Gamification is increasingly being recognized as a tool to support a change in individuals' health behaviors. However, how and under which circumstances gamification is able to support health behavior change is still largely unexplored. This study follows the call for more theory-driven research on gamification by investigating the role of gamification in health behavior change theories (HBCTs). In order to do so, we conducted a systematic review of extant literature and identified 25 studies that explore the role of gamification in the process of health behavior change to some extent. We found large discrepancies in how the authors of these studies conceptualized the role of gamification in their theory-driven health interventions. To further strengthen theory-driven research on gamification in health and well-being, we additionally propose concrete research questions. These may guide future researchers to identify valuable avenues for further explaining and predicting the influences of gamification on health behavior change.

Background In health care, the use of game-based interventions to increase motivation, engagement, and overall sustainability of health behaviors is steadily becoming more common. The most prevalent types of game-based interventions in health care research are gamification and serious games. Various researchers have discussed substantial conceptual differences between these 2 concepts, supported by empirical studies showing differences in the effects on specific health behaviors. However, researchers also frequently report cases in which terms related to these 2 concepts are used ambiguously or even interchangeably. It remains unclear to what extent existing health care research explicitly distinguishes between gamification and serious games and whether it draws on existing conceptual considerations to do so. Objective This study aims to address this lack of knowledge by capturing the current state of conceptualizations of gamification and serious games in health care research. Furthermore, we aim to provide tools for researchers to disambiguate the reporting of game-based interventions. Methods We used a 2-step research approach. First, we conducted a systematic literature review of 206 studies, published in the Journal of Medical Internet Research and its sister journals, containing terms related to gamification, serious games, or both. We analyzed their conceptualizations of gamification and serious games, as well as the distinctions between the two concepts. Second, based on the literature review findings, we developed a set of guidelines for researchers reporting on game-based interventions and evaluated them with a group of 9 experts from the field. Results Our results show that less than half of the concept mentions are accompanied by an explicit definition. To distinguish between the 2 concepts, we identified four common approaches: implicit distinction, synonymous use of terms, serious games as a type of gamified system, and distinction based on the full game dimension. Our Game-Based Intervention Reporting Guidelines (GAMING) consist of 25 items grouped into four topics: conceptual focus, contribution, mindfulness about related concepts, and individual concept definitions. Conclusions Conceptualizations of gamification and serious games in health care literature are strongly heterogeneous, leading to conceptual ambiguity. Following the GAMING can support authors in rigorous reporting on study results of game-based interventions.

BACKGROUND In healthcare, using game-based intervention approaches to increase motivation, engagement, and overall sustainability of health behaviors is steadily becoming more common. The most prevailing approaches for such game-based interventions in healthcare research are gamification and serious games. Various researchers have discussed substantial conceptual differences between these two concepts, supported by empirical studies showing differences in the effects on specific health behaviors. However, researchers also frequently report cases where terms related to these two concepts are used ambiguously or even interchangeably. It remains unclear to which extent existing healthcare research explicitly distinguishes between gamification and serious games and whether it draws on existing conceptual considerations in order to do so. OBJECTIVE Our study aims to address this lack of knowledge by capturing the current state of conceptualizations of gamification and serious games in healthcare research. Furthermore, we provide tools for researchers to disambiguate reporting on game-based interventions. METHODS We employed a 2-step research approach. First, we conducted a systematic literature review of 206 studies published in the Journal of Medical Internet Research and its sister journals containing terms related to either gamification, serious games, or both. We analyzed their conceptualizations of gamification and serious games, as well as distinctions between the two concepts. Second, based on the literature review findings, we developed a set of guidelines for researchers reporting on game-based interventions and evaluated them with a group of 7 experts from the field. RESULTS Our results show that less than half of concept mentions are accompanied by an explicit definition. For the distinction between the two concepts, we identified 4 common approaches: implicit distinction, synonymous use of terms, serious games as gamified systems, and distinction based on the full game dimension. Our Game-based Intervention Reporting Guidelines (GAMING) consist of 25 items grouped into 4 topics: (1) Conceptual Focus, (2) Contribution, (3) Mindfulness about Related Concepts, and (4) Individual Concept Definitions. CONCLUSIONS Conceptualizations of gamification and serious games in healthcare literature are strongly heterogeneous, leading to conceptual ambiguity. Following the GAMING guidelines can support authors in rigorous reporting on study results of game-based interventions.

Converging hedonic and utilitarian elements under the label of gamification has become an important phenomenon in information systems over the last decade. Yet, academic discourse on narratives in gamified IS remains scarce. To advance scholarly engagement, this study recontextualizes the concept of narratives for gamified IS. Based on the theoretical lens of hedonic and utilitarian consumption, we conducted a hermeneutic literature review in which we engaged with existing conceptualizations of narratives in a total of 84 studies across various disciplines. Results include a basic conceptualization of narratives complemented by six claims that may shape our way of thinking about narratives in gamified IS. Our findings contribute to a more comprehensive understanding of narratives in gamified IS that goes beyond that of traditional game elements. It may serve as a cornerstone for further discourse on narratives and how to meaningfully design them in gamified IS.

Gamification is increasingly utilized in information systems to afford positive experiences that are typically perceived from playing games. Despite potential benefits, gamification projects have shown to be prone for failure which may lead to severe harmful effects for its users. In traditional software projects, project managers try to mitigate failure through project risk management. However, gamification projects bring with them several differences in comparison to traditional software projects and it is unclear how extant knowledge may be transferred. We address this issue by conducting ten semi-structured interviews with experts involved in the development of gamified health behavior change support systems. Our results indicate that gamification has substantial impacts on various risk factors. We contribute to gamification and project management literature as we are among the first who conceptualize gamification projects as special software projects with different project risk factors.