My Skepticism of the Gamification of Health Remains

I decided to spend some time doing further research into the gamification of health to see if I could convince myself to support the cause. I like games. I really, really do! And I want to be a supporter of the gamification of health – not a detractor. Plus there are tons of articles like this: 3 reasons gamification might get you healthy that make me want to be a believer.

Luckily, I live in Silicon Valley and it’s pretty easy to track down people that know a thing or two about gamification. I was lucky enough to find a talk by Narvalous’ CTO, Jon Thoms, formerly of Playdom, discussing game mechanics.

So with my pen and paper handy, I managed to get some nuggets of information about gaming mechanics. Gaming mechanics essentially create an artificial emptiness for an artificial good and provide instant gratification in a world that is often lacking simplicity.

Some of the most effect gaming mechanics that can be transferred into other spheres are:

• probabilistic rewards or gambling,
• visual rewards for clicking,
• the visibility of the reward being awarded, and
• creating value by scarcity (ex – making badges hard to attain).

The 4-month dilemma

 

Then came the bombshell -the lifespan of most games is approximately 4 months.

(courtesy of digitalart)

 

This means that people play the average game for no longer than 12 weeks. And if people are only playing health games for 4 months – what does this mean for the gamification of health? Either every 4 months something new needs to be introduced into a game to make it different or else in 4 months you have to manage to significantly change someone’s health habits. In the words of Georgia Tech’s Bogost: “ By gamifying the problem, you’re spreading butter over toast so it tastes better, but it doesn’t solve the problem.”

So essentially, the goal of gamifying health is to change behaviors through a repetition of actions followed by rewards for those actions. That is quite a lofty goal but leads into the interesting topic of behavior change. I came across some great information about behavior change authored by Dr. BJ Fogg at Stanford along with his Behavior Wizard tool.

Behavior Change Mechanics

According to Dr. Fogg’s Behavior Model, in order to adopt a new lifelong habit, you need to have a motivated and able person and at then trigger the person to act. However, he points out that these types of changes can be difficult to achieve and sometimes you need a little extra help such as simplifying the behavior and overcoming the unknowns involved in adopting the habit. He considers the difficulty in making the behavior simple and finding a way to trigger people to do it.

Skepticism Reigns

And that is where I get stuck. Changing health habits is complex and there are many barriers – perceived or real – that a game can simply not remove. In order to be healthy, people need to eat a balanced and healthy diet, exercise, and sleep enough. But to break down even one of these into simple steps becomes difficult. What is a healthy diet – do you follow the Healthy Eating Pyramid, the Harvard Pyramid, Paleo Diet, South Beach, etc? What exactly is a serving size of any individual item of food? And then on top of that, if the game itself is the trigger, what happens when interest in the game wanes? Does the habit end because the trigger is absent?

Whenever I get stuck, I look for research data to prove me wrong. When I went looking for data to support the efficacy of gaming in getting people to change behaviors, I didn’t find much. The gist the few papers that I did find said that it might work but that more research needs to be done.

So where’s the hard data supporting the gamification of health? Did I just not look deep enough or is it just not available yet?

In the end, I must admit that I am still a skeptic.