ONYA—The Wellbeing Game: How to Use Gamification to Promote Wellbeing

Game not over: Explaining older adults' use and intention to continue using a gamified eHealth service

BACKGROUND

Gamification within eHealth services can increase eHealth adoption. However, little is known about factors affecting adoption of gamified eHealth among older adults. In this study, we sought to explain the (continued) use of a gamified eHealth service among older adults (55+).

METHODS

Participants used a gamified eHealth service, focusing on falls prevention, for 4 weeks and completed a post-test questionnaire based on the Technology Acceptance Model. We used Partial Least Squares Structural Equation Modeling to analyse our data.

RESULTS

Seventy-two older adults participated with a mean age of 65.1 years (SD = 7.0). Our results show that first, perceived ease of use affected use of the service (use duration: β = 0.303, R² = 0.130, and use frequency: β = 0.304, R² = 0.107). Second, perceived usefulness affected the intention to continue using the service (β = 0.754, R² = 0.640). Third, use of the service did not predict the intention to continue using it. Furthermore, enjoyment affected perceived usefulness (β = 0.783, R² = 0.563) and aesthetics affected perceived ease of use (β = 0.634, R² = 0.652).

CONCLUSIONS

This study refutes the expected relation between use and intention to continue use a gamified eHealth service. Additionally, we learned that using theoretical approaches focusing on technology acceptance, are not suitable for explaining (continued) use of gamified eHealth services.

Digital Health Promotion and Prevention in Settings: Scoping Review

BACKGROUND

Digital technologies are increasingly integrating into people's daily living environments such as schools, sport clubs, and health care facilities. These settings play a crucial role for health promotion and prevention because they affect the health of their members, as the World Health Organization has declared. Implementing digital health promotion and prevention in settings offers the opportunity to reach specific target groups, lower the costs of implementation, and improve the health of the population. Currently, there is a lack of scientific evidence that reviews the research on digital health promotion and prevention in settings.

OBJECTIVE

This scoping review aims to provide an overview of research targeting digital health promotion and primary prevention in settings. It assesses the range of scientific literature regarding outcomes such as applied technology, targeted setting, and area of health promotion or prevention, as well as identifies research gaps.

METHODS

The scoping review was conducted following the Levac, Colquhoun, and O'Brien framework. We searched scientific databases and gray literature for articles on digital setting-based health promotion and prevention published from 2010 to January 2020. We included empirical and nonempirical publications in English or German and excluded secondary or tertiary prevention and health promotion at the workplace.

RESULTS

From 8888 records, the search resulted in 200 (2.25%) included publications. We identified a huge diversity of literature regarding digital setting-based health promotion and prevention. The variety of technology types extends from computer- and web-based programs to mobile devices (eg, smartphone apps) and telemonitoring devices (sensors). We found analog, digital, and blended settings in which digital health promotion and prevention takes place. The most frequent analog settings were schools (39/200, 19.5%) and neighborhoods or communities (24/200, 12%). Social media apps were also included because in some studies they were defined as a (digital) setting. They accounted for 31.5% (63/200) of the identified settings. The most commonly focused areas of health promotion and prevention were physical activity (81/200, 40.5%), nutrition (45/200, 22.5%), and sexual health (34/200, 17%). Most of the interventions combined several health promotion or prevention methods, including environmental change; providing information, social support, training, or incentives; and monitoring. Finally, we found that the articles mostly reported on behavioral rather than structural health promotion and prevention.

CONCLUSIONS

The research field of digital health promotion and prevention in settings is heterogeneous. At the same time, we identified research gaps regarding the absence of valid definitions of relevant terms (eg, digital settings) and the lack of literature on structural health promotion and prevention in settings. Therefore, it remains unclear how digital technologies can contribute to structural (or organizational) changes in settings. More research is needed to successfully implement digital technologies to achieve health promotion and prevention in settings.

