Hostname: page-component-6dbcb7884d-cm8hq Total loading time: 0 Render date: 2025-02-13T23:14:19.418Z Has data issue: false hasContentIssue false
  • English
  • Français

GAMIFICATION AND NUDGING TECHNIQUES FOR IMPROVING USER ENGAGEMENT IN MENTAL HEALTH AND WELL-BEING APPS

Published online by Cambridge University Press:  27 July 2021

Hassan Auf ,
Jessica Dagman ,
Sara Renström  and
John Chaplin
Hassan Auf*
Affiliation:
RISE Research Institutes of Sweden Sahlgrenska Academy at the University of Gothenburg
Jessica Dagman
Affiliation:
RISE Research Institutes of Sweden
Sara Renström
Affiliation:
RISE Research Institutes of Sweden
John Chaplin
Affiliation:
Sahlgrenska Academy at the University of Gothenburg Institute of Clinical Sciences
*
Auf, Hassan, University of Gothenburg, Public health, Sweden, 7assan.3uf@gmail.com

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In the last decades, mental health disorders have been a growing source of the global burden of disease. Thousands of mental health apps are available nowadays addressing this problem, but studies show that the effectiveness of these apps is jeopardized by the low user engagement.

This study investigates the most potentially effective gamification and nudging techniques in design for improving engagement in mental health apps for young people, by carrying out app-reviews for top installed mental health apps on Google play store and connecting it with engagement data, in addition to conducting expert-interviews with professionals from gamification and design background.

From the findings, techniques that participated in improving retention rates included using app character for creating app narrative and user interaction, in addition to adopting a non-forcible language. While to improve app daily duration of use, simplification nudge, and stating the recommended minutes of use found to be useful. Personalization and social interaction techniques were potentially effective for improving the frequency of app daily use. For the young age group, using juicy feedback and high-quality gamification were recommended

Keywords

GamificationNudge theoryDesign for interfacesHuman behaviour in designDesign theory
Type
Article
Information
Proceedings of the Design Society , Volume 1: ICED21 , August 2021 , pp. 1647 - 1656
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
The Author(s), 2021. Published by Cambridge University Press

