JMIR Publications

ABSTRACT

Background:

Nowadays, numerous health-related mobile applications implement gamification in an attempt to draw on the motivational potential of video games and thereby increase user engagement or foster certain health behaviors. However, research on effective gamification is still in its infancy and researchers increasingly recognize methodological shortcomings of existing studies. What we actually know about the phenomenon today stems from fragmented pieces of knowledge, and a variety of different perspectives. Existing research primarily draws on conceptual knowledge that is gained from research prototypes, and isolated from industry best practices. We still lack knowledge on how gamification has been successfully designed and implemented within the industry and whether certain gamification approaches have shown to be particularly suitable for certain health behaviors.

Objective:

We address this lack of knowledge concerning best practices in the design and implementation of gamification for health-related mobile applications by identifying archetypes of gamification approaches that have emerged in pertinent health-related mobile applications and analyzing to what extent those gamification approaches are influenced by the underlying desired health-related outcomes.

Methods:

We employed a 3-step research approach. As a first step, we set up a database of 143 pertinent gamified health-related mobile applications from the Apple App Store and Google Play Store. Second, we classify the gamification approach of each application within our sample based on an established taxonomy for gamification in health-related applications. Finally, we conducted a two-step cluster analysis in order to identify archetypes of the most dominant gamification approaches in pertinent gamified health-related mobile applications.

Results:

Eight archetypes of gamification emerged from the analysis of health-related mobile applications: (1) physical activity through competition and collaboration, (2) pursuing self-set fitness goals without rewards, (3) episodical compliance tracking, (4) inherent gamification for external goals, (5) self-set goals for mental well-being, (6) continuous assistance through positive reinforcement, (7) medical exam preparation without rewards, and (8) learning through progressive gamification. Our results indicate a close relationship between the identified archetypes and the actual health behavior that is being targeted.

Conclusions:

By unveiling salient best practices and discussing their relationship to targeted health behaviors, our study contributes to a more profound understanding of gamification in mobile health. The results can serve as a foundation for future research that advances our knowledge on how gamification may positively influence health behavior change and guide practitioners in the design and development of highly motivating and effective health-related mobile health applications.