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Is Gamification Effective in Motivating Exercise?
Abstract
Despite the benefits of exercise, many individuals lack the motivation to integrate it into their daily lives. Recently, there has been a growing interest in the use of game principles in non-game contexts to make an activity that is perceived to be challenging, tedious or boring more enjoyable. With increased enjoyment through the infusion of game elements, it is expected that individuals will be more motivated to partake in the activity. Given this backdrop, the present study seeks to ascertain the utility of gamification for promoting exercise among individuals. We used Fitocracy as the gamification platform. Our results suggest that gamification improves not only attitudes towards and enjoyment of exercise but also shapes behavior in terms of increase in exercise activity. These findings augur well for gamification platforms and their usefulness in motivating exercise among individuals. Finally, our work suggests design implications for applications that aim to gamify exercise.
... In terms of the associated outcomes of fitness app use, most studies have only theorised on positive effects. Through this spectrum, fitness apps have been found to be associated with motivating the commencement of physical exercise (Goh and Razikin, 2015), exercising to a higher intensity (Thorsteinsen et al., 2014;Giddens et al., 2017), and intentions to continue exercising (Hamari and Koivisto, 2015;Stragier et al., 2016). When wellbeing is considered as a dependent variable, use of fitness app features are positively associated (Giddens et al., 2017;James et al., 2019), but only for the more self-determined and amotivated types of exercisers (James et al., 2019). ...
... Our findings contribute to this body of work on the dual effects of IT, particularly in relation to fitness apps. While existing studies report on the adaptive outcomes of gamification on health and fitness (Thorsteinsen et al., 2014;Goh and Razikin, 2015;Hamari and Koivisto, 2015;Stragier et al., 2016), our study demonstrates the adaptive/maladaptive duality. When motivated by peer recognition, an obsessive passion is likely to emerge with higher life burnout also a consequence. ...
Purpose
While the positive health benefits of fitness apps, which motivate and track physical exercise, are widely acknowledged, the adverse connection between these technologies and wellbeing has received little attention. The purpose of this paper is to determine how the social dimensions of fitness apps predict the type of passion (harmonious and obsessive) one has for physical exercise, and what the resulting positive and negative implications are for wellbeing.
Design/methodology/approach
Drawing from the theoretical frameworks of social influence and the dual model of passion (DMP), this study develops a model depicting how fitness apps relate to the causes and consequences of harmonious and obsessive passion for exercise. Survey data were collected from 272 fitness app using cyclists and analysed with partial least squares structural equation modelling techniques.
Findings
Different social influence aspects of fitness apps appeal to different types of exercisers. A harmonious passion for physical exercise is predicted by the positive reciprocal benefits attained from one’s fitness app community, while an obsessive passion is predicted by positive recognition. In turn, a harmonious passion for exercise is negatively associated with life burnout, while an obsessive passion strongly affirms that relationship. In addition, the relationship between social influence and life burnout is fully mediated by the type of passion a fitness app user possesses.
Originality/value
Underpinned by the DMP, the study provides a theoretical framework explaining how the use of fitness apps can result in opposing wellness outcomes.
... Mobile exergames use various modalities such as screen (Goh & Razikin, 2015;G� omez-Portes et al., 2021;Oyebode, Maurya, & Orji, 2020;Uzor & Baillie, 2014), voice (Almadhoun, Issa, Abushahla, Al-Qadi, & Issa, 2020 (Xu et al., 2021), and AR (Geelan et al., 2016). ...
... There are many examples of gamification in the literature. For instance, [90] found that using an online social network that incorporates gamification elements yielded significant differences in users' attitudes, enjoyment and habits towards exercising. In the specific area of education, a recent meta-analysis suggested that gamification has the potential to serve as an effective instructional approach for interventions focusing on cognitive, motivational, and behavioral learning outcomes [91]. ...
In addition to being a well-liked form of recreation, escape rooms have drawn the attention of educators due to their ability to foster teamwork, leadership, creative thinking, and communication in a way that is engaging for students. As a consequence, educational escape rooms are emerging as a new type of learning activity under the promise of enhancing students’ learning through highly engaging experiences. These activities, which combine some of the key principles of game design with sound learning approaches, consist of escape rooms that require students to master field-specific knowledge and skills in order to solve their puzzles and succeed in the activity. Although several studies have reported on the use of educational escape rooms in a wide range of disciplines, prior research falls short of addressing whether these novel activities can be effective for learning computer science topics. This thesis examines the use of several educational escape rooms for teaching computer science topics in different scenarios, including computer science courses covering programming and software engineering fundamentals as well as face-to-face and remote settings. This thesis also encompasses the design, implementation and evaluation of Escapp, a software platform for aiding educators in the cumbersome task of conducting engaging and effective face-to-face and remote educational escape rooms, contributing this way to overcome some of the main barriers hampering the adoption of educational escape rooms. The results reported in this thesis contribute to the understanding of educational escape rooms by showing that these activities can be engaging and effective when used for teaching computer science topics, both when they are conducted face-to-face as well as when they are conducted remotely. In this regard, the results also suggest that, although remote educational escape rooms can be as engaging as their face-to-face counterparts, their learning e_ectiveness is somewhat lower. Finally, this thesis provides evidence that the proposed Escapp platform is a well-suited solution for conducting e_ective face-to-face and remote educational escape rooms.
... The results of such studies have demonstrated the effectiveness of interactive interventions such as exergames, virtual reality (VR), and augmented reality (AR). Several researchers [22][23][24] have highlighted that games help motivate users to perform targeted actions, including physical exercise, and improve their performance in these actions. A previous study [19] has demonstrated a similar effect among older people, highlighting the improved adherence of elderly participants to exercise tasks and the potential fall prevention impact. ...
Background
Falling is one of the most common and serious age-related issues, and falls can significantly impair the quality of life of older adults. Approximately one-third of people over 65 experience a fall annually. Previous research has shown that physical exercise could help reduce falls among older adults and improve their health. However, older adults often find it challenging to follow and adhere to physical exercise programs. Interventions using mixed reality (MR) technology could help address these issues. MR combines artificial augmented computer-generated elements with the real world. It has frequently been used for training and rehabilitation purposes.
Objective
The aim of this systematic literature review and meta-analysis was to investigate the use of the full spectrum of MR technologies for fall prevention intervention and summarize evidence of the effectiveness of this approach.
Methods
In our qualitative synthesis, we analyzed a number of features of the selected studies, including aim, type of exercise, technology used for intervention, study sample size, participant demographics and history of falls, study design, involvement of health professionals or caregivers, duration and frequency of the intervention, study outcome measures, and results of the study. To systematically assess the results of the selected studies and identify the common effect of MR interventions, a meta-analysis was performed.
