An app that incorporates gamification, Mini-games, and social connection to improve Men’s Mental health and well-being (MindMax): participatory design process
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Abstract
BACKGROUND: Men have different mental health needs as compared with women, and women make up the primary audience of most digital mental health interventions. An Australian football-themed (specifically Australian Football League, AFL) app named MindMax incorporating psychoeducation, gamification, mini-games, and social connection was developed in an effort to address this issue. OBJECTIVE: The aim of this study was to identify the best way to structure and present MindMax, an app that aims to deliver psychoeducational modules, and create a Web-based community centering on well-being, AFL, and video games for men aged 16 to 35 years who are interested in AFL or video games. METHODS: We conducted 6 participatory design (PD) workshops with people aged 16 to 35 years in 3 cities in Australia, to identify the best way to present MindMax, and contracted a digital development agency to develop MindMax. We then iteratively tested MindMax prototypes with 15 user experience testing interviews across 3 separate time points: 2 before app launch and 1 after app launch. RESULTS: A total of 40 individuals (25 male and 15 female) participated in the PD workshops, and a total of 15 individuals (10 male and 5 female) participated in user experience interviews. Broadly, participants expressed a preference for activities requiring active engagement that practiced useful skills. They were also sensitive to how content was presented and wanted the ability to customize their own app experience. Although participants agreed that social motivations were important for engagement with an app, they recommended not to mimic existing social networks. CONCLUSIONS: In basing itself strongly within the AFL subculture and by incorporating gamification as well as mini-games, MindMax aimed to tackle mental health help-seeking barriers for people who enjoy AFL or video games, with a particular emphasis on men, and to provide psychoeducation on strategies to increase mental health and well-being. If MindMax is successful, this would indicate that generalizing this approach to other traditional sporting codes and even competitive video gaming leagues (esports) would be fruitful.
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Previous research shows the importance of getting the client to engage in the treatment process.
“This also becomes clear as previous research shows the importance of getting the client to engage in the treatment process (49–51).”
From A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression (2023) · cites this paper as [49]
The Introduction’s ‘Participatory Design and Knowledge Translation’ section says that designing mHealth interventions for their target audience may improve uptake and engagement. This supports the importance of engagement, but the paper discusses engagement with a mental-health app rather than clients’ engagement in a treatment process generally; its ‘Men’s Well-Being and Internet Interventions’ section describes the proposed approach as informal, not clinical. No page numbers are available in our copy. (LLM, conf=0.83)
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“The youngest age sampled across all studies was 3 years, and the oldest was 25 years as a part of a “young people” sample spanning ages 16 to 25 years [52].”
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Gómez-Cambronero, Á., Mann, A.-L., Mira, A., Doherty, G. J., & Casteleyn, S. (2024) · Multimedia Tools and Applications · doi:10.1007/s11042-024-18971-w · Cited by 19 · see citing works
Burn, A., Ford, T. J., Štochl, J., Jones, P. B., Pérez, J., & Anderson, J. (2022) · JMIR Formative Research · doi:10.2196/30565 · Cited by 19 · see citing works
“In contrast, early prototyping, the involvement of users, and continuous iteration are key principles of a user-centered design approach [40,51], which in recent years has become more prominent in the development of mental health web apps [52-56].”
BackgroundHiller, S., Götzl, C., Rauschenberg, C., Fechtelpeter, J., Koppe, G., Wierzba, E., Sauter, J., Dietrich, S., Durstewitz, D., Reininghaus, U., et al. (2025) · JMIR mhealth and uhealth · doi:10.2196/65106 · Cited by 17 · see citing works
Palacios, V. A. F., Jaramillo-Galarza, K. A., Calle, J. V. Q., & Orozco-Cantos, L. (2023) · Salud Ciencia y Tecnología · doi:10.56294/saludcyt2023639 · Cited by 15 · see citing works
Empowering Young Women: A Qualitative Co-Design Study of a Social Media Health Promotion Programme
Malloy, J. A., Kemper, J. A., Partridge, S. R., & Roy, R. (2024) · Nutrients · doi:10.3390/nu16060780 · Cited by 16 · see citing works
“This research follows the participatory process reporting of Cheng et al., as well as the Think NPC Toolkit and recommendations by the Young and Well Research Co-operative Centre and the Health Cascade Network [23–26].”
