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Onstwedder SM, Jansen ME, Cornel MC, Rigter T. Policy Guidance for Direct-to-Consumer Genetic Testing Services: Framework Development Study. J Med Internet Res 2024; 26:e47389. [PMID: 39018558 PMCID: PMC11292153 DOI: 10.2196/47389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/10/2023] [Accepted: 05/09/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND The online offer of commercial genetic tests, also called direct-to-consumer genetic tests (DTC-GTs), enables citizens to gain insight into their health and disease risk based on their genetic profiles. DTC-GT offers often consist of a combination of services or aspects, including advertisements, information, DNA analysis, and medical or lifestyle advice. The risks and benefits of DTC-GT services have been debated and studied extensively, but instruments that assess DTC-GT services and aid policy are lacking. This leads to uncertainty among policy makers, law enforcers, and regulators on how to ensure and balance both public safety and autonomy and about the responsibilities these 3 parties have toward the public. OBJECTIVE This study aimed to develop a framework that outlines aspects of DTC-GTs that lead to policy issues and to help provide policy guidance regarding DTC-GT services. METHODS We performed 3 steps: (1) an integrative literature review to identify risks and benefits of DTC-GT services for consumers and society in Embase and Medline (January 2014-June 2022), (2) structuring benefits and risks in different steps of the consumer journey, and (3) development of a checklist for policy guidance. RESULTS Potential risks and benefits of DTC-GT services were mapped from 134 papers and structured into 6 phases. In summary, these phases were called the consumer journey: (1) exposure, (2) pretest information, (3) DNA analysis, (4) data management, (5) posttest information, and (6) individual and societal impact. The checklist for evaluation of DTC-GT services consisted of 8 themes, covering 38 items that may raise policy issues in DTC-GT services. The themes included the following aspects: general service content, validity and quality assurance, potential data and privacy risks, scientific evidence and robustness, and quality of the provided information. CONCLUSIONS Both the consumer journey and the checklist break the DTC-GT offer down into key aspects that may impact and compromise individual and public health, safety, and autonomy. This framework helps policy makers, regulators, and law enforcers develop methods to interpret, assess, and act in the DTC-GT service market.
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Affiliation(s)
- Suzanne Maria Onstwedder
- Department of Public Health Genomics and Screening, Centre for Health Protection, Dutch National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Section Community Genetics, Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Personalized Medicine Programme, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Marleen Elizabeth Jansen
- Department of Public Health Genomics and Screening, Centre for Health Protection, Dutch National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Section Community Genetics, Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Personalized Medicine Programme, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Martina Cornelia Cornel
- Section Community Genetics, Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Personalized Medicine Programme, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Tessel Rigter
- Department of Public Health Genomics and Screening, Centre for Health Protection, Dutch National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Section Community Genetics, Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Personalized Medicine Programme, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Hsieh E, Morrissey BS, Chiareli IA. The Landscape of Direct-To-Consumer Genetic Testing in Reproductive Health Contexts: An Analytical Framework of Stakeholders and Their Competing Motivations. HEALTH COMMUNICATION 2024:1-14. [PMID: 38317624 DOI: 10.1080/10410236.2024.2312607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
We propose a theoretical framework that identifies (a) the different categories of stakeholders and (b) the normative values that drive their attitudes toward direct-to-consumer genetic testing, with an emphasis on the reproductive health contexts. We conducted a literature search using varied combinations of search terms, including direct-to-consumer genetic testing, decision-making, reproductive health, and policy. Using a grounded theory approach to existing literature and in combination with a narrative review, we present a systematic framework of five categories of stakeholders (i.e., genome-driven stakeholders, industry-driven stakeholders, history-driven stakeholders, value-driven stakeholders, and social justice-driven stakeholders) that shape the public's discourse. Moving beyond the dialectical ethics that have governed the public discourse, we also identify the normative values and interests that motivate different stakeholders' attitudes and decision-making through theoretical sampling under the grounded theory. We investigate the competing and conflicting values within the same category of stakeholders. For example, despite being industry-driven stakeholders, medical professionals' attitudes are driven by concerns about standards of care; in contrast, health insurance companies' concerns are centered on profit. We further explore the tensions between these stakeholders that impact their strategic alliances and pose challenges to the practices of direct-to-consumer genetic testing. Finally, we examine how these stakeholders and their corresponding values may shape future development and policies of direct-to-consumer genetic testing in the context of reproductive health.
