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Published in: Prevention Science 7/2021

01-10-2021

Gamification for Family Engagement in Lifestyle Interventions: A Systematic Review

Authors: Amanda C. Blok, Thomas S. Valley, Patricia Abbott

Published in: Prevention Science | Issue 7/2021

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Abstract

The majority of chronic conditions that plague the USA are modifiable by lifestyle change. Lifestyle interventions that incorporate family members for social support and that use game design elements to engage family members have the potential to improve upon traditional interventions, which have largely been unsustainable. Determining the populations where family member support in a lifestyle intervention are present and the extent of gamification of lifestyle intervention components that engage these family members is an important and underexplored area of work. A systematic review of lifestyle interventions involving family members were reviewed for game design elements using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Game design elements related to engaged learning and motivational affordances from previous literature were included. Sixty-one studies met inclusion criteria. These studies reported on 50 independent interventions that were reviewed. Thirty-one of these interventions addressed lifestyle in those with a chronic condition, and 19 addressed lifestyle in those at high risk for chronic conditions. The majority of the lifestyle interventions included at least one game design element, yet overall there were limited elements utilized together. Compared with successful gamified programs that have greatly impacted a population’s health behaviors, there were relatively a limited number of elements reported, particularly those that support social relatedness, such as meaningful storylines. Meaningfulness of the game design elements chosen and their arrangement was not apparent. Technology was under-utilized as a potential modality for intervention component delivery. Developing products to train researchers to properly apply game design elements to intervention components, as well as test their effectiveness, are areas for future research.
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Literature
go back to reference Admiraal, W. M., Vlaar, E. M., Nierkens, V., Holleman, F., Middelkoop, B. J., Stronks, K., & van Valkengoed, I. G. (2013). Intensive lifestyle intervention in general practice to prevent type 2 diabetes among 18 to 60-year-old South Asians: 1-year effects on the weight status and metabolic profile of participants in a randomized controlled trial. PLoS One, 8, e68605. https://doi.org/10.1371/journal.pone.0068605CrossRefPubMedPubMedCentral Admiraal, W. M., Vlaar, E. M., Nierkens, V., Holleman, F., Middelkoop, B. J., Stronks, K., & van Valkengoed, I. G. (2013). Intensive lifestyle intervention in general practice to prevent type 2 diabetes among 18 to 60-year-old South Asians: 1-year effects on the weight status and metabolic profile of participants in a randomized controlled trial. PLoS One, 8, e68605. https://​doi.​org/​10.​1371/​journal.​pone.​0068605CrossRefPubMedPubMedCentral
go back to reference Aschbrenner, K., Mueser, K., Bartels, S., Carpenter-Song, E., Pratt, S., Barre, L., et al. (2015). The other 23 hours: a qualitative study of fitness provider perspectives on social support for health promotion for adults with mental illness. Health & Social Work, 40, 91–99. https://doi.org/10.1093/hsw/hlv006CrossRef Aschbrenner, K., Mueser, K., Bartels, S., Carpenter-Song, E., Pratt, S., Barre, L., et al. (2015). The other 23 hours: a qualitative study of fitness provider perspectives on social support for health promotion for adults with mental illness. Health & Social Work, 40, 91–99. https://​doi.​org/​10.​1093/​hsw/​hlv006CrossRef
go back to reference Babamoto, K. S., Sey, K. A., Camilleri, A. J., Karlan, V. J., Catalasan, J., & Morisky, D. E. (2009). Improving diabetes care and health measures among hispanics using community health workers: Results from a randomized controlled trial. Health Education & Behavior, 36, 113–126. https://doi.org/10.1177/1090198108325911CrossRef Babamoto, K. S., Sey, K. A., Camilleri, A. J., Karlan, V. J., Catalasan, J., & Morisky, D. E. (2009). Improving diabetes care and health measures among hispanics using community health workers: Results from a randomized controlled trial. Health Education & Behavior, 36, 113–126. https://​doi.​org/​10.​1177/​1090198108325911​CrossRef
go back to reference Belur, J., Tompson, L., Thornton, A., & Simon, M. (2018). Interrater reliability in systematic review methodology: Exploring variation in coder decision-making. Sociological methods & research, 0049124118799372. Belur, J., Tompson, L., Thornton, A., & Simon, M. (2018). Interrater reliability in systematic review methodology: Exploring variation in coder decision-making. Sociological methods & research, 0049124118799372.