MethodOpozda, M. J., Oxlad, M., Turnbull, D. A., Gupta, H., Smith, J. A., Ziesing, S., Nankivell, M. E., & Wittert, G. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.11.015 · Cited by 16 · see citing works
Shan, D., Dai, Z., Ge, F., Zhang, Y., Zheng, Y., Gao, X., & Han, J. (2023) · Cureus · doi:10.7759/cureus.36334 · Cited by 12 · see citing works
“Previous studies have held opposite opinions on the impact of online gaming on mental health [3-8], indicating that something may moderate the relationship between gaming hours and well-being, ultimately leading to different outcomes.”
BackgroundResultNavarro-Mateos, C., Mora-González, J., & López, I. J. P. (2023) · Games for Health Journal · doi:10.1089/g4h.2023.0059 · Cited by 11 · see citing works
Gamification solutions for persons with disabilities: a systematic literature review
Boubakri, M., & Nafil, K. (2024) · Universal Access in the Information Society · doi:10.1007/s10209-024-01170-7 · Cited by 12 · see citing works
Martinez, R., & Squire, K. D. (2024) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642895 · Cited by 10 · see citing works
Wanniarachchi, V. U., Greenhalgh, C., & Warren, J. (2025) · Internet Interventions · doi:10.1016/j.invent.2025.100884 · Cited by 10 · see citing works
“Kenny et al. (2016), H ø gsdal et al. (2024) and Cheng et al. (2018) also identified stigma as a concern, observing that some participants preferred to keep their use of mental health apps private.”
Improving Mental Health Among Working-Class Indian Women: Insight From An Interview Study
Reen, J. K., & Orji, R. (2022) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/3491101.3519781 · Cited by 6 · see citing works
“[5] investigated the best approach to arrange”
Esposito, C., Sulla, F., Toto, G. A., Berardinetti, V., Lavanga, A., Savino, F., Iuso, S., Logrieco, M. G., & Costa, M. E. P. A. (2024) · Behavioral Sciences · doi:10.3390/bs14111052 · Cited by 6 · see citing works
“Six studies [82,84,86,87,90,93] were conducted in Europe, two [80,85] in the United States, two [81,89] in Central or South America, two [83,91] in Australia (Oceania), one [88] in East Africa, and, finally, one [92] involved participants from various regions of the world.”
InfluentialMojica, M., Palos‐Sánchez, P. R., & Cabanas, E. (2024) · European Journal of Innovation Management · doi:10.1108/ejim-11-2023-0963 · Cited by 3 · see citing works
Ospina‐Pinillos, L., Krausz, R. M., & Hickie, I. B. (2021) · Springer eBooks · doi:10.1007/978-3-030-57296-9_128 · Cited by 3 · see citing works
Potential Adverse Effects Caused by Gamification Elements in mHealth Apps
Rocha, I., & Silveira, M. S. (2024) · Journal of the Brazilian Computer Society · doi:10.5753/jbcs.2024.4310 · Cited by 1 · see citing works
Digital mental health needs a purpose-driven approach
Househ, M. S., Shah, H. A., Tariq, Z. U. A., Hassan, D. A., Khalifa, M., Schneider, J., Hamdi, M., Abd-Alrazaq, A. A., Ahmad, A., Solaiman, B., et al. (2026) · Nature Human Behaviour · doi:10.1038/s41562-025-02380-6 · Cited by 3 · see citing works
Corthésy-Blondin, L., Lemyre, A., Poitras, M., & Guay, S. (2023) · Technology Mind and Behavior · doi:10.1037/tmb0000121 · Cited by 2 · see citing works
Rufai, O. H., Chu, J., Muhideen, S., Shahani, R., & Amosun, T. S. (2021) · International Journal of Green Energy · doi:10.1080/15435075.2021.1992412 · Cited by 2 · see citing works
Marques, G., Gil, R. S., Franco, M., & Díez, I. D. L. T. (2021) · Informatics for Health and Social Care · doi:10.1080/17538157.2021.1988956 · Cited by 2 · see citing works
Design, Implementation and Evaluation of a Gamified Mobile App for Long-Term Behavior Change
Aigner, C., Basheva, V., Baranyi, R., Arnberger, C., Winkler, S., & Grechenig, T. (2025) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah65397.2025.11168422 · Cited by 1 · see citing works
“• Mental Health: MindMax is a mobile app linked to the Australian Football League (AFL) that promotes mental health among male users [12].”