Results
Seven databases were searched, and the initial search yielded 5838 results. With the considered inclusion and exclusion criteria, 21 studies were included in the qualitative synthesis and 12 were included in meta-analysis. The majority of studies demonstrated a positive effect of an MR intervention on fall risk factors among older participants. The meta-analysis demonstrated a statistically significant difference in Berg Balance Scale score between the intervention and control groups (ES: 0.564; 95% CI 0.246-0.882; P<.001) with heterogeneity statistics of I2=54.9% and Q=17.74 (P=.02), and a statistical difference in Timed Up and Go test scores between the intervention and control groups (ES: 0.318; 95% CI 0.025-0.662; P<.001) with heterogeneity statistics of I2=77.6% and Q=44.63 (P<.001). The corresponding funnel plot and the Egger test for small-study effects (P=.76 and P=.11 for Berg Balance Scale and Timed Up and Go, respectively) indicate that a minor publication bias in the studies might be present in the Berg Balance Scale results.
Conclusions
The literature review and meta-analysis demonstrate that the use of MR interventions can have a positive effect on physical functions in the elderly. MR has the potential to help older users perform physical exercises that could improve their health conditions. However, more research on the effect of MR fall prevention interventions should be conducted with special focus given to MR usability issues.
... Research suggests that integrating game design elements into sports contributes to promoting physical activity and increasing the users' exercise amount [5]. This paper introduces a design method to promote physical activity through team games and, therefore, potentially help form a habit of being active. ...
Team games with a ball provide a great workout and are social activities, making them a great way to spend free time. Unfortunately, it can be challenging to play when the participants' level is not more or less equal. We use digital augmentation technology to promote collaboration during the game and soften the focus that is usually put exclusively on the physical skill levels. Using computer game elements (attack points, defense points, life points) enables us to create a unique mixed reality playing experience that is approachable and enjoyable to various people who have different playing skills. Therefore, it works for promoting physical activity among such players. When designing a fast-paced game with a real ball, taking place in the physical world and the virtual world, special considerations on tracking the game progress, information display, and player experience have to be taken. We describe the development of the augmented dodgeball game, which includes the systems required to play the game and player status display systems. We also present a user study, which consists of questionnaires, interviews, and player-observations. We found that players had a positive experience playing the developed game; they liked the game concept and saw it as a fun activity to do with friends. The players were also communicating and collaborating more during the augmented game. This research contributes to providing design insights specific to designing for augmented reality team games with the ball.
... Instead of providing advice on physical activity, we conducted a step challenge as a gamification element within the second intervention week of the intervention. The step challenge aimed to increase participants' autonomous and controlled motivation to become physically active by promoting enjoyment and offering a reward Goh & Razikin, 2015;Shameli et al., 2017). It was announced on Monday of the second intervention week and took four days in total. ...
Heutzutage erfüllen nur 35 % der Deutschen das empfohlene Maß an körperlicher Bewegung (Robert Koch Institute, 2015). Ein möglicher Grund für diese Inaktivität ist, dass die körperliche Betätigung am Arbeitsplatz sich in den letzten Jahren um insgesamt 28% verringert hat (Wilke, Ashton, Elis, Biallas, & Froböse, 2015). Um dieser Entwicklung entgegenzuwirken, evaluiert die vorliegende Dissertation eine mHealth Intervention bestehend aus Fitnessarmbändern und einem Online Coach, welche die Bewegung von inaktiven Beschäftigten mit Gesundheitsrisiko fördern soll. Zusätzlich wird das Occupational Health Behavior Change (OHBC) Modell als theoretische Grundlage für Veränderungen von Gesundheitsverhalten im betrieblichen Kontext entwickelt. Das OHBC Modell verbindet ein gesundheitspsychologisches Modell mit einem Modell aus dem Bereich der Arbeits-& Organisationspsychologie und stellt die Grundlage für die beiden veröffentlichten Studien der Dissertation dar. Studie I bewertet den Effekt der Intervention auf körperliche Gesundheit und arbeitsbezogenem Wohlbefinden anhand eines randomisiert kontrollierten Studiendesigns und unter Berücksichtigung von Langzeiteffekten. Beschäftigte in der Interventionsgruppe zeigten eine Verbesserung ihrer physischen Gesundheit bis zu einem Jahr nach der Intervention, jedoch wurde kein Effekt auf arbeitsbezogenes Wohlbefinden gefunden. Studie II zeigt, dass die Schrittanzahl und die Beeinträchtigung des Wohlbefindens während der Intervention verbessert werden und beantwortet weiterführende Fragen über die Effektivität der Intervention anhand von modernen statistischen Methoden. Abschließend werden die Ergebnisse der beiden Studien diskutiert und dabei die Struktur des neu kreierten OHBC Modells überprüft. Insgesamt zeigt die vorliegende Dissertation, dass Fitnessarmbändern kombiniert mit einem Online Coach eine effektive Intervention darstellen, um körperliche Aktivität, physische Gesundheit und das Wohlbefinden von Beschäftigten zu fördern.
... cooperative game elements to motivate users when implementing gamification. While some studies prescribe competitive game elements to motivate users [16,17], other studies argue that competitive game elements in gamification can be demotivating for users [18,19]. These studies recommend the use of collaborative-competitive game mechanics such as inter-team competition with intra-team collaboration rather than purely competitive game mechanics. ...
This article reviews 103 gamified fitness tracker apps (Android and iOS) that incorporate step count data into gameplay. Games are labeled with a set of 13 game elements as well as meta-data from the app stores (e.g., avg rating, number of reviews). Network clustering and visualizations are used to identify the relationship between game elements that occur in the same games. A taxonomy of how steps are used as rewards is provided, along with example games. An existing taxonomy of how games use currency is also mapped to step-based games. We show that many games use the triad of Social Influence, Competition, and Challenges, with Social Influence being the most common game element. We also identify holes in the design space, such as games that include a Plot element (e.g., Collaboration and Plot only co-occur in one game). Games that use Real-Life Incentives (e.g., allow you to translate steps into dollars or discounts) were surprisingly common, but relatively simple in their gameplay. We differentiate between task-contingent rewards (including completion-contingent and engagement-contingent) and performance-contingent rewards, illustrating the differences with fitness apps. We also demonstrate the value of treating steps as currency by mapping an existing currency-based taxonomy onto step-based games and providing illustrations of nine different categories.
... Gamification has the potential to improve quality of learning through enhanced engagement with the user. In the fitness domain, gamification has demonstrated promising outcomes [41,42,43]. Until now, game mechanics have been used for macrolevel motion, such as active minutes, distance walked, ran, or bicycled. ...
This paper presents our findings from a multi-year effort to detect motion events early using inertial sensors in real-world settings. We believe early event detection is the next step in advancing motion tracking, and can enable just-in-time interventions, particularly for mHealth applications. Our system targets strength training workouts in the fitness domain, where users perform well-defined movements for each exercise, while wearing an inertial sensor. We collect data for 20 exercises across 12 users over 26 months. We propose an algorithm to detect repetitions before they end, to allow a user to visualize movement derived metrics in real-time. We further develop a gamified approach to display this information to the user and encourage them to perform consistent movements. Participants in a feasibility study find the gamified feedback useful in improving their form. Our system can detect repetition events as early as 500 ms before it ends, which is 2x faster and more accurate than state-of-the-art trackers. We believe our approach will open exciting avenues for tracking, detection, and gamification for fitness frameworks.
