Gamification: games as tools in improving health

Gamification in health is a tool that is used to achieve health prevention and promotion, physical and cognitive rehabilitation, and the rehabilitation of various pathologies or health education.

To achieve its goals, it is essential to arouse the patients’ motivation. The reasons that motivate people can be diverse: feeling of belonging to a community, competitiveness with other users, socialising, comparing their numerical data. All this can stimulate them and make the process more pleasant.

The application of games must become a user experience, it must be personalised, it must generate engagement, empower the patient, give rewards and generate challenges that can be achieved to get the user involved.
The games generate a social community around them; collaborations, feedbacks and progressive mechanics are given. Public ranking lists are made and virtual rewards are given to encourage healthy behaviours.

The use of these techniques allows healthcare professionals to be trained on different pathologies or situations to be evaluated by practising with virtual patients.
It is expected that in the future gamification will be prescribed in patients contributing to improving quality of life, as it will provide them with greater awareness of their health and improve adherence and monitoring of the treatments through games.

The games designed to improve health must check their results and have scientific evidence. Fundació TIC Salut Social, through the mHealth.cat Office and the app accreditation model of the App Health Portal, can certify that these games are prescribed because they have enough quality, efficacy and efficiency to be used by the users.

1) Physical exercise and healthy habits:
The application of serious health games has several practical examples such as Esporti Revolution  designed to improve the health of children and teenagers by promoting physical activity and healthy habits. In the adult version Esporti Masters has the aim of achieving a better health by enhancing active aging.

Playbenefit raises challenges of nutrition, physical activity, sleep and the digestive system with the aim that the user might lead a healthy life.

Pact Its community of users is committed to going to the gym, since the app pays the user for going to the gym and charges them if they don’t go.

HubBub: it creates challenges for adopting healthy lifestyle habits, performing physical activity and dieting. Participants compete to be on the lists with higher scores or more badges.

Fitbit & co allows the community to activate the motivation of the users to achieve more steps, to compete and get better scores in the gym. It encourages comparisons of achievements and progress in milestones or goals.

2) Medication and chronic disease:
Mango Health When the patients take the medication at the right times they earn points and obtain gift cards exchangeable for donations. The app also envisages possible drug interactions and their side effects.

Bayer’s Didget a blood glucose meter that connects to the Nintendo DS game platform, aimed at children between 4-14 years, to help them control their diabetes and reward them for constant blood glucose tests.

MySugr offers solutions to manage diabetes in a more amusing way. There are two versions for adults and children available in 52 countries and in 13 different languages; recently acquired by the Roche pharmaceutical company.

3) Aimed at children:
It is vital to apply gamification for medical solutions in children, since they do not understand the importance of medication or physical exercise for their health.
Sometimes, they do not want to take pills, eat vegetables, go to therapy or stay in the hospital. Gamification can help them forget that they are under therapy or treatment.

Monster Guard created by the American Red Cross: it prepares children in situations of emergencies and natural disasters (fires, hurricanes, floods and other catastrophes).

LeapBand encourages children to keep moving. It combines taking care of a virtual pet with doing physical activity and helping them make healthy choices.

Scankids Valle Hebrón an app in which paediatric radiology becomes human. It is aimed at patients between 6-12 years old who have to have diagnostic tests in hospital.
They are taught with adapted language and 3D animations: the rooms, the apparatuses, the types of tests and steps to follow at any time so they are not afraid. Accompanied by sets of bones.

4) Rehabilitation and physiotherapy:
Reflexion Health: a physical rehabilitation app where virtual therapy is applied, the movements that patients must do are reproduced by animated figures. Guided technology compares the patients’ movements with those of the models giving the guide and generates feedback with suggestions, guidelines and corrections.

Game-abling  is a platform of games for people with cerebral palsy to improve their quality of life.

SCI Hard created by the University of Michigan, it helps in the rehabilitation process for paediatric patients who have suffered injuries to the spinal cord in an accident. There are challenges like defending the city of mutants.

5) App and video game projects in pilot phase: 
Monitor Your Avatar: an app to help in the perception of the body among teenagers.

Akili  designed to treat a variety of cognitive disorders, including paediatric ADHD.

Bandit´s Shark Showdown: an app that allows motor rehabilitation after a stroke. A shark lunges at the patient to stimulate their motor skills and reflexes.

Sparx  proved to be effective in helping teens cope with depression through smart, positive, active and realistic thoughts. Only available in the New Zealand area, they are developing it to work in more countries.

Re-Mission  a game for teens and young adults with cancer. Users play with a nano-robot that travels through the body of the patient with different types of cancer, and fights the disease and the side effects of the treatment.

The gamification of serious games will gradually grow in all areas of medical care; it will allow it to be easier and more fun for patients or users to change their behaviour.