One of the most exciting tools in the Digital Health toolbox is gamification. Let me explain more about gamification and its significance…
Gamification is the application of game-design elements and game principles in non-game contexts. Gamification commonly employs game design elements which are used in so called non-game contexts in attempts to improve user engagement, organizational productivity, flow, learning, employee recruitment and evaluation, ease of use and usefulness of systems, physical exercise, traffic violations, and voter apathy, among others. A review of research on gamification shows that a majority of studies on gamification find positive effects from gamification. However, individual and contextual differences exist.
Fundamentally, gamification is about finding and harnessing people’s intrinsic motivators (i.e. motivation from within), in order to drive behavioural change. Where intrinsic motivators are not available or accessible, extrinsic motivators (e.g. external rewards) can be used.
Research shows that the ability of intrinsic motivators to drive behavioural change is stronger and longer lasting. Intrinsic motivation comes from within a person and is usually associated with enjoyment of an activity, whereas extrinsic motivation is often focused on the reward, but does not necessarily imply enjoyment of the activity.
Some important examples of intrinsic motivation include:
- Accomplishment – The feeling of having achieved something, having helped somebody else or having done a job well is a powerful motivating force for many people.
- Knowledge / Competency – The desire to be seen as knowledgeable or as a specialist drives many people to learn new skills and competencies.
- Recognition – Being recognised and developing an identity as a top performer or a valuable contributor powers many people towards their own personals goals (e.g. professional athletes).
As an example, Fitbit has harnessed some people’s intrinsic competitive nature (combined with elements of extrinsic reward) by creating groups where consumers compete to achieve the greatest number of steps in a given period of time. This gives consumers a sense of accomplishment when they do well, as well as recognition from their peers. Whilst this competitive dynamic does not appeal to everyone, it has been shown to increase physical activity in consumers using personal activity trackers.
Some important examples of extrinsic motivation include:
- Reward – Being rewarded with prizes for achievement (e.g. money, awards, etc.).
- Positive Feedback – The positive effect of positive feedback given in a public manner can be used to motivate some people.
Applying Gamification to Health to Reduce Disease Risk
Gamification has huge, largely unexplored potential in in healthcare. The recent viral success of Pokemon Go shows the power of what can be achieved when consumer motivations (both intrinsic and extrinsic) are tapped. Much has been written about the incidental health benefits of hunting Pokemon throughout cities and suburbs, and it’s true, there is some benefit (although whether it outweighs the number of people hit by cars in the process remains to be seen!). But imagine how much more is possible through “games” that are explicitly designed to change specific health, activity and nutritional behaviours.
“First generation” health games are largely working on the idea that physical activity can act as a form of in game currency. One of our favourites, which we believe has greater longevity than Pokemon Go and more explicit health outcomes designed into its game architecture is Zombies, Run!
Ideas like this are a great start, and have the potential to get a large number of game-crazy kids up and exercising, embedding positive patterns of exercise at an early age and reducing the risk of future disease. However, expect to see these somewhat crude levers become more targeted as we achieve a better understanding of how different socio-economic and demographic groups can be motivated through a mixture of intrinsic and extrinsic motivators.
Given that issues with a lack of physical exercise and poor diet are foundational to most of our current epidemic of chronic disease, there is a need to quickly move into more precise targeting of specific disease risk, as well as formal monitoring and measurement of the success of these techniques.
Gamification in Other Health Contexts
Nearly all discussion of gamification tends to focus on its use with health consumers. I have also been working on techniques for applying gamification to challenges with health providers. For example, I have recently developed some strategies for using gamification to improve the quality of data entered into Clinical Information Systems by health providers. Early indication shows that gamified approaches that harness intrinsic motivators have a greater potential to drive behavioural change than financial incentive (an extrinsic motivator). Please contact me if you’d like to discuss further!
What We’ve Learned About Gamification
My early research is leading to some interesting conclusions regarding gamification:
- Intrinsic motivators have a more powerful and longer term impact on health behaviour than extrinsic (reward-based) motivators
- It is easier to find intrinsic motivators in higher socio-economic cohorts
- Intrinsic motivation works better in the long term than financial reward
- Even the best games have a limited lifespan, ranging from days to 12 months for typical consumers. Game providers either have to “change the game” or offer a “game within the game” approach.
- Physical activity as an “in game currency” is a good start for “first generation” Digital Health solutions, but more specific targeting is required
Feel free to drop me a line if you’d like to discuss further, or see how I can help you develop innovative approaches to using gamification in your organisation.