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A Systematic Review of the Effect of Gamification on Adherence Across Disciplines

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HCI in Games: Experience Design and Game Mechanics (HCII 2021)

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Abstract

Systematic reviews of gamification research often focus on effects on motivation and engagement. Fewer studies systematically investigate the effect of gamification on ‘adherence’, the extent to which individuals use a gamified service and experience its content, as envisioned by the creators, to derive a certain benefit. To this end, this paper presents a systematic review of the effect of gamification on adherence across disciplines, including only studies with experimental designs and empirical measurements of adherence. The results lend support to the hypothesis that gamification has a positive effect on adherence: 19 out of 27 studies report a significantly positive effect or trend. However, we also demonstrate that further debate is necessary on how to conceptualize and measure adherence across disciplines, and suggest that studies on gamification on adherence not only measure the usage behavior of individuals, but equally provide an a priori operationalization of intended use along with a justification.

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References

  1. Seaborn, K., Fels, D.I.: Gamification in theory and action: a survey. Int. J. Hum. Comput. Stud. 74, 14–31 (2015)

    Article  Google Scholar 

  2. Chou, Y.-K.: Actionable Gamification: Beyond Points, Badges, and Leaderboards. Octalysis Group, Fremont (2016)

    Google Scholar 

  3. Hamari, J., Koivisto, J., Sarsa, H.: Does gamification work? - a literature review of empirical studies on gamification. In: 2014 47th Hawaii International Conference on System Sciences, (Hawai, USA), pp. 3025–3034. IEEE (2014)

    Google Scholar 

  4. Nacke, L.E., Deterding, S.: The maturing of gamification research. Comput. Hum.Behav. 71, 450–454 (2017)

    Article  Google Scholar 

  5. Rapp, A., Hopfgartner, F., Hamari, J., Linehan, C., Cena, F.: Strengthening gamification studies: current trends and future opportunities of gamification research. Int. J. Hum. Comput. Studi. 127, 1–6 (2019)

    Article  Google Scholar 

  6. Kelders, S.M., Kok, R.N., Ossebaard, H.C., Van Gemert-Pijnen, J.E.W.C.: Persuasive system design does matter: a systematic review of adherence to web-based interventions. J. Med. Internet Res. 14(6), e152 (2012)

    Article  Google Scholar 

  7. Sieverink, F., Kelders, S.M., van Gemert-Pijnen, J.E.: Clarifying the concept of adherence to eHealth technology: systematic review on when usage becomes adherence. J. Med. Internet Res. 19(12), e152 (2017)

    Article  Google Scholar 

  8. Christensen, H., Griffiths, K.M., Korten, A.E., Brittliffe, K., Groves, C.: A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behavior therapy website. J. Med. Internet Res. 6, e46 (2004)

    Article  Google Scholar 

  9. De Croon, R., et al.: Motivational design techniques to increase adherence to a telemonitoring therapy a study with adolescent pectus patients. In: 2019 IEEE International Conference on Healthcare Informatics (ICHI), pp. 1–12 (2019)

    Google Scholar 

  10. Leinonen, A.-M., Pyky, R., Ahola, R., et al.: Feasibility of gamified mobile service aimed at physical activation in young men: population-based randomized controlled study (MOPO). JMIR mHealth uHealth 5(10), e146 (2017)

    Article  Google Scholar 

  11. Krause, M., Mogalle, M., Pohl, H., Williams, J.J.: A playful game changer: fostering student retention in online education with social gamification. In: Proceedings of the Second (2015) ACM Conference on Learning @ Scale, L@S 2015, New York, NY, USA, pp. 95–102. ACM (2015)

    Google Scholar 

  12. Pechenkina, E., Laurence, D., Oates, G., Eldridge, D., Hunter, D.: Using a gamified mobile app to increase student engagement, retention and academic achievement. Int. J. Educ. Technol. High. Educ. 14(1), 1–12 (2017)

    Article  Google Scholar 

  13. Prause, C.R., Jarke, M.: Gamification for enforcing coding conventions. In: Proceedings of the 2015 10th Joint Meeting on Foundations of Software Engineering, New York, NY, USA, pp. 649–660. ACM (2015)

