Project Details

Health and Fitness Gaming

People

Lead

Lennart Nacke
Director of the HCI Games Group

Participants

Gustavo Fortes Tondello
Ph.D. Candidate, Personalization of Gameful Interactive Systems

Dennis Kappen
Ph.D. Student, Game Design and User Interaction for Older Adults

Rina Wehbe
Ph.D. Student, Errors, Perception of AI, Health Games

Rita Orji
Post Doctoral Fellow, Persuasive Games

Publications

Year 2018

Gamification of Older Adults’ Physical Activity: An Eight-Week Study

@inproceedings{Kappen2018a,
abstract = {Designing fitness programs to combat a sedentary lifestyle and foster older adults' motivation and goalsetting is not yet well-understood beyond point-based systems. To improve older adults' (over 50 years) health and wellness, we studied a gamified physical activity intervention over eight weeks in an experiment (N=30) with three conditions (gamified, non-gamified, control). Our qualitative analysis showed the gamified group exhibited more engagement and interest in performing physical activity facilitated by technology. Results from our quantitative analysis indicated significance in the perceived competence dimension compared to the nongamified and the control group. Perceived autonomy was significant for the non-gamified group against the control group. The findings from qualitative and quantitative analysis show motivation, enjoyment, and engagement were higher in the gamified group. This provides support for successfully facilitating older adults' physical activity through gamified technology, which helped us create guidelines for older adults' adaptive engagement.},
author = {Kappen, Dennis L and Mirza-Babaei, Pejman and Nacke, Lennart E.},
booktitle = {Proceedings of the 51st Annual Hawaii International Conference on System Sciences (HICSS)},
publisher = {IEEE},
title = {{Gamification of Older Adults ' Physical Activity : An Eight-Week Study}},
year = {2018}
}

Designing fitness programs to combat a sedentary lifestyle and foster older adults’ motivation and goalsetting is not yet well-understood beyond point-based systems. To improve older adults’ (over 50 years) health and wellness, we studied a gamified physical activity intervention over eight weeks in an experiment (N=30) with three conditions (gamified, non-gamified, control). Our qualitative analysis showed the gamified group exhibited more engagement and interest in performing physical activity facilitated by technology. Results from our quantitative analysis indicated significance in the perceived competence dimension compared to the nongamified and the control group. Perceived autonomy was significant for the non-gamified group against the control group. The findings from qualitative and quantitative analysis show motivation, enjoyment, and engagement were higher in the gamified group. This provides support for successfully facilitating older adults’ physical activity through gamified technology, which helped us create guidelines for older adults’ adaptive engagement.

Year 2017

Exploring the Potential of Game Audio for Wellbeing

@inproceedings{Rogers2017,
abstract = {Music listening has long-standing ties to mental health, positive affective states, and wellbeing. Even outside of clinical contexts, music is increasingly being explored as a costeffective, ubiquitous way to support emotion regulation and stress reduction in people's everyday lives. Games have also been shown to have the capability to improve player well-being in certain contexts. However, the role of players' exposure to background music in games toward leveraging this effect has not been explored specifically. We explore the potential of games to act as a tool for relaxation and stress reduction for the general public and discuss future research directions.},
address = {Amsterdam, Netherlands},
author = {Rogers, Katja and Nacke, Lennart E.},
booktitle = {Positive Gaming: Workshop on Gamification and Games for Wellbeing},
title = {{Exploring the Potential of Game Audio for Wellbeing}},
year = {2017}
}

Music listening has long-standing ties to mental health, positive affective states, and wellbeing. Even outside of clinical contexts, music is increasingly being explored as a costeffective, ubiquitous way to support emotion regulation and stress reduction in people’s everyday lives. Games have also been shown to have the capability to improve player well-being in certain contexts. However, the role of players’ exposure to background music in games toward leveraging this effect has not been explored specifically. We explore the potential of games to act as a tool for relaxation and stress reduction for the general public and discuss future research directions.