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Affiliation(s)
- Elaine Hsieh
- Department of Communication Studies, University of Minnesota-Twin Cities
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Rothe H, Lauer KB, Talbot-Cooper C, Sivizaca Conde DJ. Digital entrepreneurship from cellular data: How omics afford the emergence of a new wave of digital ventures in health. ELECTRONIC MARKETS 2023; 33:48. [PMID: 37724180 PMCID: PMC10505108 DOI: 10.1007/s12525-023-00669-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023]
Abstract
Data has become an indispensable input, throughput, and output for the healthcare industry. In recent years, omics technologies such as genomics and proteomics have generated vast amounts of new data at the cellular level including molecular, structural, and functional levels. Cellular data holds the potential to innovate therapeutics, vaccines, diagnostics, consumer products, or even ancestry services. However, data at the cellular level is generated with rapidly evolving omics technologies. These technologies use scientific knowledge from resource-rich environments. This raises the question of how new ventures can use cellular-level data from omics technologies to create new products and scale their business. We report on a series of interviews and a focus group discussion with entrepreneurs, investors, and data providers. By conceptualizing omics technologies as external enablers, we show how characteristics of cellular-level data negatively affect the combination mechanisms that drive venture creation and growth. We illustrate how data characteristics set boundary conditions for innovation and entrepreneurship and highlight how ventures seek to mitigate their impact. Supplementary Information The online version contains supplementary material available at 10.1007/s12525-023-00669-w.
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Affiliation(s)
- Hannes Rothe
- University of Duisburg Essen, Institute for Computer Science and Business Information Systems, Essen, Germany
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Akyüz K, Goisauf M, Chassang G, Kozera Ł, Mežinska S, Tzortzatou-Nanopoulou O, Mayrhofer MT. Post-identifiability in changing sociotechnological genomic data environments. BIOSOCIETIES 2023:1-28. [PMID: 37359141 PMCID: PMC10042674 DOI: 10.1057/s41292-023-00299-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 03/30/2023]
Abstract
Data practices in biomedical research often rely on standards that build on normative assumptions regarding privacy and involve 'ethics work.' In an increasingly datafied research environment, identifiability gains a new temporal and spatial dimension, especially in regard to genomic data. In this paper, we analyze how genomic identifiability is considered as a specific data issue in a recent controversial case: publication of the genome sequence of the HeLa cell line. Considering developments in the sociotechnological and data environment, such as big data, biomedical, recreational, and research uses of genomics, our analysis highlights what it means to be (re-)identifiable in the postgenomic era. By showing how the risk of genomic identifiability is not a specificity of the HeLa controversy, but rather a systematic data issue, we argue that a new conceptualization is needed. With the notion of post-identifiability as a sociotechnological situation, we show how past assumptions and ideas about future possibilities come together in the case of genomic identifiability. We conclude by discussing how kinship, temporality, and openness are subject to renewed negotiations along with the changing understandings and expectations of identifiability and status of genomic data.
