Gamification is a strategy used in many different systems, from education to daily work. It draws lessons from the gaming world and applies those to other activities to motivate certain behaviors. Gamification can include giving people points or rewards or acknowledging certain achievements in a predictable way.
“Even moderate exercise can drastically reduce cardiovascular risk, so finding low-cost ways to get people moving and stay in a fitness program that they can do at home is a huge win for public health,” said Alison Brown, registered dietitian and program officer at the National Heart, Lung, and Blood Institute (NHLBI), in a statement.
The Power of Interventions
Participants in the study were given fitness trackers and randomly placed in one of four groups—gaming-style incentives, financial incentives, both financial and gamification incentives, or a control group that got daily messages about their step count.The gamification group participants started each week with points and had to meet daily step goals to keep the points and move up a level. Not meeting goals would result in them being moved down a level. They could also recruit a “support crew”—a family member or friend who would get weekly updates about how they were performing. The highest-performing participants earned trophies at the end of the study.
Financial group participants began each week with $14 and lost $2 per day if they didn’t meet step goals. The third group received both gaming and financial incentives.
Participants added an average additional 40 minutes of moderate exercise each week, which the study concluded was equivalent to reducing premature death by 6 percent and cardiovascular-related deaths by 10 percent.
“These interventions could be deployed at scale within a health system, identifying and inviting eligible patients using electronic health record algorithms, and using automated feedback and incentive delivery,” the study reads.
More than 1,000 participants at risk for major cardiovascular events, who were already walking about 5,000 steps daily, had a mean increase in steps of nearly 1,900. The goal was to see which interventions might help them reach personal goals to increase step count by 33 percent to 50 percent.
Tapping Into Immediate Rewards
Dr. Scott Doughty, a family doctor at U.P. Holistic Medicine in Michigan, said the study reminds him of the National Diabetes Prevention Program. Launched in 2010, it uses encouragement, motivation, and community to help prediabetic patients increase physical activity, among other lifestyle goals.And it works, according to Dr. Doughty. He was involved in the early days of the program’s formation, and the lessons he learned continue to shape the way he approaches not only his patients’ fitness but also his own.
“Getting in on something, whether it’s a financial thing or game thing or buddy system—they are tools that motivate people beyond just that their doctor told them to do it,” he told The Epoch Times. “We ought not be surprised by the findings of this study. We’re all subject to factors that influence us and, as in this case, provide motivation.”
The new research builds on other short-term studies in behavioral economics, which combines economics and psychology to implement immediate rewards for people who are less apt to be motivated by future rewards. The study highlighted other research that gamification and financial incentives increased physical activity in patients at risk of atherosclerotic cardiovascular disease over control groups.
Gamification Motivation
Dr. Doughty has been personally inspired by a gaming-influenced virtual cycling program called Zwift that has offered more fun and social connection to his fitness routine. The app invites users to create digital avatars and compete in real-time with other cyclists around the world.He recently discovered a patient of his who also uses the app, and now he rides with his team weekly at 8:30 p.m.—a bit later than he prefers to work out, but he decided to join the group for the community aspect.
“Now I’m so attached to this team experience that I look forward to it and ride hard with these guys every Thursday night. You won’t be surprised to hear we’re planning rides in the real world this summer,” Dr. Doughty said. “I’m much more interested in how it feels to connect socially and psychologically, but I’m aware these games can allow you to feel motivated psychologically without having to feel that connection socially.”
Long-Term Habits Are Key
Since the study involved participants who were already willing to increase physical fitness, it noted that a fitness tracker might be motivating enough without other incentives. In addition, because the group that only used trackers also experienced success shows that there is potential to reinforce long-term changes after short-term incentives end.Mr. Go said long-term follow-up research would be helpful. He has found that developing intrinsic motivation is where his clients have found long-term success, and it can take more work than just using a tracking device.
He described it as developing a habit that becomes necessary—such as wanting to brush your teeth and never missing a day because the feeling of plaque is bothersome.
Will power won’t be able to take someone across the finish line, according to Mr. Go. He gets his clients to journal about what they want to accomplish, as well as the daily challenges they are facing.
“The more you can talk to yourself through this—it’s kind of like an internal form of therapy—the more you are going to give yourself reasons to follow through on the person you are intending to become,” he explained. “You have to bring your mind along on the journey or else you’re not going to continue on with whatever behavior you’re trying to will yourself toward.”