Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 25, 2018
Open Peer Review Period: Jul 26, 2018 - Aug 2, 2018
Date Accepted: Nov 22, 2018
(closed for review but you can still tweet)
Use of In-game Rewards to Motivate Daily Self-Report Compliance: A Randomized Controlled Trial
ABSTRACT
Background:
Encouraging individuals to report daily information such as unpleasant disease symptoms, daily activities and behaviors, or aspects of their physical and emotional state, is difficult but necessary for many studies and clinical trials that rely on patient-reported data as primary outcomes. Paper diaries are the traditional method of completing daily diaries, but digital surveys are becoming the new standard because of their increased compliance; however, they still fall short of desired compliance levels.
Objective:
Mobile games using in-game rewards offer the opportunity to increase compliance above the rates of digital diaries and paper diaries. We conducted a 5-week randomized control trial to compare the completion rates of a daily diary across three conditions: a paper-based participant reported outcome diary (Paper PRO), an electronic-based participant reported outcome diary (ePRO), and a novel electronic-based participant reported outcome diary with in-game rewards (Game-Motivated ePRO).
Methods:
We developed a novel mobile game that is a combination of the idle and pet collection genres to reward individuals who complete a daily diary with an in-game reward. One hundred ninety-seven (197) individuals aged 6-24 (Male: 100, Female: 97) were enrolled in a 5-week study after being randomized into one of the three methods of daily diary completion. One hundred fifty-seven (157) participants (Male: 84, Female: 69) completed at least one diary and were subsequently included in analysis of compliance rates.
Results:
We observed a significant difference (F(2,124) = 6.341, P=.002) in compliance to filling out daily diaries, with the Game-Motivated ePRO group having the highest compliance (Mean completion: 86.4%, StDev: 19.6%), followed by the ePRO group (Mean completion: 77.7%, StDev: 24.1%), and lastly the Paper PRO group (Mean completion: 70.6%, StDev: 23.4%). The Game-Motivated ePRO (P=.002) significantly improved compliance rates above the Paper PRO. Additionally, the Game-Motivated ePRO resulted in higher compliance rates than the ePRO alone (P=.089). Equally important, even though we observed significant differences in completion of daily diaries between groups, we did not observe any statistically significant differences in association between the responses to a daily mood question and study group, the average diary completion time (P=.517), or the System Usability Scale (SUS) score (P=.877).
Conclusions:
The Game-Motivated ePRO system encouraged individuals to complete the daily diaries above the compliance rates of the Paper PRO and ePRO without altering the participant’s responses. Clinical Trial: Clinicaltrials.gov NCT03738254, http://clinicaltrials.gov/ct2/show/NCT03738254
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.