Gamified Change: The Transformative Impact of Reflection, Empowerment, and Gamification Motivation
Tanouri, A., Kennedy, A.-M., & Veer, E. (2025) · Journal of Consumer Behaviour · doi:10.1002/cb.70088
Exploring Serious Games in Supporting Postnatal Depression: Narrative Review
Wang, W., Penney, E. S., Gay, V. C., & Garcia, J. (2025) · Interactive Journal of Medical Research · doi:10.2196/70777 · Cited by 1 · see citing works
“…is an app that incorporates gamification, mini-games, and social connection to improve men’s mental health and well-being, published by Cheng et al [56] One of the key strengths of MindMax is its incorporation of psycho-educational modules that provide users with mental health information in a…”
Ospina‐Pinillos, L., Krausz, R. M., Gorban, C., & Hickie, I. B. (2026) · Springer eBooks · doi:10.1007/978-3-319-70134-9_128-2 · Cited by 1 · see citing works
Casual Games, Cognition, and Play across the Lifespan: A Critical Synthesis
Squire, K. D., Wells, G., Anderson-Coto, M. J., & Steinkuehler, C. A. (2023) · Games Research and Practice · doi:10.1145/3594534 · Cited by 2 · see citing works
“One such project, MindMax, a multi-game application developed by researchers in conjunction with the Australian Football League (Cheng et al., 2018), combines the in-app games Crappy Birds (based heavily off of the popular Flappy Bird (2013)) and Flick Footy with a mindfulness training regimine, a journaling interface…”
InfluentialAn analysis of gamification elements in mHealth applications
Rocha, I., & Silveira, M. S. (2023) · Simpósio Brasileiro de Fatores Humanos em Sistemas Computacionais · doi:10.1145/3638067.3638126 · Cited by 1 · see citing works
“Normalmente, essa tendência é re-sumida como “gamificação”, que se conecta a conceitos e pesquisas existentes na área de Interação Humano-Computador (IHC) e nos estudos de jogos para motivar e engajar o usuário [4].”
BackgroundChau, L. W., Murphy, J., Nguyen, V. C., Tran, H. N., Minas, H., Lam, R. W. M., Hayashi, K., Nguyen, T. U. O. N. G., Krebs, E., & O'Neil, J. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-15031-x · Cited by 1 · see citing works
Ospina-Pinillos, L., Krausz, R. M., & Hickie, I. (2020) · Innovations in Global Mental Health · doi:10.1007/978-3-319-70134-9_128-1 · Cited by 2 · see citing works
A gamificação em aplicativos mHealth para o bem-estar: Um mapeamento sistemático da literatura
Martins, M. V., Conejo, G. G., Hounsell, M. D. S., & Gasparini, I. (2021) · Simpósio Brasileiro de Jogos e Entretenimento Digital (SBGames) · doi:10.5753/sbgames_estendido.2021.19721
“No entanto, as pesquisas sobre os efeitos da gamificação, em intervenções direcionadas ao bem-estar, ainda são consideradas escassas [3].”
BackgroundInfluentialAndroid-Based Protrainer Application Development to Support Personal Trainer Services
Purwantor, D. (2022) · INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS · doi:10.47191/ijmra/v5-i8-46
Empowering students to engage in the design of COVID-19 related gamified applications
Nicolaidou, I. A. (2022) · European Conference on e-Learning · doi:10.34190/ecel.21.1.731
“Cheng et al. (2018) conducted six participatory design workshops, each one of which lasted for 3 hours, with 40 participants aged 16 to 35 years in 3 different cities to identify the best way to present a gamified digital mental health intervention addressed to men (Cheng et al., 2018).”