go back to reference Bock, D. E., Robinson, T., Seabrook, J. A., Rombeek, M., Norozi, K., Filler, G., Rauch, R., & Clarson, C. L. (2014). The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study. BMC Pediatrics, 14, 296. https://doi.org/10.1186/s12887-014-0296-1 Bock, D. E., Robinson, T., Seabrook, J. A., Rombeek, M., Norozi, K., Filler, G., Rauch, R., & Clarson, C. L. (2014). The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study. BMC Pediatrics, 14, 296. https://​doi.​org/​10.​1186/​s12887-014-0296-1
go back to reference Catenacci, V. A., Barrett, C., Odgen, L., Browning, R., Schaefer, C. A., Hill, J., & Wyatt, H. (2014). Changes in physical activity and sedentary behavior in a randomized trial of an internet-based versus workbook-based family intervention study. Journal of Physical Activity and Health, 11(2), 348–358. https://doi.org/10.1123/jpah.2012-00432012-004 Catenacci, V. A., Barrett, C., Odgen, L., Browning, R., Schaefer, C. A., Hill, J., & Wyatt, H. (2014). Changes in physical activity and sedentary behavior in a randomized trial of an internet-based versus workbook-based family intervention study. Journal of Physical Activity and Health, 11(2), 348–358. https://​doi.​org/​10.​1123/​jpah.​2012-00432012-004
go back to reference Chesla, C. A., Fisher, L., Skaff, M. M., Mullan, J. T., Gilliss, C. L., & Kanter, R. (2003). Family predictors of disease management over one year in Latino and European American patients with type 2 diabetes. Family Process, 42, 375–390.CrossRef Chesla, C. A., Fisher, L., Skaff, M. M., Mullan, J. T., Gilliss, C. L., & Kanter, R. (2003). Family predictors of disease management over one year in Latino and European American patients with type 2 diabetes. Family Process, 42, 375–390.CrossRef
go back to reference Deci, E. L., & Ryan, R. M. (2012). Motivation, personality, and development within embedded social contexts: An overview of self-determination theory. Deci, E. L., & Ryan, R. M. (2012). Motivation, personality, and development within embedded social contexts: An overview of self-determination theory.
go back to reference Deci, E. L., & Vansteenkiste, M. (2004). Self-determination theory and basic need satisfaction: Understanding human development in positive psychology. Ricerche di psicologia. Deci, E. L., & Vansteenkiste, M. (2004). Self-determination theory and basic need satisfaction: Understanding human development in positive psychology. Ricerche di psicologia.
go back to reference Deterding, S., Sicart, M., Nacke, L., O'Hara, K., & Dixon, D. (2011). Gamification: Using game design elements in non-gaming contexts. ACM CHI Conference on Human Factors in Computing Systems. Deterding, S., Sicart, M., Nacke, L., O'Hara, K., & Dixon, D. (2011). Gamification: Using game design elements in non-gaming contexts. ACM CHI Conference on Human Factors in Computing Systems.