... Instead of providing advice on physical activity, we conducted a step challenge as a gamification element within the second intervention week of the intervention. The step challenge aimed to increase participants' autonomous and controlled motivation to become physically active by promoting enjoyment and offering a reward (Cugelman, 2013;Deci & Ryan, 2008;Goh & Razikin, 2015;Hamari et al., 2014;Lin et al., 2006;Shameli et al., 2017). It was announced on Monday of the second intervention week and took four days in total. ...
The present study evaluated the effectiveness of a workplace intervention combining activity trackers (behavioural approach) with an online coach (cognitive approach) in order to increase employees’ number of steps and improve their impaired well-being (i.e., emotional strain and negative affect). To analyse the intervention’s effectiveness, the study applied latent growth curve modelling. Moreover, we tested whether work-related and personal resources (i.e., job control and self-efficacy) moderated the intervention’s effectiveness and whether an increase in number of steps was associated with an improvement in impaired well-being. During the intervention, data were collected at six measurement points from 108 mainly low active employees. The results revealed that employees increased their number of steps until the second intervention week; this increase was not moderated by job control or self-efficacy. Moreover, the intervention was effective in decreasing emotional strain and negative affect over the course of the intervention. Further analyses showed that the increase in number of steps was related to the decrease in negative affect, whereas no such association was found for the increase in number of steps and the decrease in emotional strain. In conclusion, the findings showed that our intervention was effective in improving physical activity and impaired well-being among employees.
... Recent years, human computer interface (HCI) technology such as virtual reality and gamification methods were embebded into conventional methods to make balance training regimes more intereting (Fogg, 2002;Oinas-Kukkonen & Harjumaa, 2008). Gamification of exercise or training increased self-motivation and enjoyment of exercise (Goh & Razikin, 2015). In 2016, the use of HCI technology and gamification approach were reported able to create a fun and engaging way of doing rehabilitation for upper limbs in home environment (Karashanov, Manolova, & Neshov, 2016). ...
Balance training devices such as wobble board, basu ball and balance cushion are the tool use in balance training exercise programme in order to improve muscle strength and restore posture balance due degeneration of body function or injury. Recently, self-balancing scooter such as Segway and hover board showed a positive effects on rehabilitation. However, it is less known how these devices affect muscle physiological properties. This study aims to to measure ankle muscles activation on difference balance training devices and hover board. Besides, a comparison between these device will be done in order to identify if hover board has a promising feature to be an alternative balance training device. In this research, surface EMG (sEMG) was used to record tibialis anterior and gastrocnemius muscle activities. Seventeen healthy subjects were required to stand on three different types of balance training device such as wobble board, balance cushion, bosu ball and a hover board. They were asked to maintain their standing position on each devices for two minutes. Both time domain and frequency domain analysis were used to identify the features of the EMG signal. Time domain analysis measurement involved average rectified value (ARV) and root mean square (RMS), meanwhile for frequency domain, median frequency (MDF) of the signal were measured. The results shows that, the RMS is differed significantly between the balance training devices (p<0.05) for tibialis anterior muscle but not gastrocnemius muscle. Meanwhile, no significant difference between the devices in the ARV and the MDF value (p>0.05). Besides, less stable devices increased muscle activity were observed. There is not much difference between hover board and the other devices in term of physiological effects of both tibialis anterior and gastrochemious muscle. It is also suggested that hover board offers a promising feature to be an alternative device for balance training device.
... Moreover, they also found that badges have a positive effect on the interaction between the users, as seen by a significant increase in the amount of comments posted. Lastly, Goh & Razikin (2015) found that gamification in 'Fitocracy' positively influenced attitude towards, enjoyment of exercising and effectively increased exercise behavior. Based on results of our studies, we believe that especially social gamification features, such as leaderboards can be effective in creating enjoyment and engagement and consequently, continued OFC use. ...
The care of elderly people with neurodegenerative diseases leading to cognitive disorders and dementia represents a major health issue. In this context, serious games (SGs) can improve cognitive functions efficiently. Exergames can boost cognitive functions such as attention and memory. In this population, negative feelings can be exacerbated by inadapted technological design. The aim of this study is to design and evaluate an adapted exergame named Escapad for older adults suffering from Mild Cognitive Impairment (MCI). As part of preliminary study, two versions of Escapad were used with both therapists and MCI patients, who rated version 2 as more adaptable. Hence, we have implemented Escapad to stimulate several cognitive domains in elderly people with MCI who have a depressive tendency. Our results showed a significant improvement in visuospatial abilities/executive functions (p = 0.033), temporo-spatial orientation (p = 0.048) and a significant reduction in depression (p = 0.033). Technical aspects and game use are discussed in this paper.KeywordsSerious GameDementiaCognitive ImpairmentRehabilitation
This study uses a self-development gamified health-related app, “Work? Out!” as an example. To set up two experimental devices: the App prototype (Hi-Fi prototype) and the Board game prototype (Lo-Fi prototype), and to test them respectively. This research is intended to measure the differences between the two devices in game experience and the satisfaction of game elements. Also, it analyzes the demand attribute of the user to game elements, the optimal order of game elements, and the correspondence between game elements and game experience. The research results show that the “board game prototype” can help the “App prototype” usability test to verify the gamification strategy in the early stage of design. In the “game experience” measurement, the performance of the two groups was very similar, and there was no significant difference in the six measurement factors (P value > 0.05). “Game Element Satisfaction” shows that “App Prototype” is generally better than “Board Game Prototype”. According to the Analysis of variance (ANOVA), only two game elements have significant differences, which need to be paid special attention to. Although there are obvious differences in the “demand attributes of game elements for users” and the “ “optimized ranking of game elements”, there is still a similarity of nearly 60%. This study found 6 elements with the same attributes in the two groups, which can be used for the optimization of “App Prototype”.
KeywordsGamificationGame ExperienceGame ElementsMobile ApplicationBoard Game
Designers commonly use gamification to improve the frequency of engagement with apps, but often fail to consider the impact of placement on reward value. As rewards tend to depreciate if delayed (termed temporal discounting), placing a reward further into the future can significantly affect its ability to motivate behaviour. We examine the most effective placement of gamified rewards so as to reduce discounting and to increase the frequency an application is used. In two online studies, users were asked to choose between fictional budget tracking applications that varied in the placement of either monetary (N=70) or gamified (N=70) rewards. In both experiments we found that people more frequently used the application that provided rewards before, rather than after, the task. As predicted by temporal discounting, our work suggests that placing rewards early in the interaction sequence leads to an improvement in the perceived value of that reward, motivating further selection. We discuss the findings in the context of designing effective reward structures to encourage more frequent app engagement.
Find the articles presented at the 3 days scientific conference ConVRgence (VRIC) which take place during Laval Virtual 2019 (April 20-22).
Background and Aim: Gamefulness is commonly cited as the primary goal of gamification, a family of approaches employed in education, business, healthcare, government, and elsewhere. However, gamefulness is defined imprecisely across the literature. To address this, we present a theory of gamefulness that splits gamefulness into more specific constructs and outlines their effects in a process model.
