The role of playfulness in gamification for health behavior motivation

• Main Author: Qiu, Yang
• Other Authors: Vun Chan Hua, Nicholas
• Format: Thesis-Doctor of Philosophy
• Language: English
• Published: Nanyang Technological University 2024
• Subjects: Computer and Information Science; Gamification; Playfulness; Healthcare
• Online Access: https://hdl.handle.net/10356/176087
• Institution: Nanyang Technological University

Gamification started to gain prominence during the latter part of 2010 due to the increasing influence of gaming in everyday culture. It was soon integrated into the healthcare sector as a potential strategy to encourage positive health behaviors. Despite a decade of advancements, the effectiveness of gamification to consistently achieve desired health behavior outcomes is still inconclusive. This work aims to contribute to the collective effort to boost the efficacy and consistency of healthcare gamification. It specifically focuses on the role of an understudied factor—the individual’s playfulness trait—examining its potential impact on gamified health behaviors. A systematic review was first conducted to examine the current state of playfulness within the healthcare gamification context. The goal was to identify existing evidence that supported the consideration of playfulness trait for gamified health behaviors, but it became clear that the playfulness trait is a notable research gap. To pave the way for incorporating playfulness trait within the context of healthcare gamification, a theoretical framework was then developed, synthesizing the core concepts of gamification, playfulness and health behavior motivation. Specifically, this framework established a theoretical link between the playfulness trait and healthcare gamification, laying the groundwork for subsequent studies. Drawing from the theoretical framework and previous research, the next study postulated a role for playfulness trait in shaping individuals’ attitudes and intentions toward gamified health behaviors. The hypothesized role was tested through analysis of survey data. The results showed that playfulness trait indeed has significant positive impact on both factors, hence confirming its hypothesized role. Building on the influence of the playfulness trait affirmed via the survey, its impact in a real-world healthcare gamification scenario on actual gamified health behaviors was then tested and verified. The next study, part of a broader intervention project addressing hyperglycemia, hypertension, and hyperlipidemia, aimed to investigate the effect of the playfulness trait on attitude and actual gamified health behavior. This study also delved into how playfulness interacts with individuals’ perceptions of their health situation, as signified by health beliefs, and assessed its bearing on preferences for specific game elements and engagement. The results confirmed that playfulness trait can enable individuals to perceive greater benefits associated with health behaviors and exhibit a more positive attitude towards gamification, consequently leading to playful health behaviors. Individuals with a stronger playfulness trait might be more inclined towards playful game elements and engage with social game features more frequently. In the work presented herein, the findings highlight the significance of the playfulness trait, suggesting its importance as a crucial element to consider during the design of gamified systems. These findings provide empirical evidence, shed light on the future design of healthcare gamification and lay the foundation for subsequent research in this context.