The Need to ‘Git Gud’: A Review of Potential and Pitfalls in Mobile Gamification of Paediatric Health Education

Main Article Content

Gabriel Malvas, MD

Abstract

Conventional health initiatives aimed at paediatric populations struggle heavily with inefficacy. The ubiquity and utility of mobile devices offer a promising way to reach broad and distinct populations, cross-cultural demographics, and socioeconomic strata. As children and adolescents are accustomed to smartphones and related technology, this medium potentially can bridge the divide between health interventions and their daily lives. Conventional and previously attempted mobile interventions struggle with a bipartite hurdle that cripples their effectiveness: first, the production and preservation of motivation and second, the lack thereof within youth. Non-adoption, attrition, and eventual abandonment have led to mediocre efficacy. In the face of this challenge, the incorporation of game elements with health behaviours, by way of serious games and gamification, has hinted at a vast, yet untapped ability to circumvent this problem of engagement. However, the current application of game elements has not produced expected levels of results. This review not only examines potential causes for this inefficacious gamification, but also works to delineate a path forward.


Methods: A scoping search of extant academic literature was conducted using three databases, Web of Science, ERIC, and PsycInfo. Articles were evaluated by relevance, being required to pertain to mobile health, gamification, and paediatric populations.


Results: A total of 20 journal articles met the inclusion criteria and consequently were evaluated. The included papers were a plethora of studies including randomized controlled trials, mixed methods experiment, and systematic reviews. The current literature suggests substantial potential is carried by both mobile health applications and gamification, especially in relation to difficult-to-reach paediatric populations. Secondarily, examination of the articles brought existing shortcomings to the surface.


Conclusions: Mobile health and gamification present an incredible, pioneering opportunity to reach children and adolescents. Given the challenges associated with the acceptance of conventional interventions, current and future research should continue to explore the utility of mobile health. To combat the lackluster engagement and motivation also connected to the aforementioned initiatives, the incorporation of game elements should not simply be implemented, but further investigated and improved.

Article Details

How to Cite
MALVAS, Gabriel. The Need to ‘Git Gud’: A Review of Potential and Pitfalls in Mobile Gamification of Paediatric Health Education. Medical Research Archives, [S.l.], v. 12, n. 3, mar. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5263>. Date accessed: 13 apr. 2024. doi: https://doi.org/10.18103/mra.v12i3.5263.
Section
Research Articles