Method: We integrate extant literature from psychology, human-computer interaction, and other fields to define gameful design, systems, and experiences. Most critically, we argue that gameful experience is the core focal construct of this theory and define it as an interactive state occurring when a person perceives non-trivial achievable goals created externally, is motivated to pursue them under an arbitrary set of behavioral rules, and evaluates that motivation as voluntary.
Results: We present six resulting propositions: (1) gameful systems lead to gameful experiences, (2) gameful systems impact psychological characteristics, (3) effective gameful design leads to a gameful system, (4) gameful systems lead to behavioral change, (5) behavioral change causes the distal outcomes gamification designers target, and (6) individual differences moderate the effectiveness of gameful systems.
Conclusion: Gameful experience theory provides researchers with a unified foundation to study gamification from any social scientific lens.
Many online platforms support social functions that enable their members to communicate, befriend, and join groups with one another. These social engagements are known to shape individuals’ future behavior. However, most work has focused solely on how peers influence behavior and little is known what additional role online groups play in changing behavior. We investigate the capacity for group membership to lead users to change their behavior in three settings: (1) selecting physical activities, (2) responding to help requests, and (3) remaining active on the platform. To do this, we analyze nearly half a million users over five years from a popular fitness-focused social media platform whose unique affordances allow us to precisely control for the effects of social ties, user demographics, and communication. We find that after joining a group, users readily adopt the exercising behavior seen in the group, regardless of whether the group was exercise and non-exercise themed, and this change is not explained by the influence of pre-existing social ties. Further, we find that the group setting equalizes the social status of individuals such that lower status users still receive responses to requests. Finally, we find, surprisingly, that the number of groups one joins is negatively associated with user retention, when controlling for other behavioral and social factors.
This paper examines the role of gamification for enjoyment in physical exercise and a healthy diet. The lack of motivation for these health-related behaviors is associated with the rising incidence of cardiovascular diseases, diabetes, hypertension, and obesity. Gamification involves leveraging on enjoyment derived from game mechanics that could galvanize individuals to exercise and consume healthier meals. Literature has also noted that enjoyment is associated with competing activities, personal investments, valuable opportunities, social constraints, and social support. This work introduces Zest!, a gamified application designed to enhance enjoyment to exercise and diet. Zest! aims to enhance enjoyment by entwining exercising and dieting activities with game mechanics. An evaluation was conducted to understand users’ perception of enjoyment associated with exercising and dieting as a result of using Zest!. It validates the game mechanics in enhancing the enjoyment to the activities. A total of 70 participants took part in the study and used it for two days. During the study, the participants were given tasks to utilize the available features. A questionnaire was administered at the end of the study to elicit their perceptions. Regression analyses were performed on the data collected. The results indicate that gamified applications has to potential to enhance enjoyment for physical exercise and a healthy diet. The implications from this study are presented.
Interest in gamification is growing steadily. But as the underlying mechanisms of gamification are not well understood yet, a closer examination of a gamified activity’s meaning and individual game design elements may provide more insights. We examine the effects of points – a basic element of gamification, – and meaningful framing – acknowledging participants’ contribution to a scientific cause, – on intrinsic motivation and performance in an online image annotation task. Based on these findings, we discuss implications and opportunities for future research on gamification.
Game design elements are often implemented in persuasive systems aimed to promote physical activity, a process called “gamification.” Gamification is believed to motivate users to become more active, and is commonly implemented in commercial products. However, relatively few studies rigorously evaluated the effectiveness of gamification, and they yielded contradicting findings. We set out to evaluate the effectiveness of virtual rewards and social comparison—two game elements prevalent in persuasive systems. We developed a research prototype, called “StepByStep,” aimed to promote routine walking. We created different versions of StepByStep, implemented as an application on Android-based mobile devices, and compared their effectiveness in two field studies. Study 1 showed that a quantified version of the application—offering continuous measurement of walking time, a daily goal, and real-time feedback on progress toward this goal—facilitated reflection on activity and significantly increased walking time over baseline level. Study 2 showed that gamified versions offering virtual rewards and social comparison were only as effective as the quantified version. Thus, we advise designers to facilitate reflection on meaningful aspects of physical activity by developing novel ubiquitous measures. Furthermore, our findings highlight the importance of systematic comparisons between quantified and gamified elements for better understanding their motivational affordances.
Exercise-related affective changes are well documented across a variety of settings and populations. In addition to the stimulus properties of exercise itself, social environmental factors are thought to influence affective responses. One factor that may be associated with psychological responses to exercise is enjoyment. Individuals who enjoy exercise may exhibit more positive affective responses compared to those who enjoy exercise less. The purpose of this study was to examine whether exercise enjoyment was related to affective changes associated with an acute bout of exercise in a naturalistic setting. Study 1 used a categorical approach to assess affect and sampled college-aged female group fitness participants. Study 2 was based on a dimensional affect conceptualization and sampled corporate fitness participants. Across both studies, results revealed a significant decrease in negative affect and increase in positive affect following exercise. Enjoyment was positively related to increases in positive affect but unrelated to changes in negative affect.
Of key importance to avoiding significant health problems such as cardiac disease and stroke is eating nutritious foods and leading an active lifestyle. However, leading a healthy lifestyle remains elusive and obesity continues to increase in North America. We investigate how online social networks (OSN) can change health behaviour by blending theories from health behaviour and participation in OSNs. We designed, prototyped and evaluated an OSN, called VivoSpace, using factors derived from the blend of theoretical models with the intention to change health behaviour. Our results from field studies with 35 participants from two clinical and one non-clinical social network groups revealed that designing these factors into the online social network lead to positive health behaviour change, namely, improved diet for the clinical group. The use of theoretical models in the evaluation provided a means to understand how the design can be improved to see further health behaviour change.
This paper reviews peer-reviewed empirical studies on gamification. We create a framework for examining the effects of gamification by drawing from the definitions of gamification and the discussion on motivational affordances. The literature review covers results, independent variables (examined motivational affordances), dependent variables (examined psychological/behavioral outcomes from gamification), the contexts of gamification, and types of studies performed on the gamified systems. The paper examines the state of current research on the topic and points out gaps in existing literature. The review indicates that gamification provides positive effects, however, the effects are greatly dependent on the context in which the gamification is being implemented, as well as on the users using it. The findings of the review provide insight for further studies as well as for the design of gamified systems.
Many people have turned to technological tools to help them be physically active. To better understand how goal-setting, rewards, self-monitoring, and sharing can encourage physical activity, we designed a mobile phone application and deployed it in a four-week field study (n=23). Participants found it beneficial to have secondary and primary weekly goals and to receive nonjudgmental reminders. However, participants had problems with some features that are commonly used in practice and suggested in the literature. For example, trophies and ribbons failed to motivate most participants, which raises questions about how such rewards should be designed. A feature to post updates to a subset of their Facebook NewsFeed created some benefits, but barriers remained for most participants.
Interest in gamification is growing steadily. But as the underlying mechanisms of gamification are not well understood yet, a closer examination of a gamified activity's meaning and individual game design elements may provide more insights. We examine the effects of points -- a basic element of gamification, -- and meaningful framing -- acknowledging participants' contribution to a scientific cause, -- on intrinsic motivation and performance in an online image annotation task. Based on these findings, we discuss implications and opportunities for future research on gamification.