go back to reference Dickey, M. D. (2005). Engaging by design: How engagement strategies in popular computer and video games can inform instructional design. Educational Technology Research and Development, 53, 67–83.CrossRef Dickey, M. D. (2005). Engaging by design: How engagement strategies in popular computer and video games can inform instructional design. Educational Technology Research and Development, 53, 67–83.CrossRef
go back to reference Espinoza, J., Chen, A., Orozco, J., Deavenport-Saman, A., & Yin, L. (2017). Effect of personal activity trackers on weight loss in families enrolled in a comprehensive behavioral family-lifestyle intervention program in the Federally Qualified Health Center setting: a randomized controlled trial. Contemporary clinical trials communications, 7, 86-94. https://doi.org/10.1016/j.conctc.2017.06.004 Espinoza, J., Chen, A., Orozco, J., Deavenport-Saman, A., & Yin, L. (2017). Effect of personal activity trackers on weight loss in families enrolled in a comprehensive behavioral family-lifestyle intervention program in the Federally Qualified Health Center setting: a randomized controlled trial. Contemporary clinical trials communications, 7, 86-94. https://​doi.​org/​10.​1016/​j.​conctc.​2017.​06.​004
go back to reference Fedele, D., Lucero, R., Janicke, D., Abu-Hasan, M., McQuaid, E., Moon, J., Fidler, A., Wallace Farquharson, T., & Lindberg, D. (2019). Protocol for the Development of a Behavioral Family Lifestyle Intervention Supported by Mobile Health to Improve Weight Self-Management in Children With Asthma and Obesity. JMIR Research Protocol, 8(6), e13549. https://doi.org/10.2196/13549 Fedele, D., Lucero, R., Janicke, D., Abu-Hasan, M., McQuaid, E., Moon, J., Fidler, A., Wallace Farquharson, T., & Lindberg, D. (2019). Protocol for the Development of a Behavioral Family Lifestyle Intervention Supported by Mobile Health to Improve Weight Self-Management in Children With Asthma and Obesity. JMIR Research Protocol, 8(6), e13549. https://​doi.​org/​10.​2196/​13549
go back to reference Fenner, A. A., Howie, E. K., Davis, M. C., & Straker, L. M. (2016). Relationships between psychosocial outcomes in adolescents who are obese and their parents during a multi-disciplinary family-based healthy lifestyle intervention: One-year follow-up of a waitlist controlled trial (Curtin University's Activity, Food and Attitudes Program). Health and quality of life outcomes, 14(1), 100. https://doi.org/10.1186/s12955-016-0501-z Fenner, A. A., Howie, E. K., Davis, M. C., & Straker, L. M. (2016). Relationships between psychosocial outcomes in adolescents who are obese and their parents during a multi-disciplinary family-based healthy lifestyle intervention: One-year follow-up of a waitlist controlled trial (Curtin University's Activity, Food and Attitudes Program). Health and quality of life outcomes, 14(1), 100. https://​doi.​org/​10.​1186/​s12955-016-0501-z
go back to reference Fisher, L., & Weihs, K. L. (2000). Can addressing family relationships improve outcomes in chronic disease? Report of the National Working Group on Family-Based Interventions in Chronic Disease. The Journal of Family Practice, 49(6), 561–566.PubMed Fisher, L., & Weihs, K. L. (2000). Can addressing family relationships improve outcomes in chronic disease? Report of the National Working Group on Family-Based Interventions in Chronic Disease. The Journal of Family Practice, 49(6), 561–566.PubMed
