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      Health Behavior Theory in Physical Activity Game Apps: A Content Analysis

      , MPH(c) 1 , , , MPH(c) 1 , , MS(c) 2
      (Reviewer), (Reviewer)
      JMIR Serious Games
      JMIR Publications Inc.
      health and fitness apps, mobile phone, behavioral health, theory, content analysis, physical activity

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          Physical activity games developed for a mobile phone platform are becoming increasingly popular, yet little is known about their content or inclusion of health behavior theory (HBT).


          The objective of our study was to quantify elements of HBT in physical activity games developed for mobile phones and to assess the relationship between theoretical constructs and various app features.


          We conducted an analysis of exercise and physical activity game apps in the Apple App Store in the fall of 2014. A total of 52 apps were identified and rated for inclusion of health behavior theoretical constructs using an established theory-based rubric. Each app was coded for 100 theoretical items, containing 5 questions for 20 different constructs. Possible total theory scores ranged from 0 to 100. Descriptive statistics and Spearman correlations were used to describe the HBT score and association with selected app features, respectively.


          The average HBT score in the sample was 14.98 out of 100. One outlier, SuperBetter, scored higher than the other apps with a score of 76. Goal setting, self-monitoring, and self-reward were the most-reported constructs found in the sample. There was no association between either app price and theory score ( P=.5074), or number of gamification elements and theory score ( P=.5010). However, Superbetter, with the highest HBT score, was also the most expensive app.


          There are few content analyses of serious games for health, but a comparison between these findings and previous content analyses of non-game health apps indicates that physical activity mobile phone games demonstrate higher levels of behavior theory. The most common theoretical constructs found in this sample are known to be efficacious elements in physical activity interventions. It is unclear, however, whether app designers consciously design physical activity mobile phone games with specific constructs in mind; it may be that games lend themselves well to inclusion of theory and any constructs found in significant levels are coincidental. Health games developed for mobile phones could be potentially used in health interventions, but collaboration between app designers and behavioral specialists is crucial. Additionally, further research is needed to better characterize mobile phone health games and the relative importance of educational elements versus gamification elements in long-term behavior change.

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          Most cited references43

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          The Motivational Pull of Video Games: A Self-Determination Theory Approach

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              Mobile applications for weight management: theory-based content analysis.

              The use of smartphone applications (apps) to assist with weight management is increasingly prevalent, but the quality of these apps is not well characterized. The goal of the study was to evaluate diet/nutrition and anthropometric tracking apps based on incorporation of features consistent with theories of behavior change. A comparative, descriptive assessment was conducted of the top-rated free apps in the Health and Fitness category available in the iTunes App Store. Health and Fitness apps (N=200) were evaluated using predetermined inclusion/exclusion criteria and categorized based on commonality in functionality, features, and developer description. Four researchers then evaluated the two most popular apps in each category using two instruments: one based on traditional behavioral theory (score range: 0-100) and the other on the Fogg Behavioral Model (score range: 0-6). Data collection and analysis occurred in November 2012. Eligible apps (n=23) were divided into five categories: (1) diet tracking; (2) healthy cooking; (3) weight/anthropometric tracking; (4) grocery decision making; and (5) restaurant decision making. The mean behavioral theory score was 8.1 (SD=4.2); the mean persuasive technology score was 1.9 (SD=1.7). The top-rated app on both scales was Lose It! by Fitnow Inc. All apps received low overall scores for inclusion of behavioral theory-based strategies. © 2013 American Journal of Preventive Medicine.

                Author and article information

                JMIR Serious Games
                JMIR Serious Games
                JMIR Serious Games
                JMIR Publications Inc. (Toronto, Canada )
                Jul-Dec 2015
                13 July 2015
                : 3
                : 2
                : e4
                [1] 1Computational Health Science Research Group Department of Health Science Brigham Young University Provo, UTUnited States
                [2] 2Human Performance Research Group Department of Exercise Science Brigham Young University Provo, UTUnited States
                Author notes
                Corresponding Author: Hannah E Payne hannahp413@ 123456gmail.com
                ©Hannah E Payne, Victor BA Moxley, Elizabeth MacDonald. Originally published in JMIR Serious Games (http://games.jmir.org), 13.07.2015.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on http://games.jmir.org, as well as this copyright and license information must be included.

                : 28 December 2014
                : 15 January 2015
                : 10 May 2015
                : 24 May 2015
                Original Paper
                Original Paper

                health and fitness apps,mobile phone,behavioral health,theory,content analysis,physical activity


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