Persuasive games are an effective approach for motivating health behavior, and recent years have seen an increase in games designed for changing human behaviors or attitudes. However, these games are limited in two major ways: first, they are not based on theories of what motivates healthy behavior change. This makes it difficult to evaluate why a persuasive approach works. Second, most persuasive games treat players as a monolithic group. As an attempt to resolve these weaknesses, we conducted a large-scale survey of 642 gamers' eating habits and their associated determinants of healthy behavior to understand how health behavior relates to gamer type. We developed seven different models of healthy eating behavior for the gamer types identified by BrainHex. We then explored the differences between the models and created two approaches for effective persuasive game design based on our results. The first is a one-size-fits-all approach that will motivate the majority of the population, while not demotivating any players. The second is a personalized approach that will best motivate a particular type of gamer. Finally, to make our approaches actionable in persuasive game design, we map common game mechanics to the determinants of healthy behavior.
Two studies examined the reliability and validity of the Physical Activity Enjoyment Scale (PACES). In Study 1, each of 37 undergraduates rode an exercise bicycle under control and external focus conditions. As predicted, Ss reported enjoying the exercise more, as measured by the PACES, in the external focus condition. Moreover, there was a significant negative correlation in the control condition between Ss PACES scores and their scores on a measure of boredom proneness. In Study 2, each of 37 undergraduates rode an exercise bicycle and jogged on a minitrampoline in separate sessions; each then chose one of these activities for their 3rd session. As predicted, there was a significant relationship between Ss PACES ratings (completed after each activity) and their choices of activity. Test–retest reliability was high for jogging and moderate for bicycling. The PACES had high internal consistency in both studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Effective procedures are needed to prevent the substantial increases in adiposity that have been occurring among children and adults. Behavioral change may occur as a result of changes in variables that mediate interventions. These mediating variables have typically come from the theories or models used to understand behavior. Seven categories of theories and models are reviewed to define the concepts and to identify the motivational mechanism(s), the resources that a person needs for change, the processes by which behavioral change is likely to occur, and the procedures necessary to promote change. Although each model has something to offer obesity prevention, the early promise can be achieved only with substantial additional research in which these models are applied to diet and physical activity in regard to obesity. The most promising avenues for such research seem to be using the latest variants of the Theory of Planned Behavior and Social Ecology. Synergy may be achieved by taking the most promising concepts from each model and integrating them for use with specific populations. Biology-based steps in an eating or physical activity event are identified, and research issues are suggested to integrate behavioral and biological approaches to understanding eating and physical activity behaviors. Social marketing procedures have much to offer in terms of organizing and strategizing behavioral change programs to incorporate these theoretical ideas. More research is needed to assess the true potential for these models to contribute to our understanding of obesity-related diet and physical activity practices, and in turn, to obesity prevention.
A sedentary lifestyle is a contributing factor to chronic diseases, and it is often correlated with obesity. To promote an increase in physical activity, we created a social computer game, Fish'n'Steps, which links a player's daily foot step count to the growth and activity of an animated virtual character, a fish in a fish tank. As further encouragement, some of the players' fish tanks in- cluded other players' fish, thereby creating an environment of both cooperation and competition. In a fourteen-week study with nineteen participants, the game served as a catalyst for promoting exercise and for improving game players' at- titudes towards physical activity. Furthermore, although most player's enthusi- asm in the game decreased after the game's first two weeks, analyzing the re- sults using Prochaska's Transtheoretical Model of Behavioral Change suggests that individuals had, by that time, established new routines that led to healthier patterns of physical activity in their daily lives. Lessons learned from this study underscore the value of such games to encourage rather than provide negative reinforcement, especially when individuals are not meeting their own expecta- tions, to foster long-term behavioral change.
"Gamification" is an informal umbrella term for the use of video game elements in non-gaming systems to improve user experience (UX) and user engagement. The recent introduction of 'gamified' applications to large audiences promises new additions to the existing rich and diverse research on the heuristics, design patterns and dynamics of games and the positive UX they provide. However, what is lacking for a next step forward is the integration of this precise diversity of research endeavors. Therefore, this workshop brings together practitioners and researchers to develop a shared understanding of existing approaches and findings around the gamification of information systems, and identify key synergies, opportunities, and questions for future research.
To understand why and how people share health information online, we interviewed fourteen people with significant health concerns who participate in both online health communities and Facebook. Qualitative analysis of these interviews highlighted the ways that people think about with whom and how to share different types of information as they pursue social goals related to their personal health, including emotional support, motivation, accountability, and advice. Our study suggests that success in these goals depends on how well they develop their social networks and how effectively they communicate within those networks. Effective communication is made more challenging by the need to strike a balance between sharing information related to specific needs and the desire to manage self-presentation. Based on these observations, we outline a set of design opportunities for future systems to support health-oriented social interactions online, including tools to help users shape their social networks and communicate effectively within those.
Physical activity is recommended by physicians to patients with non-insulin-dependent diabetes mellitus (NIDDM), because it increases sensitivity to insulin. Whether physical activity is effective in preventing this disease is not known.
We used questionnaires to examine patterns of physical activity and other personal characteristics in relation to the subsequent development of NIDDM in 5990 male alumni of the University of Pennsylvania. The disease developed in a total of 202 men during 98,524 man-years of follow-up from 1962 to 1976.
Leisure-time physical activity, expressed in kilocalories expended per week in walking, stair climbing, and sports, was inversely related to the development of NIDDM: The incidence rates declined as energy expenditure increased from less than 500 kcal to 3500 kcal. For each 500-kcal increment in energy expenditure, the age-adjusted risk of NIDDM was reduced by 6 percent (relative risk, 0.94; 95 percent confidence interval, 0.90 to 0.98). This association remained the same when the data were adjusted for obesity, hypertension, and a parental history of diabetes. The association was weaker when we considered weight gain between the time of college attendance and 1962 (relative risk, 0.95; 95 percent confidence interval, 0.90 to 1.00). The protective effect of physical activity was strongest in persons at highest risk for NIDDM, defined as those with a high body-mass index, a history of hypertension, or a parental history of diabetes. These factors, in addition to weight gain since college, were also independent predictors of the disease.
Increased physical activity is effective in preventing NIDDM, and the protective benefit is especially pronounced in persons at the highest risk for the disease.
The associations of physical activity and sedentary behavior with barriers, enjoyment, and preferences were examined in a population-based mail survey of 1,332 adults. Respondents reporting high enjoyment and preference for physical activity were more likely to report high levels of activity. Those reporting cost, the weather, and personal barriers to physical activity were less likely to be physically active. Preference for sedentary behavior was associated with the decreased likelihood of being physically active, and the weather a barrier to physical activity was associated with the increased likelihood of sedentary behavior. These constructs can be used to examine individual and environmental influences on physical activity and sedentary behavior in specific populations and could inform the development of targeted interventions.
We examined the associations among physical activity, sedentary behavior, and metabolic syndrome in a representative sample of U.S. adults.
