Gamification In Theory And Action A Survey Pdf

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Towards a motivational design? Connecting gamification user types and online learning activities

Compared to traditional persuasive technology and health games, gamification is posited to offer several advantages for motivating behaviour change for health and well-being, and increasingly used. Yet little is known about its effectiveness. We aimed to assess the amount and quality of empirical support for the advantages and effectiveness of gamification applied to health and well-being.

We identified seven potential advantages of gamification from existing research and conducted a systematic literature review of empirical studies on gamification for health and well-being, assessing quality of evidence, effect type, and application domain. We identified 19 papers that report empirical evidence on the effect of gamification on health and well-being.

Results were clear for health-related behaviours, but mixed for cognitive outcomes. The current state of evidence supports that gamification can have a positive impact in health and wellbeing, particularly for health behaviours. However several studies report mixed or neutral effect. Findings need to be interpreted with caution due to the relatively small number of studies and methodological limitations of many studies e.

The major health challenges facing the world today are shifting from traditional, pre-modern risks like malnutrition, poor water quality and indoor air pollution to challenges generated by the modern world itself. Today, the leading global risks for mortality and chronic diseases — high blood pressure, tobacco use, high blood glucose, physical inactivity, obesity, high cholesterol — are immediately linked to a modern lifestyle characterized by sedentary living, chronic stress, and high intake of energy-dense foods and recreational drugs Stevens et al.

Practically all modern lifestyle health risks and resulting diseases are directly affected by people's individual health behaviours — be it physical activity, diet, recreational drug use, medication adherence, or preventive and rehabilitative exercises Glanz et al. By one estimate, three quarters of all health care costs in the US are attributable to chronic diseases caused by poor health behaviours Woolf, , the effective management of which again requires patients to change their behaviours Sola et al.

Similarly, research indicates that well-being can be significantly improved through small individual behaviours Lyubomirsky and Layous, , Seligman, Behaviour change has therefore become one of the most important and frequently targeted levers for reducing the burden of preventable disease and death and increasing well-being Glanz, K. A main factor driving behaviour change is the individual's motivation. Motives are a core target of a wide range of established behaviour change techniques Michie et al.

However, following self-determination theory SDT , a well-established motivation theory, not all forms of motivation are equal Deci and Ryan, A crucial consideration is whether behaviour is intrinsically or extrinsically motivated.

Extrinsically motivated activity is done for an outcome separable from the activity itself, like rewards or punishments, which thwarts autonomy need satisfaction and gives rise to experiences of unwillingness, tension, and coercion Deci and Ryan, In recent years, SDT has become a key framework for health behaviour interventions and studies.

A large number of studies have demonstrated advantages of intrinsic over extrinsic motivation with regard to health behaviours Fortier et al. In short, in our modern life world, health and well-being strongly depend on the individual's health behaviours, motivation is a major factor of health behaviour change, and intrinsically motivated behaviour change is desirable as it is both sustained and directly contributes to well-being.

This raises the immediate question what kind of interventions are best positioned to intrinsically motivate health behaviour change. The last two decades have seen the rapid ascent of computing technology for health behaviour change and well-being Glanz, K. This includes a broad range of consumer applications for monitoring and managing one's own health and well-being Knight et al.

One important sector is serious games for health Wattanasoontorn et al. Like serious games in general, health games have seen rapid growth Kharrazi et al. A main rationale for using games for serious purposes like health is their ability to motivate: Games are systems purpose-built for enjoyment and engagement Deterding, b.

Research has confirmed that well-designed games are enjoyable and engaging because playing them provides basic need satisfaction Mekler et al. Turning health communication or health behaviour change programs into games might thus be a good way to intrinsically motivate users to expose themselves to and continually engage with these programs Baranowski et al. However, the broad adoption of health games has faced major hurdles.

