JMIR Publications

ABSTRACT

Background:

While gamification continues to be a popular approach to increase engagement, motivation, and adherence to behavioral interventions, it has rarely been the focus of empirical study. There is a need to empirically evaluate gamification models to increase understanding of how to integrate gamification into interventions.

Objective:

The model of gamification principles for digital health interventions proposes a set of five independent yet interrelated gamification principles. The aim of the current investigation is to examine the validity and reliability of this model to inform its use in web and mobile-based apps.

Methods:

17 digital health interventions were selected from a scientifically curated website of mobile and web-based applications (www.psyberguide.org). 133 independent raters trained in gamification evaluation techniques were instructed to evaluate the applications and rate the degree in which gamification principles are present. Multiple ratings (n ≥ 20) were collected for each of the five gamification principles within each application. Existing measures, including the Psyberguide Credibility Score, Mobile App Rating Scale (MARS) and the application store rating, of each app were collected and their relationship with the gamification principle scores were investigated.

Results:

Applications varied widely in the degree of gamification implemented (i.e., the mean gamification rating ranged from 0.17 ≤ m ≤ 4.65 out of 5). Inter-rater reliability of gamification scores for each application was acceptable (f ≥ 0.5). There was no significant correlation between any of the five gamification principles and the PsyberGuide Credibility Score (p ≥ 0.485 in all cases). Three gamification principles (Supporting Player Archetypes, Feedback, Visibility) were significantly correlated with the MARS Score, while three principles (Meaningful Purpose, Meaningful Choice, Supporting Player Archetypes) were significantly correlated with the application store rating. One gamification principle was statistically significant with both the MARS and the Application Store Rating (Supporting Player Archetypes).

Conclusions:

Overall, results support the validity and potential utility of the model of gamification principles for digital health interventions. As expected, there was some overlap between several gamification principles and existing app measures (e.g., MARS). However, the results indicate that the gamification principles are not redundant with existing measures and highlight the potential utility of a five-factor gamification model structure in digital behavioral health apps. These gamification principles may be used to improve user experience and enhance engagement with digital health programs.