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Publication: Kappen, D. L., Mirza-Babaei, P., & Nacke, L. E. (2018). Gamification of Older Adults ’ Physical Activity: An Eight-Week Study. In Proceedings of the Annual Hawaii International Conference on System Sciences-51.
Game-based technology that makes mundane tasks more interesting and playful by appealing to our emotions is becoming more popular. This is also known as gamification, which is the process of using game design principles (Kappen & Nacke, 2013) in non-game contexts (Deterding, Dixon, Khaled, & Nacke, 2011; Juho Hamari, Koivisto, & Sarsa, 2014). Research suggests that gamified fitness applications are one way to engage people in regular physical activity (PA) (Lister, West, Cannon, Sax, & Brodegard, 2014). However, not all older adults are physically active in the same way, and they often face more substantial cognitive and physical challenges compared to a younger population.
Our recently published paper (HICSS -51, 2018) addresses the problem of investigating the disenchantment of older adults with PA, reasons for their lack of engagement with PA, and contributes motivational affordances for PA technology. We conducted an experimental eight-week study that was a synchronous, three-condition (gamified, non-gamified, control), with a total of 30 participants. Results of the qualitative analysis indicated that technology facilitation of PA was prevalent in the gamified and the non-gamified groups of participants. From a technology artifact perspective, results also indicated granular categorizations for PA motivation, setting up goals, feeling of accomplishments, rewards, and tracking of PA. Quantitative analysis of the data also yielded significant differences between the groups with higher engagement for gamified and non-gamified groups. These results indicated that technology facilitation of PA can be achieved through the usage of motivational affordances as behavior change technologies using the gamification construct.
Gamified PA Interventions and Older Adults
While prior research indicated the relevance of intrinsic motivations in traditional PA, preliminary studies investigating motivations of older adults’ towards technology-facilitated PA, indicated the impact of intrinsic motivations for successful gamified PA (Kappen, Nacke, Gerling, & Tsotsos, 2016).
Current research does not identify specific motivational affordances for older adults to participate in PA or daily exercise using gamified technology. An understanding of these motivational affordances specific to older adults is important for developing technology to foster increased adherence to PA through gamification. Our study helped to further this understanding of PA motivation by identifying intrinsic, extrinsic, and feedback elements of gamified PA technology.
Research Questions
Our main research questions were:
How can gamification elements be used to foster the intrinsic and extrinsic motivations for physical activity and daily exercise routines among older adults?
How can customization of gamification elements be done for PA applications for this demographic?
In the related literature, a minimum effective exercise program for habit formation was six weeks (Kaushal & Rhodes, 2015; Martinson et al., 2010; van der Bij, Laurant, & Wensing, 2002). Therefore, we designed our PA intervention for older adults (50+) over an eight-week study period in a synchronous, three-condition study (N=30). Participants were randomized to one of three conditions:
- Group 1: Physically active and use of a gamified physical activity app (Spirit50)
- Group 2: Physically active and use of a pedometer
- Control: Physically active
Baseline current PA was assessed using the International Physical Activity Questionnaire (IPAQ) (IPAQ-Group, 2005). All participants filled in a questionnaire once a week, for eight weeks, which combined the following scales (dependent variables):
- Measuring the enjoyment and engagement of the participants over the eight-week period using the self-report Intrinsic Motivation Scale (IMI),(45 item, 7-point Likert scale, 1 = not at all true, 7 = very true) (Lavigne et al., 2009)
- Measuring the motivation aspect of the participants over the eight-week period using the self-report Psychological Need Satisfaction in Exercise Scale instrument (PNSE) ),(24 item, 7-point Likert scale, 1= not at all true, 7 = very true) (Wilson, Rogers, Rodgers, & Wild, 2006)
- Measuring exertion using the Rating of Perceived Exertion scale (RPE) (Borg, 1982) after each session
Participants were also interviewed once a week for the period of the study. They had the option of being interviewed over the phone, Skype, or answering the interview and the self-report questions online.
Data Collection and Analysis
Data were gathered as qualitative information from responses to interview questions and quantitative scale data from the motivation questionnaires.
Data Analysis – Interviews
With three groups of participants, 10 participants in each group for eight-week sessions, we had 240 instances of data collection points. There were 100 audio recordings of interviews from participants from the three groups. Each recording spanned an average of 15 minutes. In addition, answers to interview questions were provided in written format and online or via emails. The audio recordings were transcribed to text using Transcribe[1], an online transcription tool. Once transcribed, the answers were collated under the six interview questions listed in the Interview Protocol section. This resulted in six Excel spreadsheets under the following interview questions: motivation to participate in PA, setting up goals to participate in PA, fears or barriers to participate in PA, accomplishments, rewards, and tracking.
Grounded Theory Bifurcation
Since its inception in 1967 (Glaser & Strauss, 1967), grounded theory (GT) has bifurcated into two methodical approaches: Glasser’s traditional method and the Strauss et al. approach (Heath & Cowley, 2004; Walker & Myrick, 2006). While Glasser’s traditional method is recognized as the original GT method which had a more inductive method, many researchers have used the Strauss method because of its flexibility with respect to deductive and inductive analysis, ease of data management and code saturation (Eduardo, 2009; Heath & Cowley, 2004; Walker & Myrick, 2006). In this study, we used the GT analysis as proposed by Strauss where code saturation was achieved by coding until no new code emerged (Charmaz, 2006; Corbin & Strauss, 2015).
