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European Research Studies Journal
Volume XXVII, Issue 4, 2024
pp. 985-1007
Gamification in Ηealth Promotion in the Context of Creating
the Concept of Health 2.0 - A Comparative Analysis of
Selected Health Mobile Applications
Submitted 30/09/24, 1st revision 20/10/24, 2nd revision 11/11/24, accepted 25/11/24
Iwona Czerska
1
Abstract:
Purpose: This article aims to explore and explain the importance of gamification in health
promotion within the framework of the Health 2.0 concept based on a comparative analysis
of selected health mobile apps.
Design/Methodology/Approach: The following research methods were used in this paper:
content analysis of health mobile apps and their comparative analysis. Based on the 2023
rankings, 12 apps were selected from the Apple App Store and Google Play Store, the most
interesting, in the author's opinion, in terms of gamification elements. The chosen apps were
tabulated in terms of purpose, target group, gamification elements, and use benefits. The
study consists of the following sections: introduction, literature review, research
methodology, results, discussion, limitations, conclusions, and practical implications.
Findings: The utilisation of gamification in the promotion of health possesses the potential
to captivate audiences, furnish amusement, and bring forth motivational and cognitive
advantages, consequently potentially serving the objectives of Health 2.0. Implementing
gamification in mobile health applications can enhance user involvement and cultivate
specific health-related behaviours. Furthermore, gamification can be pivotal in inspiring
individuals within higher education establishments, thus contributing to the goals of Health
2.0 by endorsing healthy environments and lifestyles among students and educators.
Moreover, gamification can effectively provoke employee engagement, stimulate customers,
and enhance learning in healthcare institutions.
Limitations: Limitations of the study that may have affected the overall picture of
considerations were identified. Firstly, only selected health mobile apps were taken for
comparative analysis. Secondly, the collation and comparative study of the mobile apps in
question focused on the most popular gamification elements, which aligns with the results of
the literature review. Thirdly, only mobile health apps appearing simultaneously in the Apple
App Store and Google Play Store were taken for comparative analysis. These three
limitations may have limited the study with additional findings and suggestions.
Originality/value: The comparative analysis of mobile health applications is based on
applications resulting from the 2023 rankings of such applications. The inclusion of issues
treating gamification in health promotion in the context of creating the concept of Health 2.0
is based on the latest literature on the subject, Polish and foreign, enriching the previous
1
Wroclaw University of Economics and Business, Poland, ORCID: 0000-0002-9680-6695,
e-mail: iwona.czerska@ue.wroc.pl;
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
986
scientific output concerning the healthcare industry and management, signalling the author's
contribution to the development of the discipline of management and quality sciences.
Keywords: Gamification, health promotion, Health 2.0, benchmarking, health mobile apps.
JEL codes: C88, D1, I1, I18
Paper type: Research article.
Research funding: Research funding: Co-financed by the Minister of Science under the
“Regional Excellence Initiative”.
1. Introduction
Gamification, the application of mechanisms known from games to areas outside of
them, is becoming increasingly popular in various fields, including health
promotion. In the context of the concept of Health 2.0, which involves the active
involvement of patients in managing their health through digital technologies,
gamification can play a crucial role. Health programs, including mobile apps, based
on gamified elements such as points, levels, challenges, rankings, and rewards can
increase motivation to lead healthier lifestyles, improve adherence to medical
recommendations, and increase patient involvement in treatment.
Gamification can also help in health education, making it easier to understand
complex health issues in a friendly, exciting, and interactive way. Indeed, according
to a report compiled by (Wolny and Wojtasik, 2023), health education and health
promotion have become a necessary educational and educational process in the 21st
century, which responds to the threats caused by consumerist lifestyles - especially
among children and adolescents.
In addition, the document's authors emphasise that health promotion can effectively
support health education at the practical level by promoting healthy lifestyles in all
educational areas. According to (Włodarczyk, 2019), health promotion involves a
carefully designed process to protect and promote human health through health
education and public health strategies. On the other hand, health education plays a
crucial role in setting health priorities and demonstrates methods for achieving them.
However, despite its promising potential, gamification in health promotion is still a
relatively new field that requires further research. It is essential to understand how to
design and implement gamification-based health solutions to be practical, attractive,
and accessible to different populations. In addition, it is also essential to understand
the potential challenges and limitations of gamification in health, such as privacy
and data security, equity of access to technology, or, finally, the risk of
oversimplifying complex health issues.
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Despite these barriers, gamification has excellent potential in the context of Health
2.0, but its practical use requires further exploration and innovation.
This study aims to understand and clarify the role of gamification in health
promotion in the context of the Health 2.0 concept through a comparative analysis of
selected health mobile applications. The following research questions were
developed to verify this objective:
• What gamification elements are most commonly used in health mobile apps,
and how do they affect user engagement and motivation?
• What are gamification's key benefits and limitations in health promotion?
• How can gamification contribute to the goals of Health 2.0?
2. Literature Review
Gamification, inspired by computer games, aims to increase people's interest and
involvement in products or situations that are not games. Gamification works by
setting goals for the user and rewarding them for achieving them. The goals can be
set by the user or the developer of the program or application. Sometimes, the goals
are hidden, and the reward surprises the user, motivating him to continue using the
application. Gamification uses the principle of positive reinforcement and rewards
for effort, using the app and engaging family and friends to work together (Łosiak-
Pilch, 2018).
