Gamification in health behaviour change produces muddled results. Why? Because game design elements, behaviour change techniques, etc. are too decontextualised and underspecified to guide design implementation. Talk at the CBC 2018 conference "Behaviour Change for Health: Digital & Beyond", February 21, 2018, London.

1. gamification for health
behaviour change
Sebastian Deterding
@dingstweets
Digital Creativity Labs
University of York

2. a quick distinction
serious games
full-fledged games
communication,
training & transfer
gamification
game design elements
intervention,
motivating behaviour
Deterding et al., 2011

3. a quick equation
game design elements persuasive principlesbehaviour change techniques
≈ ≈
“an active component of an intervention designed to change behaviour ...
the smallest component compatible with retaining the postulated active
ingredients” (Michie & Johnson, 2013, p. 182)
Fogg, 2003; Deterding et al., 2011; Michie et al., 2013

4. Lister, West, Cannon et al., 2014
a deluge in tracking & self-management

5. the 7 promises of gamification for health behaviour change
1. intrinsic motivation: Better adoption, retention, long-term behaviour change
2. direct wellbeing support: Positive experiences directly contribute to
psychosocial wellbeing
3. broad access: Gamification uses mobile phones & ubicomp
4. broad appeal: Games are enjoyed by young & old, men & women
5. broad applicability: Gamification is used for all major chronic health risks
6. cost-benefit efficiency: Gamification is less costly than games
7. everyday life fit: Gamification directly reorganises activity rather than
demanding extra learning task & hoping for transfer of learning
Johnson, Deterding, Kuhn et al., 2016

6. putting promises to the test: a systematic review
Johnson, Deterding, Kuhn et al., 2016

7. results: a muddle
Johnson, Deterding, Kuhn et al., 2016
59% positive, 41% mixed/null, 10% negative ux effects

8. Why?

9. specific understandings and uses differ – and matter
codecademy
van Roy, Deterding & Zaman, 2018, under review; Antin & Churchill, 2011
khan academy

10. specific contexts differ – and matter
5%
500 steps
8th day without cycling – you really should step it
up! What about a 5 minute ride today? C’mon,
your friends in California did it!
Frank & Engelke, 2001

11. specific designs differ – and matter
Goveia, Pereira, Karapanos et al., 2016

12. positive-negative dynamics of gamification
+
performance feedback
goal-setting
social comparison
competenceautonomy
-
+
-
highlighting success,
superior ability
highlighting failure,
inferior ability
perceived self-determined
goal pursuit
perceived outer pressure,
social comparison
specific subject, context, design relations
work in progress

13. Motivation and behaviour
emerge from specific
subject-environment
relations.
hypothesis 1
Lewin, 1936; Gibson, 1977; Warren, 1984; Deterding, 2011

14. “Game design elements”* are therefore too
underspecified as a construct to reliably
predict effects.
hypothesis 2
* I withhold judgment on behaviour change techniques and persuasive principles.

15. We currently rely on designers to translate
our underspecified, general, analytic
constructs into local syntheses of specific
designs fitting specific contexts and users
– giving them insufficient reliable guidance.
hypothesis 3

16. a practical gap between psychology and design
“Instantiating theory is a difficult task as
theoretical constructs lack specificity for
concrete design situations.” (Hekler, Klasna,
Froehlich et al, 2013, p. 3310)
“less than half of the HCI eco-feedback papers
referenced behavioral psychology literature and
58% referenced environmental psychology
literature. Even more dramatically, no study in
environmental psychology referred back to
HCI.” (Froehlich, Linklater & Findlay, 2010, pp.
2003-2004)

17. Lomas, 2015
we need a dialogue between research and design
Application
Data

18. sebastian@digitalcreativity.ac.uk
@dingstweets
digitalcreativity.ac.uk
thank you.

19. digital creativity labs
• Impact-driven research on games and interactive media merging
data, AI, and experience design
• 30+ researchers, 100+ industry partners across York, Goldsmiths,
Falmouth
• digitalcreativity.ac.uk
sebastian deterding
• Designer/researcher working on motivational design, applied
gaming for human flourishing
• Co-editor, The Gameful World (MIT Press, 2015), founder of
Gamification Research Network, 30+ industry projects
• sebastian@digitalcreativity.ac.uk