The Use of Gamification in Health & Fitness Apps

Theoretical Background and research questions/hypothesis: Gamification has been a predominant focus of the health app industry in recent years. However, to date there has been no review of elements of gamification in relation to health behavior constructs, or insight into the true proliferation of gamification in health apps. The purpose of this study was to identify the extent to which gamification is used in health apps, and analyze gamification of health and fitness apps as a potential component of influencing a consumer’s health behavior. 

Methods: A content analysis of health and fitness apps related to physical activity and diet was conducted among apps in the Apple App Store in winter of 2014. This content analysis reviewed a sample of 132 apps for the 10 effective game components, the 6 core elements of health gamification, and 13 core health behavior constructs. A regression analysis was conducted in order to measure correlation between health behavior constructs, gamification components, and effective game elements.

Results: This review of the most popular apps showed widespread use of gamification principles, but low adherence to any professional guidelines or industry standard. Regression analysis showed that game elements were associated with gamification. Behavioral theory was associated with gamification but not game elements, and upon further analysis gamification was only associated with composite motivational behavior scores and not capacity or opportunity/trigger.

Conclusions: This research represents the first comprehensive review of gamification use in health and fitness apps, and the potential to impact health behavior. Results show that use of gamification in health and fitness apps has become immensely popular, as evidenced by the number of apps found in the app store containing at least some components of gamification. This shows a lack of integrating important elements of behavioral theory from the app industry, which can potentially impact the efficacy of gamification apps to change behavior.

Implications for research and/or practice: Apps represent a very promising burgeoning market and landscape in which to disseminate health behavior change interventions. Initial results show an abundant use of gamification in health and fitness apps, which necessitates the in-depth study and evaluation of the potential of gamification to change health behaviors.