Gamification Use and Design in Popular Health and Fitness Mobile Applications

Purpose: To evaluate the presence of gamification in popular mobile applications and whether principles from behavioral economics were incorporated in the design. Design: The top 50 ranked free health and fitness applications were downloaded. Gamification elements were predetermined through literature review, and applications were evaluated for their presence. Setting: App Store by Apple Inc. Measures: Presence of gamification, type of game element, and use of behavioral economic principles. Analysis: We classified the types and frequencies of targeted behaviors and features of gamification. Use of behavioral economic principles focused on designing rewards or points using loss aversion (allocated upfront and could be lost), variable reinforcement (not allocated constantly), and probability inflation (using drawings or lottery designs). Results: Gamification was used by 64% of mobile applications. Most applications that included gamification (97%) targeted behaviors related to physical activity and weight loss. Applications focused on other areas such as reproductive health, meditation, and sleep used gamification less often (11%). Game elements used most commonly included goal setting (78%), social influences (78%), and challenges (63%), while less common elements included points (6%) and levels (3%). No applications incorporated behavioral economics principles specified in the study. Conclusions: Gamification was commonly used by popular health and fitness mobile applications, but none used the specified behavioral economic principles to design rewards or points. Mobile applications could potentially improve their use if their design better leveraged principles from behavioral economics.