Archetypes of Gamification: Analysis of mHealth Apps

Abstract

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.

Optimizing Healthcare Through Digital Health and Wellness Solutions to Meet the Needs of Patients With Chronic Disease During the COVID-19 Era

“…Gamification, which is just one strategy of many to improve adherence and engagement, is defined as the use of game design elements in non-game contexts (22). Gamification of digital health and wellness technologies via gaming elements have been effectively used to optimize patient engagement, attention, motivation, and adherence to treatments and healthy lifestyle behaviors (22)(23)(24). For example, a clinically validated gamification health application Rafi-Tone was developed to promote effective inhaler techniques in asthmatic children, who may be at higher risk of getting sick from COVID-19, through a series of challenging games (25).…”

Understanding the evaluation of mHealth app features based on a cross-country Kano analysis

“…Using gamification in mHealth apps is a relatively young and emerging trend (Schmidt-Kraepelin et al, 2020 ) that has the potential to promote behavioral health changes (Miller et al, 2016 ), to improve user self-management (Charlier et al, 2016 ), and to overcome a loss of interest and user engagement over time (Schmidt-Kraepelin et al, 2020 ). Several contemporary studies have applied various “game design elements in non-game contexts” (Deterding et al, 2011 , p. 10), for example, in chronic disease rehabilitation (AlMarshedi et al, 2015 ) and mental health (Miloff et al, 2015 ).…”

“…Several contemporary studies have applied various “game design elements in non-game contexts” (Deterding et al, 2011 , p. 10), for example, in chronic disease rehabilitation (AlMarshedi et al, 2015 ) and mental health (Miloff et al, 2015 ). By analyzing 143 apps from the Apple App Store and the Google Play Store, Schmidt-Kraepelin et al ( 2020 ) identify eight archetypes of gamification that are applied in mHealth apps (e.g., competition and collaboration, episodical compliance tracking, internal rewards for self-set goals). Previous research has shown that gamification can increase user satisfaction by fulfilling psychological needs, such as social relatedness (Sailer et al, 2017 ) and by increasing motivation or improving users’ emotional experiences (Sardi et al, 2017 ).…”

Are Gamification Projects Different? An Exploratory Study on Software Project Risks for Gamified Health Behavior Change Support Systems

“…a general cultural and societal transformation stemming from an increased engagement with games and gameful interactions). As gamification in HBCSSs is predominantly applied as a design strategy that explicitly aims to increase motivation or promote continuous system usage in order to ultimately sustain desirable health behaviors [8,17], we solely focus on intentional gamification in this study.…”

“…However, in some contexts, consequences may be more severe. For instance, gamification is prominently implemented in health behavior change support systems (HBCSSs) to foster beneficial health behaviors like increased physical activity [7,8]. In such contexts, the consequences of gamification project failure may be particularly severe, as it may translate to negative influences on users' health [9].…”