Gamification through the Application of Motivational Affordances for Physical Activity Technology

@inproceedings{Kappen2017a,
abstract = {Motivational affordances are attributes of interactive technologies or game elements that promote participation in physical activity (PA) routines. Although these affordances have been previously integrated into technologies in non-tailored approaches, the motivations of adults for PA are specific (e.g., to improve one's health, wellness, or fitness). There are no previous comparisons of either the motivation to participate in PA or motivational affordances that facili-tate PA in different age groups. Therefore, we conducted an online survey with 150 participants using the Exercise Motivations Inventory-2 scale (EMI-2) together with long-form questions to explore motivational affordances and PA technology preferences in four age groups. Our results suggest health-related pressures are significant motivations for PA in different age groups. Additionally, a content analysis of preferences allowed us to distinguish between gamified motivational affordances and feedback elements. These results provide age-group-specific gamification design guidelines for incorporating motivational elements in PA technology.},
author = {Kappen, Dennis L and Mirza-Babaei, Pejman and Nacke, Lennart E.},
booktitle = {The ACM SIGCHI Annual Symposium on Computer-Human Interaction in Play (CHI PLAY 2017)},
doi = {10.1145/3116595.3116604},
keywords = {Motivational affordances,gamification,motivation,physical activity,user experience design},
publisher = {ACM},
title = {{Gamification through the Application of Motivational Affordances for Physical Activity Technology}},
year = {2017}
}

Motivational affordances are attributes of interactive technologies or game elements that promote participation in physical activity (PA) routines. Although these affordances have been previously integrated into technologies in non-tailored approaches, the motivations of adults for PA are specific (e.g., to improve one’s health, wellness, or fitness). There are no previous comparisons of either the motivation to participate in PA or motivational affordances that facili-tate PA in different age groups. Therefore, we conducted an online survey with 150 participants using the Exercise Motivations Inventory-2 scale (EMI-2) together with long-form questions to explore motivational affordances and PA technology preferences in four age groups. Our results suggest health-related pressures are significant motivations for PA in different age groups. Additionally, a content analysis of preferences allowed us to distinguish between gamified motivational affordances and feedback elements. These results provide age-group-specific gamification design guidelines for incorporating motivational elements in PA technology.

Positive Gaming: Workshop on Gamification and Games for Wellbeing

@inproceedings{Tondello2017b,
abstract = {Gamification and games have been used and studied in a variety of applications related with health and wellbeing. Nevertheless, there are very few studies aimed at designing games (whether serious games or recreational games) or gameful applications for improving wellbeing or flourishing – the pursuit of a happy and meaningful life, rather than the avoidance of illness. Therefore, this full-day Workshop aims to form a community, discuss theoretical and practical considerations, and promote the development of research projects focused on “Positive Gaming” – the use of gamification and games as tools for realizing Positive Computing objectives. This will create the opportunities for interested researchers to form a common understanding, develop methods and procedures, and establish a roadmap for future research in Positive Gaming.},
address = {Amsterdam, Netherlands},
author = {Tondello, Gustavo F. and Orji, Rita and Vella, Kellie and Johnson, Daniel and van Dooren, Marierose M.M. and Nacke, Lennart E.},
booktitle = {Proceedings of the 2017 Annual Symposium on Computer-Human Interaction in Play - CHI PLAY '17 Extended Abstracts},
doi = {10.1145/3130859.3131442},
isbn = {9781450351119},
keywords = {Gameful Design,Games,Gamification,Health,Positive Computing,Positive Gaming,Wellbeing},
publisher = {ACM},
title = {{Positive Gaming : Workshop on Gamification and Games for Wellbeing}},
year = {2017}
}

Gamification and games have been used and studied in a variety of applications related with health and wellbeing. Nevertheless, there are very few studies aimed at designing games (whether serious games or recreational games) or gameful applications for improving wellbeing or flourishing – the pursuit of a happy and meaningful life, rather than the avoidance of illness. Therefore, this full-day Workshop aims to form a community, discuss theoretical and practical considerations, and promote the development of research projects focused on “Positive Gaming” – the use of gamification and games as tools for realizing Positive Computing objectives. This will create the opportunities for interested researchers to form a common understanding, develop methods and procedures, and establish a roadmap for future research in Positive Gaming.