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Affiliation(s)
- Kaya Akyüz
- Department of Science and Technology Studies, University of Vienna, Universitätsstraße 7/Stiege II/6, Stock (NIG), 1010 Vienna, Austria
- BBMRI-ERIC, Graz, Austria
| | - Melanie Goisauf
- Department of Science and Technology Studies, University of Vienna, Universitätsstraße 7/Stiege II/6, Stock (NIG), 1010 Vienna, Austria
- BBMRI-ERIC, Graz, Austria
| | - Gauthier Chassang
- CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
- Plateforme GenoToul Societal “Ethique et Biosciences”, Toulouse, France
| | | | - Signe Mežinska
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
- BBMRI.LV, Riga, Latvia
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Archila PA, Restrepo S, Truscott de Mejía AM, Bloch NI. Drama as a Powerful Tool to Enrich Socio-scientific Argumentation. INTERNATIONAL JOURNAL OF SCIENCE AND MATHEMATICS EDUCATION 2022; 21:1661-1683. [PMID: 36217324 PMCID: PMC9535234 DOI: 10.1007/s10763-022-10320-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/12/2022] [Indexed: 05/05/2023]
Abstract
Socio-scientific argumentation (SSA) is increasingly being recognized as a key aspect of scientific literacy. Much of the reason for this is that this skill is crucial for helping students to become active participants in twenty-first-century democratic societies in which the construction of informed and critical views of socio-scientific issues (e.g. climate change, COVID-19 vaccination, genetic testing) plays a fundamental role. The problem is that instructors rarely give students explicit and research-based opportunities to enrich their SSA skills. Therefore, the aim of this study was to provide evidence that drama can be used as a platform to enrich argumentation in genetic testing. The data were derived from the written responses and the audio recordings of seventy-six university students (37 females and 39 males, 16-29 years old) in Colombia during a complete drama-based teaching-learning sequence (TLS) supervised by the same instructor. The outcomes suggest that the sequence can be used to enrich argumentation in genetic testing as it effectively provided participants with explicit opportunities to produce both arguments and counterarguments about the controversy whether the use of genetic tests among people should be encouraged. This study contributes to the literature on SSA in science education by demonstrating that drama is a promising tool to enhance argumentation about science-based social issues. Supplementary Information The online version contains supplementary material available at 10.1007/s10763-022-10320-3.
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Affiliation(s)
- Pablo Antonio Archila
- Vice-Presidency of Research and Creation, Universidad de los Andes, Bogotá, Colombia
| | - Silvia Restrepo
- Vice-Presidency of Research and Creation, Universidad de los Andes, Bogotá, Colombia
| | | | - Natasha I. Bloch
- Department of Biomedical Engineering, Universidad de los Andes, Bogotá, Colombia
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von Ulmenstein U, Tretter M, Ehrlich DB, Lauppert von Peharnik C. Limiting medical certainties? Funding challenges for German and comparable public healthcare systems due to AI prediction and how to address them. Front Artif Intell 2022; 5:913093. [PMID: 35978652 PMCID: PMC9376350 DOI: 10.3389/frai.2022.913093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Current technological and medical advances lend substantial momentum to efforts to attain new medical certainties. Artificial Intelligence can enable unprecedented precision and capabilities in forecasting the health conditions of individuals. But, as we lay out, this novel access to medical information threatens to exacerbate adverse selection in the health insurance market. We conduct an interdisciplinary conceptual analysis to study how this risk might be averted, considering legal, ethical, and economic angles. We ask whether it is viable and effective to ban or limit AI and its medical use as well as to limit medical certainties and find that neither of these limitation-based approaches provides an entirely sufficient resolution. Hence, we argue that this challenge must not be neglected in future discussions regarding medical applications of AI forecasting, that it should be addressed on a structural level and we encourage further research on the topic.
