2019
DOI: 10.2196/11444
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Effectiveness of a Behavior Change Technique–Based Smartphone Game to Improve Intrinsic Motivation and Physical Activity Adherence in Patients With Type 2 Diabetes: Randomized Controlled Trial

Abstract: Background Regular physical activity (PA) is an essential component of a successful type 2 diabetes treatment. However, despite the manifest evidence for the numerous health benefits of regular PA, most patients with type 2 diabetes remain inactive, often due to low motivation and lack of PA enjoyment. A recent and promising approach to help overcome these PA barriers and motivate inactive individuals to change their PA behavior is PA-promoting smartphone games. While short-term results of these g… Show more

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Cited by 75 publications
(129 citation statements)
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“…There is limited research on the impact of gamification on attrition in mobile health apps. In an RCT with type 2 diabetes patients, Höchsmann et al [33] found significant increases in motivation and adherence to physical exercise in a gamified health app intervention group compared with a control group (one-time lifestyle counseling). Interestingly, the intervention group reported significantly higher enjoyment and perceived competence, which lends support to the assumption that gamification influences behavior change via intrinsic motivation.…”
Section: Plos Onementioning
confidence: 99%
“…There is limited research on the impact of gamification on attrition in mobile health apps. In an RCT with type 2 diabetes patients, Höchsmann et al [33] found significant increases in motivation and adherence to physical exercise in a gamified health app intervention group compared with a control group (one-time lifestyle counseling). Interestingly, the intervention group reported significantly higher enjoyment and perceived competence, which lends support to the assumption that gamification influences behavior change via intrinsic motivation.…”
Section: Plos Onementioning
confidence: 99%
“…Most frameworks focused on mechanics of specific interventions (simulation theory [ 33 ], cognitive training reorganization on brain network infrastructure [ 34 ], spaced education [ 35 ], neurofeedback for pain control [ 36 ], integrative rehabilitation [ 31 ], and self-management [ 33 , 37 ]). Other frameworks focused on intervention development (intervention mapping approach [ 38 ] and Gagne’s instruction strategies [ 39 ]) and rationales for serious game features (behavioral economics [ 40 , 41 ], dual-task training [ 32 ], narrative transportation theory [ 42 ], self-determination theory [ 42 - 44 ], and behavior change theory [ 43 , 44 ]).…”
Section: Resultsmentioning
confidence: 99%
“…This varied vastly from serious games meant to provide additional, novel, and meaningful support but otherwise not replacing an existing intervention, such as interventions focused on teaching self-management or coping skills. For example, Höchsmann et al [ 43 , 44 ] reported on their intervention—MOBIGAME—which aimed to reduce diabetes by engaging patients in an immersive, relaxing program focused on increasing physical activity, motivation, and adherence.…”
Section: Resultsmentioning
confidence: 99%
“…However, more recent advances with microtailoring based on season, geographic location, momentary mood, personal characteristics, employment and parenting demands, or other life circumstances would provide more actionable, meaningful, and potentially more motivating messages. Further tailoring to PA levels may also be effective, such as messaging when there is a gap in synced data [ 68 ], and the addition of more strategies to motivate and engage [ 69 ]. A challenge with mHealth interventions is that the novelty of the intervention may be motivating for a short period, but after the novelty wears off, the interventions lose their effectiveness.…”
Section: Discussionmentioning
confidence: 99%