    Google Scholar 

  14. Sabaté, E.: Adherence to long-term therapies. Technical report, World Health Organization (2013)

    Google Scholar 

  15. Christensen, H., Griffiths, K.M., Farrer, L.: Adherence in internet interventions for anxiety and depression. J. Med. Internet Res. 11, e13 (2009)

    Article  Google Scholar 

  16. Brown, E., Cairns, P.: A grounded investigation of game immersion. In: CHI 2004 Extended Abstracts on Human Factors in Computing Systems, CHI EA 2004, New York, NY, USA, p. 1297–1300. Association for Computing Machinery (2004)

    Google Scholar 

  17. Brockmyer, J.H., Fox, C.M., Curtiss, K.A., McBroom, E., Burkhart, K.M., Pidruzny, J.N.: The development of the game engagement questionnaire: a measure of engagement in video game-playing. J. Exp. Soc. Psychol. 45(4), 624–634 (2009)

    Article  Google Scholar 

  18. Denisova, A., Nordin, A.I., Cairns, P.: The convergence of player experience questionnaires. In: Proceedings of the 2016 Annual Symposium on Computer-Human Interaction in Play, CHI PLAY 2016, New York, NY, USA, pp. 33–37. ACM (2016)

    Google Scholar 

  19. Sardi, L., Idri, A., Fernández-Alemán, J.L.: A systematic review of gamification in e-health. J. Biomed. Inform. 71, 31–48 (2017)

    Article  Google Scholar 

  20. Guertler, D., Vandelanotte, C., Kirwan, M., Duncan, M.J.: Engagement and nonusage attrition with a free physical activity promotion program: the case of 10,000 steps Australia. J. Med. Internet Res. 17, e176 (2015)

    Article  Google Scholar 

  21. Saul, J.E., Amato, M.S., Cha, S., Graham, A.L.: Engagement and attrition in internet smoking cessation interventions: insights from a cross-sectional survey of “one-hit-wonders.” Internet Interventions 5, 23–29 (2016)

    Google Scholar 

  22. Hassan, L., Hamari, J.: Gameful civic engagement: a review of the literature on gamification of e-participation. Gov. Inf. Q. 37, 101461 (2020)

    Article  Google Scholar 

  23. Koivisto, J., Hamari, J.: The rise of motivational information systems: a review of gamification research. Int. J. Inf. Manag. 45, 191–210 (2019)

    Article  Google Scholar 

  24. Koivisto, J., Malik, A.: Gamification for Older Adults: A Systematic Literature Review. The Gerontologist (2020)

    Google Scholar 

  25. Looyestyn, J., Kernot, J., Boshoff, K., Ryan, J., Edney, S., Maher, C.: Does gamification increase engagement with online programs? a systematic review. PLoS One 12(3), e0173403 (2017)

    Article  Google Scholar 

  26. Brown, M., O’Neill, N., van Woerden, H., Eslambolchilar, P., Jones, M., John, A.: Gamification and adherence to web-based mental health interventions: a systematic review. JMIR Ment. Health 3, e39 (2016)

    Article  Google Scholar 

  27. Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Prisma Group: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6(7), e1000097 (2009)

    Google Scholar 

  28. Grönvall, E., Verdezoto, N., Bagalkot, N., Sokoler, T.: Concordance: a critical participatory alternative in healthcare IT. In: Aarhus Series on Human Centered Computing, vol. 1, p. 4 (Oct 2015)

    Google Scholar 

  29. Bodduluri, L., Boon, M.Y., Ryan, M., Dain, S.J.: Impact of gamification of vision tests on the UX. Games Health J. 6(4), 229–236 (2017)

    Article  Google Scholar 

  30. Fotaris, P., Mastoras, T., Leinfellner, R., Rosunally, Y.: From hiscore to high marks: empirical study of teaching programming through gamification. In: Proceedings of the European Conference on Games-based Learning, Bristol, UK, pp. 186–194. UWE Bristol (2015)

    Google Scholar 

  31. Scase, M., Marandure, B., Hancox, J., Kreiner, K., Hanke, S., Kropf, J.: Development of and adherence to a computer-based gamified environment designed to promote health and wellbeing in older people with mild cognitive impairment. Stud. Health Tech. Inf. 236, 348–355 (2017)

