Investigating the Direct Impact of a Gamified Versus Nongamified Well-Being Intervention: An Exploratory Experiment

Abstract

BackgroundGamification is a promising strategy to increase the effectiveness of Web-based mental health interventions by enhancing engagement. However, because most studies focus on the longer term effects of gamification (eg, effectiveness or adherence at the end of the intervention period), there is limited insight into how gamification may enhance engagement. Research implies that gamification has a direct impact at the time of use of the intervention, which changes the experience of the users, and thereby motivates users. However, it is unclear what this direct impact of gamification might be and how it can be measured.ObjectiveThe objective of this study was to explore the direct impact of gamification on behavioral, cognitive, and affective engagement in the context of a Web-based mental health intervention and to explore whether and how the different components of engagement are related.MethodsA pilot (n=19) and a real-life (n=75) randomized between-groups experiment was carried out, where participants used a gamified or nongamified version of the same Web-based well-being intervention for a single session. Participants (68%, 64/94 female, mean age 23 years) were asked to use the intervention in one session for research purposes. Gamification elements included a map as visualization of the different lessons, a virtual guide, and badges. Later, behavioral, cognitive, and affective engagement were measured.ResultsThe pilot experiment showed no differences between the gamified and nongamified intervention. However, in the real-life experiment, participants in the gamified intervention scored higher on cognitive engagement, that is, involvement (P=.02) and some elements of affective engagement, that is, flow as a combination of cognitive and affective engagement (P=.049), and the emotions ”interest” (P=.03) and “inspiration” (P=.009). Furthermore, the effect of gamification on cognitive engagement was mediated by the influence of gamification on specific positive emotions.ConclusionsThe gamified intervention seemed to be able to increase cognitive engagement and the combination of cognitive and affective engagement but not behavioral and affective engagement alone. However, positive emotions seem to play an important role in mediating the effect of gamification on engagement. In conclusion, we cannot say that gamification ”works” but that the design of an intervention, in this case, gamification, can have an impact on how participants experience the intervention.

Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial

“…Importantly, the attrition rate in the group using a gamified mental well-being app was significantly reduced, supporting the idea that gamification may indeed strengthen adherence when using mental health apps. This is in line with a study by Kelders et al [36], who investigated the impact of a gamified versus a non-gamified web-based well-being intervention. According to the authors, gamification increased involvement and flow when using the intervention.…”

“…According to the authors, gamification increased involvement and flow when using the intervention. Although we did not test this directly, based on the results by Kelders et al [36], it is also reasonable to suggest that higher involvement and flow led to a reduced attrition rate in the gamified app group in our study. Importantly, however, that Kelders et al found that gamification did not increase behavioral engagement in terms of time spent with the intervention or exercises completed [36].…”

“…Although we did not test this directly, based on the results by Kelders et al [36], it is also reasonable to suggest that higher involvement and flow led to a reduced attrition rate in the gamified app group in our study. Importantly, however, that Kelders et al found that gamification did not increase behavioral engagement in terms of time spent with the intervention or exercises completed [36]. Moreover, there are other potential explanations for the significantly lower attrition rate in the gamified app group, such as the purpose of the app itself.…”

“…However, participants were not randomized in that trial, and the sample involved only a subgroup of those with major depression. To our knowledge, there is only one study directly testing the impact of gamified versus non-gamified versions of the same web-based-intervention on well-being [36]. Results of that study showed no difference between interventions on positive affect.…”

Adaption of the Gamification Hexad Player Types and Cognitive Awareness in an Engineering Student

“…Also, 106 respondents gave a "neutral" answer while 28 respondents gave "disagree" answer and the remaining 22 respondents gave very "disagree" answers on this topic. Recent studies show that the use of badges is low in terms of treatment (Kelders, Spijkerman & Goldberg, 2018 Table 3 visualizes the highest mean of min is 4.06 representing item number seven. 152 respondents responded "strongly agree" and 144 respondents responded in agreement.…”