Gamification elements are increasingly being used in mobile applications
(Zichermann and Cunningham, 2011). These include, but are not limited to, tasks
and challenges, known as missions; progress bars, which show how much of a task
has already been completed and how much is still missing to earn a reward; badges
and trophies awarded for completing a single task; rankings, which allow users to
compare achievements with other app users or with the community; points, which
can be collected to unlock additional app features; virtual items, which can be gifted
to friends after they are earned (Dan and Lai, 2013).
As a mobile application based on gamification elements, these health applications
are perfect for health promotion activities that encourage individuals to monitor their
health regularly, take steps towards a healthier lifestyle (increasing physical activity,
modifying their diet, eliminating unhealthy habits), and consistently counteract a
variety of conditions and diseases that often have an unfavourable prognosis
(Korczak, 2016).
Research indicates that health mobile apps positively impact the health behaviour of
their users, provided that the apps are used regularly. Regularly using health apps
leads to changes in daily habits, shaping those that positively affect health (Eyles et
al., 2014; Safran Naimark et al., 2015). However, it was found that most e-health
apps studied engage users only briefly through the rewards offered.
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
988
Therefore, it is essential to create e-health solutions based on sound theories that
leverage the experience and psychological effects of game mechanics (Sardi et al.,
2017a) because satisfying basic psychological needs as a result of interaction with
game elements increases user engagement, which in turn leads to positive marketing
results (Bitrián et al., 2021).
The issue of user involvement is crucial in the context of interaction with subsequent
challenges within a given health application; hence, using the potential of
gamification mechanisms for health promotion processes, which is one of the critical
issues in the creation of the Health 2.0 concept, health awareness is raised, and
health-promoting behaviour is created in society.
Health 2.0 can be defined as the integration of health data and health information
into the patient's experience through information and communication technologies
(ICT), which allows active and responsible participation in the process of taking care
of one's health and receiving health care (eHealth Solutions – rozwiązania
informatyczne w ochronie zdrowia, n.d.).
In other words, and to put it more deeply, the idea combines mHealth with the latest
advances in intelligent sensors, 5G communications, and advanced Web 2.0, cloud
computing, and social media technologies to create personalised health services that
are patient-centred (Istepanian and Al-Anzi, 2018; Istepanian and Woodward, 2016).
According to (Duplaga and Szulc, 2019), Health 2.0, by creating online communities
and publishing their health content, represents another dimension of the
development, after e-health, of ICT systems in health care. In general, Health 2.0 is
still an evolving concept, and the results of a systematic review (Van De Belt et al.,
2010) highlighted 46 unique definitions of Health 2.0, with the following keywords
recurring: Web 2.0, patients, professionals, social networks, health information,
collaboration, health care change.
Despite the credit given to health mobile apps working in developing the Health 2.0
concept, it is important to note various barriers, including those related to the use of
these apps. According to (Smarżewska, 2018), all barriers related to their use can be
divided into four groups: those related to oversight (e.g., the lack of specific
interoperability standards or the lack of clear regulations on the protection of
personal data), those related to the structure of health care systems (e.g., the lack of
consistency in terms of cooperation between different levels and sectors of health
care or the change in the way the processes of implementing a given app are
managed); technical (e.g., the lack of standardised data transmission protocols or the
too-late involvement of physicians in the design of apps); economic (e.g., the lack of
reimbursement mechanisms for specific solutions for patients or the limited
awareness of health care providers about the benefits of using a given app).
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According to Kajzer and Szlachetka (2017), the most significant barrier preventing
the spread of a given health app is its unfamiliarity. Therefore, education is urgently
needed to inform patients, particularly those in the 65+ age group, who could
successfully use such solutions daily.
There are also many other barriers to the development of the mobile health app
ecosystem, among which, according to Jagiela et al. (2023), the following can be
mentioned: low digital maturity of a given society, digital exclusion, paternalistic
model of health care, advanced age of doctors and their resistance to change,
insufficient financing of the health app market.
On the other hand, from a global perspective, significant barriers may be
(Kuczabski, 2019) political factors, investment expenditures and the risk associated
with their return, reduction of direct contact between doctor and patient, trust in
modern technologies, specifics of the market. In contrast, there are unique barriers to
using mobile health apps for low-income populations, including a lack of or low
familiarity with mobile apps, limited health literacy, and a historical lack of trust in
healthcare systems (Liu et al., 2020).
Other barriers identified in the literature based on its review include lack of
interpersonal communication and encouragement from medical professionals, fear of
less communication due to lack of support and non-verbal cues that could be picked
up when interacting with a doctor in person, fear of wasting time due to high
engagement (Ahmad et al., 2022).
3. Research Methodology
The article first uses a content analysis of health mobile apps as a research method.
Secondly, a comparative analysis was used, in which, based on foundational data,
selected health programs in the form of gamification-based mobile applications were
reviewed, evaluated, and compared in terms of their characteristic elements and
usability. The focus was on gamified health-related mobile apps from the Apple App
Store and Google Play Store. The key to selecting apps was their various 2023
rankings, based on which 12 apps were selected that, according to the author,
seemed most interesting in terms of gamification elements.
4. Results
A selection of gamification-based health mobile apps that appear simultaneously in
the Apple App Store and Google Play Store was reviewed. Key to the selection of
apps was the 2023 rankings of gamification-based health mobile apps (Top 10 health
apps in 2023 - ITpoland, 2023; App Gamification, 2023; Best et al. in Poland -
Itech360, 2023; Gurram, 2022; Kasraszwili, 2023; Monkey, 2023) of which twelve
were selected for analysis. Table 1 summarises these apps based on purpose, target
audience, gamification elements, and user benefits.
