’Gamification’ may improve effectiveness of weight loss interventions
Weight loss interventions with game elements, especially competition, result in significantly greater increases in physical activity among overweight and obese adults compared with those that do not have game elements, according to study results published in JAMA Internal Medicine.
“Gamification is the use of game design elements, such as points and levels in nongame contexts, and is increasingly being used to promote healthy behaviors,” Mitesh S. Patel, MD, MBA, MS, an assistant professor of medicine in the department of medicine at the Perelman School of Medicine at the University of Pennsylvania, and colleagues wrote.
They noted that gamification interventions had previously been successful at promoting workplace wellness and shorter weight loss interventions, but the long-term results had not previously been tested.
The trial consisted of a 2-week baseline period followed by a 24-week intervention and a 12-week follow-up period. Participants were asked wear devices connected to a smartphone app to track their daily steps and were monitored remotely.
Once enrolled, participants were randomly assigned the control arm or to a support, collaboration or competitive gamification arm where they were entered into a game with points and levels.
Participants in the gamification arm were given 70 points at the beginning of each week and lost 10 points each day they did not achieve their step goal. To demonstrate their progress in the game, participants had the opportunity to move up or down a level at the end of each week based on the points they earned. Participants received feedback regularly from both the wearable device and the smartphone application.
In the support arm, participants’ friends or family members were sent weekly performance reports. The collaboration arm placed participants into teams of three, and a different member was randomly selected to represent the team each day, making members accountable to each other. The competitive arm placed participants in groups of three and ranked them based on their progress at the end of each week.
The study included 602 participants with obesity and overweight from 40 states.
Researchers found that compared with those in the control arm, participants experienced greater step count increases in the competition arm (adjusted difference = 920; 95% CI, 513-1,328), support arm (adjusted difference = 689; 95% CI, 267-977), and collaboration arm (adjusted difference = 637; 95% CI, 258-1,017).
Physical activity remained significantly greater in the competition arm than the control arm during follow up (adjusted difference = 569; 95% CI, 142-996). The support and collaboration arms did not have significantly greater physical activity than the control arm during follow up.
“The results of the STEP UP trial indicate that small changes to the design of gamification can lead to important differences in effectiveness,” Patel and colleagues wrote. – by Erin Michael
Disclosures: Patel reported receiving personal fees as the owner of Catalyst Health LLC, stock options from Life Vest Health, personal fees and stock options from Health Mine, Inc, and personal fees from Deloitte Consulting LLP and Holistic Industries outside the submitted work. Please see study for all other authors’ relevant financial disclosures.