title: A game plan: Gamification design principles in mHealth applications for chronic disease management.
abstract: Effective chronic disease management is essential to improve positive health outcomes, and incentive strategies are useful in promoting self-care with longevity. Gamification, applied with mHealth (mobile health) applications, has the potential to better facilitate patient self-management. This review article addresses a knowledge gap around the effective use of gamification design principles, or mechanics, in developing mHealth applications. Badges, leaderboards, points and levels, challenges and quests, social engagement loops, and onboarding are mechanics that comprise gamification. These mechanics are defined and explained from a design and development perspective. Health and fitness applications with gamification mechanics include: bant which uses points, levels, and social engagement, mySugr which uses challenges and quests, RunKeeper which uses leaderboards as well as social engagement loops and onboarding, Fitocracy which uses badges, and Mango Health, which uses points and levels. Specific design considerations are explored, an example of the efficacy of a gamified mHealth implementation in facilitating improved self-management is provided, limitations to this work are discussed, a link between the principles of gaming and gamification in health and wellness technologies is provided, and suggestions for future work are made. We conclude that gamification could be leveraged in developing applications with the potential to better facilitate self-management in persons with chronic conditions.
authors.affiliation: Centre for Global eHealth Innovation, University Health Network, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Miller
authors.affiliation: Centre for Global eHealth Innovation, Techna Institute, University Health Network; Institute of Health Policy, Management and Evaluation, University of Toronto; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Canada.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Cafazzo
authors.affiliation: Centre for Global eHealth Innovation, Techna Institute, University Health Network; Institute of Health Policy, Management and Evaluation, University of Toronto Emily.Seto@uhn.ca.
authors.forename: Emily
authors.initials: E
authors.lastname: Seto
mesh_terms: D040421:Cell Phone; D002908:Chronic Disease; D019468:Disease Management; D006801:Humans; D063731:Mobile Applications / Q000706:statistics & numerical data*; D012201:Reward; D012648:Self Care; D017216:Telemedicine; D018910:Video Games
keywords: consumer health; health informatics; innovation; mHealth; patient engagement