go back to reference Hingle, M. D., Turner, T., Going, S., Ussery, C., Roe, D. J., Saboda, K., Kutob, R., & Stump, C. (2019). Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The E.P.I.C. Kids (Encourage, Practice, and Inspire Change) Study. Preventive medicine reports, 14, 100840. https://doi.org/10.1016/j.pmedr.2019.100840 Hingle, M. D., Turner, T., Going, S., Ussery, C., Roe, D. J., Saboda, K., Kutob, R., & Stump, C. (2019). Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The E.P.I.C. Kids (Encourage, Practice, and Inspire Change) Study. Preventive medicine reports, 14, 100840. https://​doi.​org/​10.​1016/​j.​pmedr.​2019.​100840
go back to reference Hu, R., Cancela, J., Arredondo Waldmeyer, M. T., Cea, G., Vlachopapadopoulou, E. A., Fotiadis, D. I., & Fico, G. (2016). OB CITY—Definition of a family-based intervention for childhood obesity supported by information and communication technologies. IEEE Journal of Translational Engineering in Health and Medicine, 4, 2200114. https://doi.org/10.1109/JTEHM.2016.2526739CrossRef Hu, R., Cancela, J., Arredondo Waldmeyer, M. T., Cea, G., Vlachopapadopoulou, E. A., Fotiadis, D. I., & Fico, G. (2016). OB CITY—Definition of a family-based intervention for childhood obesity supported by information and communication technologies. IEEE Journal of Translational Engineering in Health and Medicine, 4, 2200114. https://​doi.​org/​10.​1109/​JTEHM.​2016.​2526739CrossRef
go back to reference Institute of Medicine (US) Committee on Health and Behavior: Research, P., and Policy. Health and behavior: The interplay of biological, behavioral, and societal influences. Washington (DC): National Academies Press (US); 2001. 5, Individuals and Families: Models and Interventions. https://www.ncbi.nlm.nih.gov/books/NBK43749/ Institute of Medicine (US) Committee on Health and Behavior: Research, P., and Policy. Health and behavior: The interplay of biological, behavioral, and societal influences. Washington (DC): National Academies Press (US); 2001. 5, Individuals and Families: Models and Interventions. https://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK43749/​
go back to reference Kerr, M. E. (1981). Family systems theory and therapy. Handbook of family therapy, 1, 226–264. Kerr, M. E. (1981). Family systems theory and therapy. Handbook of family therapy, 1, 226–264.
go back to reference King, H. A., Jeffreys, A. S., McVay, M. A., Coffman, C. J., & Voils, C. I. (2014). Spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle change intervention to improve patient low-density lipoprotein cholesterol. Journal of behavioral medicine, 37(6), 1102-1107. https://doi.org/10.1007/s10865-014-9559-4 King, H. A., Jeffreys, A. S., McVay, M. A., Coffman, C. J., & Voils, C. I. (2014). Spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle change intervention to improve patient low-density lipoprotein cholesterol. Journal of behavioral medicine, 37(6), 1102-1107. https://​doi.​org/​10.​1007/​s10865-014-9559-4
go back to reference Ling, J., Robbins, L. B., Zhang, N., Kerver, J. M., Lyons, H., Wieber, N., & Zhang, M. (2018). Using Facebook in a Healthy Lifestyle Intervention: Feasibility and Preliminary Efficacy. Western journal of nursing research, 40(12), 1818-1842. https://doi.org/10.1177/0193945918756870 Ling, J., Robbins, L. B., Zhang, N., Kerver, J. M., Lyons, H., Wieber, N., & Zhang, M. (2018). Using Facebook in a Healthy Lifestyle Intervention: Feasibility and Preliminary Efficacy. Western journal of nursing research, 40(12), 1818-1842. https://​doi.​org/​10.​1177/​0193945918756870​