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
990
Table 1. Summary of selected health gamification-based mobile applications
Applicatio
n name
Purpose(s) of
the application
Target
group(s)
Gamification elements
Benefits of use
Rzuć
palenie! /
Rzucić
palenie
- Continuously
maintaining
motivation in the
process of
quitting smoking;
- Increase user
engagement and
improve their
chances of
quitting;
- Quit smoking
forever
- People
addicted to
smoking
cigarettes:
- Adult
smokers who
smoke at least
one cigarette a
day and intend
to quit within
a self-imposed
timeframe
- Tracking progress;
- Advancement system: the
ability to unlock more levels;
- Motivating by pointing out the
benefits of quitting smoking;
- Prizes;
- Progress monitoring log
- Getting inspired
by the benefits of
quitting smoking;
- Greater
engagement with
gamification
elements associated
with a greater
likelihood of
quitting smoking in
the short term;
- Support in
quitting smoking by
providing users
with daily
reminders and
motivational
messages
Lifesum
Food
Tracker
and
Planner
- Personalized
nutrition;
- Weight
management
- Those
wishing to
lose weight;
- Those
planning to
build muscle;
- Those
wishing to
adopt a
healthier diet
- Food journal with convenient
barcode scanner;
- Calorie counter;
- Macro (protein, carbohydrate
and fat) tracking and food
evaluation;
- Water monitor;
- Diet plans for weight loss and
body composition;
- Intermittent fasting plans;
- Meal plans with shopping lists;
- Life Score test for personalised
dietary recommendations
- Building healthy
eating habits for
life;
- Supporting
personal goals
through a
personalised
nutrition plan;
- Selecting the
proper diet for
users' taste and
lifestyle from
among the
following: ketone
diet, Mediterranean
diet, high protein
diet, Clean Eating
diet, Scandinavian
diet, climate diet
Runtastic
Provide tools to
unlock the
potential of
running and
cycling
- Joggers
- Cyclists
- Distance tracking;
- Speed measurement;
- Duration measurement;
- Measurement of calories
burned;
- Voice coaching;
- Live tracking;
- Sharing their successes with
the global community;
- Seamless integration with
other fitness platforms
- Taking running
and cycling
performance to a
new level
- Opportunity to
join various
challenges to
increase motivation
for action
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Fitbit
Improve health
and well-being
People who
want to take
care of their
health and
well-being
- Pop-up notifications to
encourage further effort;
- Badges for achieving
milestones;
- Tracking progress on charts
and graphs;
- Leaderboard to compete with
friends;
- Personalized health
information
- Hydration measurement
- Monitoring
activity, training,
sleep, nutrition, and
stress levels;
- Weight
management - the
ability to connect
wirelessly to the
Aria Wi-Fi Smart
Scale to track
weight, BMI, lean
mass, body fat
percentage, and
trends
MyFitness
Pal
- Encouraging
smarter food
choices;
- Motivation and
support in
achieving health
goals
People who
want to
develop good
habits and
understand the
principles of
nutrition
- Diet tracking;
- Meal planner;
- Monitoring physical activity;
- Progress charts;
- Goal setting;
- Food journal;
- Monitor water and nutrient
consumption;
- Tracking posts;
- Calorie counter;
- Protein counter;
- Personalized dashboard;
- Joining communities in active
forums
Support healthy
eating and weight
loss by monitoring
diet and recording
physical activity.
Zombies
Run +
Marvel
Move
Going from zero
running
experience to
being able to run
an entire 5 km
Runners -
beginners and
advanced
- At each run, automatic
collection of necessary supplies;
- Building the post-apocalyptic
community;
- Immersive audio stories that
turn workouts into epic
adventures;
- Running together with their
favourite superheroes;
- Training logs shared with
episode banners
- The ideal
combination of
game design and
physical activity
tracking module;
- A mix of uplifting
audio drama and
pulsating tracks
from the playlist
Habitica
- Turning daily
habits and to-do
lists into a game;
- Motivation to
stick to healthy
habits
People who
want to
increase their
motivation to
perform daily,
boring
activities
- Rewards for their efforts in the
form of experience, food, eggs
and potions;
- Dynamic progress bars;
- A pixelated avatar on the
watch face;
- A flexible module for tracking
task habits;
- Color-coded tasks and series
counters;
- A levelling system to visualise
overall progress;
- Customizable avatars;
- Regular content releases and
seasonal events;
- Cooperation with friends;
- Automatic
repetition of tasks
scheduled as part of
daily, weekly, or
monthly routines;
- Plenty of
collectable
equipment and
animals to match
the user's style
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
992
- Reminders and widgets;
- Customizable colour themes
with dark and light modes
SuperBette
r: Mental
Health
Improve mental
health, resilience,
and social-
emotional skills.
