JMIR Publications

ABSTRACT

Background:

In healthcare, using game-based intervention approaches to increase motivation, engagement, and overall sustainability of health behaviors is steadily becoming more common. The most prevailing approaches for such game-based interventions in healthcare research are gamification and serious games. Various researchers have discussed substantial conceptual differences between these two concepts, supported by empirical studies showing differences in the effects on specific health behaviors. However, researchers also frequently report cases where terms related to these two concepts are used ambiguously or even interchangeably. It remains unclear to which extent existing healthcare research explicitly distinguishes between gamification and serious games and whether it draws on existing conceptual considerations in order to do so.

Objective:

Our study aims to address this lack of knowledge by capturing the current state of conceptualizations of gamification and serious games in healthcare research. Furthermore, we provide tools for researchers to disambiguate reporting on game-based interventions.

Methods:

We employed a 2-step research approach. First, we conducted a systematic literature review of 206 studies published in the Journal of Medical Internet Research and its sister journals containing terms related to either gamification, serious games, or both. We analyzed their conceptualizations of gamification and serious games, as well as distinctions between the two concepts. Second, based on the literature review findings, we developed a set of guidelines for researchers reporting on game-based interventions and evaluated them with a group of 7 experts from the field.

Results:

Our results show that less than half of concept mentions are accompanied by an explicit definition. For the distinction between the two concepts, we identified 4 common approaches: implicit distinction, synonymous use of terms, serious games as gamified systems, and distinction based on the full game dimension. Our Game-based Intervention Reporting Guidelines (GAMING) consist of 25 items grouped into 4 topics: (1) Conceptual Focus, (2) Contribution, (3) Mindfulness about Related Concepts, and (4) Individual Concept Definitions.

Conclusions:

Conceptualizations of gamification and serious games in healthcare literature are strongly heterogeneous, leading to conceptual ambiguity. Following the GAMING guidelines can support authors in rigorous reporting on study results of game-based interventions.