Basics of qualitative research: Grounded theory procedures and techniques

Gamification has drawn the attention of academics, practitioners and business professionals in domains as diverse as education, information studies, human-computer interaction, and health. As yet, the term remains mired in diverse meanings and contradictory uses, while the concept faces division on its academic worth, underdeveloped theoretical foundations, and a dearth of standardized guidelines for application. Despite widespread commentary on its merits and shortcomings, little empirical work has sought to validate gamification as a meaningful concept and provide evidence of its effectiveness as a tool for motivating and engaging users in non-entertainment contexts. Moreover, no work to date has surveyed gamification as a field of study from a human-computer studies perspective. In this paper, we present a systematic survey on the use of gamification in published theoretical reviews and research papers involving interactive systems and human participants. We outline current theoretical understandings of gamification and draw comparisons to related approaches, including alternate reality games (ARGs), games with a purpose (GWAPs), and gameful design. We present a multidisciplinary review of gamification in action, focusing on empirical findings related to purpose and context, design of systems, approaches and techniques, and user impact. Findings from the survey show that a standard conceptualization of gamification is emerging against a growing backdrop of empirical participants-based research. However, definitional subjectivity, diverse or unstated theoretical foundations, incongruities among empirical findings, and inadequate experimental design remain matters of concern. We discuss how gamification may to be more usefully presented as a subset of a larger effort to improve the user experience of interactive systems through gameful design. We end by suggesting points of departure for continued empirical investigations of gamified practice and its effects. We present findings from a survey of the gamification literature.Theoretical findings suggest that gamification is a distinct concept.Conceptual foundations tend to converge on psychological theories of motivation.Early applied work suggests positive-leaning but mixed results.Empirical work on specific elements with direct ties to theory and stronger experimental designs is needed.

Gamification in theory and action

https://cyberleninka.org/article/n/140802.pdf

Gamification for Health and Wellbeing : A Systematic Review of the Literature

The rise of motivational information systems: A review of gamification research

This paper examines the state of the art in mobile clinical and health-related apps. A 2012 estimate puts the number of health-related apps at no fewer than 40,000, as healthcare professionals and consumers continue to express concerns about the quality of many apps, calling for some form of app regulatory control or certification to be put in place. We describe the range of apps on offer as of 2013, and then present a brief survey of evaluation studies of medical and health-related apps that have been conducted to date, covering a range of clinical disciplines and topics. Our survey includes studies that highlighted risks, negative issues and worrying deficiencies in existing apps. We discuss the concept of ‘apps as a medical device’ and the relevant regulatory controls that apply in USA and Europe, offering examples of apps that have been formally approved using these mechanisms. We describe the online Health Apps Library run by the National Health Service in England and the calls for a vetted medical and health app store. We discuss the ingredients for successful apps beyond the rather narrow definition of ‘apps as a medical device’. These ingredients cover app content quality, usability, the need to match apps to consumers’ general and health literacy levels, device connectivity standards (for apps that connect to glucometers, blood pressure monitors, etc.), as well as app security and user privacy. ‘Happtique Health App Certification Program’ (HACP), a voluntary app certification scheme, successfully captures most of these desiderata, but is solely focused on apps targeting the US market. HACP, while very welcome, is in ways reminiscent of the early days of the Web, when many “similar” quality benchmarking tools and codes of conduct for information publishers were proposed to appraise and rate online medical and health information. It is probably impossible to rate and police every app on offer today, much like in those early days of the Web, when people quickly realised the same regarding informational Web pages. The best first line of defence was, is, and will always be to educate consumers regarding the potentially harmful content of (some) apps.