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Affiliation(s)
| | - Max Tretter
- Department of Systematic Theology, Friedrich Alexander University of Erlangen Nuremberg, Erlangen, Bavaria, Germany
| | - David B. Ehrlich
- Department of Economics and Management, Karlsruhe Institute of Technology (KIT), Karlsruhe, Baden-Württemberg, Germany
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Toussaint PA, Renner M, Lins S, Thiebes S, Sunyaev A. Direct-to-Consumer Genetic Testing on Social Media: Topic Modeling and Sentiment Analysis of YouTube Users' Comments. JMIR INFODEMIOLOGY 2022; 2:e38749. [PMID: 37113449 PMCID: PMC10014090 DOI: 10.2196/38749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/15/2022] [Accepted: 08/18/2022] [Indexed: 04/29/2023]
Abstract
Background With direct-to-consumer (DTC) genetic testing enabling self-responsible access to novel information on ancestry, traits, or health, consumers often turn to social media for assistance and discussion. YouTube, the largest social media platform for videos, offers an abundance of DTC genetic testing-related videos. Nevertheless, user discourse in the comments sections of these videos is largely unexplored. Objective This study aims to address the lack of knowledge concerning user discourse in the comments sections of DTC genetic testing-related videos on YouTube by exploring topics discussed and users' attitudes toward these videos. Methods We employed a 3-step research approach. First, we collected metadata and comments of the 248 most viewed DTC genetic testing-related videos on YouTube. Second, we conducted topic modeling using word frequency analysis, bigram analysis, and structural topic modeling to identify topics discussed in the comments sections of those videos. Finally, we employed Bing (binary), National Research Council Canada (NRC) emotion, and 9-level sentiment analysis to identify users' attitudes toward these DTC genetic testing-related videos, as expressed in their comments. Results We collected 84,082 comments from the 248 most viewed DTC genetic testing-related YouTube videos. With topic modeling, we identified 6 prevailing topics on (1) general genetic testing, (2) ancestry testing, (3) relationship testing, (4) health and trait testing, (5) ethical concerns, and (6) YouTube video reaction. Further, our sentiment analysis indicates strong positive emotions (anticipation, joy, surprise, and trust) and a neutral-to-positive attitude toward DTC genetic testing-related videos. Conclusions With this study, we demonstrate how to identify users' attitudes on DTC genetic testing by examining topics and opinions based on YouTube video comments. Shedding light on user discourse on social media, our findings suggest that users are highly interested in DTC genetic testing and related social media content. Nonetheless, with this novel market constantly evolving, service providers, content providers, or regulatory authorities may still need to adapt their services to users' interests and desires.
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Affiliation(s)
- Philipp A Toussaint
- Department of Economics and Management Karlsruhe Institute of Technology Karlsruhe Germany
- HIDSS4Health - Helmholtz Information and Data Science School for Health Karlsruhe/Heidelberg Germany
| | - Maximilian Renner
- Department of Economics and Management Karlsruhe Institute of Technology Karlsruhe Germany
| | - Sebastian Lins
- Department of Economics and Management Karlsruhe Institute of Technology Karlsruhe Germany
| | - Scott Thiebes
- Department of Economics and Management Karlsruhe Institute of Technology Karlsruhe Germany
| | - Ali Sunyaev
- Department of Economics and Management Karlsruhe Institute of Technology Karlsruhe Germany
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Malgorzata M, Maria S, Michał W. Genetic testing-whether to allow complete freedom? Direct to consumer tests versus genetic tests for medical purposes. J Appl Genet 2022; 63:119-126. [PMID: 34826052 PMCID: PMC8755658 DOI: 10.1007/s13353-021-00670-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/04/2021] [Accepted: 11/12/2021] [Indexed: 10/26/2022]
Abstract
Direct-to-consumer tests opened the opportunity of genetic testing without medical supervision, e.g., without medical referral and medical interpretation of the results. Thus, these approaches allow for free access to information concerning individual genetic profile increasing the area of personal freedom, but also posing the risk of false (positive and negative) or misinterpreted results along with health and psychological negative consequences. The paper discusses medical and non-medical applications of DTC, exploring also the legal framework implemented by European states and organizations. These legal acts strive to control the developing DTC market through such basic principles as patient protection, informed consent, medical information confidentiality, and the rights to know and to refuse knowledge about one's genetic predispositions.
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Affiliation(s)
- Madej Malgorzata
- Institute of Political Science, University of Wroclaw, Wrocław, Poland
| | - Sąsiadek Maria
- Department of Genetics, Medical University of Wroclaw, Wrocław, Poland.