Thus, there is no developed market and business model for health games, wherefore the entertainment game and the health industries have by and large not moved into the space Parker, n. A second adoption hurdle is that most health games are delivered through a dedicated device like a game console, and require users to create committed spaces and times in their life for gameplay. This demand often clashes with people's varied access to technology, their daily routines and rituals, as well as busy and constantly shifting schedules Munson et al.

Ryan and Rigby, , Seaborn and Fels, By one estimate, the gamification market is poised to reach 2. It is little wonder, then, that several scholars have pointed to health gamification as a promising new approach to health behaviour change Cugelman, , King et al. Conceptually, health gamification sits at the intersection of persuasive technology, serious games, and personal informatics Cugelman, , Munson et al. Several authors have in fact suggested that many game design elements can be mapped to established behaviour change techniques Cheek et al.

Like serious games, gamification aims to drive these behaviours through the intrinsically motivating qualities of well-designed games. Like personal informatics, gamification usually revolves around the tracking of individual behaviours, only that these are then not only displayed to the user, but enrolled in some form of goal-setting and progress feedback.

Indeed, many applications commonly classified as gamification are also labelled personal informatics, and gamification is seen as a way to sustain engagement with personal informatics applications e.

The reasons why gamification is potentially relevant to health behaviour change today, and the shortcomings of other digital health and well-being interventions include:. Intrinsic motivation. Like games, gamified systems can intrinsically motivate the initiation and continued performance of health and well-being behaviours Deterding, b for similar arguments regarding gamification in general; King et al. Seaborn and Fels, , Sola et al. In contrast, personal informatics can lack sustained appeal, and persuasive technologies often employ extrinsic motivators like social pressure or overt rewards Oinas-Kukkonen and Harjumaa, Broad accessibility through mobile technology and ubiquitous sensors.

Activity trackers and mobile phones, equipped with powerful sensing, processing, storage, and display capacities, are excellent and widely available platforms to extend a game layer to everyday health behaviours, making gamified applications potentially more accessible than health games which rely on bespoke gaming devices King et al.

Broad appeal. As wider and wider audiences play games, games and game design elements become approachable and appealing to wider populations King et al. Broad applicability. Current health gamification domains cover all major chronic health risks: physical activity, diet and weight management, medication adherence, rehabilitation, mental well-being, drug use, patient activation around chronic diseases like Diabetes, cancer, or asthma Munson et al.

Cost-benefit efficiency. Everyday life fit. Gamified systems using mobile phones or activity trackers can encompass practically all trackable everyday activity, unlike health games requiring people to add dedicated time and space to their life Munson et al. Whereas standard health games typically try to fit another additional activity into people's schedules, gamification aims to reorganise already-ongoing everyday conduct in a more well-being conducive manner Deterding, b ; see Hassenzahl and Laschke, Supporting well-being.

Beyond motivating health behaviours, engaging with gamified applications can directly contribute to well-being by generating positive experiences of basic psychological need satisfaction as well as other elements of well-being like positive emotions, engagement, relationships, meaning, and accomplishment cf.

Johnson et al. Promising as gamification for health and well-being may be, the essential question remains whether gamified interventions are effective in driving behaviour change, health, and well-being, and more specifically, whether they manage to do so via intrinsic motivation.

These questions are especially relevant as a general-purpose literature reviews on gamification have flagged the lack of high-quality effect studies on gamification Hamari et al. Seaborn and Fels, , and b critics have objected that gamification often effectively entails standard behavioural reinforcement techniques and reward systems that are extrinsically motivating, not emulating the intrinsically motivating features of well-designed games Juul, , Walz and Deterding, To our knowledge, there is no systematic review on the effectiveness and quality of health and well-being gamification applications available.

Existing reviews include a survey spanning several application domains which identified four health-related papers cf. Seaborn and Fels, , a review of gamification features in commercially available health and fitness applications Lister et al. While these reviews offer important and valuable insights, none have examined gamification for both health and well-being nor the effectiveness of gamification.

Additionally, existing reviews do not directly consider and evaluate the quality of evidence underlying the conclusions drawn. We therefore conducted a systematic literature review of peer-reviewed papers examining the effectiveness of gamified applications for health and well-being, assessing the quality of evidence provided by studies.

