Unlocking New High-Scores: Investigating the Psychology Behind Health Gamification

Abstract

Serious games in health are emerging as an important tool for patient engagement and education. At this time, however, few studies have extended beyond qualitative anecdotal evidence to rigorously analyze the causes behind perceived patient benefits. What game elements are particularly conducive to bringing about positive changes in patient outcome? Further, motivation and engagement have often been examined alone but seldom in conjunction with more outcome-based variables such as knowledge and behavior. The purpose of this study is thus three-fold. Using Wizdy Diner, a game for food allergy management, this experiment: 1) examines the effects of a game on motivation, knowledge, and behavioral intention, 2) unpacks motivation into several components to more closely analyze potential motivational pathways, and 3) hones in on the story aspect of games to determine the relative effect of stories on the dependent measures above. The hypotheses were first that the game would increase motivation, and by doing so, increase knowledge retention and positive behavioral intentions. Second, we expect a broader range of motivational pathways to be at work than previously examined, among these competence and value. Third, a compelling story should contribute positively to the effects of game especially through the motivational pathways relevant to story. Our results demonstrate that game and story independently have positive effects on engagement and motivation, but their interaction is negative. Further, despite their effect on engagement and motivation, neither contribute positively to knowledge retention, though game has a small positive effect on behavioral intentions. The present study has implications for improving games in health—game difficulty needs to be considered carefully, else increased engagement and motivation may not necessarily lead to better knowledge retention.