Background Encouraging individuals to report daily information such as unpleasant disease symptoms, daily activities and behaviors, or aspects of their physical and emotional state is difficult but necessary for many studies and clinical trials that rely on patient-reported data as primary outcomes. Use of paper diaries is the traditional method of completing daily diaries, but digital surveys are becoming the new standard because of their increased compliance; however, they still fall short of desired compliance levels. Objective Mobile games using in-game rewards offer the opportunity to increase compliance above the rates of digital diaries and paper diaries. We conducted a 5-week randomized control trial to compare the completion rates of a daily diary across 3 conditions: a paper-based participant-reported outcome diary (Paper PRO), an electronic-based participant-reported outcome diary (ePRO), and a novel ePRO diary with in-game rewards (Game-Motivated ePRO). Methods We developed a novel mobile game that is a combination of the idle and pet collection genres to reward individuals who complete a daily diary with an in-game reward. Overall, 197 individuals aged 6 to 24 years (male: 100 and female: 97) were enrolled in a 5-week study after being randomized into 1 of the 3 methods of daily diary completion. Moreover, 157 participants (male: 84 and female: 69) completed at least one diary and were subsequently included in analysis of compliance rates. Results We observed a significant difference ( F 2,124 =6.341; P =.002) in compliance to filling out daily diaries, with the Game-Motivated ePRO group having the highest compliance (mean completion 86.4%, SD 19.6%), followed by the ePRO group (mean completion 77.7%, SD 24.1%), and finally, the Paper PRO group (mean completion 70.6%, SD 23.4%). The Game-Motivated ePRO ( P =.002) significantly improved compliance rates above the Paper PRO. In addition, the Game-Motivated ePRO resulted in higher compliance rates than the rates of ePRO alone ( P =.09). Equally important, even though we observed significant differences in completion of daily diaries between groups, we did not observe any statistically significant differences in association between the responses to a daily mood question and study group, the average diary completion time ( P= .52), or the System Usability Scale score ( P =.88). Conclusions The Game-Motivated ePRO system encouraged individuals to complete the daily diaries above the compliance rates of the Paper PRO and ePRO without altering the participants’ responses. Trial Registration ClinicalTrials.gov NCT03738254; http://clinicaltrials.gov/ct2/show/NCT03738254 (Archived by WebCite at http://www.webcitation.org/74T1p8u5...

Self-tracking physiological and psychological data poses the challenge of presentation and interpretation. Insightful narratives for self-tracking data can motivate the user towards constructive self-reflection. One powerful form of narrative that engages audience across various culture and age groups is animated movies. We collected a week of self-reported mood and behavior data from each user and created in Unity a personalized animation based on their data. We evaluated the impact of their video in a randomized control trial with a nonpersonalized animated video as control. We found that personalized videos tend to be more emotionally engaging, encouraging greater and lengthier writing that indicated self-reflection about moods and behaviors, compared to non-personalized control videos.

Background: Encouraging individuals to report daily information such as disease symptoms, daily activities and behaviors, or aspects of their physical and emotional state, is difficult, but necessary for many studies and clinical trials that rely on patient-reported data as primary outcomes. Paper diaries are the traditional method of completing daily diaries, but digital surveys are becoming the new standard because of their increased compliance; however, they still fall short of desired compliance levels. Objective: Mobile games using in-game rewards offer the opportunity to increase compliance above the rates of digital diaries and paper diaries. We conduct a 5-week randomized control trial to compare the completion rates of a daily diary across three conditions: a paper-based participant reported outcome diary (Paper PRO), an electronic-based participant reported outcome diary (ePRO), and a novel electronic-based participant reported outcome diary with in-game rewards (Game-Motivated ePRO). Methods: We developed a novel mobile game that is a combination of the idle and pet collection genres to reward individuals who complete a daily diary with an in-game reward. One hundred ninety-seven (197) individuals aged 6-24 (Male: 100, Female: 97) were enrolled in a 5-week study and randomized into one of the three methods of daily diary completion. One hundred fifty-seven (157) participants (Male: 84, Female: 69) completed at least one diary and were subsequently included in analysis of compliance rates. Results: We observed a significant difference in compliance to filling out daily diaries, with the GameMotivated ePRO group having the highest compliance (86.4% completion), followed by the ePRO group (77.7% completion), and lastly the Paper PRO group (70.6% completion). Both the ePRO ((odds ratio: 2.04, P=0.0414) and the Game-Motivated ePRO (odds ratio: 5.17, P<.0001) significantly improved compliance rates above the Paper PRO. Additionally, the Game-Motivated ePRO resulted in higher compliance rates than the ePRO alone (odds ratio: 2.53, P=0.0144). Equally important, even though we observed significant differences in completion of daily diaries between groups, we did not observe any statistically significant differences in the types of responses to a daily mood question (all P-values >0.58), the average diary completion time (P=0.57), or the System Usability Scale (SUS) score (P=0.61). Conclusions:The Game-Motivated ePRO system encouraged individuals to complete the daily diaries above the compliance rates of the Paper PRO and ePRO without altering the participant's responses.