Abstract
BackgroundIt is well known that regular physical exercise has associated benefits; yet, participation remains suboptimal. Mobile health (mHealth) has become an indispensable medium to deliver behavior change interventions, and there is a growing interest in the gamification apps in mHealth to promote physical activity (PA) participation. Gamification could use game design elements (such as points, leaderboards, and progress bars), and it has the potential to increase motivation for PA and engagement. However, mHealth-based gamification interventions are still emerging, and little is known about the application status and efficacy of such interventions.ObjectiveThis systematic review aims to investigate gamification apps in mHealth for improving PA levels and simultaneously summarize the impact of gamification interventions on PA participation.MethodsWe searched PubMed, Scopus, Web of Science, Embase, CINAHL (EBSCO host), and IEEE Xplore from inception to December 20, 2020. Original empirical research exploring the effects of gamification interventions on PA participation was included. The papers described at least one outcome regarding exercise or PA participation, which could be subjective self-report or objective indicator measurement. Of note, we excluded studies about serious games or full-fledged games.ResultsOf 2944 studies identified from the database search, 50 (1.69%) were included, and the information was synthesized. The review revealed that gamification of PA had been applied to various population groups and broadly distributed among young people but less distributed among older adults and patients with a disease. Most of the studies (30/50, 60%) combined gamification with wearable devices to improve PA behavior change, and 50% (25/50) of the studies used theories or principles for designing gamified PA interventions. The most frequently used game elements were goal-setting, followed by progress bars, rewards, points, and feedback. This review demonstrated that gamification interventions could increase PA participation; however, the results were mixed, and modest changes were attained, which could be attributed to the heterogeneity across studies.ConclusionsOverall, this study provides an overview of the existing empirical research in PA gamification interventions and provides evidence for the efficacy of gamification in enhancing PA participation. High-quality empirical studies are needed in the future to assess the efficacy of a combination of gamification and wearable activity devices to promote PA, and further exploration is needed to investigate the optimal implementation of these features of game elements and theories to enhance PA participation.
Highlights
BackgroundRegular physical activity (PA) correlates with varied physical and mental health benefits [1-4]
This review demonstrated that gamification interventions could increase PA participation; the results were mixed, and modest changes were attained, which could be attributed to the heterogeneity across studies
Of the 8 single-group studies, only 1 (13%) showed no trend toward improvement, and the pre–post difference was not significant in terms of the time spent in overall PA after the gamification intervention; the study used just 1 game element and did not use any theory. These findings revealed that a combination of multiple game elements could be more effective for PA participation than a single game element, and gamification intervention using theory guidance could be more effective than a gamification intervention without any theory guidance
Summary
BackgroundRegular physical activity (PA) correlates with varied physical and mental health benefits [1-4]. Guidelines reviewed by the Physical Activity Guidelines Advisory Committee recommended that even small increases in light-intensity PA participation can lead to health benefits [5-7]. Despite proven benefits of PA participation, approximately one-third of the global adult population is insufficiently active and fails to fulfill the minimum PA guideline recommendations [8]. It has become an essential medium to bring about behavior change interventions and has demonstrated a promising role in improving PA levels [13]; for example, wearable activity trackers enable users to objectively monitor their PA levels when used in conjunction with a mobile app. It is well known that regular physical exercise has associated benefits; yet, participation remains suboptimal. Mobile health (mHealth) has become an indispensable medium to deliver behavior change interventions, and there is a growing interest in the gamification apps in mHealth to promote physical activity (PA) participation. MHealth-based gamification interventions are still emerging, and little is known about the application status and efficacy of such interventions
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