    Google Scholar 

  32. O’Donnell, N., Kappen, D.L., Fitz-Walter, Z., Deterding, S., Nacke, L.E., Johnson, D.: How multidisciplinary is gamification research? results from a scoping review. In: Extended Abstracts Publication of the Annual Symposium on Computer-Human Interaction in Play, CHI PLAY 2017 Extended Abstracts, New York, NY, USA, pp. 445–452. ACM (2017)

    Google Scholar 

  33. Landis, R.J., Koch, G.G.: The measurement of observer agreement for categorical data. Biometrics 33, 159–174 (1977)

    Article  Google Scholar 

  34. Lombard, M., Snyder-Duch, J., Bracken, C.C.: Content analysis in mass communication: assessment and reporting of intercoder reliability. Hum. Commun. Res. 28(4), 587–604 (2002)

    Article  Google Scholar 

  35. Zamuner, T.S., Kilbertus, L., Weinhold, M.: Game-influenced methodology: addressing child data attrition in language development research. Int. J. Child-Comput. Interact. 14, 15–22 (2017)

    Article  Google Scholar 

  36. Dugas, M., et al.: Individual differences in regulatory mode moderate the effectiveness of a pilot mHealth trial for diabetes management among older veterans. PLoS One 13(3), e0192807 (2018)

    Article  Google Scholar 

  37. Gremaud, A.L., et al.: Gamifying accelerometer use increases physical activity levels of sedentary office workers. J. Am. Heart Assoc. 7(13), 1–12 (2018)

    Article  Google Scholar 

  38. Ryan, J., Edney, S., Maher, C.: Engagement, compliance and retention with a gamified online social networking physical activity intervention. Transl. Behav. Med. 7(4), 702–708 (2017)

    Article  Google Scholar 

  39. Zhao, Z., Arya, A., Whitehead, A., Chan, G., Etemad, S.A.: Keeping users engaged through feature updates: a long-term study of using wearable-based exergames. In: Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems, New York, NY, USA, pp. 1053–1064. Association for Computing Machinery (2017)

    Google Scholar 

  40. Stanculescu, L.C., Bozzon, A., Sips, R.-J., Houben, G.-J.: Work and play: an experiment in enterprise gamification. In: Proceedings of the 19th CSCW, New York, NY, USA, pp. 346–358. ACM (2016)

    Google Scholar 

  41. Anderson, P.E., Nash, T., McCauley, R.: Facilitating programming success in data science courses through gamified scaffolding and learn2mine. In: Proceedings of the 2015 ACM Conference on Innovation and Technology in Computer Science Education, New York, NY, USA, pp. 99–104. ACM (2015)

    Google Scholar 

  42. Boot, W.R., Souders, D., Charness, N., Blocker, K., Roque, N., Vitale, T.: The gamification of cognitive training: older adults’ perceptions of and attitudes toward digital game-based interventions. In: Zhou, J., Salvendy, G. (eds.) ITAP 2016, Part I. LNCS, vol. 9754, pp. 290–300. Springer, Cham (2016). https://doi.org/10.1007/978-3-319-39943-0_28

    Chapter  Google Scholar 

  43. Cafazzo, J.A., Casselman, M., Hamming, N., Katzman, D.K., Palmert, M.R.: Design of an mHealth app for the self-management of adolescent type 1 diabetes: a pilot study. J. Med. Internet Res. 14(3), E70 (2012)

    Article  Google Scholar 

  44. Cunha Leite, R.M., Bastos Costa, D., Meijon Morêda Neto, H., Araújo Durão, F.: Gamification technique for supporting transparency on construction sites: a case study. Eng. Constr. Archit. Manag. 23(6), 801–822 (2016)

    Google Scholar 

  45. De-Marcos, L., Domínguez, A., Saenz-de Navarrete, J., Pagés, C.: An empirical study comparing gamification and social networking on e-learning. Comput. Educ. 75, 82–91 (2014)

    Article  Google Scholar 

  46. Harrington, B., Chaudhry, A.: TrAcademic: improving participation and engagement in cs1/cs2 with gamified practicals. In: Proceedings of the 2017 ACM Conference on Innovation and Technology in Computer Science Education, ITiCSE 2017, New York, NY, USA, pp. 347–352. Association for Computing Machinery (2017)

    Google Scholar 

  47. Kelders, S.M., Sommers-Spijkerman, M., Goldberg, J.: Investigating the direct impact of a gamified versus nongamified well-being intervention: an exploratory experiment. J. Med. Internet Res. 20(7), e247 (2018)

