The Effects of mHealth-Based Gamification Interventions on Participation in Physical Activity: Systematic Review

Abstract

Background It is well known that regular physical exercise has associated benefits; yet, participation remains suboptimal. Mobile health (mHealth) has become an indispensable medium to deliver behavior change interventions, and there is a growing interest in the gamification apps in mHealth to promote physical activity (PA) participation. Gamification could use game design elements (such as points, leaderboards, and progress bars), and it has the potential to increase motivation for PA and engagement. However, mHealth-based gamification interventions are still emerging, and little is known about the application status and efficacy of such interventions. Objective This systematic review aims to investigate gamification apps in mHealth for improving PA levels and simultaneously summarize the impact of gamification interventions on PA participation. Methods We searched PubMed, Scopus, Web of Science, Embase, CINAHL (EBSCO host), and IEEE Xplore from inception to December 20, 2020. Original empirical research exploring the effects of gamification interventions on PA participation was included. The papers described at least one outcome regarding exercise or PA participation, which could be subjective self-report or objective indicator measurement. Of note, we excluded studies about serious games or full-fledged games. Results Of 2944 studies identified from the database search, 50 (1.69%) were included, and the information was synthesized. The review revealed that gamification of PA had been applied to various population groups and broadly distributed among young people but less distributed among older adults and patients with a disease. Most of the studies (30/50, 60%) combined gamification with wearable devices to improve PA behavior change, and 50% (25/50) of the studies used theories or principles for designing gamified PA interventions. The most frequently used game elements were goal-setting, followed by progress bars, rewards, points, and feedback. This review demonstrated that gamification interventions could increase PA participation; however, the results were mixed, and modest changes were attained, which could be attributed to the heterogeneity across studies. Conclusions Overall, this study provides an overview of the existing empirical research in PA gamification interventions and provides evidence for the efficacy of gamification in enhancing PA participation. High-quality empirical studies are needed in the future to assess the efficacy of a combination of gamification and wearable activity devices to promote PA, and further exploration is needed to investigate the optimal implementation of these features of game elements and theories to enhance PA participation.

Effectiveness of gamified team competition as mHealth intervention for medical interns: a cluster micro-randomized trial

“…For instance, Patel et al found that mobile-based gamified competition can increase daily step count for overweight and obese adults in the United States 29 . However, the effect size from our study is smaller than previous studies 18 , 28 – 30 . There are multiple reasons.…”

“…Also, intra-institutional competition decreased the efficacy of competition, suggesting potential improvements in strategies of assigning opponent teams to boost the efficacy of team competition. Xu et al have identified eight randomized controlled trials reporting that mHealth-based gamification intervention exerted a positive impact on step count, and our finding on the beneficial effect of mobile-based gamified team competition upon physical activity is consistent with these previous studies 18,[27][28][29] . For instance, Patel et al found that mobile-based gamified competition can increase daily step count for overweight and obese adults in the United States 29 .…”

“…To date, many previous studies have shown the effectiveness of wearable and smartphone-based interventions on health outcomes [12][13][14] . Some studies included gamification, a strategy that attempts to enhance user enjoyment and engagement 15 by introducing game mechanics into a non-game environment [16][17][18] . Theories of health behavior change suggest that gamification elements that prompt self-monitoring, such as performance feedback, progress monitoring, and social comparison have the potential to motivate changes in behavioral outcomes 19,20 .…”

Data-driven decarbonisation pathways for reducing life cycle GHG emissions from food waste in the hospitality and food service sectors

“…Furthermore, this system provided another means of efficient food waste image data collection, as merely three hours of deployment yielded over 700 images. Gamification has been used in other settings such as enhancing physical activity participation 48 . Literature reviews have shown that gamification can increase user motivation and engagement but does greatly depend on the context of the issue, as well as on the users using it 49 .…”

Nuevas tecnologías en Medicina

“…A nivel educativo la TF ha alcanzado un gran desarrollo, habiendo demostrado su utilidad tanto para la enseñanza de personal sanitario, como de pacientes o cuidadores. La "gamificación" es una nueva modalidad de TF y tiene como objetivo aplicar la mecánica del juego con el fin de generar beneficios cognitivos y de motivación [35,36].…”