Investigating the Direct Impact of a Gamified Versus Nongamified Well-Being Intervention: An Exploratory Experiment

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Gamification is a promising strategy to increase the effectiveness of Web-based mental health interventions by enhancing engagement. However, because most studies focus on the longer term effects of gamification (eg, effectiveness or adherence at the end of the intervention period), there is limited insight into how gamification may enhance engagement. Research implies that gamification has a direct impact at the time of use of the intervention, which changes the experience of the users, and thereby motivates users. However, it is unclear what this direct impact of gamification might be and how it can be measured.

Objective

The objective of this study was to explore the direct impact of gamification on behavioral, cognitive, and affective engagement in the context of a Web-based mental health intervention and to explore whether and how the different components of engagement are related.

Methods

A pilot (n=19) and a real-life (n=75) randomized between-groups experiment was carried out, where participants used a gamified or nongamified version of the same Web-based well-being intervention for a single session. Participants (68%, 64/94 female, mean age 23 years) were asked to use the intervention in one session for research purposes. Gamification elements included a map as visualization of the different lessons, a virtual guide, and badges. Later, behavioral, cognitive, and affective engagement were measured.

Results

The pilot experiment showed no differences between the gamified and nongamified intervention. However, in the real-life experiment, participants in the gamified intervention scored higher on cognitive engagement, that is, involvement ( P=.02) and some elements of affective engagement, that is, flow as a combination of cognitive and affective engagement ( P=.049), and the emotions ”interest” ( P=.03) and “inspiration” ( P=.009). Furthermore, the effect of gamification on cognitive engagement was mediated by the influence of gamification on specific positive emotions.

Conclusions

The gamified intervention seemed to be able to increase cognitive engagement and the combination of cognitive and affective engagement but not behavioral and affective engagement alone. However, positive emotions seem to play an important role in mediating the effect of gamification on engagement. In conclusion, we cannot say that gamification ”works” but that the design of an intervention, in this case, gamification, can have an impact on how participants experience the intervention.

Related collections

Most cited references 31

Record: found
Abstract: found
Article: not found

The broaden-and-build theory of positive emotions.

Barbara L. Fredrickson (2004)

The broaden-and-build theory describes the form and function of a subset of positive emotions, including joy, interest, contentment and love. A key proposition is that these positive emotions broaden an individual's momentary thought-action repertoire: joy sparks the urge to play, interest sparks the urge to explore, contentment sparks the urge to savour and integrate, and love sparks a recurring cycle of each of these urges within safe, close relationships. The broadened mindsets arising from these positive emotions are contrasted to the narrowed mindsets sparked by many negative emotions (i.e. specific action tendencies, such as attack or flee). A second key proposition concerns the consequences of these broadened mindsets: by broadening an individual's momentary thought-action repertoire--whether through play, exploration or similar activities--positive emotions promote discovery of novel and creative actions, ideas and social bonds, which in turn build that individual's personal resources; ranging from physical and intellectual resources, to social and psychological resources. Importantly, these resources function as reserves that can be drawn on later to improve the odds of successful coping and survival. This chapter reviews the latest empirical evidence supporting the broaden-and-build theory and draws out implications the theory holds for optimizing health and well-being.

0 comments Cited 708 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

Saskia M Kelders, Robin N Kok, Hans Ossebaard … (2013)

Background Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p < .001), updates (p < .001), frequency of interaction with a counselor (p < .001), the system (p = .003) and peers (p = .017), duration (F = 6.068, p = .004), adherence (F = 4.833, p = .010) and the number of primary task support elements (F = 5.631, p = .005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Conclusions Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere.

0 comments Cited 569 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Conference Proceedings: not found

From game design elements to gamefulness

Sebastian Deterding, Dan A Dixon, Rilla Khaled … (2011)

0 comments Cited 506 times – based on 0 reviews

Bookmark

All references

Author and article information

Contributors

Saskia Marion Kelders:

Center for eHealth and Wellbeing ResearchDepartment of Psychology, Health and TechnologyUniversity of TwenteDrienerlolaan 5Enschede,Netherlands31 534896055s.m.kelders@utwente.nl

ORCID: http://orcid.org/0000-0001-8949-6871

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: July 2018

Publication date (Electronic): 26 July 2018

Volume: 20

Issue: 7

Electronic Location Identifier: e247

Affiliations

[1] ¹ Center for eHealth and Wellbeing Research Department of Psychology, Health and Technology University of Twente Enschede Netherlands

[2] ² Optentia Research Focus Area North-West University Vanderbijlpark South Africa

Author notes

Corresponding Author: Saskia Marion Kelders s.m.kelders@ 123456utwente.nl

Author information

Saskia Marion Kelders http://orcid.org/0000-0001-8949-6871

Marion Sommers-Spijkerman http://orcid.org/0000-0003-0648-8708

Jochem Goldberg http://orcid.org/0000-0001-8648-770X

Article

Publisher ID: v20i7e247

DOI: 10.2196/jmir.9923

PMC ID: 6085554

PubMed ID: 30049669

SO-VID: 39d4246e-a4ce-400e-90da-4afac82e9492

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/.as well as this copyright and license information must be included.

History

Date received : 24 January 2018

Date revision requested : 25 March 2018

Date revision received : 18 May 2018

Date accepted : 29 May 2018

Comments

Comment on this article

scite_

Cited by 25

See all cited by

Most referenced authors 612

See all reference authors

Submit your digital health research with an established publisher
- celebrating 25 years of open access