Data Analysis – Questionnaires
The data from the weekly report of the IMI engagement and enjoyment) and PNSE (motivation) and RPE questionnaire were analyzed using SPSS. We had 10 participants in each group giving us a total of 80 responses (240 items for 3 groups) in each group
Results
Based on the findings from analysis of qualitative data, we illustrate the elements are crucial for facilitating engagement and enjoyment in PA for older adults through gamification. In the paper, we propose the term adaptive engagement which means: tailoring of older adults’ engagement through customization and personalization of motivational affordances for PA. Based on the clustering of motivational affordances (J Hamari & Koivisto, 2013; Romero, Sturm, Bekker, de Valk, & Kruitwagen, 4392), we categorize emergent motivational affordances into intrinsic, extrinsic, and feedback elements.
| Intrinsic Motivation Elements | Guidelines |
| Attainable goals | Understanding the ability that is specific on an individual level should be the focus of PA goals (quests). |
| Challenges mirroring ability | Increasing challenges progressively to reflect the individual’s ability so that it inspires confidence and provides a sense of accomplishment. |
| Increased agency | Challenges and levels should provide older adults with the feeling of a sense of being in control of their bodies based on their own physical limitations. |
| Choice of types of exercises | Combining activities to provide exercise and PA that improve endurance, flexibility, strength training within an indoor and outdoor environment. |
| Choice of intensity increases or decreases | Gamification of PA activities should have provisions of trying out new challenges or change the intensity level so that the activity feels like a challenge or have the potential of downgrading the challenge. |
| Inspiring curiosity | Gamification elements should provide the opportunity to provide a mystery PA module for older adults to try out for a new reward. |
| Interjecting unpredictability | The opportunity to do random PA activities to increase levels and rewards fosters the element of engaged participation. |
| Facilitating spontaneity and instantaneous gratification | Include elements that allow for spontaneous PA and instantaneous gratification in the form of feeling the burn, completion, achievement as internalized rewards. |
| Freedom of usage and habit formation | Allowing the possibility of activities to be done anywhere and anytime with simplicity and memorability to help with habit formation. |
| Facilitating competency | Providing challenges that help promote health benefits and increased mental satisfaction. |
| Social facilitation | Providing the possibility for older adults to share and post achievements, challenges with specific routines. |
Table 1: Adaptive Engagement Guidelines-1
| Extrinsic Motivation Elements | Guidelines |
| Attainable rewards | Challenges should provide the opportunity of instantaneous rewards while scaffolding to inspire active participation. It gives older adults the feeling of satisfaction that certain tasks and milestones are achievable based on their ability, rewarded and measurable. |
| Validation of efforts | While receiving points and stars seemed frivolous, its attainment after doing PA activity provided a sense of validation of one’s efforts. |
| Progression reflecting ability | Progression should show the competence of older adults in being able to do a specific level to afford a sense of accomplishment. |
| Progression reflecting efforts | Combining activities to offer exercise activities that provide endurance, flexibility, and strength training within an indoor and outdoor environment. |
| Highlighting achievements | Providing badges and points that help to showcase their achievements and completion of difficult challenges. |
| Intangible rewards | Rewarding ability to perform the tasks and complete the tasks and providing the opportunity for bragging rights, recognition, as well as achievement levels will contribute to engagement and enjoyment of the PA activity. |
| Tangible rewards | Facilitate usage of experience points earned to be redeemed for ancillary contexts such as diet plans, fitness plans, fitness gear, books and competitions. |
Table 2: Adaptive Engagement Guidelines -2
| Feedback Cycle Elements | Guidelines |
| Correctness of form | Real-time feedback on posture correction, gait and correctness of stance when doing the exercise routines is a difficult technology challenge but was desired by many older adults for increased participation. |
| Performance characteristics | The possibility of providing feedback on reps and steps, speed of completion, and tracking metrics such as calorie burn, heart rate, weight loss provides increased engagement |
| Encouragement through praise | Real-time feedback in the form of praise and checkmarks for task completion through the gamification app will help to reassure older adults |
| Visual representation of progression | Progression representation of daily, weekly and monthly indicating competence in all or specific activities in a graph format is more easily understandable by older adults |
| Onboarding and education | Older adults should have the opportunity to overcome challenges with understanding game, gaming and gamification terminology through training and education modules of the gamification app |
Table 3: Adaptive Engagement Guidelines -3
Original Publication:
Kappen, D. L., Mirza-Babaei, P., & Nacke, L. E. (2018). Gamification of Older Adults ’ Physical Activity : An Eight-Week Study. In Proceedings of the Annual Hawaii International Conference on System Sciences-51.https://scholarspace.manoa.hawaii.edu/handle/10125/50036
Powerpoint: Slideshare
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