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      Gamification for health and wellbeing: A systematic review of the literature

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          Abstract

          Background

          Compared to traditional persuasive technology and health games, gamification is posited to offer several advantages for motivating behaviour change for health and well-being, and increasingly used. Yet little is known about its effectiveness.

          Aims

          We aimed to assess the amount and quality of empirical support for the advantages and effectiveness of gamification applied to health and well-being.

          Methods

          We identified seven potential advantages of gamification from existing research and conducted a systematic literature review of empirical studies on gamification for health and well-being, assessing quality of evidence, effect type, and application domain.

          Results

          We identified 19 papers that report empirical evidence on the effect of gamification on health and well-being. 59% reported positive, 41% mixed effects, with mostly moderate or lower quality of evidence provided. Results were clear for health-related behaviours, but mixed for cognitive outcomes.

          Conclusions

          The current state of evidence supports that gamification can have a positive impact in health and wellbeing, particularly for health behaviours. However several studies report mixed or neutral effect. Findings need to be interpreted with caution due to the relatively small number of studies and methodological limitations of many studies (e.g., a lack of comparison of gamified interventions to non-gamified versions of the intervention).

          Highlights

          • A systematic review is conducted to assess the empirical effectiveness of gamification in the health and wellbeing domain.

          • Twenty-one papers are identified that report empirical evidence on the effectiveness of gamification in health and wellbeing.

          • Overall the evidence suggests gamification can have a positive impact for health and wellbeing related interventions.

          • The evidence is strongest for the use of gamification to target behavioural outcomes, particularly physical activity.

          • Further research that isolates the impacts of gamification is needed.

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          Most cited references46

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          Empirical validation of affect, behavior, and cognition as distinct components of attitude.

          A prevalent model of attitude structure specifies three components: affect, behavior, and cognition. The validity of this tripartite model was evaluated. Five conditions needed for properly testing the three-component distinction were identified. Two new studies were then designed to validate the tripartite model. A consideration of the tripartite model's theoretical basis indicated that the most important validating conditions are (a) the use of nonverbal, in addition to verbal, measures of affect and behavior, and (b) the physical presence of the attitude object. Study 1, in which subjects' attitudes toward snakes were examined, indicated very strong support for this tripartite model: The model was statistically acceptable, its relative fit was very good, and the intercomponent correlations were moderate (.38 less than r less than .71). Study 2 was a verbal report analogue of Study 1. Results from Study 2 indicated that higher intercomponent correlations occurred when attitude measures derived solely from verbal reports and when the attitude object was not physically present.
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            • Article: not found

            A motivational model of video game engagement.

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              Is Open Access

              Apps to promote physical activity among adults: a review and content analysis

              Background In May 2013, the iTunes and Google Play stores contained 23,490 and 17,756 smartphone applications (apps) categorized as Health and Fitness, respectively. The quality of these apps, in terms of applying established health behavior change techniques, remains unclear. Methods The study sample was identified through systematic searches in iTunes and Google Play. Search terms were based on Boolean logic and included AND combinations for physical activity, healthy lifestyle, exercise, fitness, coach, assistant, motivation, and support. Sixty-four apps were downloaded, reviewed, and rated based on the taxonomy of behavior change techniques used in the interventions. Mean and ranges were calculated for the number of observed behavior change techniques. Using nonparametric tests, we compared the number of techniques observed in free and paid apps and in iTunes and Google Play. Results On average, the reviewed apps included 5 behavior change techniques (range 2–8). Techniques such as self-monitoring, providing feedback on performance, and goal-setting were used most frequently, whereas some techniques such as motivational interviewing, stress management, relapse prevention, self-talk, role models, and prompted barrier identification were not. No differences in the number of behavior change techniques between free and paid apps, or between the app stores were found. Conclusions The present study demonstrated that apps promoting physical activity applied an average of 5 out of 23 possible behavior change techniques. This number was not different for paid and free apps or between app stores. The most frequently used behavior change techniques in apps were similar to those most frequently used in other types of physical activity promotion interventions.
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                Author and article information

                Contributors
                Journal
                Internet Interv
                Internet Interv
                Internet Interventions
                Elsevier
                2214-7829
                02 November 2016
                November 2016
                02 November 2016
                : 6
                : 89-106
                Affiliations
                [a ]Queensland University of Technology (QUT), GPO Box 2434, Brisbane, QLD 4001, Australia
                [b ]Digital Creativity Labs, University of York, York YO10 5GE, United Kingdom
                Author notes
                [* ]Corresponding author. dm.johnson@ 123456qut.edu.au
                Article
                S2214-7829(16)30038-0
                10.1016/j.invent.2016.10.002
                6096297
                30135818
                7d969526-4cdf-4503-9547-d599c3649ad8
                © 2016 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 July 2016
                : 25 October 2016
                : 25 October 2016
                Categories
                Review Article

                gamification,health,wellbeing,systematic review
                gamification, health, wellbeing, systematic review

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