Towards Personality-driven Persuasive Health Games and Gamified Systems

@inproceedings{Orji2017,
abstract = {Persuasive games and gamified systems are effective tools for motivating behavior change using various persuasive strategies. Research has shown that tailoring these systems can increase their efficacy. However, there is little knowledge on how game-based persuasive systems can be tailored to individuals of various personality traits. To advance research in this area, we conducted a large-scale study of 660 participants to investigate how different personalities respond to various persuasive strategies that are used in persuasive health games and gamified systems. Our results reveal that people's personality traits play a significant role in the perceived persuasiveness of different strategies. Conscientious people tend to be motivated by goal setting, simulation, self-monitoring and feedback; people who are more open to experience are more likely to be demotivated by rewards, competition, comparison, and cooperation. We contribute to the CHI community by offering design guidelines for tailoring persuasive games and gamified designs to a particular group of personalities.},
author = {Orji, Rita and Nacke, Lennart E. and DiMarco, Chrysanne},
booktitle = {Proceedings of the SIGCHI Conference on Human Factors in Computing Systems},
doi = {10.1145/3025453.3025577},
isbn = {9781450346559},
publisher = {ACM},
title = {{Towards Personality-driven Persuasive Health Games and Gamified Systems}},
year = {2017}
}

Persuasive games and gamified systems are effective tools for motivating behavior change using various persuasive strategies. Research has shown that tailoring these systems can increase their efficacy. However, there is little knowledge on how game-based persuasive systems can be tailored to individuals of various personality traits. To advance research in this area, we conducted a large-scale study of 660 participants to investigate how different personalities respond to various persuasive strategies that are used in persuasive health games and gamified systems. Our results reveal that people’s personality traits play a significant role in the perceived persuasiveness of different strategies. Conscientious people tend to be motivated by goal setting, simulation, self-monitoring and feedback; people who are more open to experience are more likely to be demotivated by rewards, competition, comparison, and cooperation. We contribute to the CHI community by offering design guidelines for tailoring persuasive games and gamified designs to a particular group of personalities.

Using technology to boost employee wellbeing? How gamification can help or hinder results

@inproceedings{Pogrebtsova2017,
abstract = {Research can help improve the lives of employees by revealing ways in which technology can be leveraged to progress innovative, time and cost-effective ways to promote their wellbeing. However, even with the trends of building “positive organizations” and promoting employees' wellbeing using the latest technologies in today's best companies worldwide, there has been a lack of rigorous research to provide solid evidence for these decisions. In this review, we present a call for future research to integrate and test technologically facilitated positive psychology interventions with gamification elements to better understand how to minimize harm and promote user benefits. We review the current online positive psychology intervention research, which we argue provides a critical guide for the development of future wellbeing technology. We also explore how gamification shows promise for promoting the benefits of positive psychology interventions (e.g., user enjoyment, autonomous motivation), as well as areas where gamification can pose a threat to wellbeing. There may be a fine line between harmful and helpful wellbeing solutions in our connected and technologically driven world of work; research now needs to uncover where to draw that line.},
address = {Amsterdam, Netherlands},
author = {Pogrebtsova, Ekaterina and Tondello, Gustavo F. and Premsukh, Hardy and Nacke, Lennart E.},
booktitle = {Positive Gaming: Workshop on Gamification and Games for Wellbeing},
keywords = {Wellbeing,gamification,positive organizations,positive psychology},
title = {{Using technology to boost employee wellbeing ? How gamification can help or hinder results}},
year = {2017}
}

Research can help improve the lives of employees by revealing ways in which technology can be leveraged to progress innovative, time and cost-effective ways to promote their wellbeing. However, even with the trends of building “positive organizations” and promoting employees’ wellbeing using the latest technologies in today’s best companies worldwide, there has been a lack of rigorous research to provide solid evidence for these decisions. In this review, we present a call for future research to integrate and test technologically facilitated positive psychology interventions with gamification elements to better understand how to minimize harm and promote user benefits. We review the current online positive psychology intervention research, which we argue provides a critical guide for the development of future wellbeing technology. We also explore how gamification shows promise for promoting the benefits of positive psychology interventions (e.g., user enjoyment, autonomous motivation), as well as areas where gamification can pose a threat to wellbeing. There may be a fine line between harmful and helpful wellbeing solutions in our connected and technologically driven world of work; research now needs to uncover where to draw that line.