References

Arno, A. and Thomas, S. (2016) 'The efficacy of nudge theory strategies in influencing adult dietary behaviour: a systematic review and meta-analysis', BMC public health, 16(1), 676. https://doi.org/10.1186/s12889-016-3272-xCrossRefGoogle ScholarPubMed
Bakker, D. and Rickard, N. (2018) 'Engagement in mobile phone app for self-monitoring of emotional wellbeing predicts changes in mental health: MoodPrism', Journal of Affective Disorders, 227, 432–442. https://doi.org/10.1016/j.jad.2017.11.016CrossRefGoogle ScholarPubMed
Bauer, M., Glenn, T., Geddes, J., Gitlin, M., Grof, P., Kessing, L.V., Monteith, S., Faurholt-Jepsen, M., Severus, E. and Whybrow, P.C. (2020) 'Smartphones in mental health: a critical review of background issues, current status and future concerns', International journal of bipolar disorders, 8(1), 1–19. https://doi.org/10.1186/s40345-019-0164-xCrossRefGoogle ScholarPubMed
Baumel, A., Muench, F., Edan, S. and Kane, J.M. (2019) 'Objective user engagement with mental health apps: systematic search and panel-based usage analysis', Journal of medical Internet research, 21(9), e14567. https://doi.org/10.2196/14567CrossRefGoogle ScholarPubMed
Chandrashekar, P. (2018) 'Do mental health mobile apps work: evidence and recommendations for designing high-efficacy mental health mobile apps', mHealth, 4. https://dx.doi.org/10.21037%2Fmhealth.2018.03.02CrossRefGoogle ScholarPubMed
Cheng, V.W.S., Davenport, T., Johnson, D., Vella, K. and Hickie, I.B. (2019) 'Gamification in apps and technologies for improving mental health and well-being: systematic review', JMIR mental health, 6(6), e13717. https://doi.org/10.2196/13717CrossRefGoogle ScholarPubMed
Glenn, D., Golinelli, D., Rose, R.D., Roy-Byrne, P., Stein, M.B., Sullivan, G., Bystritksy, A., Sherbourne, C. and Craske, M.G. (2013) 'Who gets the most out of cognitive behavioral therapy for anxiety disorders? The role of treatment dose and patient engagement', Journal of consulting and clinical psychology, 81(4), 639. https://psycnet.apa.org/doi/10.1037/a0033403CrossRefGoogle ScholarPubMed
Hagman, W. (2018) When are nudges acceptable?: Influences of beneficiaries, techniques, alternatives and choice architects, unpublished thesis, Linköping University Electronic Press. https://doi.org/10.3384/diss.diva-152788CrossRefGoogle Scholar
Hagman, W., Andersson, D., Västfjäll, D. and Tinghög, G. (2015) 'Public views on policies involving nudges', Review of philosophy and psychology, 6(3), 439–453. https://doi.org/10.1007/s13164-015-0263-2CrossRefGoogle Scholar
Hicks, K., Gerling, K., Richardson, G., Pike, T., Burman, O. and Dickinson, P. (2019) 'Understanding the effects of gamification and juiciness on players', in 2019 IEEE Conference on Games (CoG), IEEE, 1-8. https://doi.org/10.1109/cig.2019.8848105CrossRefGoogle Scholar
Hoffmann, A., Christmann, C.A. and Bleser, G. (2017) 'Gamification in stress management apps: a critical app review', JMIR serious games, 5(2), e13. https://doi.org/10.2196/games.7216CrossRefGoogle ScholarPubMed
Hunicke, R., LeBlanc, M. and Zubek, R. (2004) 'MDA: A formal approach to game design and game research', in Proceedings of the AAAI Workshop on Challenges in Game AI, 1722.Google Scholar
Hwang, W.J. and Jo, H.H. (2019) 'Evaluation of the Effectiveness of Mobile App-Based Stress-Management Program: A Randomized Controlled Trial', International journal of environmental research and public health, 16(21), 4270. https://doi.org/10.3390/ijerph16214270CrossRefGoogle ScholarPubMed
IHME (2019) The Institute for Health Metrics and Evaluation - Global Burden Of Disease Compare | Viz Hub, available: https://vizhub.healthdata.org/gbd-compare/ [accessed 10 December 2020].Google Scholar
Legaard, J.F. (2020) 'Designing aesthetics for play (fulness)', DS 101: Proceedings of NordDesign 2020, Lyngby, Denmark, 12th-14th August 2020, 1-12. https://doi.org/10.35199/norddesign2020.44CrossRefGoogle Scholar
Les MacLeod EdD, M. (2012) 'Making SMART goals smarter', Physician executive, 38(2), 68. PMID: 23971403.Google Scholar
Lockton, D. (2017) 'Design with intent and the field of design for sustainable behaviour' in Living labs Springer, 75–88. https://doi.org/10.1007/978-3-319-33527-8_7CrossRefGoogle Scholar
Matjasko, J.L., Cawley, J.H., Baker-Goering, M.M. and Yokum, D.V. (2016) 'Applying behavioral economics to public health policy: illustrative examples and promising directions', American Journal of Preventive Medicine, 50(5), S13–S19. https://doi.org/10.1016/j.amepre.2016.02.007CrossRefGoogle ScholarPubMed
Michie, S., Ashford, S., Sniehotta, F.F., Dombrowski, S.U., Bishop, A. and French, D.P. (2011) 'A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy', Psychology & health, 26(11), 1479–1498. https://doi.org/10.1080/08870446.2010.540664CrossRefGoogle ScholarPubMed
Mills, S. (2020) 'Personalized nudging', Behavioural Public Policy, 2020/04/13, 1–10, available: http://doi.org/10.1017/bpp.2020.7.CrossRefGoogle Scholar
Minguillon, J., Lopez-Gordo, M.A., Renedo-Criado, D.A., Sanchez-Carrion, M.J. and Pelayo, F. (2017) 'Blue lighting accelerates post-stress relaxation: Results of a preliminary study', PloS one, 12(10), e0186399.CrossRefGoogle ScholarPubMed
Moore, A.W., Gruber, T., Derose, J. and Malinowski, P. (2012) 'Regular, brief mindfulness meditation practice improves electrophysiological markers of attentional control', Frontiers in human neuroscience, 6, 18. https://doi.org/10.3389/fnhum.2012.00018CrossRefGoogle ScholarPubMed
Nicholson, S. (2015) 'A RECIPE for Meaningful Gamification' in Reiners, T. and Wood, L. C., eds., Gamification in Education and Business, Cham: Springer International Publishing, 1–20. https://doi.org/10.1007/978-3-319-10208-5_1Google Scholar
Sharma, M.P. and Andrade, C. (2012) 'Behavioral interventions for insomnia: Theory and practice', Indian journal of psychiatry, 54(4), 359. https://dx.doi.org/10.4103%2F0019-5545.104825CrossRefGoogle ScholarPubMed
Stawarz, K., Cox, A.L. and Blandford, A. (2015) 'Beyond self-tracking and reminders: designing smartphone apps that support habit formation', in Proceedings of the 33rd annual ACM conference on human factors in computing systems, 2653-2662. https://doi.org/10.1145/2702123.2702230CrossRefGoogle Scholar
Sunstein, C.R. (2014) 'Nudging: a very short guide', Journal of Consumer Policy, 37(4), 583–588. https://doi.org/10.7551/mitpress/11974.003.0008CrossRefGoogle Scholar
Sunstein, C.R. (2017) 'Nudges that fail', Behavioural Public Policy, 1(1), 4–25. https://doi.org/10.1017/bpp.2016.3CrossRefGoogle Scholar
Thaler, R.H. and Sunstein, C.R. (2009) Nudge: Improving decisions about health, wealth, and happiness, Penguin. https://doi.org/10.1007/s10602-008-9056-2Google Scholar
Wang, K., Varma, D.S. and Prosperi, M. (2018) 'A systematic review of the effectiveness of mobile apps for monitoring and management of mental health symptoms or disorders', Journal of Psychiatric Research, 107, 73–78. https://doi.org/10.1016/j.jpsychires.2018.10.006CrossRefGoogle ScholarPubMed
Werbach, K. and Hunter, D. (2015) The gamification toolkit: dynamics, mechanics, and components for the win, Wharton School Press.Google Scholar
Yeung, K. (2017) '‘Hypernudge’: Big Data as a mode of regulation by design', Information, Communication & Society, 20(1), 118–136. https://doi.org/10.1080/1369118X.2016.1186713Google Scholar
Zichermann, G. and Cunningham, C. (2011) Gamification by design: Implementing game mechanics in web and mobile apps, ”O'Reilly Media, Inc.”.Google Scholar