title: Does gamification increase engagement with online programs? A systematic review.
abstract: BACKGROUND
  Engagement in online programs is difficult to maintain. Gamification is the recent trend that offers to increase engagement through the inclusion of game-like features like points and badges, in non-game contexts. This review will answer the following question, 'Are gamification strategies effective in increasing engagement in online programs?'
  
  
  METHODS
  Eight databases (Web of Science, PsycINFO, Medline, INSPEC, ERIC, Cochrane Library, Business Source Complete and ACM Digital Library) were searched from 2010 to the 28th of October 2015 using a comprehensive search strategy. Eligibility criteria was based on the PICOS format, where "population" included adults, "intervention" involved an online program or smart phone application that included at least one gamification feature. "Comparator" was a control group, "outcomes" included engagement and "downstream" outcomes which occurred as a result of engagement; and "study design" included experimental studies from peer-reviewed sources. Effect sizes (Cohens d and 95% confidence intervals) were also calculated.
  
  
  RESULTS
  1017 studies were identified from database searches following the removal of duplicates, of which 15 met the inclusion criteria. The studies involved a total of 10,499 participants, and were commonly undertaken in tertiary education contexts. Engagement metrics included time spent (n = 5), volume of contributions (n = 11) and occasions visited to the software (n = 4); as well as downstream behaviours such as performance (n = 4) and healthy behaviours (n = 1). Effect sizes typically ranged from medium to large in direct engagement and downstream behaviours, with 12 out of 15 studies finding positive significant effects in favour of gamification.
  
  
  CONCLUSIONS
  Gamification is effective in increasing engagement in online programs. Key recommendations for future research into gamification are provided. In particular, rigorous study designs are required to fully examine gamification's effects and determine how to best achieve sustained engagement.
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Jemma
authors.initials: J
authors.lastname: Looyestyn
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Kernot
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Kobie
authors.initials: K
authors.lastname: Boshoff
authors.affiliation: Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Jillian
authors.initials: J
authors.lastname: Ryan
authors.affiliation: Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Edney
authors.affiliation: Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Maher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012984:Software; D055815:Young Adult