Year 2016

ABOVE WATER: An Educational Game for Anxiety

@inproceedings{Wehbe2016,
Abstract = {We present Above Water - a digital/physical hybrid game to inform people about the available strategies to cope with two types of Anxiety Disorders - Generalized Anxiety Disorder and Panic Disorder. The game teaches players about existing treatments. This hybrid game is designed to inspire players to share their experiences and develop their own personal narrative. The document also outlines an assessment strategy to study the game and determine its effectiveness as a game for health. The game is designed to educate non-institutionalized individuals with clinical anxiety and panic disorder. Potential players may be diagnosed, seeking intervention information, or a supportive friend.},
Address = {Austin, TX, USA},
Author = {R. R. Wehbe, D. K. Watson, G. F. Tondello, M. Ganaba, M. Stocco, A. Lee, and L. E. Nacke},
Booktitle = {Proceedings of the 2016 annual symposium on computer-human interaction in play extended abstracts - chi play ea '16},
Doi = {10.1145/2968120.2971804},
File = {::},
Img = {http://hcigames.com/wp-content/uploads/2016/08/anxiety.jpg},
Keywords = {Game for Health, Psychology, Mental Health},
Publisher = {ACM},
Title = {ABOVE WATER: An Educational Game for Anxiety},
Url = {https://hcigames.com/download/above-water-educational-game-anxiety},
Year = {2016},

We present Above Water - a digital/physical hybrid game to inform people about the available strategies to cope with two types of Anxiety Disorders - Generalized Anxiety Disorder and Panic Disorder. The game teaches players about existing treatments. This hybrid game is designed to inspire players to share their experiences and develop their own personal narrative. The document also outlines an assessment strategy to study the game and determine its effectiveness as a game for health. The game is designed to educate non-institutionalized individuals with clinical anxiety and panic disorder. Potential players may be diagnosed, seeking intervention information, or a supportive friend.

ABOVE WATER: Extending the Play Space for Health

@inproceedings{Wehbe2016a,
Abstract = {ABOVE WATER is a game that disseminates information about Clinical Anxiety Disorders, particularly Generalized Anxiety Disorder and Panic Disorder. This game focuses on teaching players about treatments as well as providing a safe space for discussion of personal experiences. This game focuses on using the physical world (physical space, physical and tangible cards) and the digital world (accessible by any phone or tablet with a modern web browser) as part of its gameplay.},
Address = {Niagara Falls, ON, Canada},
Author = {R. R. Wehbe, D. K. Watson, G. F. Tondello, and L. E. Nacke},
Booktitle = {Proceedings of the 2016 international conference on interactive surfaces and spaces - iss '16},
Doi = {10.1145/2992154.2996882},
File = {::},
Img = {http://hcigames.com/wp-content/uploads/2016/08/anxiety.jpg},
Keywords = {Games for Health, Mobile Games, Psychology},
Publisher = {ACM},
Title = {ABOVE WATER: Extending the Play Space for Health},
Url = {https://hcigames.com/download/above-water-extending-play-space-for-health},
Year = {2016},

ABOVE WATER is a game that disseminates information about Clinical Anxiety Disorders, particularly Generalized Anxiety Disorder and Panic Disorder. This game focuses on teaching players about treatments as well as providing a safe space for discussion of personal experiences. This game focuses on using the physical world (physical space, physical and tangible cards) and the digital world (accessible by any phone or tablet with a modern web browser) as part of its gameplay.