- Youth;
- Teens;
- Young
adults;
- Secondary
school
teachers
promoting
social-
emotional
learning;
- Small
groups, teams,
and clubs to
support youth
mental health
and resilience;
- Universities
that ensure
student
success and
well-being;
- Small
businesses
- Challenges;
- Assuming a secret identity;
- Tasks;
- Activating reinforcements;
- Contacting allies;
- Tracking strengths in the
game;
- Building resilience of the
whole person - mental, social,
emotional and physical
- Using the same
strengths that
appear naturally in
the game to face
challenges in real
life, develop skills,
deal with stress, and
practice self-care;
- By implementing
the 7 principles of
active living, the
user becomes more
robust, happier,
braver, and more
resilient to
everyday life
Mindbloo
m
- Encouraging
users to practice
mindfulness and
adopt positive
life habits;
- Help with
anxiety or
depression
- People
experiencing
anxiety;
- Depressed
individuals;
- Persons with
mental
disorders
- Development path: Users can
choose their therapeutic goal
and track their progress on an
interactive map;
- Points and badges that can be
exchanged for rewards such as
guided sessions, extra doses of
ketamine, or access to additional
resources;
- Badges for achieving specific
goals or levels;
- Rankings and community;
- Storyline and feedback: The
user's story as a hero travels
through fantastic worlds to
discover his true power and heal
his soul. The app also provides
the user with quick and positive
feedback to highlight their
progress and encourage them to
continue working on themselves
Building mental
toughness on the
progress
Happify /
Happify:
for Stress
and Worry
Helping users get
in touch with
their thoughts
and feelings
using positive
psychology skills
and cognitive
People who
want to
improve their
emotional
well-being
- An advancement system that
allows to unlock more levels;
- Activity logs;
- Awards
- Higher
engagement with
gamification
elements associated
with a higher
likelihood of
improved well-
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behavioural
therapy
being in the short
term;
- Support in
improving well-
being by providing
users with daily
reminders and
motivating
messages
mySugr -
Diary of a
Diabetic
- Helping to
control and
manage diabetes;
- Complement
the daily routine
of a diabetic
(type 1, type 2,
or gestational
diabetes) with an
app that makes
life easier
People with
diabetes
- Personalized panel;
- Automatic data logging;
- A bolus calculator that
provides precise dosage
recommendations;
- Clear graphs of blood sugar
levels;
- Daily, weekly, and monthly
reports that can be shared
directly with the doctor;
- Integrations with various
devices and platforms, such as
pedometers, activity, blood
pressure, weight, and others
- Keeping diabetes
data under control
by using the Diary;
- Greater
involvement in the
process of
monitoring and
managing their
diabetes;
- Support in
managing diabetes
through daily
reminders and
motivational
messages
Sidekick
Health
- Helping to
manage chronic
diseases by
monitoring and
controlling
disease data
daily;
- Partnering with
pharmaceutical
companies and
insurers to
deliver gamified,
digital care
programs to help
patients manage
disease and
treatment
Persons with
chronic
diseases wish
to make daily
life more
manageable.
- Automatic data logging;
- Integrations with various
devices and platforms;
- Coaching: an opportunity to
talk with a health specialist,
help set goals, and stay
motivated to achieve them;
- Mindfulness: information on
adding mindful habits to daily
life to reduce stress and
symptoms of anxiety and
depression;
- Daily lessons and tasks on
fatigue, mental health, sleep,
nutrition and physical activity;
- Educational content on sleep
habits in the context of
developing healthy sleep
hygiene;
- medication reminders
- Greater
involvement in the
process of
monitoring and
managing their
chronic disease;
- Support in
managing chronic
disease through
daily reminders and
motivational
messages
Source: Own compilation based on: (Bell, 2023; Fitbit – Aplikacje w Google Play, n.d.;
Fitbit, 2024; Habitica, 2023; Habitica, n.d.; Happify – Aplikacje w Google Play, n.d.;
Happify, 2023; Happify, n.d.; Lifesum Food Tracker and Planner, 2023; Lifesum, n.d.;
Mindbloom, 2024; Mindbloom – Aplikacje w Google Play, n.d.; Mindbloom, n.d.;
MyFitnessPal – Aplikacje w Google Play, n.d.; MyFitnessPal, 2024; mySugr - Dzienniczek
diabetyka, 2024; mySugr - Dzienniczek diabetyka – Aplikacje w Google Play, n.d.; Rzuć
Palenie! – Aplikacje w Google Play, n.d.; Rzucić palenie, 2023; Sidekick Health, 2024;
Sidekick Health – Aplikacje w Google Play, n.d.; SuperBetter, 2023; SuperBetter, n.d.; ZRX,
2024; ZRX, n.d.; Kasraszwili, 2023; Rajani et al., 2023; Runtastic, n.d.; Switzer, 2023;
Takahashi, 2011, 2011; Tredrea et al., 2017).
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
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Table 1 above provides a comprehensive overview of various mobile apps designed
to improve health and well-being in various aspects of life. Each health app
presented in Table 1 has its unique approach to gamification, as manifested by
different gamification elements. In addition, the effectiveness of gamification may
depend on the individual user's preferences and motivations. Hence, the performance
of a given app may be more or less effective depending on the specific user.
Smoking cessation apps target adult smokers who want to quit, using progress
tracking, a progression system with unlockable levels, and rewards to encourage
smokers to quit. They also provide a diary to monitor progress and use motivational
messages highlighting the benefits of quitting smoking.
Nutrition and food tracking apps target those looking to lose weight, build muscle
mass, or develop healthier eating habits, offering features such as food diaries, diet
tracking, and personalised eating plans. They also offer a personalised dashboard
and macro tracking. The gamification here is less about gaining levels and more
about giving users a clear picture of their eating habits and progress.
In contrast, runners, cyclists, and people, in general well-being, are dedicated to
fitness and activity-tracking apps. They provide performance tracking, challenges,
and integration with other fitness platforms and use pop-up notifications, badges for
milestones, scoreboards, and graphs to visualise progress. These elements foster a
sense of competition and personal achievement.