A total of 1626 men and women > or =20 years old from National Health and Nutrition Examination Survey 1999 to 2000 who attended the morning examination were evaluated. The metabolic syndrome was defined by using the definition from the National Cholesterol Education Program.
In unadjusted analysis, participants who did not engage in any moderate or vigorous physical activity during leisure time had almost twice the odds of having metabolic syndrome [odds ratio (OR), 1.90; 95% confidence interval (CI), 1.22 to 2.97] as those who reportedly engaged in > or =150 min/wk of such activity. Adjustment for age, sex, race or ethnicity, educational status, smoking status, and alcohol use attenuated the OR (OR, 1.46; 95% CI, 0.87 to 2.45). Compared with participants who watched television or videos or used a computer <1 h/d outside of work, the adjusted ORs for having metabolic syndrome were 1.41 (95% CI 0.80 to 2.51) for 1 h/d, 1.37 (95% CI 0.85 to 2.20) for 2 h/d, 1.70 (95% CI 0.92 to 3.14) for 3 h/d, and 2.10 (95% CI 1.27 to 3.47) for > or =4 h/d. Additional adjustment for physical activity or sedentary behavior minimally affected the ORs.
Sedentary behavior is an important potential determinant of the prevalence of the syndrome. Efforts to lessen the amount of time that U.S. adults spend watching television or videos or using a computer, especially if coupled to increases in physical activity, could result in substantial decreases in the prevalence of metabolic syndrome.
Social support has been reliably related to lower rates of morbidity and mortality. An important issue concerns the physiological mechanisms by which support influences such health endpoints. In this review, I examine evidence linking social support to changes in cardiovascular, neuroendocrine, and immune function. Consistent with epidemiological evidence, social support appears to be related to more positive "biological profiles" across these disease-relevant systems. Recent research on immune-mediated inflammatory processes is also starting to provide data on more integrative physiological mechanisms potentially linking social support to health. The implications of these links, along with future research directions are discussed.
The purpose of this study was to evaluate the effectiveness of interactive video games (combined with stationary cycling) on health-related physical fitness and exercise adherence in comparison with traditional aerobic training (stationary cycling alone). College-aged males were stratified (aerobic fitness and body mass) and then assigned randomly to experimental (n = 7) or control (n = 7) conditions. Program attendance, health-related physical fitness (including maximal aerobic power (VO2 max), body composition, muscular strength, muscular power, and flexibility), and resting blood pressure were measured before and after training (60%-75% heart rate reserve, 3 d/week for 30 min/d for 6 weeks). There was a significant difference in the attendance of the interactive video game and traditional training groups (78% +/- 18% vs. 48% +/- 29%, respectively). VO2 max was significantly increased after interactive video game (11% +/- 5%) but not traditional (3% +/- 6%) training. There was a significantly greater reduction in resting systolic blood pressure after interactive video game (132 +/- 6 vs. 123 +/- 6 mmHg) than traditional (131 +/- 7 vs. 128 +/- 8 mmHg) training. There were no significant changes in body composition after either training program. Attendance mediated the relationships between condition and changes in health outcomes (including VO2 max, vertical jump, and systolic blood pressure). The present investigation indicates that a training program that links interactive video games to cycle exercise results in greater improvements in health-related physical fitness than that seen after traditional cycle exercise training. It appears that greater attendance, and thus a higher volume of physical activity, is the mechanism for the differences in health-related physical fitness.
Research and practice partnerships have the potential to enhance the translation of research findings into practice.
This paper describes such a partnership in the development of Walk Kansas (WK) and highlights individual and organizational level outcomes.
Phase 1 examined: (a) the reach of WK, (b) physical activity changes, and (c) maintenance of physical activity changes 6 months after the program was completed. Phase 2 explored WK adoption and sustainability over 5 years.
WK attracted a large number of participants who were more likely to be female, more active, and older than the adult population within the counties where they resided. Inactive or insufficiently active participants at baseline experienced significant increases in both moderate (p < 0.001) and vigorous (p < 0.001) physical activity. A random selection of participants who were assessed 6 months post-program did not demonstrate a significant decrease in moderate or vigorous activity between program completion and 6-month follow-up. The number of counties adopting the program increased across years, peaking at 97 in 2006 and demonstrated the sustainability of the WK over 5 years.
WK is effective, has a broad reach, and enables participants to maintain increased activity. It also shows promise for broad adoption and sustainability.
Physical activity levels of girls decline dramatically during adolescence and may be a contributor to the increasing number of obese teens in the United States. Research has shown that social support is positively correlated with physical activity levels in adolescents, particularly girls. We present the findings from a three week field study of a mobile phone application designed to create a support group for physical activity within an existing social network of adolescent girls. Our findings suggest design considerations for technologies that encourage physical activity for this user group.
Risk of first heart attack was found to be related inversely to energy expenditure reported by 16,936 Harvard male alumni, aged 35–74 years, of whom 572 experienced heart attacks in 117,680 person-years of followup. Stairs climbed, blocks walked, strenuous sports played, and a composite physical activity index all opposed risk. Men with index below 2000 kilocalories per week were at 64% higher risk than classmates with higher Index. Adult exercise was independent other influences on heart attack risk, and peak exertion as strenuous sports play enhanced the effect of total energy expenditure. Notably, alumni physical activity supplanted student athleticisn; assessed in college 16–50 years earlier. If it is postulated that varsity athlete status implies selective cardiovascular fitness, such selection alone is insufficient to explain lower heart attack risk in later adult years. Ex-varsity athletes retained lower risk only if they maintained high physical activity Index as alumni.
Risk of first heart attack was found to be related Inversely to energy expenditure reported by 16,936 Harvard male alumni, aged 35–74 years, of whom 572 experienced heart attacks In 117,680 person-years of followup. Stairs climbed, blocks walked, strenuous sports played, and a composite physical activity Index all opposed risk. Men with Index below 2000 kilocalories per week were at 64% higher risk than classmates with higher Index. Adult exercise was Independent of other influences on heart attack risk, and peak exertion as strenuous sports play enhanced the effect of total energy expenditure. Notably, alumni physical activity supplanted student athleticism assessed in college 16–50 years earlier. If it Is postulated that varsity athlete status implies selective cardiovascular fitness, such selection alone Is insufficient to explain lower heart attack risk in later adult years. Ex-varsity athletes retained lower risk only If they maintained a high physical activity Index as alumni.
Can the Web help people live healthier lives? This paper seeks to answer this question through an examination of sites, apps and online communities designed to help people improve their fitness, better manage their disease(s) and conditions, and to solve the often elusive connections between the symptoms they experience, diseases and treatments. These health social machines employ a combination of both simple and complex social and computational processes to provide such support. We first provide a descriptive classification of the kinds of machines currently available, and the support each class offers. We then describe the limitations exhibited by these systems and potential ways around them, towards the design of more effective machines in the future.