| | - Witt Michał
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
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Toussaint PA, Thiebes S, Schmidt-Kraepelin M, Sunyaev A. Perceived fairness of direct-to-consumer genetic testing business models. ELECTRONIC MARKETS 2022; 32:1621-1638. [PMID: 35874303 PMCID: PMC9294841 DOI: 10.1007/s12525-022-00571-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/29/2022] [Indexed: 05/14/2023]
Abstract
UNLABELLED Although consumers and experts often express concerns regarding the questionable business practices of direct-to-consumer (DTC) genetic testing services (e.g., reselling of consumers' genetic data), the DTC genetic testing market keeps expanding rapidly. We employ retail fairness as our theoretical lens to address this seeming paradox and conduct a discrete choice experiment with 16 attributes to better understand consumers' fairness perceptions of DTC genetic testing business models. Our results suggest that, while consumers perceive privacy-preserving DTC genetic testing services fairer, price is the main driver for fairness perception. We contribute to research on consumer perceptions of DTC genetic testing by investigating consumer preferences of DTC genetic testing business models and respective attributes. Further, this research contributes to knowledge about disruptive business models in healthcare and retail fairness by contextualizing the concept of retail fairness in the DTC genetic testing market. We also demonstrate how to utilize discrete choice experiments to elicit perceived fairness. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12525-022-00571-x.
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Affiliation(s)
- Philipp A. Toussaint
- Department of Economics and Management, Karlsruhe Institute of Technology, Kaiserstr. 89, 76133 Karlsruhe, Germany
| | - Scott Thiebes
- Department of Economics and Management, Karlsruhe Institute of Technology, Kaiserstr. 89, 76133 Karlsruhe, Germany
| | - Manuel Schmidt-Kraepelin
- Department of Economics and Management, Karlsruhe Institute of Technology, Kaiserstr. 89, 76133 Karlsruhe, Germany
| | - Ali Sunyaev
- Department of Economics and Management, Karlsruhe Institute of Technology, Kaiserstr. 89, 76133 Karlsruhe, Germany
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Uhlig HH, Charbit-Henrion F, Kotlarz D, Shouval DS, Schwerd T, Strisciuglio C, de Ridder L, van Limbergen J, Macchi M, Snapper SB, Ruemmele FM, Wilson DC, Travis SP, Griffiths AM, Turner D, Klein C, Muise AM, Russell RK. Clinical Genomics for the Diagnosis of Monogenic Forms of Inflammatory Bowel Disease: A Position Paper From the Paediatric IBD Porto Group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2021; 72:456-473. [PMID: 33346580 PMCID: PMC8221730 DOI: 10.1097/mpg.0000000000003017] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND It is important to identify patients with monogenic IBD as management may differ from classical IBD. In this position statement we formulate recommendations for the use of genomics in evaluating potential monogenic causes of IBD across age groups. METHODS The consensus included paediatric IBD specialists from the Paediatric IBD Porto group of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and specialists from several monogenic IBD research consortia. We defined key topics and performed a systematic literature review to cover indications, technologies (targeted panel, exome and genome sequencing), gene panel setup, cost-effectiveness of genetic screening, and requirements for the clinical care setting. We developed recommendations that were voted upon by all authors and Porto group members (32 voting specialists). RESULTS We recommend next-generation DNA-sequencing technologies to diagnose monogenic causes of IBD in routine clinical practice embedded in a setting of multidisciplinary patient care. Routine genetic screening is not recommended for all IBD patients. Genetic testing should be considered depending on age of IBD-onset (infantile IBD, very early-onset IBD, paediatric or young adult IBD), and further criteria, such as family history, relevant comorbidities, and extraintestinal manifestations. Genetic testing is also recommended in advance of hematopoietic stem cell transplantation. We developed a diagnostic algorithm that includes a gene panel of 75 monogenic IBD genes. Considerations are provided also for low resource countries. CONCLUSIONS Genomic technologies should be considered an integral part of patient care to investigate patients at risk for monogenic forms of IBD.
