One good thing about a zombie apocalypse is that escaping one's own zombification, and ultimately the end of civilization, is likely to include a lot of running.
What a great opportunity to burn off a few extra calories! At least that was the hope of the designers of Zombies, Run! – a game app designed to motivate people for fitness by guiding them through missions and stories requiring running in order to avoid the end of humanity (or at least their own zombification).
This is an extreme example of gamification – the practice of adding aspects of games to non-game contexts to boost motivation and engagement. With video gaming now mainstream (there were more than 2.5 billion gamers worldwide in 2021), game designers have developed increasingly sophisticated ways to capture imaginations, and can make use of the multiple sensors built into mobile technologies to track and motivate behavior.
Most gamification tactics do not involve mythical creatures or imaginary adventures. More commonly, wellness program designers will employ simpler tactics, such as awarding points and badges for desired behaviors, allowing users to create avatars, or developing leader boards so that gamers can compete with one another. Could such gamification strategies work for insurers who, as RGA research shows, want to engage customers and motivate healthier behaviors?
Certainly, digital wellness engagement and retention rates are often quite low: According to some research, 75% of digital wellness app users drop off within the first 90 days, and determining how best an app can motivate healthy behaviors can be a difficult challenge to navigate. Strategies are needed to inspire users and to improve stickiness. But does the success of video games really mean wellness app designers can simply borrow gaming principles and expect success?
A common misconception is that incorporating gaming tactics into any wellness program or app will make it more engaging. Although research shows that gamification can have a positive impact on health behavior, it is easy for wellness designers to fail to understand gamification’s limits.
For example, it would be easy to assume that because “unlocking” achievements is a common reward for progressing through video games, digital wellness app users would be motivated by achievement badges that are unlocked for achieving particular behavior landmarks. This type of tactic mistakes the surface-level game device, e.g., receiving a badge, for the actual psychological elements that govern user motivations. Simply put, if a user does not derive any sense of value from the badge, it is unlikely to be a meaningful way to provide motivation.
It is vital, then, that designers base any gamification tactics incorporated into a wellness or fitness app on recognized elements of the psychology of behavior change.
Behavioral science has identified several techniques for which there is good evidence of positive effects on behavior. Many of these techniques can be used in wellness app gamification, such as goal-setting, performance feedback, reinforcing behavior with rewards and punishments, and fostering friendly competition.
Designers wanting to optimize the gamification aspect of the digital wellness user experience (UX) need to place the science of motivation at the heart of their designs. This means understanding what confers value to users: social recognition, achieving or making progress towards internalized goals, feeling competent, or even financial gain. It also means understanding users’ motivations in the wellness program’s unique context through rigorous research and testing.
Gamified digital wellness is likely to be more successful when the behavior change techniques it incorporates supports users’ existing motivations for engaging in particular behaviors, rather than trying to create new motivations. Take, for example, the behavior change technique of goal-setting. Gamified apps often set implicit goals for users by offering missions and challenges. However, it is rarer that apps are configured to allow users to decide on their own goals – whether a short-term quantitative target such as a number of steps, or a long-term qualitative goal such as being able to play a certain sport at a higher level, staying healthy, or even getting into shape for a beach holiday.
The extent to which gamification can support deeper psychological needs and latent motivations is likely to dictate its success. Game features which have no bearing on users’ psychological needs are unlikely to motivate even if they come straight from the standard gamification playbook.
Gamification has achieved the buzzword badge (so to speak) in digital design and is often described as a promising design component and tactic for engaging wellness users. The evidence does show that gamification can indeed be positive. However, wellness app designers would do well to remember that borrowing features from video games without considering recognized behavior change science or users’ real psychological needs may limit their success.
Still, if designers can build an app where the experience is based on the behavioral science of motivation and understand their users’ context while injecting narrative and fun into experiences, it can be a recipe for stronger engagement.
Importantly, wellness app designers should acknowledge that users’ intrinsic motivation is a key driving force for engagement and health behaviors. When designs can support and bring to life users’ motivations to behave in healthy ways, rather than simply injecting superficial gameplay elements, they are more likely to design excellent and successful experiences for wellness programs.
Perhaps, though, this is why wellness programs may be more successful by selecting healthy users rather than by creating healthy users out of those who, whether due to chronic health conditions or a total lack of motivation, might not be able to utilize such programs successfully. Indeed, some users may even be motivated to make behavior changes but lack the capability or opportunity to do so, due to medical conditions or other circumstances. Whether gamified experiences can cater for such individuals’ needs to make a genuine difference is unclear.
Wellness programs may be best placed to support those with latent motivations that bubble under the surface, ultimately needing just a small push, or even no push at all, to make desired behavior changes. Gamified experiences are well-placed to help those users, but gamification is not the tool to create motivations from scratch. Running from the virtual zombie apocalypse might be fun for those who just need a little nudge to get their sneakers on, but at this point may be unlikely to be the key to engaging the unmotivated.