What is the number and quality of available effect studies? This follows the observation that gamification research is lacking high-quality effect studies.

What effects are reported? This follows the question whether health gamification is indeed effective. What game design elements are used and tested? These questions follow whether health gamification drives outcomes through the same processes of intrinsic motivation that make games engaging, and whether directly supporting well-being through positive experiences.

What delivery platforms are used and tested? This probes whether current health gamification does make good on the promise of greater accessibility, pervasiveness, and everyday life fit through mobile phones or multiple platforms. Which theories of motivation e. This explores to what extent health gamification explicitly draws on motivational theory and to whether design incorporating these theories leads to better outcomes.

Is gamification shown to be more effective with gaming affinitive audiences? This assesses whether the benefits of gamification are limited to audience already familiar with or drawn to game elements as engaging and motivating. Have the benefits of health gamification been shown to extend to audiences that are not already intrinsically motivated?

This explores whether there is evidence of gamification working when users are not already intrinsically motivated to perform the target activity e. The protocol for the review was developed and agreed by the authors prior to commencement. All studies that explored the association between gamification and health were considered for this review. Three additional studies were identified with a manual search of the reference lists of key studies, including existing gamification reviews, identified during the database search process.

Our review focused on high quality scholarly work reporting original research on the impact and effectiveness of gamification for health and wellbeing. From this focus, we developed the following inclusion criteria:. User experience — any subjective measure of experience while using the gamified or non-gamified version of the intervention. Criteria 1—4 were chosen to ensure focus on high-quality work reporting original research. Criteria 3, 4, and 7 were also included to enable assessment of quality of evidence.

Criteria 5—6 ensured the paper reported on gamification, not serious games or persuasive technology mislabeled as gamification a common issue, cf. Seaborn and Fels, Criteria 7—8 were chosen to assess reported health and well-being outcomes and potential mediators, with user experience included given its prevalence as an outcome measure in gamification research see Table 1.

Our exclusion criteria mirror the focus on high quality scholarly work that reports the impact and effectiveness of gamification for health and well-being. They were particularly framed to exclude duplicate reporting of earlier versions of studies fully reported later.

We excluded papers with the following features:. Criteria 1—2 exclude peer-reviewed yet early and incomplete versions of studies.

Gamification in theory and action: A survey

Print Send Add Share. Notes Abstract: This study sought to address a problem of practice by incentivizing job requirements through the addition of achievements in an online web portal. To do this, a workplace analysis was conducted, along with a thorough review of relevant literature. The result was the creation of a framework for designing gamified systems entitled Self-Determined Gamification. Using this framework as a guide, an attempt was made to design achievements with Self-Determination Theory SDT in mind, paying particular attention to organizational goals, equity in attaining achievements, employee autonomy in interacting and engaging with the achievements, and individual goals.

Gamification in theory and action: A survey

Barata, G. Improving participation and learning with gamification. Barrios, M.

Metrics details.

Gamification of health professions education: a systematic review

Recent years have witnessed the arrival of new methodological horizons in teacher training. Technological resources and mobile connections play a major role in these studies. At the same time, there is a focus on play to increase commitment and motivation.

Contents lists available at ScienceDirect. Human-Computer Studies journal homepage: www. Article history: Gamication has drawn the attention of academics, practitioners and business professionals in domains Received 10 January as diverse as education, information studies, humancomputer interaction, and health. As yet, the term Received in revised form remains mired in diverse meanings and contradictory uses, while the concept faces division on its 18 June academic worth, underdeveloped theoretical foundations, and a dearth of standardized guidelines for Accepted 26 September application. Despite widespread commentary on its merits and shortcomings, little empirical work has Communicated by K.


Gamification in theory and action: A survey. KATIE SEABORN. Mechanical & Industrial Engineering. University of Toronto. DEBORAH I. FELS.


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Gamification for health and wellbeing: A systematic review of the literature

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