/pdf/mobile-medical-and-health-apps-state-of-the-art-concerns-2omrhasv0g.pdf

Mobile medical and health apps: state of the art, concerns, regulatory control and certification

Background: The use of mHealth apps has shown improved health outcomes in adult populations with type 2 diabetes mellitus. However, this has not been shown in the adolescent type 1 population, despite their predisposition to the use of technology. We hypothesized that a more tailored approach and a strong adherence mechanism is needed for this group. Objective: To design, develop, and pilot an mHealth intervention for the management of type 1 diabetes in adolescents. Methods: We interviewed adolescents with type 1 diabetes and their family caregivers. Design principles were derived from a thematic analysis of the interviews. User-centered design was then used to develop the mobile app bant . In the 12-week evaluation phase, a pilot group of 20 adolescents aged 12–16 years, with a glycated hemoglobin (HbA 1c ) of between 8% and 10% was sampled. Each participant was supplied with the bant app running on an iPhone or iPod Touch and a LifeScan glucometer with a Bluetooth adapter for automated transfers to the app. The outcome measure was the average daily frequency of blood glucose measurement during the pilot compared with the preceding 12 weeks. Results: Thematic analysis findings were the role of data collecting rather than decision making ; the need for fast, discrete transactions ; overcoming decision inertia ; and the need for ad hoc information sharing . Design aspects of the resultant app emerged through the user-centered design process, including simple, automated transfer of glucometer readings; the use of a social community; and the concept of gamification, whereby routine behaviors and actions are rewarded in the form of iTunes music and apps. Blood glucose trend analysis was provided with immediate prompting of the participant to suggest both the cause and remedy of the adverse trend. The pilot evaluation showed that the daily average frequency of blood glucose measurement increased 50% (from 2.4 to 3.6 per day, P = .006, n = 12). A total of 161 rewards (average of 8 rewards each) were distributed to participants. Satisfaction was high, with 88% (14/16 participants) stating that they would continue to use the system. Demonstrating improvements in HbA 1c will require a properly powered study of sufficient duration. Conclusions: This mHealth diabetes app with the use of gamification incentives showed an improvement in the frequency of blood glucose monitoring in adolescents with type 1 diabetes. Extending this to improved health outcomes will require the incentives to be tied not only to frequency of blood glucose monitoring but also to patient actions and decision making based on those readings such that glycemic control can be improved. [J Med Internet Res 2012;14(3):e70]

Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study

mHealth applications, or “apps” as they are more commonly known, offer the opportunity to improve healthcare delivery and clinical outcomes. The ability to monitor patients remotely can enable patient risk-factor management and improve treatment compliance, thus allowing early detection of medical complications and ultimately preventing unnecessary hospitalizations. In addition to enhancing the delivery of care, one of the most significant opportunities that mHealth offers is in the consumer health domain, allowing patients to actively engage in and self manage their condition. Mobile phones also allow for the design of timely interventions based on user behavior. mHealth-mediated behavioral interventions can produce cognitive, behavioral, emotional, and social health-oriented responses. As such, mHealth apps are particularly appropriate for problems where treatments depend on patient behavioral change, such as those related to smoking, obesity, diabetes, and other chronic conditions. Despite the many potential benefits of mHealth apps, pilot studies aimed at evaluating the effectiveness of mHealth interventions have yielded mixed results. Furthermore, a quarter of all app downloads are used only once. Consumers often do not return to applications that do not immediately engage them, therefore undermining the intervention’s potential effectiveness. Regrettably, there is no simple formula for designing engaging and effective mHealth apps. Currently, many electronic health (eHealth) and mHealth interventions are designed on the basis of existing healthcare system constructs and may not be as effective as those that involve end users in the design process. Moreover, designers often base their designs on assumptions that are not validated with primary user input. The resulting systems may lack key features, and subsequent evaluations of the effectiveness of the interventions may be compromised. For this reason, we employ the user-centered design (UCD) process—an evidence-based approach informed by the needs and understanding of a specific end-user group. In our experience, designing mHealth and other apps, UCD plays a key role in achieving user engagement, thus improving the likelihood of the intervention’s effectiveness. The World Health Organization agrees, and advises that user evaluation be incorporated into the mHealth project lifecycle to ensure effective outcomes. mHealth Consumer Apps The Case for User-Centered Design

Mark Casselman

Papers

Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study

mHealth Consumer Apps: The Case for User-Centered Design

133. Bant: An mHealth App for Adolescent Type I Diabetes – A Pilot Study