Design Strategies for Gamified Physical Activity Applications for Older Adults

@inproceedings{Kappen2016,
abstract = {Staying physically active is essential to wellbeing in late life. However, many older adults experience barriers to physical activity. Past research has investigated the development of playful interactive systems to support exercise routines and reduce access barriers. Yet, little research has been done on older adults' needs and preferences regarding technologies that support physical activity. We address this issue through an exploration of older adults' exercise motivations grouped around themes relevant to technology design. We conducted semi-structured interviews with 19 older adults, and followed up with a focus group study of physical trainers and older adults with an active lifestyle. Based on our results, we discuss their conflicting perspectives and challenges on exercise and technology, which leads us to contribute design strategies to support designers as well as researchers wishing to create meaningful and playful fitness applications for older adults.},
author = {Kappen, Dennis L. and Nacke, Lennart E. and Gerling, Kathrin M. and Tsotsos, Lia E.},
booktitle = {Proceedings of the Annual Hawaii International Conference on System Sciences-49},
doi = {10.1109/HICSS.2016.166},
file = {:C$\backslash$:/Users/Gustavo/Dropbox/PhD/HCI Games Publications/2016/Design Strategies for Gamified Physical Activity Applications for Older Adults.pdf:pdf},
mendeley-groups = {HCI Games Group Publications},
pages = {1309--1318},
title = {{Design Strategies for Gamified Physical Activity Applications for Older Adults}},
year = {2016}
}

Staying physically active is essential to wellbeing in late life. However, many older adults experience barriers to physical activity. Past research has investigated the development of playful interactive systems to support exercise routines and reduce access barriers. Yet, little research has been done on older adults’ needs and preferences regarding technologies that support physical activity. We address this issue through an exploration of older adults’ exercise motivations grouped around themes relevant to technology design. We conducted semi-structured interviews with 19 older adults, and followed up with a focus group study of physical trainers and older adults with an active lifestyle. Based on our results, we discuss their conflicting perspectives and challenges on exercise and technology, which leads us to contribute design strategies to support designers as well as researchers wishing to create meaningful and playful fitness applications for older adults.

Year 2015

Adaptive Engagement of Older Adults’ Fitness through Gamification

@inproceedings{Kappen2015,
Abstract = {Many older adults lead sedentary lifestyles, as the challenges of aging can complicate efforts to maintain a healthy level of physical activity. These challenges can include decreasing strength, reduced mental capacity, social isolation, and the development of chronic health conditions. My PhD research attempts to analyze the needs and challenges of older adults and review their attitudes and motivations towards physical activity (PA). Furthermore, I aim to investigate various approaches in the development of socially interactive fitness activity programs, with the goal of increasing positive lifestyle motivations and quality of life (QoL). This research defines a taxonomy of motivational and personality characteristics of older adults to engage in PA. Lastly, this dissertation proposes the development of an adaptive application that addresses fitness gamification from the motivational perspective of an older adult. This application will empower older adults to engage in PA as a means to gain freedom, mobility and social interdependence within their public spheres.},
Address = {London, United Kingdom},
Author = {D. L. Kappen},
Booktitle = {Proceedings of chi play 2015},
Doi = {10.1145/2793107.2810276},
File = {::},
Img = {http://hcigames.com/wp-content/uploads/2015/10/DC.jpg},
Isbn = {9781450334662},
Keywords = {elderly,entertainment technology,game design,gamification,human factors,interaction design,older adults,social interaction,usability},
Publisher = {ACM},
Title = {Adaptive Engagement of Older Adults’ Fitness through Gamification},
Url = {https://hcigames.com/download/adaptive-engagement-of-older-adults-fitness-through-gamification},
Year = {2015},@inproceedings{Kappen2015,

Many older adults lead sedentary lifestyles, as the challenges of aging can complicate efforts to maintain a healthy level of physical activity. These challenges can include decreasing strength, reduced mental capacity, social isolation, and the development of chronic health conditions. My PhD research attempts to analyze the needs and challenges of older adults and review their attitudes and motivations towards physical activity (PA). Furthermore, I aim to investigate various approaches in the development of socially interactive fitness activity programs, with the goal of increasing positive lifestyle motivations and quality of life (QoL). This research defines a taxonomy of motivational and personality characteristics of older adults to engage in PA. Lastly, this dissertation proposes the development of an adaptive application that addresses fitness gamification from the motivational perspective of an older adult. This application will empower older adults to engage in PA as a means to gain freedom, mobility and social interdependence within their public spheres.