go back to reference Martin, L. J., Burke, S. M., Shapiro, S., Carron, A. V., Irwin, J. D., Petrella, R., Prapavessis, H., & Shoemaker, K. (2009). The use of group dynamics strategies to enhance cohesion in a lifestyle intervention program for obese children. BMC Public Health, 9, 277. https://doi.org/10.1186/1471-2458-9-277 Martin, L. J., Burke, S. M., Shapiro, S., Carron, A. V., Irwin, J. D., Petrella, R., Prapavessis, H., & Shoemaker, K. (2009). The use of group dynamics strategies to enhance cohesion in a lifestyle intervention program for obese children. BMC Public Health, 9, 277. https://​doi.​org/​10.​1186/​1471-2458-9-277
go back to reference McHugh, M. L. (2012). Interrater reliability: The kappa statistic. Biochemical Medicine (Zagreb), 22, 276–282.CrossRef McHugh, M. L. (2012). Interrater reliability: The kappa statistic. Biochemical Medicine (Zagreb), 22, 276–282.CrossRef
go back to reference Monden, C. W., de Graaf, N. D., & Kraaykamp, G. (2003). How important are parents and partners for smoking cessation in adulthood? An event history analysis. Prev Med, 36, 197–203.PubMed Monden, C. W., de Graaf, N. D., & Kraaykamp, G. (2003). How important are parents and partners for smoking cessation in adulthood? An event history analysis. Prev Med, 36, 197–203.PubMed
go back to reference Po'e, E. K., Heerman, W. J., Mistry, R. S., & Barkin, S. L. (2013). Growing Right Onto Wellness (GROW): a family-centered, community-based obesity prevention randomized controlled trial for preschool child-parent pairs. Contemporary clinical trials, 36(2), 436-449. https://doi.org/10.1016/j.cct.2013.08.013 Po'e, E. K., Heerman, W. J., Mistry, R. S., & Barkin, S. L. (2013). Growing Right Onto Wellness (GROW): a family-centered, community-based obesity prevention randomized controlled trial for preschool child-parent pairs. Contemporary clinical trials, 36(2), 436-449. https://​doi.​org/​10.​1016/​j.​cct.​2013.​08.​013
go back to reference Rigby, S., & Ryan, R. M. (2011). Glued to games: How video games draw us in and hold us spellbound: How video games draw us in and hold us spellbound. AbC-CLIo. Rigby, S., & Ryan, R. M. (2011). Glued to games: How video games draw us in and hold us spellbound: How video games draw us in and hold us spellbound. AbC-CLIo.
go back to reference Ryan, R. M., Rigby, C. S., & Przybylski, A. (2006). The motivational pull of video games: A self-determination theory approach. Motivation and emotion, 30, 344–360.CrossRef Ryan, R. M., Rigby, C. S., & Przybylski, A. (2006). The motivational pull of video games: A self-determination theory approach. Motivation and emotion, 30, 344–360.CrossRef
go back to reference Savoye, M., Nowicka, P., Shaw, M., Yu, S., Dziura, J., Chavent, G., O'Malley, G., Serrecchia, J. B., Tamborlane, W. V., & Caprio, S. (2011). Long-term results of an obesity program in an ethnically diverse pediatric population. Pediatrics, 127(3), 402-410. https://doi.org/10.1542/peds.2010-0697 Savoye, M., Nowicka, P., Shaw, M., Yu, S., Dziura, J., Chavent, G., O'Malley, G., Serrecchia, J. B., Tamborlane, W. V., & Caprio, S. (2011). Long-term results of an obesity program in an ethnically diverse pediatric population. Pediatrics, 127(3), 402-410. https://​doi.​org/​10.​1542/​peds.​2010-0697
go back to reference Schlechty, P. C. (2011). Engaging students: The next level of working on the work. John Wiley & Sons. Schlechty, P. C. (2011). Engaging students: The next level of working on the work. John Wiley & Sons.