Mental health and resilience apps are also among the tabulation. These are designed
for young people, teachers, and those experiencing anxiety or depression, using
gamified tasks, challenges, and therapeutic journeys to build social-emotional skills
and mental resilience. In addition, these apps include promotion systems, activity
logs, rewards, and secret identities. These types of health apps aim to build resilience
by integrating game-like challenges that mimic real-life strategies for coping with
stress.
E-health solutions for chronic disease management are also not absent from the
benchmarking study. This situation is served by mobile apps that help people with
chronic diseases or diabetes by offering monitoring tools, coaching, educational
content, and integration with medical devices to manage daily life and treatment.
Gamification elements include personalised dashboards, automatic data logging, and
flexible task habit modules. The gamification strategy focuses on visually tracking
progress and providing a sense of control over the disease management process.
The final group of health apps specified are comprehensive lifestyle apps, including
points and badges redeemable for rewards, customisable avatars, story progression,
feedback mechanisms, and community rankings. They turn daily habits into a game,
with dynamic progress bars and regular content updates to keep users engaged.
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Apps of this type have the most distinctive gamification elements, keeping users
engaged and motivated for the longest. Each app in Table 1 uses gamification
elements ranging from simple progress tracking and rewards to more complex
systems involving levels, challenges, storylines, and personalised feedback to
increase user engagement and support in achieving health-related goals.
Gamification elements by category can be seen most clearly in the following
applications:
• Progress tracking and diaries: Rzuć palenie! / Rzucić palenie, MyFitnessPal,
Fitbit, Runtastic, SuperBetter: Mental Health;
• promotion and levels: Rzuć palenie! / Rzucić palenie, Happify, Mindbloom;
• rewards and badges: Habitica, Fitbit, Mindbloom;
• personalisation and customisation: mySugr, Sidekick Health, Habitica;
• challenges and missions: SuperBetter: Mental Health, Zombies, Run +
Marvel Move;
• community and social interaction: Runtastic, Fitbit, Mindbloom;
• feedback mechanisms: Fitbit, Habitica.
By integrating the above gamification elements, apps make tracking and managing
health more engaging and potentially increase the likelihood that users will stick to
their health goals in the long term.
In summary, benchmarked health apps provide practical benefits by helping users
build and maintain healthy habits, offering support systems, and improving the
overall quality of life through interactive and personalised experiences.
5. Discussion
The health mobile apps summarised in Table 1 use gamification, or the motivational
potential of video games, to increase user engagement by promoting specific health
behaviours. Selected mHealth apps analysed from the Apple App Store and Google
Play Store include:
• applications to support users in following a healthy diet (Choi et al., 2021;
Coughlin et al., 2015; de la Torre Díez et al., 2017; Dute et al., 2016;
Gilliland et al., 2015; Mhd Salim et al., 2017; Tang et al., 2015; Vasiloglou
et al., 2021; Wang et al., 2016; West et al., 2017);
• apps that motivate users to increase physical activity (Hamper, 2015;
Hosseinpour and Terlutter, 2019; Knight et al., 2015; Matthews et al., 2016;
Middelweerd et al., 2014; Pradal-Cano et al., 2020; Tong et al., 2018; Wang
et al., 2016);
• applications to help appropriately manage chronic diseases (El-Rashidy et
al., 2021; Fernández et al., 2023; Georga et al., 2014; Ownby et al., 2017;
Pérez et al., 2019; Stinson et al., 2013; Whitehead and Seaton, 2016);
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
996
• applications to support mental health and well-being (Catuara-Solarz et al.,
2022; Cheng et al., 2019; Eisenstadt et al., 2021; Kaonga and Morgan,
2019; McKay et al., 2019; Ponzo et al., 2020; Rathbone and Prescott, 2017;
Rickard et al., 2016; Stawarz et al., 2019).
An example of an app that supports users in following a healthy diet and motivates
them to increase physical activity is Lifesum. It is a free app that allows people to
monitor their food intake and daily physical activity, providing precise and
customised nutritional information (Tredrea et al., 2017).
The multi-faceted app combines smartphone functions, an activity tracker wristband,
and brief tips. It effectively facilitates weight loss, improving body composition,
physical activity, and caloric intake among overweight and obese individuals over
12 months (Lugones-Sanchez et al., 2022). Such activity-monitoring smartphone
apps can effectively encourage physical activity in adults, with gamification
elements, including text messaging and personalisation features, proving more
effective (Laranjo et al., 2021).
Mobile apps with integrated meal planning and shopping lists can help promote
healthy food delivery to families. However, they require user engagement and
behavioural support functions to achieve optimal effectiveness (Mauch et al., 2018).
Mobile apps emphasising diet quality have been shown to significantly improve
eating behaviours and reduce the risk of heart disease among those who are
overweight or obese (Kwon et al., 2020), as well as effectively improving nutrition-
related outcomes such as obesity rates, blood pressure, and blood lipids (Villinger et
al., 2019). In addition, the use of smartphone food photo features in health apps was
associated with increased weight loss, mediated by more extended use of the app
(Neriah and Geliebter, 2019).
Most of the peer-reviewed diet-tracking apps show good usability and have the
potential to promote self-efficacy. However, some differences exist in nutrient
coding and behaviour change functions (Ferrara et al., 2019). In summary, existing
mobile apps can contribute to healthier food purchasing behaviour; however, to
maximise their effectiveness, the quality of nutrition content and user experience
must be improved (Flaherty et al., 2018).
In mobile apps that motivate users to increase physical activity, gamification
elements such as leaderboards that promote social comparisons are positively
associated with increased physical activity (Maher et al., 2022), and combining
multiple gamification elements in a single app is effective in increasing user
retention rates (Olivas Martinez et al., 2023).
