Supplementing a widely available weight loss program with gamified inhibitory control training: A randomized pilot study

Abstract

Background: Increasing evidence suggests that targeting self-regulatory processes may improve obesity treatment outcomes. Incorporating gamification principles in inhibitory control training may promote sustained training adherence and resulting benefits. This pilot study evaluated the preliminary efficacy of supplementing an evidence-based weight management program (WW) with sustained gamified inhibitory control training (PolyRules!) on change in Body Mass Index (BMI) among adults with overweight/obesity. Methods: 30 adults with overweight/obesity (M age 49.9 � 12.4, 86.7% female; 23.3% Hispanic, mean BMI 35.3 � 6.3) were randomly assigned to receive WW with or without PolyRules! for 12 weeks. The primary outcome was change in BMI from baseline to post-intervention across study arms. Implementation and process indicators were captured to inform larger trials. Results: Average change in BMI was −0.9 in the WW arm and −1.2 in the WW + PolyRules! arm (Cohen's d = 0.26). In the WW + PolyRules! arm, increased training was associated with greater decreases in BMI (r = −0.506, p = 0.0454). WW + PolyRules! participants completed an average of 60.4% sessions and reported positive experiences. There was no difference in frequency of food (d = −0.02) and weight tracking (d = −0.19) between arms. Conclusions: Studies in larger samples should evaluate training-related effects on weight. Supplementing WW with gamified inhibitory training appears feasible, with no detrimental effect on engagement.

The Use of Gamification in the Self-Management of Patients With Chronic Diseases: Scoping Review

“…In this review, some studies (31/70, 44%) indicated that relevant theories or concepts guided their gamification practices in the self-management of patients with chronic diseases. A total of 37 concepts or theoretical frameworks were mentioned in the included articles, most of which originated from psychology and cross-disciplinarity (n=33, 89%), such as self-determination theory [38,40,[42][43][44], flow theory [33,[45][46][47][48][49], social cognition theory [27,[50][51][52], goal-setting theory [34,43], information-motivation-behavioral technology model of behavior change [32,43], intrinsic motivation [16,53], self-efficacy [17,45], persuasion system design model [54], inhibitory control [55,56], patient-reported outcome [32], co-design approach, and participatory design [57].…”

“…Overall, "human-computer interaction" was an important game design element in the gamification design of the physical activity and rehabilitation training, providing timely feedback data for both health care professionals and patients such as training duration, intensity, and training action; allowing patients to see physical function changes with exercise rehabilitation; and improving their compliance with exercise and rehabilitation [13,16,19,20,28,30,33,35,37,42,44,[46][47][48][49][51][52][53][54][55][56][58][59][60][64][65][66][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83]85].…”

“…This is because the user learns the rules of the game and processes them quickly and accurately in the game, which keeps the brain active to avoid cognitive decline [45] and improves cognitive control and attention [42]. The time-limited game design element was used to train attention and goal-oriented behavior in obese patients, control the frequency of their consumption of a high-carbohydrate diet (eg, dessert), and strengthen their adherence to a healthy diet [55,56]. Users who received the gaming intervention were more concerned about daily food intake than those who received regular weight management (65.3% vs 33.6%), and the average weight loss in the intervention group was greater than that in the control group (3.4% vs 2.5%) [56].…”

“…User Satisfaction Evaluation Questionnaire [78] 3 (8) Self-designed questionnaire [52,61,62] 3 (8) One-dimensional subjective score [35,51,55] User experience 1 (3) User Experience Questionnaire [58] 1 (3) Game Experience Questionnaire [53] 6 (15) Self-designed questionnaire [32,44,49,74,78,91] 14 (36) Interview [13,16,27,[29][30][31]37,49,58,63,65,69,78,80] User preference 1 (3) User interface features [58] 3 (8) Self-designed questionnaire [41,77,78] 6 (15) Interview [13,40,57,58,73,78] Completion or participation 4 (10) Statistical results [55,56,62,…”