Gamification Use and Design in Popular Health and Fitness Mobile Applications

Cotton, Victor; Patel, Mitesh S.

doi:10.1177/0890117118790394

Cited by 110Educational Games and GamificationMobile Health and mHealth ApplicationsInnovative Human-Technology Interaction

Gamification Use and Design in Popular Health and Fitness Mobile Applications

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Cotton, Victor, Patel, Mitesh S.·2019·American Journal of Health Promotion

DOI 10.1177/0890117118790394PMC PMC6348030

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Abstract

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.

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A study from 2017 found that physical activity and weight loss apps most frequently (97%) used gamification.
“A study from 2017, where the top 50 health and fitness apps were downloaded from the Apple app store, found that physical activity and weight loss apps most frequently (97%) used gamification [36].”
From System Usability Scale Benchmarking for Digital Health Apps: Meta-analysis (2022) · cites this paper as [36]
The Methods say the top 50 free health and fitness apps in Apple’s App Store were evaluated in August 2017, and the Results say gamification was most prevalent in physical activity and weight-loss apps. But the Results report that 100% of those apps used gamification. The Abstract’s 97% describes the share of gamified apps that targeted physical activity or weight loss, not the share of apps in those categories that used gamification. (LLM, conf=0.89)
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Authors: Cotton, V., & Patel, M. S.
Affiliations: University of Pennsylvania (US)
Philadelphia VA Medical Center (US)
Corresponding author: Patel, Mitesh S.
ORCID: Patel, Mitesh S.
Venue: American Journal of Health Promotion
Publisher: SAGE Publications
Published: 2018-07-26
Volume: 33
Issue: 3
Pages: 448-451
ISSN: 0890-1171 (ISSN-L)
2168-6602
DOI: 10.1177/0890117118790394
PMC: PMC6348030
OpenAlex: W2884180038
Cited by: 110
References: 9
Citations by year: 2026: 9 · 2025: 12 · 2024: 9 · 2023: 16 · 2022: 16 · 2021: 17 · 2020: 17 · 2019: 13 · 2018: 1
FWCI: 23.56
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: American Journal of Health Promotion (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: University of Pennsylvania Health System
Topics: Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
Keywords: gamification, behavioral economics, loss aversion, variable reinforcement, goal setting, social influence, physical activity, weight loss, mobile application design
MeSH terms: Goals, Humans, Motivation, Physical Fitness, Social Support, Health Behavior, Exercise, Video Games, Economics, Behavioral, Mobile Applications

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Gamification Use and Design in Popular Health and Fitness Mobile Applications

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