Emotional Well-Being and Traditional Cypriot Easter Games: A Qualitative Analysis

The aim of the current study is to examine the effect of the Traditional Easter Games of Cyprus on the emotional well-being of the participants. Data were collected using a qualitative analysis. It consisted of interviews from 51 participants aged 32-93 years old, and observations were made from audiovisual material of the Traditional Cypriot Easter Games being played by a sample of 20 children aged 6-14 years old and 43 adults aged 18-65 years old. Demographic data were collected by using interviews and analyzed using IBM SPSS program. The observations of the audiovisual material focused on the emotions of the participants and were grouped into prevailing and secondary emotions according to frequency and duration. The results indicate that games produce emotions such as joy, excitement, and euphoria. Emotions such as embarrassment, frustration, and anger were also observed occasionally, specifically in situations of competitiveness and defeat. In addition, the differences and similarities between adults and children were recorded. The findings of the present study extend previous work by demonstrating the positive impact of the traditional games on children's and adult's emotional well-being.

Spielerische Ansätze in Prävention und Gesundheitsförderung: Serious Games und Gamification

Digitale Spieleanwendungen können im Bereich Prävention und Gesundheitsförderung eingesetzt werden, um etwa gesundheitsrelevante Informationen zu vermitteln oder Verhaltensänderungen zu evozieren. Dabei sind die beiden relevantesten spielerischen Ansätze Serious Games (Spiele mit ernsthaftem Hintergrund) und Gamification (Anwendung spieltypischer Elemente in spielfremden Kontexten). Der Begriff Serious Games umschreibt Spiele, die eingesetzt werden, um ernsthafte Inhalte, wie zum Beispiel gesundheitliche Themen, zu vermitteln. Bei Gamification werden Spieldesignelemente, wie beispielsweise Punkte, Bestenlisten, Auszeichnungen, Profilgestaltung und Teamevents, eingesetzt, um eine Motivations- und Leistungssteigerung etwa in Lernumgebungen zu bewirken. Der vorliegende narrative Beitrag beleuchtet die Wirkungsweise und Studienlage sowie die Vor- und Nachteile spielerischer Anwendungen in der Prävention und Gesundheitsförderung und führt einige dieser Anwendungen exemplarisch auf.

Serious Games und Gamification zeigen in der Prävention und Gesundheitsförderung ein großes Potenzial. Insbesondere bei schwer erreichbaren und desinteressierten Zielgruppen kann ein direkter Bezug zu deren Lebenswelt hergestellt werden. Grundlagen für den wirkungsvollen Einsatz spielerischer Ansätze in der Arbeit und Ausbildung von Gesundheitsberufen sind die bereits hohe Vertrautheit mit dem Medium Spiel sowie die direkte Adressierung der psychologischen Grundbedürfnisse zur Steigerung der Motivation.

Investigating the Potential of Gamification to Improve Seniors’ Experience and Use of Technology

A non-negligible proportion of seniors rarely uses new technology. Far too often, these rather tech unexperienced seniors struggle with new soft- or hard-ware, that do not provide easy access. As a result, some seniors avoid or completely desist to further use “these modern technologies” and consequently miss out on the benefits of digital age. Game-inspired design is supposed to be a promising way to overcome some perceived barriers of seniors by providing hedonic value during early interaction. Previous research has shown that game-inspired design is suitable to motivate seniors’ use of Health-IT. To investigate its potential to facilitate the use of information and communication technology (ICT), an experimental study was conducted. The study investigated the appeal of various gamification features, which were embedded in a prototype of an ICT learning software and compared it to a non-gamified version of the software. Results indicate that the concept of gamified ICT learning software appeals to seniors in general, but that the acceptance of different gamification features is quite diverse. A clear-cut superiority of adding gamification to the software was not found. After interacting with both software versions, seniors in around equal parts preferred either the non-gamified version, the gamified version, or could not decide. Those seniors that clearly favored the gamified version were particularly fond of continuous positive feedback and receiving rewards for each task they have accomplished. Whereas the remaining seniors rather disliked the intensive endorsement through these two features and decided against the gamified version, albeit they liked many of the other game features. Our results underline the necessity of following a user-centered design approach when developing game-inspired applications, and the need for an individualized use of gamification elements to meet the needs of the heterogeneous group of senior users.