According to (Spillers and Asimakopoulos, 2014), gamification elements in mobile
fitness apps can improve user motivation and lead to short-term positive behaviour
change, but feature richness negatively affects user adoption. In contrast,
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participating in walking competitions through mobile apps can increase physical
activity by 23% and improve user engagement (Shameli et al., 2017). Other
gamification elements that are important to users and can increase motivation for
physical activity are feedback, activity suggestions, and monetary incentives
(Meixner et al., 2020).
Gamification has the potential to positively influence health and well-being,
particularly in terms of health behaviours. However, its impact on cognitive
outcomes is mixed or neutral, as (Johnson et al., 2016) indicated. Using
gamification-based interventions has proven effective in promoting healthy
behaviours, including elements such as points, badges, and leaderboards, potentially
enhancing participant engagement in interventions targeting health behaviour change
(Uechi et al., 2018).
Furthermore, gamification offers strategies for health promotion, prevention, and
self-management of chronic conditions, thereby increasing patient engagement in
health information technology, as (Marston et al., 2016) demonstrated. In workplace
health promotion programs, incorporating gamification elements enhances employee
engagement. It improves health outcomes, including increased physical activity and
the likelihood of achieving the daily step goal of 10,000, as supported by (Harrison
et al., 2019).
Gamification techniques, such as badges, leaderboards, and health-related challenges
in mobile applications, can motivate individuals to adopt healthier behaviours
(Iurchenko, 2017). The benefits of gamification in health promotion are manifold,
including promoting intrinsic motivation through high-quality game design,
increased accessibility through mobile technology, and the ability to address a wide
range of health challenges, as elucidated by (Edwards et al., 2016).
Furthermore, gamification can foster a more motivated and engaged workforce,
potentially enhancing health promotion efforts, as (Dale, 2014) posited.
Additionally, gamification can play a role in encouraging self-efficacy and
normalising sustainable nutritional behaviour, thus promoting healthy
habits (Berger and Schrader, 2016). However, it is essential to note that while
gamification in e-health may lead to short-term engagement through extrinsic
rewards, there is a lack of valid empirical evidence supporting its effectiveness, and
the realisation of its full potential requires the establishment of well-founded
theories, as emphasised by (Sardi et al., 2017b).
Finally, gamification in the context of exercise has yielded more excellent social
benefits for women. However, it is worth noting that the enjoyment and usefulness
of gamification decline with prolonged use, and its ease of use diminishes with age,
as highlighted by (Koivisto and Hamari, 2014).
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998
To summarise the information above, the application of gamification in the field of
eHealth has the potential to captivate audiences, provide amusement, and yield
motivational and cognitive advantages, thereby potentially contributing to the
objectives of Health 2.0 (Sardi et al., 2017b).
Using gamification in mobile health applications can enhance user engagement and
cultivate specific health-related behaviours. Furthermore, a strong correlation exists
between recognised archetypes and targeted health behaviours (Schmidt-Kraepelin
et al., 2020). In addition, gamification can serve as a driving force to encourage
individuals to take charge of their health.
This situation can be achieved through challenging objectives, incentives for
achievements, and exposure to social networks, which can positively influence
outcomes (Yang and Li, 2021). Moreover, gamification can also play a pivotal role
in motivating individuals within higher education institutions, thereby contributing
to the goals of Health 2.0 by promoting healthy environments and lifestyles for
students and educators (Navarro-Espinosa et al., 2022). Furthermore, gamification
can effectively engage staff members, inspire clients, and enhance learning in
healthcare settings (Brull and Finlayson, 2016).
6. Limitations
The article contains several limitations. First, only selected health mobile apps were
taken for comparative analysis, which may have omitted other valuable apps from
the perspective of using gamification elements. Second, the tabulation and
comparative analysis of the mobile apps in question focused on the most popular
gamification elements, according to the literature review results, which may have
narrowed the analysis in terms of the engagement and motivation of users of the
apps in question. Third, only mobile health apps appearing simultaneously in the
Apple App Store and Google Play Store were taken for benchmarking.
Health apps in other shops, such as the Amazon App Store, Galaxy Store, or Aurora
Store, were not included. This situation may have limited the study with additional
findings and suggestions.
7. Conclusions and Practical Implications
The purpose of the article, which was to understand and clarify the role of
gamification in health promotion in the context of the Health 2.0 concept through a
comparative analysis of selected health mobile apps, was achieved. To this end,
three research questions were verified.
First, health mobile apps' most frequently used gamification elements are goals and
mini-goals, player archetypes, interactive stories, rewards, badges and points, levels,
rankings, feedback, personalisation, and social features. These can increase user
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engagement, motivation, and satisfaction but face challenges and barriers related to
usability, design, and privacy issues.
Secondly, regarding the second research question, the essential benefits of
gamification in health promotion are stimulating and increasing patient engagement,
improving health behaviour, and assisting in the self-management of chronic
diseases.
In contrast, the most critical limitations of gamification in health promotion are the
subjective value of reinforcement, lack of interest in health promotion on the part of
users, and a mixed or neutral impact on cognitive outcomes. Finally, regarding the
third research question, gamification can contribute to the goals of Health 2.0 in
several ways. First, it increases user engagement and motivation to take health-
promoting actions through gamification mechanisms used in mobile health apps.
Second, gamification can improve the efficiency of health processes by increasing
the regularity and relevance of health-promoting activities. Third, gamification can
promote healthy lifestyles by rewarding regular exercise or healthy eating habits.
