for recruitment to phase 1 is October 2020. Conclusions Given the availability, affordability, and versatility of mobile phones, it is proposed that they will aid in improving adherence to treatment advice and hence improve treatment completion rates. If effective, the applicability of this methodology to developing behavior change/modification interventions and improving adherence to treatment across health care provides an exciting opportunity. Trial Registration ClinicalTrials.gov NCT04184739; https://clinicaltrials.gov/ct2/show/NCT04184739 International Registered Report Identifier (IRRID) PRR1-10.2196/18021


2021 ◽  
Author(s):  
Laura Struik ◽  
Danielle Rodberg ◽  
Ramona Sharma

BACKGROUND Smoking rates in Canada remain unacceptably high, and cessation rates have stalled in recent years. Online cessation programs, touted for their ability to reach many different populations anytime, have shown promise in their efficacy. The Government of Canada has therefore funded provincial and national smoking cessation websites across the country. However, little is known about the behavior change techniques (BCTs) that underpin the content of these websites, which is key to establishing the quality of the websites, as well as a way forward for evaluation. OBJECTIVE The purpose of this study, therefore, was to apply the BCTTv1 taxonomy to Canadian provincial and federal websites and determine which BCTs they use. METHODS A total of 12 government-funded websites across Canada were included for analysis. Using deductive content analysis, and through training in applying the BCTTv1 taxonomy, the website content was coded according to the 93 BCTs across the 16 BCT categories. RESULTS Of the 16 BCT categories, 14 were present within the websites. The most widely represented BCT categories (used in all 12 websites) included: 1. Goals and planning, 3. Social support, 5. Natural consequences, and 11. Regulation. The most saturated BCT categories (those most heavily used) included: 10. Reward and threat, 12. Antecedents, 1. Goals and planning, and 5. Natural consequences. Implementation of BCTs within these categories varied across the sites. CONCLUSIONS This study addresses a critical gap in knowledge around the behavior change techniques that underpin government-funded smoking cessation websites in Canada. The findings offer programmers and researchers with tangible directions for prioritizing and enhancing provincial and national smoking cessation programs, and an evaluation framework to assess smoking cessation outcomes in relation to the web-based content.


2022 ◽  
Author(s):  
Jezdancher Watti ◽  
Máté Millner ◽  
Kata Siklósi ◽  
Hedvig Kiss ◽  
Oguz Kelemen ◽  
...  

BACKGROUND The Transtheoretical Model recommends "processes of change", while the Motivational Interviewing approach offers “motivational language” as indicators of health behavior change. The relationship between these indicators and the usage of Facebook reaction buttons is little known. However, this relationship may highlight how to evaluate one of the most popular engagement indicators (Facebook reactions) in online health behavior change interventions. OBJECTIVE The study aim was to understand the relationship between processes of change, motivational language, Facebook users’ gender, and the Facebook reaction buttons. METHODS A total of 821 comments were analyzed in the current study (N=821), which came from different Facebook users, and responded to image-based, smoking cessation support contents. The processes of change (experiential and behavioral processes) and the motivational language (change talk and sustain talk) in the investigated comments were identified. The presence, the number, and the proportion of these linguistic categories were compared with the Facebook users’ gender and the usage of reaction buttons. RESULTS The Facebook users who used the “Haha” reaction button wrote significantly higher proportion of sustain talk than those who used the “Like” or “Love” reaction (P=.011). No significant difference in the number or proportion of linguistic categories was found between those who used the "Like" reaction button, and those who did not use reaction buttons. The Facebook users who combined the comment and “Love” reaction wrote significantly more change talk than those who used the “Haha” and “Like” reactions, or those who did not utilize these buttons (P<.001). Significant female dominance was observed in the presence, the number, and the proportion of experiential processes and change talk (P<.05). In addition, significant male predominance was found in the presence, the number, and the proportion of sustain talk (P<.05). CONCLUSIONS The "Haha" reaction may be a negative engagement indicator, the "Like" reaction may be a neutral engagement indicator, and the "Love" reaction may be a positive engagement indicator in terms of the smoking cessation during Facebook-based interventions. Furthermore, female engagement may be characterized by utilizing the terms of experiential processes and change talk, while the usage of sustain talk can be typical for male engagement. We recommend the evaluation of processes of change and motivational utterances in participants' comments during online public health interventions.


2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 98-98
Author(s):  
Lawson Eng ◽  
Sophia Yijia Liu ◽  
Qihuang Zhang ◽  
Delaram Farzanfar ◽  
Sabrina Yeung ◽  
...  

98 Background: Health behavior change including smoking cessation, physical activity (PA) and alcohol moderation are important aspects of cancer survivorship. We assessed cancer pt interest and perceptions of programs for these behaviours. Methods: 501 cancer pts were surveyed on their smoking, PA and alcohol use along with their interest and perceptions for programs for these behaviors. Multivariate logistic regression models identified factors associated with pt interest and perceptions. Results: At diagnosis, 115 pts smoked; 184 were exposed to second hand smoke (SHS); 313 did not meet PA guidelines; 238 were drinking alcohol. At risk pts’ (e.g, smokers for smoking cessation, SHS exposed for household smoking cessation) survey results are shown in the table. Most pts perceived smoking (90%), SHS (83%) and alcohol (56%) to be harmful on quality of life, survival and fatigue while PA (77%) was felt to improve these outcomes. These perceptions were not associated with program interest ( P> 0.05). However, pts perceiving that alcohol worsened and PA improved these outcomes were more to likely believe associated programs are beneficial (alcohol aORs = 2.1-2.2 P< 0.03; PA aORs = 1.9-3.2 P< 0.02) and should be routine care (alcohol aORs = 1.9-3.5 P< 0.03; PA aORs = 1.7-2.4 P< 0.1). Pts with more pack-yrs smoked less likely perceived a benefit in a household smoking cessation program (aOR = 1.02 P< 0.007). Pts preferred discussing programs with doctors ( > 35%) or counsellors ( > 42%). Conclusions: About half of pts feel that health behavior change programs would be beneficial and should be part of routine care. These factors were more important than perception of the behaviors on outcomes in influencing pt interest. Initial discussions with pts should focus on discussing benefits of these programs. [Table: see text]


1982 ◽  
Vol 7 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Robert W. Jeffery ◽  
Brian G. Danaher ◽  
John Killen ◽  
John W. Farquhar ◽  
Richard Kinnier

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