Most design advice for the development of successful gamification systems has focused on how best to engage the end user while imbuing the system with playfulness. This paper argues that it is also critical for designers to focus on the broad context of the system's deployment, including the identification of stakeholder requirements, requirements from the hosting organization, deep understanding of the diversity of the target population, understanding of limits in the agency of the target users, and constraints arising from the post-deployment environment. To illustrate the importance of such contextual and stakeholder analysis, the paper presents issues and associated solutions that were discovered through the creation of a children's nutrition and fitness education gamification system. The problems identified through a broad analysis of context significantly altered the design of the system and led to the realization that the initially conceptualized project would have been unusable. The paper concludes with concrete lessons for designers.
Study Objective: To assess the effect of weight-bearing exercise training and subsequent detraining on lumbar bone mineral content in postmenopausal women.
Design: Non-randomized, controlled, short-term (9 months) trial and long-term (22 months) exercise training and detraining (13 months).
Setting: Section of applied physiology at a university school of medicine.
Patients: Thirty-five healthy, sedentary postmenopausal women, 55 to 70 years old. All women completed the study. There was 90% compliance with exercise training.
Interventions: All women were given calcium, 1500 mg daily. The exercise group did weight-bearing exercise (walking, jogging, stair climbing) at 70% to 90% of maximal oxygen uptake capacity for 50 to 60 min, 3 times weekly.
Measurements and Main Results: Bone mineral content increased 5. 2% (95% confidence interval [Cl], 2.0% to 8.4%; P = 0.0037) above baseline after short-term training whereas there was no change (-1.4%) in the control group. After 22 months of exercise, bone mineral content was 6.1% (95% Cl, 3.9% to 8.3% above baseline; P =0.0001) in the long-term training group. After 13 months of decreased activity, bone mass was 1.1% above baseline in the detraining group.
Conclusions: Weight-bearing exercise led to significant increases above baseline in bone mineral content which were maintained with continued training in older, postmenopausal women. With reduced weight-bearing exercise, bone mass reverted to baseline levels. Further studies are needed to determine the threshold exercise prescription that will produce significant increases in bone mass.
Can the Web help people live healthier lives? This paper seeks to answer this question through an examination of sites, apps and online communities designed to help peo- ple improve their fitness, better manage their disease(s) and conditions, and to solve the often elusive connections be- tween the symptoms they experience, diseases and treat- ments. These health social machines employ a combination of both simple and complex social and computational pro- cesses to provide such support. We first provide a descriptive classification of the kinds of machines currently available, and the support each class offers. We then describe the limitations exhibited by these systems and potential ways around them, towards the design of more effective machines in the future.
Hypothesizes that an emphasis on enjoyment of physical activity may have significant positive outcomes by facilitating continued involvement in activity and by countering stress and facilitating positive psychological health. Pertinent research is reviewed in support of this hypothesis. Enjoyment and adherence are considered with respect to exercise goals, social interaction, and challenge and competence. Enjoyment and psychological benefits are considered with respect to attitudinal and personality factors, intrinsic motivation, and mindfulness. Although the underlying processes linking enjoyment to psychological health are unspecified, the association appears sufficiently strong to warrant serious consideration by those using physical activity as a treatment for such maladies as anxiety and depression. (French, Spanish, German & Italian abstracts) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A perceived availability of social support measure (the ISEL) was designed with independent subscales measuring four separate support functions. In a sample of college students, both perceived availability of social support and number of positive events moderated the relationship between negative life stress and depressive and physical symptomatology. In the case of depressive symptoms, the data fit a “buffering” hypothesis pattern, i.e., they suggest that both social support and positive events protect one from the pathogenic effects of high levels of life stress but are relatively unimportant for those with low levels of stress. In the case of physical symptoms, the data only partially support the buffering hypothesis. Particularly, the data suggest that both social support and positive events protect one from the pathogenic effects of high levels of stress but harm those (i.e., are associated with increased symptomatology) with low levels of stress. Further analyses suggest that self-esteem and appraisal support were primarily responsible for the reported interactions between negative life stress and social support. In contrast, frequency of past social support was not an effective life stress buffer in either the case of depressive or physical symptomatology. Moreover, past support frequency was positively related to physical symptoms and unrelated to depressive symptoms, while perceived availability of support was negatively related to depressive symptoms and unrelated to physical symptoms.
This paper describes the development of the Exercise Motivations Inventory (EMI), a 44-item, multidimensional instrument designed to test theoretically derived predictions concerning the influences of personal exercise on goals exercise participation. Items were generated from responses to an open-ended questionnaire and from an examination of the literature on exercise adherence. A 71-item version of the EMI was completed by 249 regular exercisers. Principal components analysis with equamax rotation yielded 12 factors with eigenvalues greater than 1.0, accounting for 69.4% of the total variance. The factors were labelled Stress Management, Weight Management, Re-creation, Social Recognition, Enjoyment, Appearance, Personal Development, Affiliation, Ill-Health Avoidance, Competition, Fitness, and Health Pressures. The internal consistency of the 12 subscales was generally acceptable with Cronbach's alpha reliability coefficients ranging from 0.63 to 0.90. Test-retest reliability coefficients over a 4 to 5 week period ranged from 0.59 to 0.88. None of the subscales appear to suffer from a social desirability response bias, as evidenced by weak, non-significant correlations with the short form of the Marlowe-Crowne Social Desirability Scale. Preliminary evidence for the discriminative and construct validity of the EMI is presented.
The global obesity epidemic has prompted our community to explore the potential for technology to play a stronger role in promoting healthier lifestyles. Although there are several examples of successful games based on focused physical interaction, persuasive applications that integrate into everyday life have had more mixed results. This underscores a need for designs that encourage physical activity while addressing fun, sustainability, and behavioral change. This note suggests a new perspective, inspired in part by the social nature of many everyday fitness applications and by the successful encouragement of long term play in massively multiplayer online games. We first examine the game design literature to distill a set of principles for discussing and comparing applications. We then use these principles to analyze an existing application. Finally, we present Kukini, a design for an everyday fitness game.
Human computation games (HCGs) are applications that use games to harness human intelligence to perform various computational tasks. That is, users perform computations as a byproduct of being entertained while playing a game. Such games are increasing in popularity and it is critical to examine how different types of HCG affect players’ perceptions and performance. In addition, understanding their motivational appeal to different players is also important to good HCG design. In the present research, we focus on image tagging HCGs, where users play games to generate keywords for images. Three versions were created: a collaborative HCG which required players to cooperate, a competitive HCG where players worked against each other, and a control non-game manual tagging application. The applications were evaluated to uncover the quality of the tags, users’ perceptions of these variants, and the influence of motivational needs on usage intention. Results suggest that, while participants reported liking the collaborative and competitive HCGs over the control application, those using the latter seemed to generate better quality tags. Further, using the trichotomy of needs theory, we found that an individual’s need for achievement and power influenced intention to use the various applications.
The importance of regular physical activity to overall health has been well established, yet adults in the United States are leading increasingly sedentary lives. Research suggests that lowering perceived barriers to exercise is an effective strategy for encouraging physical activity. This article describes the top barriers that emerged from a qualitative analysis of message board traffic from a three-month healthy lifestyle intervention that promoted physical activity and healthy eating. The findings further elaborate known barriers to physical activity-two of which are not reported as key barriers in prior research-and illustrate the value of a grounded approach to studying health and fitness behaviors. Based on our analysis, we identify design considerations for technologies that encourage and support physical activity. Understanding the needs of a population is a critical step in the design process, and this paper offers unique insights for those working in this growing domain.
