The 'gamification' of health: What motivates you?

Think of a game you enjoy playing, any game at all. Now imagine your boss said you were required to play this game for an hour every day. Would you still find it as fun?

According to QUT Ph.D. researcher Robert Mitchell, turning health messages into games, particularly apps, has lots of potential, but this "gamification of health" can also risk falling flat.

Ironically, one of the most successful smart phone games to get people moving in recent years – Pokémon GO – wasn't even designed with public health in mind.

"It worked because it was fun and it was something different you could do with your mobile phone," said Mr Mitchell, who is a keynote speaker at the 2018 Australasian Symposium on Health Communication, Advertising and Marketing at QUT on September 25.

"In fact, the lack of an obvious health motive might just be what allows Pokémon Go to be as effective as it is in promoting exercise in low activity populations.

"And that's what makes game apps such a challenge in public health … how do you get your message across without seeming to have a message.

"If you're going to jump on the bandwagon you need to really think about who your target audience is.

"One basic method of gamification is to add a points system to whatever the task is. It's a bit like parents trying to motivate kids to tidy their rooms by giving them points and making a game of it.

"With public health messages, game apps that use points and rankings are only motivational if someone already wants to change and is into running, fitness, healthy eating or whatever the health message is. For other people, it can just be off-putting and depressing.

"For people who are harder to reach – who don't have that pre-existing motivation to draw on – the number one rule is to make the game fun and take the competitive aspect away."

Mr Mitchell has a background in psychology and marketing and is nearing end of his Ph.D. research with QUT's School of Advertising, Marketing and Public Relations.

His research over the past three years has looked at gamification and behaviour change and the implications for social marketing across areas including health promotion and the corporate world.

He said people were driven by either extrinsic (external) motivation – such as rewards, punishments or social pressure – or intrinsic (internal) motivation, which comes from a personal interest in or enjoyment of the task itself.

"Both can get you to perform a task, but too much extrinsic motivation often has negative side effects," he said.

"There's a famous example of a corporate app that the Disneyland hotels in the USA introduced for their cleaning and laundry staff.

"They did a gamified laundry app that gave points for how quickly you could strip and change a bed, wash it down, etc, and there was a public leaderboard in the staffroom. It really split their workforce in half with some people loving it and others describing it as an 'electronic whip'. They felt very pressured and it really tanked employee morale.

"So gamification doesn't always work."

With 800 million downloads (and counting) Pokémon GO is a runaway winner when it comes to activity-based apps.

But Mr Mitchell said there were other game apps that also championed movement.

"There's a fitness app called 'Zombies, Run!' which gets runners to undertake 'missions' while being pursued by an augmented reality zombie hoard – you run and play it with your earbuds in and the app tells the story and uses simulated sounds so that you hear the zombies gaining on you and have to run faster," he said.

"If you're not into zombies, there's another one called The Walk which counts your steps as you listen to a spy story where you're the star and have to walk across a country to deliver a package that could save millions of people.

"And there's Geocaching which is basically a family-friendly world-wide outdoor treasure hunt where you search for real items in hidden containers – geocaches – and trade them for items you donate to the hunt."