Towards a Personalized Playful Digital Wellness Assistant

@inproceedings{Tondello2015b,
Abstract = {Positive effects of using digital games to improve personal health have been studied, but it remains unclear which game design techniques are most successful at motivating and changing long-term behaviour to improve wellbeing. To inform the design of gamified and effective personal healthcare, we will develop design guidelines and tools for gameful health and wellbeing applications, personalized to the needs and challenges of each individual user.},
Address = {London, UK},
Author = {G. F. Tondello, R. R. Wehbe, and L. E. Nacke},
Booktitle = {Workshop on personalization in serious and persuasive games and gamified interactions},
File = {::},
Img = {http://hcigames.com/wp-content/uploads/2015/10/squash-793062_640.jpg},
Keywords = {Adaptive Systems,Health Games,Personal Assistant,Personalization,Persuasive Technologies,Wellness},
Title = {Towards a Personalized Playful Digital Wellness Assistant},
Url = {https://hcigames.com/download/towards-a-personalized-playful-digital-wellness-assistant},
Year = {2015},

Positive effects of using digital games to improve personal health have been studied, but it remains unclear which game design techniques are most successful at motivating and changing long-term behaviour to improve wellbeing. To inform the design of gamified and effective personal healthcare, we will develop design guidelines and tools for gameful health and wellbeing applications, personalized to the needs and challenges of each individual user.

Year 2014

Social Player Analytics in a Facebook Health Game

@inproceedings{Nacke:2014:SPA:2729485.2729512,
Abstract = {Social health games can drive healthy behaviour. To track social behaviour change in social network games (SNGs), gameplay metrics should quantify socially-engaging gameplay behaviour based on player interactions. We developed social player metrics in a quantitative study of player behaviour in a social health game called Healthseeker (developed by Ayogo Health Inc.). This Facebook game targets people with diabetes to help them manage health goals in real life. Our metrics identify which game mechanics led to more gameplay success, connectedness and virality. We also identified how the behaviour of successful players differs from unsuccessful players in the game. Our results support that game mechanics aiming at social interactions can motivate players to solve more missions, to fulfill more healthy goals and to play the game longer. We conclude that having a well-connected social network can improve player success in solving game missions.},
Address = {Seoul, Republic of Korea},
Author = {L. E. Nacke, M. Klauser, and P. Prescod},
Booktitle = {Proceedings of HCI Korea},
Img = {http://hcigames.com/wp-content/uploads/2015/05/HealthSeeker.png},
Isbn = {978-89-6848-752-1},
Numpages = {8},
Pages = {180-187},
Publisher = {Hanbit Media, Inc.},
Series = {HCIK '15},
Title = {Social Player Analytics in a Facebook Health Game},
Url = {https://hcigames.com/download/social-player-analytics-in-a-facebook-health-game},
Year = {2014},

Social health games can drive healthy behaviour. To track social behaviour change in social network games (SNGs), gameplay metrics should quantify socially-engaging gameplay behaviour based on player interactions. We developed social player metrics in a quantitative study of player behaviour in a social health game called Healthseeker (developed by Ayogo Health Inc.). This Facebook game targets people with diabetes to help them manage health goals in real life. Our metrics identify which game mechanics led to more gameplay success, connectedness and virality. We also identified how the behaviour of successful players differs from unsuccessful players in the game. Our results support that game mechanics aiming at social interactions can motivate players to solve more missions, to fulfill more healthy goals and to play the game longer. We conclude that having a well-connected social network can improve player success in solving game missions.