Finally, gamification can support the implementation of health policies by
promoting health in all areas and caring for vulnerable groups.
In summary, Health 2.0 responds to the needs of today's health consumers by taking
care of their health on their terms and at their own pace, using health mobile apps.
Moreover, such activities increase engagement, motivation, and positive health
behaviour in various contexts, such as physical activity, nutrition, mental health, and
health care.
This comparative analysis contributes to a deeper understanding of gamification in
mobile health, and the results could serve as a basis for future research that will
expand the understanding of how gamification can positively influence health
behaviour change. In addition, the analysis results could help practitioners design
and develop highly motivating and effective mobile health apps.
Several practical implications have been developed based on a comparative analysis
of selected health mobile apps and a literature review. First, the continuous
improvement of the functionality and performance of health mobile apps opens up
many opportunities to effectively promote healthy lifestyles, especially among
children and adolescents who frequently use such apps. Second, the availability of
digital health tools is not possible without marketing.
Hence, developing and disseminating various information channels and promotional
campaigns for new mobile health e-solutions would be necessary. Third, to improve
user experience, engagement, and self-management, it would be necessary to
popularise the inclusion, in health mobile apps, of player archetypes, feedback,
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
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design principles, and personalisation while focusing on therapeutic aspects and
tailoring functionalities to the needs and expectations of stakeholders.
References:
10 najlepszych aplikacji medycznych w 2023 roku – ITpoland. 2023. https://itpoland.io/10-
najlepszych-aplikacji-medycznych-w-2023-roku/.
Ahmad, N.A., Ludin, A.F.M., Shahar, S., Noah, S.A.M., Tohit, N.M. 2022. Willingness,
perceived barriers and motivators in adopting mobile applications for health-related
interventions among older adults: A scoping review. BMJ Open, 12(3), e054561.
https://doi.org/10.1136/bmjopen-2021-054561.
App Gamification: 9 Examples of Mobile Apps Using Gamification | Helpshift. 2023.
https://www.helpshift.com/app-gamification-9-examples-of-mobile-apps-using-
gamification-2/.
Bell, C. 2023. Happify App Review 2023: Pros and Cons, Cost, and Who It’s Right For.
Choosing Therapy. https://www.choosingtherapy.com/happify-app-review/.
Berger, V., Schrader, U. 2016. Fostering Sustainable Nutrition Behavior through
Gamification. Sustainability, 8(1), Article 1. https://doi.org/10.3390/su8010067.
Bitrián, P., Buil, I., Catalán, S. 2021. Enhancing user engagement: The role of gamification
in mobile apps. Journal of Business Research, 132, 170-185.
https://doi.org/10.1016/j.jbusres.2021.04.028.
Brull, S., Finlayson, S. 2016. Importance of Gamification in Increasing Learning. The
Journal of Continuing Education in Nursing, 47(8), 372-375.
https://doi.org/10.3928/00220124-20160715-09.
Catuara-Solarz, S., Skorulski, B., Estella-Aguerri, I., Avella-Garcia, C.B., Shepherd, S.,
Stott, E., Hemmings, N.R., Villa, A.R. de, Schulze, L., Dix, S. 2022. The Efficacy of
“Foundations,” a Digital Mental Health App to Improve Mental Well-being During
COVID-19: Proof-of-Principle Randomized Controlled Trial. JMIR mHealth and
uHealth, 10(7), e30976. https://doi.org/10.2196/30976.
Cheng, V.W.S., Davenport, T., Johnson, D., Vella, K., Hickie, I.B. 2019. Gamification in
Apps and Technologies for Improving Mental Health and Well-Being: Systematic
Review. JMIR Mental Health, 6(6), e13717. https://doi.org/10.2196/13717.
Choi, J., Chung, C., Woo, H. 2021. Diet-Related Mobile Apps to Promote Healthy Eating
and Proper Nutrition: A Content Analysis and Quality Assessment. International
Journal of Environmental Research and Public Health, 18(7), Article 7.
https://doi.org/10.3390/ijerph18073496.
Coughlin, S.S., Whitehead, M., Sheats, J.Q., Mastromonico, J., Hardy, D., Smith, S.A. 2015.
Smartphone Applications for Promoting Healthy Diet and Nutrition: A Literature
Review. Jacobs Journal of Food and Nutrition, 2(3), 021.
Dale, S. 2014. Gamification: Making work fun or making fun of work? Business Information
Review, 31(2), 82-90. https://doi.org/10.1177/0266382114538350.
Dan, O., Lai, J. 2013. How Am I Doing? The Effects of Gamification and Social Sharing on
User Engagement, 4374-4388. https://aapor.org/past-conferences/aapor-2013-
annual-conference-plenary-session-and-presidential-address/.
de la Torre Díez, I., Garcia-Zapirain, B., López-Coronado, M., Rodrigues, J.J.P.C., and del
Pozo Vegas, C. 2017. A New mHealth App for Monitoring and Awareness of
Healthy Eating: Development and User Evaluation by Spanish Users. Journal of
Medical Systems, 41(7), 109. https://doi.org/10.1007/s10916-017-0753-0.
Iwona Czerska
1001
Duplaga, M., Szulc, K. 2019. Ewolucja zastosowań systemów teleinformatycznych w
ochronie zdrowia: Od telemedycyny do zdrowia 2.0. Zeszyt Naukowy Wyższej
Szkoły Zarządzania i Bankowości w Krakowie, 53, 14-25.