go back to reference Smith, L. R., Chadwick, P., Radley, D., Kolotourou, M., Gammon, C. S., Rosborough, J., & Sacher, P. M. (2013). Assessing the short-term outcomes of a community-based intervention for overweight and obese children: The MEND 5-7 programme. BMJ Open, 3(5). https://doi.org/10.1136/bmjopen-2013-002607 Smith, L. R., Chadwick, P., Radley, D., Kolotourou, M., Gammon, C. S., Rosborough, J., & Sacher, P. M. (2013). Assessing the short-term outcomes of a community-based intervention for overweight and obese children: The MEND 5-7 programme. BMJ Open, 3(5). https://​doi.​org/​10.​1136/​bmjopen-2013-002607
go back to reference Sola, D., Couturier, J., & Voyer, B. (2015). Unlocking patient activation in chronic disease care. British Journal of Healthcare Management, 21, 220–225.CrossRef Sola, D., Couturier, J., & Voyer, B. (2015). Unlocking patient activation in chronic disease care. British Journal of Healthcare Management, 21, 220–225.CrossRef
go back to reference Touyz, L. M., Cohen, J., Cohn, R. J., Garnett, S. P., Anazodo, A., Gohil, P., Grech, A. M., Ng, A., & Wakefield, C. E. (2019). Childhood cancer survivors report preferring lifestyle interventions delivered in person rather than online: An adolescent and parent perspective. Pediatr Blood Cancer, e27922. https://doi.org/10.1002/pbc.27922 Touyz, L. M., Cohen, J., Cohn, R. J., Garnett, S. P., Anazodo, A., Gohil, P., Grech, A. M., Ng, A., & Wakefield, C. E. (2019). Childhood cancer survivors report preferring lifestyle interventions delivered in person rather than online: An adolescent and parent perspective. Pediatr Blood Cancer, e27922. https://​doi.​org/​10.​1002/​pbc.​27922
go back to reference Vansteenkiste, M., Niemiec, C. P., & Soenens, B. (2010). The development of the five mini-theories of self-determination theory: An historical overview, emerging trends, and future directions. In The decade ahead: Theoretical perspectives on motivation and achievement. Emerald Group Publishing Limited. Vansteenkiste, M., Niemiec, C. P., & Soenens, B. (2010). The development of the five mini-theories of self-determination theory: An historical overview, emerging trends, and future directions. In The decade ahead: Theoretical perspectives on motivation and achievement. Emerald Group Publishing Limited.
go back to reference Viitasalo, A., Eloranta, A. M., Lintu, N., Vaisto, J., Venalainen, T., Kiiskinen, S., Karjalainen, P., Peltola, J., Lampinen, E. K., Haapala, E. A., Paananen, J., Schwab, U., Lindi, V., & Lakka, T. A. (2016). The effects of a 2-year individualized and family-based lifestyle intervention on physical activity, sedentary behavior and diet in children. Preventive medicine, 87, 81-88. https://doi.org/10.1016/j.ypmed.2016.02.027 Viitasalo, A., Eloranta, A. M., Lintu, N., Vaisto, J., Venalainen, T., Kiiskinen, S., Karjalainen, P., Peltola, J., Lampinen, E. K., Haapala, E. A., Paananen, J., Schwab, U., Lindi, V., & Lakka, T. A. (2016). The effects of a 2-year individualized and family-based lifestyle intervention on physical activity, sedentary behavior and diet in children. Preventive medicine, 87, 81-88. https://​doi.​org/​10.​1016/​j.​ypmed.​2016.​02.​027
go back to reference Waling, M., Backlund, C., Lind, T., & Larsson, C. (2012). Effects on metabolic health after a 1-year-lifestyle intervention in overweight and obese children: a randomized controlled trial. Journal of nutrition and metabolism, 2012, 913965. https://doi.org/10.1155/2012/913965 Waling, M., Backlund, C., Lind, T., & Larsson, C. (2012). Effects on metabolic health after a 1-year-lifestyle intervention in overweight and obese children: a randomized controlled trial. Journal of nutrition and metabolism, 2012, 913965. https://​doi.​org/​10.​1155/​2012/​913965
go back to reference Werbach, K. (2014). (Re) defining gamification: A process approach. International conference on persuasive technology, Werbach, K. (2014). (Re) defining gamification: A process approach. International conference on persuasive technology,
go back to reference Werbach, K., & Hunter, D. (2012). For the win: How game thinking can revolutionize your business. Wharton Digital Press. Werbach, K., & Hunter, D. (2012). For the win: How game thinking can revolutionize your business. Wharton Digital Press.
Metadata
Title
Gamification for Family Engagement in Lifestyle Interventions: A Systematic Review
Authors
Amanda C. Blok
Thomas S. Valley
Patricia Abbott
Publication date
01-10-2021
Publisher
Springer US
Published in
Prevention Science / Issue 7/2021
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-021-01214-x

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