The purpose of this study was to investigate the importance of enjoyment of exercise in a health care-based intervention aimed at promoting physical exercise in primary health care patients. In a controlled study design, the intervention group was offered a wide range of group exercises over 3 months, followed by support in designing their own exercise program. The control group received usual care. Enjoyment of exercise and exercise level were measured. Associations between enjoyment and exercise level were analyzed using Spearman's rank correlation coefficients. Changes in enjoyment between and within study groups were analyzed by the independent and paired t-test. Associations were found between enjoyment and exercise level (r=0.36, P<0.01), as well as between changes in enjoyment and changes in exercise level (r=0.34, P<0.01). At the 12-month follow-up, enjoyment of exercise was 25% higher in the intervention group than in the control group (P<0.01). In this group of primary health care patients, enjoyment of exercise was associated with exercise level. Enjoyment of exercise seems to be a mediator of exercise level. Furthermore, health care-based interventions seem to be able to affect enjoyment of exercise. Enjoyment of exercise may be important for the long-term effectiveness, of health care-based interventions.
We examined patterns of physical activity and other characteristics that might deter hypertension or delay all-cause mortality among university alumni, 1962-1985. Collegiate sports play did not alter hypertension incidence, nor did contemporary walking, stair-climbing, or light sports play among 5463 University of Pennsylvania alumni, 739 of whom developed hypertension. But vigorous sports play reduced hypertension incidence; and overweight, gain in weight, history of parental hypertension, or any combination of these, increased it. Among 819 hypertensive Pennsylvania alumni (138 died during follow-up), vigorous sports play had minimal influence on mortality; but freedom from overweight and cigarette smoking deferred death. Among 16,936 Harvard College alumni, of whom 2614 died during follow-up, lack of vigorous sports play, or presence of hypertension, cigarette smoking, and overweight increased risk of premature mortality, heightened by any combination of these adverse characteristics. Overall, we found an inverse relationship between vigorous sports participation and hypertension risk but a direct relationship between risk and weight-for-height, weight gain, or parental hypertension. With regard to all-cause mortality, cigarette smoking and hypertension were most hazardous for the individual; smoking and lack of vigorous recreational play were most hazardous for the alumnus population as a whole.
Risk of first heart attack was tound to be related inversely to energy expenditur reported by 16,936 Harvard male alumni, aged 35-74 years, of whom 572 experienced heart attacks in 117,880 person-years of followup. Stairs climbed, blocks walked, strenuous sports played, and a composite physical activity index all opposed risk. Men with Index below 2000 ktlocalorlea per week were at 64% higher risk than classmates with higher index. Adult exercise was Independent of other influences on heart attack risk, and peak exertion as strenuous sports play enhanced the effect of total energy expenditure. Notably, alumni physical activity supplanted 8tudent athieti clam assessed in college 16-50 years earlier. If it Is postulated that varsity athlete status implies selective cardiovascular fitness, such selection alone is Jnsutflcient to explain lower heart attack rlek In later adult years. Ex-varsity athletes retained lower risk only if they maintained a high physical activity index as alumni.
The purpose of this study was to examine cognitive constructs from the theory of planned behavior (i.e., attitude, perceived behavioral control, and intention) as potential mediators of the relationship between selected social influence constructs (i.e., subjective norm, social support, and cohesion) and adherence to structured exercise classes. Sixty-two participants completed self-administered questionnaires during the fourth week (social influence constructs) and eighth week (cognitive constructs) of a 12-week exercise program. Exercise adherence was monitored during weeks 9 through 12 using perceived intensity and attendance. Pearson correlations indicated that social support correlated with perceived behavioral control, whereas cohesion correlated with attitude. Path analysis supported two distinct paths from social influence to exercise adherence: (a) social support-->perceived behavioral control-->intention-->exercise adherence, and (b) cohesion-->attitude-->intention-->exercise adherence. Discussion focuses on the theoretical importance of these findings, conceptual and measurement issues regarding subjective norm, and suggestions for future research.
Many American adults remain sedentary despite many known health benefits. Research on the determinants of physical activity have indicated that social support is one of the strongest correlates, but little is known about this relation in important subgroups of middle and older-aged women.
The purpose of this study was to assess the association of physical activity-related social support on several measures of physical activity in a national sample of minority women. A unique aspect of these measures is the inclusion of vigorous household tasks and occupational physical activities.
The US Women's Determinants Study was conducted in 1996-1997. The survey was a modified-random sample, telephone survey of 2912 Black, Hispanic, American Indian/Alaskan Native, and White women age 40 and older. A composite score of physical activity social support (PASS) was analyzed as the independent variable in logistic regression analyses. Four measures of physical activity levels served as the dependent variables. A separate analysis was done to distinguish PASS from friends versus PASS from relatives. The potential confounding effect of race/ethnicity, marital status, age, income and education were evaluated and adjusted in the models.
Hispanic women were more likely to have high PASS scores than the other racial/ethnic groups. Odds ratios indicate that subjects with high levels of PASS were significantly less likely to be sedentary than those with low support, even after adjusting for race/ethnicity. While there were significant associations among levels of social support and physical activity, this was not true for the measure of "regular exercise." There was no significant difference between the contribution of "friend" support versus "family" support on all four measures on physical activity.
Based on our results, enhancing social support may be an important aspect of interventions aimed at increasing physical activity in a population of sedentary women of various racial/ethnic backgrounds. Also, "regular exercisers" in this population appear to be less reliant social support to maintain their behavior.
The study evaluated whether targeted changes in factors influencing enjoyment of physical education (PE), physical activity enjoyment, and self-efficacy beliefs about participating in physical activity mediated the effect of the Lifestyle Education for Activity Program (LEAP) intervention on participation in physical activity.
High schools (N=24) paired on enrollment size, racial composition, urban or rural location, and class structure were randomized into control (N=12) or experimental (N=12) groups. Of the 4044 girls enrolled and eligible, 2087 (51.6%) participated in the measurement component of the study. There were 1038 girls in the control group and 1049 girls in the experimental group.
LEAP was a comprehensive school-based intervention emphasizing changes in instruction and school environment designed to increase physical activity among black and white adolescent girls. It was organized according to the Coordinated School Health Program and included a PE component with core objectives of promoting enjoyment of PE, physical activity enjoyment, and self-efficacy.
Latent variable structural equation modeling indicated that: 1) the intervention had direct, positive effects on physical activity and factors influencing enjoyment of PE, which subsequently explained the effects of increased physical activity enjoyment and self-efficacy on increased physical activity; and 2) an additional, indirect effect of physical activity enjoyment on physical activity operated by an influence on self-efficacy.
Increases in enjoyment partially mediated the positive effect of the LEAP intervention. To our knowledge, we have provided the first experimental evidence from a randomized controlled trial linking increased enjoyment with increased physical activity among black and white adolescent girls.
Gamification. using game-design elements in non-gaming contexts
- S Deterding
- M Sicart
- L Nacke
- K Hara
- D Dixon