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 Table of Contents  
Year : 2018  |  Volume : 31  |  Issue : 4  |  Page : 253-254

Gamification for nurturing healthy habits

International Institute of Health Management Research Sector 18, Dwarka New Delhi, India

Date of Web Publication14-May-2019

Correspondence Address:
Jyotika Maggo Sood
International Institute of Health Management Research Sector 18, Dwarka New Delhi
Suptendra Nath Sarbadhikari
International Institute of Health Management Research Sector 18, Dwarka New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-258X.258236

How to cite this article:
Sarbadhikari SN, Sood JM. Gamification for nurturing healthy habits. Natl Med J India 2018;31:253-4

How to cite this URL:
Sarbadhikari SN, Sood JM. Gamification for nurturing healthy habits. Natl Med J India [serial online] 2018 [cited 2021 May 17];31:253-4. Available from: http://www.nmji.in/text.asp?2018/31/4/253/258236

Achieving the highest attainable standard of health is a fundamental right of every human being. The present global health scenario is facing a ‘triple burden of diseases’ including the unfinished agenda of communicable diseases, newly emerging and re-emerging diseases along with an unprecedented rise of non-communicable chronic diseases. The factors that aid progress and development, such as globalization of trade, urbanization and ease of global travel, act as a double-edged sword. While they lead to positive health outcomes, they also increase the vulnerability to poor health contributing to sedentary lifestyles and unhealthy dietary habits.[1] Healthy habits comprise health, nutrition and safety practices, which if performed regularly, over a period of time, contribute to improved overall physical, social and mental health. Well-being is a positive outcome that reflects good living conditions. It integrates physical as well as mental health resulting in more holistic approaches to health promotion and disease prevention.

Health and well-being can be improved through modification of individual behaviours.[2] Intrinsically motivated behaviour change is more desirable as it is both sustainable and contributes directly to well-being. Health literacy implies the attainment of a required level of knowledge, personal skills and confidence to act to improve personal and community health by changing personal lifestyle and living conditions.[3]

Globalization and information and communications technologies (ICTs) continue to change the world we live in.[4] ICT can act as a medium of intervention in distributing health information and behaviour change, as a research instrument in data collection and reaching research subjects, and for professional development.[5] Serious games constitute an important area for health as they can contribute in changing health behaviour. The main rationale for using games for serious purposes such as health is their ability to motivate people.[6]

A gamification approach in health-related mobile applications can change people’s health-related behaviour and influence forming of new healthy habits.[7] Gamification refers to the ‘use of game design elements within non-game contexts’.[8] Gamification encourages behaviour change in health, and it can be a tool for increasing the awareness on serious issues and helping societies overcome epidemics. Gamification also has the potential to help people with chronic diseases by assisting them in the management of their medical regimens.[9] Studies have shown promising links between gamification principles and health behaviour change. Different levels of user engagement depend on the presence of the elements of gamification.[10]

Gamification relies on 4 semantic components: (i) game;(ii) elements; (iii) design; and (iv) non-game contexts. It also involves 7 core elements: (i) goal setting; (ii) capacity to overcome challenges; (iii) providing feedback on performance; (iv) reinforcement; (v) comparing progress; (vi) social connectivity; and (vii) fun and playfulness. These elements have shown clear linkages to proven behaviour change strategies, with the exception of fun and playfulness, which has perhaps not received much attention in the literature on changing health behaviour.[11] For enhancing the effectiveness of gamification, gamified technology must outperform other design patterns, in its ability to influence people’s beliefs, attitudes or behaviours.[12] Moreover, the impact of gamification must have long- term sustainability and offer more than a short-term novelty effect.

Hence, compared to existing approaches such as serious games for health or persuasive technology, gamification has been posited as a promising new alternative that embodies a ‘new model for health’: ' seductive, ubiquitous, lifelong health interfaces’ for well-being and self-care.[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21] More specifically, 7 potential advantages of gamification for health and well-being are: (i) supporting intrinsic motivation (as games have been shown to motivate intrinsically); (ii) broad accessibility through mobile technology and ubiquitous sensors; (iii) broad appeal across audiences (as gaming has become mainstream); (iv) broad applicability across health and well–being risks and factors; (v) cost-benefit efficiency of enhancing existing systems (versus building bespoke games); (vi) everyday life fit (reorganizing existing activity rather than adding additional demands to people’s lives); and (vii) direct well-being support (by providing positive experiences).

Therefore, gamification should be encouraged to tackle the triple burden of diseases, through raising awareness and changing individual and community behaviour and ushering in a healthy India.