Backgroundde Murcia, U., Belmonte, M. L., España, Prados, M. Á. H., España, U. D. M., Cantero, I. G., & España, U. D. M. (2022) · Educación Lenguaje y Sociedad · doi:10.19137/els-2022-202006
“El uso de los juegos de mesa en el aprendizaje de inglés reduce la ansiedad (Cheng et al., 2018) y posibilita el cambio de actitud y por ende comportamental, sin tener que hacer uso de la coerción o el engaño (Díaz & Troyano, 2013), y contribuye a la creación de un clima de aula positivo y cómodo…”
BackgroundBaschera, V. L. (2023) · SASH. Revista argentina de sexualidad humana/SASH Revista Argentina de Sexualidad Humana · doi:10.58751/3bbtkv21
“Para eso, se desarrolló el concepto de “Gamification” (ludificación en español) potenciado por el ámbito empresarial en los últimos años (Cheng et al, 2018).”
Doyle, M. A., Singh, M., McNulty, P., Slavin, S., Smith, M., Walker, H., Khan, W., & Percy‐Smith, B. (2024) · Nursing Children and Young People · doi:10.7748/ncyp.2024.e1503
Wang, W., Penney, E. S., Gay, V. C., & Garcia, J. A. (2025) · doi:10.2196/preprints.70777
Zhang, Z., Sun, J., Peters, D., & Calvo, R. A. (2025) · Designing Interactive Systems Conference · doi:10.1145/3715336.3735681
“Moreover, gamification elements, which are now commonly regarded as an engagement-facilitating approach in HCI [6, 13, 24], may inadvertently diminish users’ competence if not applied with caution [90].”
Alamer, A. S. (2025) · International Journal of Child Health and Nutrition · doi:10.6000/1929-4247.2025.14.03.7
Co‐Designing a Family e‐Hub: A Systemic, Relational, Digital Mental Health Resource
Welsh, E. T., Cloud, Z. C. G., Boyd, J., & McIntosh, J. E. (2026) · Journal of Marital and Family Therapy · doi:10.1111/jmft.70174
“Participatory design allows developers to address practical, cultural, and contextual factors that may influence engagement, usability, and effectiveness, ultimately supporting the creation of digital tools that are both user‐ centered and clinically relevant (Cheng et al. 2018).”
User preferences for game design elements in digital mental health interventions
Hu, S., Schmidt-Kraepelin, M., Krohmann, S., Thiebes, S., & Sunyaev, A. (2026) · Behaviour and Information Technology · doi:10.1080/0144929x.2026.2736084
Chauhan, P., Gupta, S., Gupta, H., Singh, P., & Deb, K. S. (2026) · doi:10.2196/preprints.113988
Li, Y. (2026) · Entertainment Computing · doi:10.1016/j.entcom.2026.101259
- Authors
- Cheng, V. W. S., Davenport, T. A., Johnson, D., Vella, K., Mitchell, J., & Hickie, I. B.
- Affiliations
- The University of Sydney (AU)
- Queensland University of Technology (AU)
- Corresponding author
- Cheng, Vanessa Wan Sze
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2018-11-19
- Volume
- 5
- Issue
- 4
- Pages
- e11068
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC6277826
- OpenAlex
- W2890428821
- Cited by
- 62
- References
- 51
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 10 · 2023: 13 · 2022: 7 · 2021: 7 · 2020: 6 · 2019: 4
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by)
- Funders
- Movember Foundation
- Australian Football League
- University of Sydney
- Queensland University of Technology
- Young and Well Cooperative Research Centre
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- men's mental health, gamification, mini-games, social connectedness, mobile health apps, psychoeducation, Australian Football League, video games, esports, help-seeking barriers, well-being, participatory design, user experience, youth and young adults, online communities
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