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Affiliation(s)
- Holm H. Uhlig
- Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom
- Department of Pediatrics, University of Oxford, Oxford, United Kingdom
- Biomedical Research Center, University of Oxford, Oxford, United Kingdom
| | - Fabienne Charbit-Henrion
- Université de Paris, INSERM UMR 1163 Immunité Intestinale, APHP, Hôpital Necker Enfants Malades, Service de Génétique moléculaire, Paris, France
| | - Daniel Kotlarz
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Dror S. Shouval
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Schwerd
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Munich, Germany
| | | | - Lissy de Ridder
- Department of Paediatric Gastroenterology, Erasmus University Medical Center Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Johan van Limbergen
- Amsterdam University Medical Centres, Emma Children’s Hospital, The Netherlands and Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology and Metabolism, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Marina Macchi
- Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom
| | - Scott B. Snapper
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Frank M. Ruemmele
- Université de Paris, APHP, Hôpital Necker Enfants Malades, Service de Gastroentérologie pédiatrique, Paris, France
| | - David C. Wilson
- Child Life and Health, University of Edinburgh, Department of Paediatric Gastroenterology, The Royal Hospital for Sick Children, Edinburgh
| | - Simon P.L. Travis
- Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom
- Biomedical Research Center, University of Oxford, Oxford, United Kingdom
| | - Anne M. Griffiths
- The Hospital for Sick Children, University of Toronto
- SickKids Inflammatory Bowel Disease Centre and Cell Biology Program, Research Institute, The Hospital for Sick Children
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Toronto, Ontario, Canada
| | - Dan Turner
- Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Aleixo M. Muise
- The Hospital for Sick Children, University of Toronto
- SickKids Inflammatory Bowel Disease Centre and Cell Biology Program, Research Institute, The Hospital for Sick Children
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Toronto, Ontario, Canada
| | - Richard K. Russell
- Child Life and Health, University of Edinburgh, Department of Paediatric Gastroenterology, The Royal Hospital for Sick Children, Edinburgh
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Schmidt-Kraepelin M, Toussaint PA, Thiebes S, Hamari J, Sunyaev A. Archetypes of Gamification: Analysis of mHealth Apps. JMIR Mhealth Uhealth 2020; 8:e19280. [PMID: 33074155 PMCID: PMC7605978 DOI: 10.2196/19280] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/03/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nowadays, numerous health-related mobile apps implement gamification in an attempt to draw on the motivational potential of video games and thereby increase user engagement or foster certain health behaviors. However, research on effective gamification is still in its infancy and researchers increasingly recognize methodological shortcomings of existing studies. What we actually know about the phenomenon today stems from fragmented pieces of knowledge, and a variety of different perspectives. Existing research primarily draws on conceptual knowledge that is gained from research prototypes, and isolated from industry best practices. We still lack knowledge on how gamification has been successfully designed and implemented within the industry and whether certain gamification approaches have shown to be particularly suitable for certain health behaviors. OBJECTIVE We address this lack of knowledge concerning best practices in the design and implementation of gamification for health-related mobile apps by identifying archetypes of gamification approaches that have emerged in pertinent health-related mobile apps and analyzing to what extent those gamification approaches are influenced by the underlying desired health-related outcomes. METHODS A 3-step research approach is employed. As a first step, a database of 143 pertinent gamified health-related mobile apps from the Apple App Store and Google Play Store is set up. Second, the gamification approach of each app within the database is classified based on an established taxonomy for gamification in health-related apps. Finally, a 2-step cluster analysis is conducted in order to identify archetypes of the most dominant gamification approaches in pertinent gamified health-related mobile apps. RESULTS Eight archetypes of gamification emerged from the analysis of health-related mobile apps: (1) competition and collaboration, (2) pursuing self-set goals without rewards, (3) episodical compliance tracking, (4) inherent gamification for external goals, (5) internal rewards for self-set goals, (6) continuous assistance through positive reinforcement, (7) positive and negative reinforcement without rewards, and (8) progressive gamification for health professionals. The results indicate a close relationship between the identified archetypes and the actual health behavior that is being targeted. CONCLUSIONS By unveiling salient best practices and discussing their relationship to targeted health behaviors, this study contributes to a more profound understanding of gamification in mobile health. The results can serve as a foundation for future research that advances the knowledge on how gamification may positively influence health behavior change and guide practitioners in the design and development of highly motivating and effective health-related mobile health apps.
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Affiliation(s)
| | - Philipp A Toussaint
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Scott Thiebes
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Juho Hamari
- Gamification Group, Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Ali Sunyaev
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
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