    Article  Google Scholar 

  48. Khalil, M., Ebner, M., Admiraal, W.: How can gamification improve MOOC student engagement? In: Proceedings of the European Conference on Game Based Learning, Sonning Common, UK, pp. 819–828. ACPI (2017)

    Google Scholar 

  49. Lehtonen, T., Aho, T., Isohanni, E., Mikkonen, T.: On the role of gamification and localization in an open online learning environment: Javala experiences. In: Proceedings of the 15th Koli Calling Conference on Computing Education Research, Koli Calling 2015, New York, NY, USA, pp. 50–59. Association for Computing Machinery (2015)

    Google Scholar 

  50. Lumsden, J., Skinner, A., Coyle, D., Lawrence, N., Munafo, M.: Attrition from web-based cognitive testing: a repeated measures comparison of gamification techniques. J. Med. Internet Res. 19(11), 1–18 (2017)

    Article  Google Scholar 

  51. Nevin, C.R., et al.: Gamification as a tool for enhancing graduate medical education. Postgrad. Med. J. 90(1070), 685–693 (2014)

    Article  Google Scholar 

  52. Palacin-Silva, M.V., Knutas, A., Ferrario, M.A., Porras, J., Ikonen, J., Chea, C.: The role of gamification in participatory environmental sensing: a study in the wild. In: Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems, CHI 2018, New York, NY, USA, pp. 1–13. Association for Computing Machinery (2018)

    Google Scholar 

  53. Pramana, G., Parmanto, B., Lomas, J., Lindhiem, O., Kendall, P.C., Silk, J.: Using mobile health gamification to facilitate cognitive behavioral therapy skills practice in child anxiety treatment: open clinical trial. JMIR Serious Games 6(2), 1–15 (2018)

    Article  Google Scholar 

  54. Zuckerman, O., Gal-Oz, A.: Deconstructing gamification: evaluating the effectiveness of continuous measurement, virtual rewards, and social comparison for promoting physical activity. Pers. Ubiquit. Comput. 18(7), 1705–1719 (2014)

    Article  Google Scholar 

  55. Lewin, A.B., et al.: Validity and reliability of an adolescent and parent rating scale of type 1 diabetes adherence behaviors: the self-care inventory (SCI). J. Pediatr. Psychol. 34(9), 999–1007 (2009)

    Article  Google Scholar 

  56. ukkinstituutti.fi. Helsinki: Ministry of Education and Culture & Nuori Suomi ry. Recommendation for the physical activity of school-aged children (2018)

    Google Scholar 

  57. Koivisto, J., Hamari, J.: Demographic differences in perceived benefits from gamification. Comput. Hum. Behav. 35, 179–188 (2014)

    Article  Google Scholar 

  58. Clark, K.R.: The effects of the flipped model of instruction on student engagement and performance in the secondary mathematics classroom. J. Educ. Online 12(1), 91–115 (2015)

    Google Scholar 

  59. Werbach, K., Hunter, D.: For the Win: How Game Thinking Can Revolutionize Your Business. Wharton Digital Press, Philadelphia (2012)

    Google Scholar 

  60. Deterding, S.: Eudaimonic design, or: Six invitations to rethink gamification. In: Rethinking Gamification, pp. 305–331, Lüneburg, Germany. Meson Press, Lüneburg (June 2014)

    Google Scholar 

  61. Bogost, I.: Why gamification is bullshit. Gameful World Approach. Issues Appl. 65, 65–79 (2015)

    Google Scholar 

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Acknowledgments

This work is part of the research projects PANACEA Gaming Platform with project number HBC.2016.0177, and Personal Health Empowerment with project number HBC.2018.2012, which are financed by Flanders Innovation & Entrepreneurship.

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Correspondence to Robin De Croon .

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De Croon, R., Geuens, J., Verbert, K., Vanden Abeele, V. (2021). A Systematic Review of the Effect of Gamification on Adherence Across Disciplines. In: Fang, X. (eds) HCI in Games: Experience Design and Game Mechanics. HCII 2021. Lecture Notes in Computer Science(), vol 12789. Springer, Cham. https://doi.org/10.1007/978-3-030-77277-2_14

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