Conflicts of interest. None declared

  References Top

Kumar S, Preetha G. Health promotion: An effective tool for global health. Indian J Community Med 2012;37:5-12.  Back to cited text no. 1
Lyubomirsky S, Layous K. How do simple positive activities increase well-being? Curr Dir Psychol Sci 2013;22:57-62.  Back to cited text no. 2
Sarbadhikari SN. How to make healthcare delivery in India more ‘informed’. Educ Health (Abingdon) 2010;23:456.  Back to cited text no. 3
Abbott PA, Coenen A. Globalization and advances in information and communication technologies: The impact on nursing and health. Nurs Outlook 2008;56:238-46.e2.  Back to cited text no. 4
Lintonen TP, Konu AI, Seedhouse D. Information technology in health promotion. Health Educ Res 2008;23:560-6.  Back to cited text no. 5
Hamari J, Koivisto J. Social motivations to use gamification: An empirical study of gamifying exercise. ECIS 2013 Completed Research; 2013:105. Available at www.aisel.aisnet.org/ecis2013_cr/105 (accessed on 1 Mar 2018).  Back to cited text no. 6
Iurchenko A. An Exploratory Study of Health Habit Formation through Gamification; 2017. Available at www.arxiv.org/ftp/arxiv/papers/1708/1708.04418.pdf’(accessed on 26 Sep 2017).  Back to cited text no. 7
Deterding S, Dixon D, Khaled R, Nacke L. From game design elements to gamefulness: Defining “gamification”. Paper Presented at the 15th International Academic MindTrek Conference, Tampere; 2011:9-15.Available at https://dl.acm.org/citation.cfm?id= 2181040 (accessed on 26 Sep 2017).  Back to cited text no. 8
Miller AS, Cafazzo JA, Seto E. A game plan: Gamification design principles in mHealth applications for chronic disease management. Health Informatics J 2016;22:184-93.  Back to cited text no. 9
Sailer M, Hense JU, Mayr SK, Mandl H. How gamification motivates: An experimental study of the effects of specific game design elements on psychological need satisfaction. ComputHum Behav 2017;69:371-80.  Back to cited text no. 10
Johnson D, Deterding S, Kuhn KA, Staneva A, Stoyanov S, Hides L. Gamification for health and well-being: A systematic review of the literature. Internet Interv 2016;6:89-106.  Back to cited text no. 11
Cugelman B. Gamification: What it is and why it matters to digital health behavior change developers. JMIR Serious Games 2013;1:e3.  Back to cited text no. 12
Arnab S. Game-based interventions in public health: Exploiting the engaging factor of gameplay. In: Encyclopedia of Computer Graphics and Games. Cham:Springer; 2015:1-8. Available at https://doi.org/10.1007/978-3-319-08234-9_29-1 (accessed on 26 Sep 2017).  Back to cited text no. 13
Brown M, O’Neill N, van Woerden H, Eslambolchilar P, Jones M, John A, et al Gamification and adherence to web-based mental health interventions: A systematic review. JMIR Ment Health 2016;3:e39.  Back to cited text no. 14
de Ridder M, Kim J, Jing Y, Khadra M, Nanan R. A systematic review on incentive- driven mobile health technology: As used in diabetes management. J Telemed Telecare 2017;23:26-35.  Back to cited text no. 15
Edwards EA, Lumsden J, Rivas C, Steed L, Edwards LA, Thiyagarajan A, et al. Gamification for health promotion: Systematic review of behaviour change techniques in smartphone apps. BMJ Open 2016;6:e012447.  Back to cited text no. 16
Lau HM, Smit JH, Fleming TM, Riper H. Serious games for mental health: Are they accessible, feasible, and effective? A systematic review and meta-analysis. Front Psychiatry 2016;7:209.  Back to cited text no. 17
Looyestyn J, Kernot J, Boshoff K, Ryan J, Edney S, Maher C, et al. Does gamification increase engagement with online programs? A systematic review. PLoS One 2017;12:e0173403.  Back to cited text no. 18
McCoy L, Lewis JH, Dalton D. Gamification and multimedia for medical education: A landscape review. J Am Osteopath Assoc 2016;116:22-34.  Back to cited text no. 19
Rapp A. Drawing inspiration from world ofWarcraft: Gamification design elements for behavior change technologies. Interact Comput 2017;29:648-78.  Back to cited text no. 20
Sardi L, Idri A, Fernandez-Aleman JL. A systematic review of gamification in e- health. JBiomedInform 2017;71:31-48.  Back to cited text no. 21


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