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      Maintenance of behaviour change following a community-wide gamification based physical activity intervention

      research-article
      Preventive Medicine Reports
      Elsevier
      Gamification, Physical activity, Community, Technology, Intervention

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          Abstract

          Gamification refers to the use of game mechanics (e.g. competition, point scoring, progress visualisation and task setting) to engage and motivate people to achieve an end goal. Public health programs that incorporate gamification-based approaches which aim to improve the public's health have grown in popularity, however most commonplace are individualistic, smartphone-based applications and few studies have been conducted on community-wide interventions. Furthermore, the few studies which have been conducted have relied on small sample sizes with short-term follow-up. In view of this gap in current understanding, this study explored the impact of a community-wide gamified intervention, called ‘Beat the Street’ (in Reading UK) on levels of physical activity at 1 and 2-years post-intervention (between 2014 and 2016). Data were available for N = 1567 participants at one-year post-intervention and N = 723 participants at 2-years post-intervention. A Pretest-Posttest analysis revealed a 11% and 13% decrease in levels of inactivity at 1 and 2-years post-intervention respectively. Furthermore, participants who were inactive at baseline reported undertaking 3.4 and 3.8 days of activity at 1 and 2-years post-intervention, respectively. These findings provide promising preliminary evidence that gamification may be effective for decreasing physical inactivity and game-design mechanisms which may support behaviour change are discussed.

          Highlights

          • This study explored behaviour change 1 and 2 year’s following a community-wide gamified physical activity intervention

          • 61% and 72% of inactive participants had become active at 1 and 2-years following the intervention, respectively.

          • Inactive participants were undertaking an average of 3.4 and 3.8 days of activity at 1 and 2-years, respectively

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          Most cited references13

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          Time use and physical activity: a shift away from movement across the globe.

          Technology linked with reduced physical activity (PA) in occupational work, home/domestic work, and travel and increased sedentary activities, especially television viewing, dominates the globe. Using detailed historical data on time allocation, occupational distributions, energy expenditures data by activity, and time-varying measures of metabolic equivalents of task (MET) for activities when available, we measure historical and current MET by four major PA domains (occupation, home production, travel and active leisure) and sedentary time among adults (>18 years). Trends by domain for the United States (1965-2009), the United Kingdom (1961-2005), Brazil (2002-2007), China (1991-2009) and India (2000-2005) are presented. We also project changes in energy expenditure by domain and sedentary time (excluding sleep and personal care) to 2020 and 2030 for each of these countries. The use of previously unexplored detailed time allocation and energy expenditures and other datasets represents a useful addition to our ability to document activity and inactivity globally, but highlights the need for concerted efforts to monitor PA in a consistent manner globally, increase global PA and decrease sedentary behavior. Given the potential impact on weight gain and other cardiometabolic health risks, the differential declines in MET of activity and increases in sedentary time across the globe represent a major threat to global health. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.
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            Gamification: What It Is and Why It Matters to Digital Health Behavior Change Developers

            This editorial provides a behavioral science view on gamification and health behavior change, describes its principles and mechanisms, and reviews some of the evidence for its efficacy. Furthermore, this editorial explores the relation between gamification and behavior change frameworks used in the health sciences and shows how gamification principles are closely related to principles that have been proven to work in health behavior change technology. Finally, this editorial provides criteria that can be used to assess when gamification provides a potentially promising framework for digital health interventions.
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              Just a Fad? Gamification in Health and Fitness Apps

              Background Gamification has been a predominant focus of the health app industry in recent years. However, to our knowledge, there has yet to be a review of gamification elements in relation to health behavior constructs, or insight into the true proliferation of gamification in health apps. Objective The objective of this study was to identify the extent to which gamification is used in health apps, and analyze gamification of health and fitness apps as a potential component of influence on a consumer’s health behavior. Methods An analysis of health and fitness apps related to physical activity and diet was conducted among apps in the Apple App Store in the winter of 2014. This analysis reviewed a sample of 132 apps for the 10 effective game elements, the 6 core components of health gamification, and 13 core health behavior constructs. A regression analysis was conducted in order to measure the correlation between health behavior constructs, gamification components, and effective game elements. Results This review of the most popular apps showed widespread use of gamification principles, but low adherence to any professional guidelines or industry standard. Regression analysis showed that game elements were associated with gamification (P<.001). Behavioral theory was associated with gamification (P<.05), but not game elements, and upon further analysis gamification was only associated with composite motivational behavior scores (P<.001), and not capacity or opportunity/trigger. Conclusions This research, to our knowledge, represents the first comprehensive review of gamification use in health and fitness apps, and the potential to impact health behavior. The results show that use of gamification in health and fitness apps has become immensely popular, as evidenced by the number of apps found in the Apple App Store containing at least some components of gamification. This shows a lack of integrating important elements of behavioral theory from the app industry, which can potentially impact the efficacy of gamification apps to change behavior. Apps represent a very promising, burgeoning market and landscape in which to disseminate health behavior change interventions. Initial results show an abundant use of gamification in health and fitness apps, which necessitates the in-depth study and evaluation of the potential of gamification to change health behaviors.
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                Author and article information

                Contributors
                Journal
                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                Elsevier
                2211-3355
                13 November 2018
                March 2019
                13 November 2018
                : 13
                : 37-40
                Affiliations
                Cardiff Metropolitan University, School of Sport and Health Sciences, United Kingdom of Great Britain and Northern Ireland
                Article
                S2211-3355(18)30266-3
                10.1016/j.pmedr.2018.11.009
                6260258
                30510892
                ca61c8b8-f817-45f6-91d6-5fd0fc537c2f
                © 2018 The Author. Published by Elsevier Inc.

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

                History
                : 1 July 2018
                : 6 November 2018
                : 10 November 2018
                Categories
                Regular Article

                gamification,physical activity,community,technology,intervention

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