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What is gamification and how can it be used to improve health and wellbeing?

Gamification is a term used to explain the use of gaming elements in non-gaming contexts. Such as providing rewards (i.e., points or streaks) to people which motivate them towards a particular action. For example, take apps which help you learn a new language or instrument, they keep you coming back by sending you on a hot streak.


Gamification is becoming more and more common in our daily lives as businesses try to keep us using their products more often and for longer. But can gamification be used to help us lose weight or maintain an exercise routine? Some key gamification strategies, such as providing feedback to allow people to set goals and monitor progression, competing with others and use of incentives, are all evidence-based Behaviour Change Techniques.


Self-determination theory proposes that people become motivated when their needs for competence, relatedness, and autonomy are fulfilled. Competence is a term used to describe someone who has sufficient qualities to perform a given task. Relatedness is a sense of belonging or attachment to other people. Autonomy is the ability to feel in control of one's behaviour and destiny. Researchers have begun to understand how gamification can be used to improve our health and wellbeing. Studies have found that health behaviours which are gamified work through (1) competition; (2) incentives and the (3) influence of friends. Competition helps people feel competent in their ability to perform a certain behaviour. Social groups help people build an attachment between new behaviours and the bonds they share. Incentives help provide autonomy and enable people to feel in control of their behaviours.


A person’s competence refers to their perception that they can achieve a goal or target. Gamification can help people set and achieve meaningful targets and give them a reward when they do so. This reward reinforces their belief in their ability. A person’s autonomy refers to their ability to be in control of their own behaviours. Gamification allows individuals to choose what elements of the game are most important to them. Whether they want to compete with others to win, compete with themselves for the sense of personal achievement, or succeed as part of a wider social group or cause. Relatedness explains the bond between a person and other people involved in the experience. Gamification can create a community of like-minded individuals sharing the same journey. This can create a powerful connection between a specific behaviour or goal and a person’s sense of social connection.


One example of a gamification-based approach to help people improve their mental well-being, fitness, nutrition, and sleep is Lumihealth. Lumihealth links to a smartwatch which powers a virtual world. Each time a user completes healthy actions, they achieve points. These points give Lumi, a virtual character, energy which helps them move through different virtual worlds. In return, the user gets coins which can be exchanged for vouchers to be used in the real world. Everyone is a winner.


What are the challenges or pitfalls?

Gamification can make behaviours more desirable by enabling people to set targets, gain consistent reinforcement and engage with other people. This can make a behaviour more enjoyable and rewarding. Self-determination theory also states that when individuals have autonomy, feel competent and relate to a particular behaviour, they become more internally motivated. There are, however, certain limitations to gamification which need to be considered. For new behaviours to be sustained, individuals must develop an intrinsic motivation to carry on. This suggests that game elements which have an over-reliance upon extrinsic motivations (such as scoring points or earning badges) may have a negative effect by removing a person’s autonomy. Games which use competition to reinforce behaviour also require careful planning. If the competition becomes unfair, or the goal becomes too unattainable or stressful to achieve, relatedness, competence and autonomy can be jeopardised. To be successful, games should provide a level playing field, where people have an equal chance of achieving success, provided they give equal effort. Gamification which uses a team-based competition can mitigate the potential negative impact of competition by facilitating a more social and collaborative experience. There is also an ethical concern with gamification. There is a need to ensure that people don’t become too reliant upon the game itself or too engrossed in the virtual world it creates. One potential solution to this issue is to give the gamification experience a fixed time period. This could solve two issues: it could ensure people don’t become too reliant on the external rewards provided by the game and provide the benefits of the experience before individuals lose interest.


To summarise:

Gamification has a strong and unique potential to change behaviour. However, programme designers need to a have a clear understanding of the behaviours they are trying to influence, the game design elements which will have the greatest success for these behaviours and the potential pitfalls of specific game elements. To support sustained behaviour change, gamification-based programmes need to support players to develop intrinsic motivation towards a particular behaviour. This could be achieved through building autonomy, competence, and relatedness.


References:

  1. Michie S, Richardson M, Johnston M, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med 2013; 46: 81–95. doi:10.1007/s12160-013-9486-6

  2. Corepal, R., Best, P., O’neill, R., Tully, M. A., Edwards, M., Jago, R., ... & Hunter, R. F. (2018). Exploring the use of a gamified intervention for encouraging physical activity in adolescents: a qualitative longitudinal study in Northern Ireland. BMJ open, 8(4), e019663.

  3. Cameron, J., Banko, K. M., & Pierce, W. D. (2001). Pervasive negative effects of rewards on intrinsic motivation: The myth continues. The Behavior Analyst, 24(1), 1-44.

  4. Oliver, R., & Williams, R. L. (2006). Performance patterns of high, medium, and low performers during and following a reward versus non-reward contingency phase. School Psychology Quarterly, 21(2), 119.

  5. Landers, R. N., & Landers, A. K. (2014). An empirical test of the theory of gamified learning: The effect of leaderboards on time-on-task and academic performance. Simulation & Gaming, 45(6), 769-785.

  6. Landers, R. N., Bauer, K. N., Callan, R. C., & Armstrong, M. B. (2015). Psychological theory and the gamification of learning. In Gamification in education and business (pp. 165-186). Springer, Cham.

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