References

1. Elliot DL, Lindemulder SJ, Goldberg L, Stadler DD, Smith J. Health promotion for adolescent childhood leukemia survivors: Building on prevention science and ehealth. Pediatric Blood & Cancer. 2013;60(6):905-910. doi:10.1002/pbc.24372
2. Van Lippevelde W, Vangeel J, De Cock N, et al. Using a gamified monitoring app to change adolescents’ snack intake: the development of the REWARD app and evaluation design. BMC Public Health. 2016;16(1):725. doi:10.1186/s12889-016-3286-4
3. Papanastasiou G, Drigas A, Skianis C, Lytras M, Papanastasiou E. Patient-centric ICTs based healthcare for students with learning, physical and/or sensory disabilities. Telematics and Informatics. 2018;35(4):654-664. doi:10.1016/j.tele.2017.09.002
4. Lee C, Lee K, Lee D. Mobile Healthcare Applications and Gamification for Sustained Health Maintenance. Sustainability. 2017;9(5): 772. doi:10.3390/su9050772
5. Curtis KE, Lahiri S, Brown KE. Targeting Parents for Childhood Weight Management: Development of a Theory-Driven and User-Centered Healthy Eating App. JMIR mHealth uHealth. 2015;3(2):e69. doi:10.2196/mhealth.3857
6. Badawy SM, Cronin RM, Hankins J, et al. Patient-Centered eHealth Interventions for Children, Adolescents, and Adults With Sickle Cell Disease: Systematic Review. J Med Internet Res. 2018;20(7):e10940. doi:10.2196/10940
7. Sousa P, Duarte E, Ferreira R, et al. An MH ealth intervention programme to promote healthy behaviours and prevent adolescent obesity (TeenPower): A study protocol. Journal of Advanced Nursing. 2019;75(3):683-691. doi:10.1111/jan.13905
8. Pakarinen A, Parisod H, Smed J, Salanterä S. Health game interventions to enhance physical activity self‐efficacy of children: a quantitative systematic review. Journal of Advanced Nursing. 2017;73(4):794-811. doi:10.1111/jan.13160
9. Webb K. The $120 billion gaming industry is going through more change than it ever has before, and everyone is trying to cash in. Business Insider. Accessed April 21, 2020. https://www.businessinsider.com/video-game-industry-120-billion-future-innovation-2019-9.
10. Koksal I. Video Gaming Industry & its revenue shift. Forbes. November 12, 2019. Accessed April 21, 2020. https://www.forbes.com/sites/ilkerkoksal/2019/11/08/video-gaming-industry--its-revenue-shift/#73f2b8fd663e.
11. Ell KA. Video game industry is booming with continued revenue. CNBC. July 20, 2018. Accessed April 21, 2020. https://www.cnbc.com/2018/07/18/video-game-industry-is-booming-with-continued-revenue.html.
12. SocialBlade.com. YouTube, Twitch, Twitter, & Instagram statistics - socialblade.com. Accessed April 21, 2020. https://socialblade.com/.
13. Khamzina M, Parab KV, An R, Bullard T, Grigsby-Toussaint DS. Impact of Pokémon Go on Physical Activity: A Systematic Review and Meta-Analysis. American Journal of Preventive Medicine. 2020;58(2):270-282. doi:10.1016/j.amepre.2019.09.005
14. Doolan L. Ring fit adventure is so popular it keeps selling out. Nintendo Life. March 15, 2020. Accessed April 21, 2020. http://www.nintendolife.com/news/2020/03/ring_fit_adventure_is_so_popular_it_keeps_selling_out.
15. Pramana G, Parmanto B, Lomas J, Lindhiem O, Kendall PC, Silk J. Using Mobile Health Gamification to Facilitate Cognitive Behavioral Therapy Skills Practice in Child Anxiety Treatment: Open Clinical Trial. JMIR Serious Games. 2018;6(2):e9. doi:10.2196/games.8902
16. Puigdomenech E, Martin A, Lang A, et al. Promoting healthy teenage behaviour across three European countries through the use of a novel smartphone technology platform, PEGASO fit for future: study protocol of a quasi-experimental, controlled, multi-Centre trial. BMC Med Inform Decis Mak. 2019;19(1):278. doi:10.1186/s12911-019-0958-x
17. Kamel Boulos MN, Gammon S, Dixon MC, et al. Digital Games for Type 1 and Type 2 Diabetes: Underpinning Theory With Three Illustrative Examples. JMIR Serious Games. 2015;3(1):e3. doi:10.2196/games.3930
18. Sousa P, Martinho R, Reis CI, et al. Controlled trial of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower): Effectiveness analysis. Journal of Advanced Nursing. 2020;76(4):1057-1068. doi:10.1111/jan.14301
19. Martin A, Caon M, Adorni F, et al. A Mobile Phone Intervention to Improve Obesity-Related Health Behaviors of Adolescents Across Europe: Iterative Co-Design and Feasibility Study. JMIR Mhealth Uhealth. 2020;8(3):e14118. doi:10.2196/14118
20. Tark R, Metelitsa M, Akkermann K, Saks K, Mikkel S, Haljas K. Usability, Acceptability, Feasibility, and Effectiveness of a Gamified Mobile Health Intervention (Triumf) for Pediatric Patients: Qualitative Study. JMIR Serious Games. 2019;7(3):e13776. doi:10.2196/13776
21. Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. 2018;20(10):e10361. doi:10.2196/10361
22. Boulos MN, Yang SP. Exergames for health and fitness: the roles of GPS and geosocial apps. Int J Health Geogr. 2013;12(1):18. doi:10.1186/1476-072X-12-18
23. Cafazzo JA, Casselman M, Hamming N, Katzman DK, Palmert MR. Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study. J Med Internet Res. 2012;14(3):e70. doi:10.2196/jmir.2058
24. Barnes S, Prescott J. Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review. JMIR Serious Games. 2018;6(1):e3. doi:10.2196/games.9530
25. Ong JG, Lim-Ashworth NS, Ooi YP, et al. An Interactive Mobile App Game to Address Aggression (RegnaTales): Pilot Quantitative Study. JMIR Serious Games. 2019;7(2):e13242. doi:10.2196/13242
26. Fleming T, Merry S, Stasiak K, et al. The Importance of User Segmentation for Designing Digital Therapy for Adolescent Mental Health: Findings From Scoping Processes. JMIR Ment Health. 2019;6(5):e12656. doi:10.2196/12656
27. Flores G, Abreu M, Chaisson CE, Sun D. Keeping Children Out of Hospitals: Parents’ and Physicians’ Perspectives on How Pediatric Hospitalizations for Ambulatory Care-Sensitive Conditions Can Be Avoided. Pediatrics. 2003;112(5):1021-1030. doi:10.1542/peds.112.5.1021
28. Steam charts. Welcome to Steam. Accessed May 8, 2020. https://store.steampowered.com/stats/Steam-Game-and-Player-Statistics?l=english.
29. Orland K. Valve leaks steam game player counts; we have the numbers. Ars Technica. July 6, 2018. Accessed May 08, 2020. https://arstechnica.com/gaming/2018/07/steam-data-leak-reveals-precise-player-count-for-thousands-of-games/.