Dute, D.J., Bemelmans, W.J.E., Breda, J. 2016. Using Mobile Apps to Promote a Healthy
Lifestyle Among Adolescents and Students: A Review of the Theoretical Basis and
Lessons Learned. JMIR mHealth and uHealth, 4(2), e3559.
https://doi.org/10.2196/mhealth.3559.
Edwards, E.A., Lumsden, J., Rivas, C., Steed, L., Edwards, L.A., Thiyagarajan, A.,
Sohanpal, R., Caton, H., Griffiths, C.J., Munafò, M.R., Taylor, S., Walton, R.T.
2016. Gamification for health promotion: Systematic review of behaviour change
techniques in smartphone apps. BMJ Open, 6(10), e012447.
https://doi.org/10.1136/bmjopen-2016-012447.
eHealth Solutions – rozwiązania informatyczne w ochronie zdrowia. (n.d.). Zdrowie 2.0 i
Medycyna 2.0. Retrieved: https://ehsol.pl/dziedziny/zdrowie-2-0-i-medycyna-2-0/.
Eisenstadt, M., Liverpool, S., Infanti, E., Ciuvat, R.M., Carlsson, C. 2021. Mobile Apps That
Promote Emotion Regulation, Positive Mental Health, and Well-being in the General
Population: Systematic Review and Meta-analysis. JMIR Mental Health, 8(11),
e31170. https://doi.org/10.2196/31170.
El-Rashidy, N., El-Sappagh, S., Islam, S.M.R.M., El-Bakry, H., Abdelrazek, S. 2021. Mobile
Health in Remote Patient Monitoring for Chronic Diseases: Principles, Trends, and
Challenges. Diagnostics, 11(4), Article 4.
https://doi.org/10.3390/diagnostics11040607.
Eyles, H., McLean, R., Neal, B., Doughty, R.N., Jiang, Y., Ni Mhurchu, C. 2014. Using
mobile technology to support lower-salt food choices for people with cardiovascular
disease: Protocol for the SaltSwitch randomized controlled trial. BMC Public
Health, 14, 950. https://doi.org/10.1186/1471-2458-14-950.
Fernández, C., Vicente, M.A., Guilabert, M., Carrillo, I., Mira, J.J. 2023. Developing a
mobile health app for chronic illness management: Insights from focus groups.
Digital Health, 9, 20552076231210662.
https://doi.org/10.1177/20552076231210662.
Ferrara, G., Kim, J., Lin, S., Hua, J., Seto, E. 2019. A Focused Review of Smartphone Diet-
Tracking Apps: Usability, Functionality, Coherence With Behavior Change Theory,
and Comparative Validity of Nutrient Intake and Energy Estimates. JMIR mHealth
and uHealth, 7(5), e9232. https://doi.org/10.2196/mhealth.9232.
Fitbit – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/web/store/apps/details?id=com.fitbit.FitbitMobileandhl=pl.
Fitbit: Health and Fitness. 2024. App Store. https://apps.apple.com/pl/app/fitbit-health-
fitness/id462638897?l=pl.
Flaherty, S.J., McCarthy, M., Collins, A., McAuliffe, F. 2018. Can existing mobile apps
support healthier food purchasing behaviour? Content analysis of nutrition content,
behaviour change theory and user quality integration. Public Health Nutrition, 21(2),
288-298. https://doi.org/10.1017/S1368980017002889.
Georga, E.I., Protopappas, V.C., Bellos, C.V., Fotiadis, D.I. 2014. Wearable systems and
mobile applications for diabetes disease management. Health and Technology, 4(2),
101-112. https://doi.org/10.1007/s12553-014-0082-y.
Gilliland, J., Sadler, R., Clark, A., O’Connor, C., Milczarek, M., Doherty, S. 2015. Using a
Smartphone Application to Promote Healthy Dietary Behaviours and Local Food
Consumption. BioMed Research International, 2015, e841368.
https://doi.org/10.1155/2015/841368.
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
1002
Gurram, S. 2022. Gamification in Healthcare: Best Practices and Examples for 2023.
Upshot.Ai. https://www.upshot.ai/blog/gamification-in-healthcare-best-practices-
and-examples-for-2023/.
Habitica: Gamified Taskmanager. 2023. App Store. https://apps.apple.com/pl/app/habitica-
gamified-taskmanager/id994882113?l=pl.
Habitica: Gamify Your Tasks – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.habitrpg.android.habiticaandhlpl.
Hamper, A. 2015. A Context Aware Mobile Application for Physical Activity Promotion.
2015 48th Hawaii International Conference on System Sciences, 3197-3206.
https://doi.org/10.1109/HICSS.2015.386.
Happify – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.happify.happifyincandhl=pl.
Happify: For Stress and Worry. 2023. App Store. https://apps.apple.com/pl/app/happify-for-
stress-worry/id730601963?l=pl.
Happify: Science-Based Activities and Games. (n.d.). Happify.Com. Retrieved from:
https://happify.com/.
Harrison, J.D., Jones, J.M., Small, D.S., Rareshide, C.A.L., Szwartz, G., Steier, D., Guszcza,
J., Kalra, P., Torio, B., Reh, G., Hilbert, V., Patel, M.S. 2019. Social incentives to
encourage physical activity and understand predictors (STEP UP): Design and
rationale of a randomized trial among overweight and obese adults across the United
States. Contemporary Clinical Trials, 80, 55-60.
https://doi.org/10.1016/j.cct.2019.04.001.
Hosseinpour, M., Terlutter, R. 2019. Your Personal Motivator is with You: A Systematic
Review of Mobile Phone Applications Aiming at Increasing Physical Activity.
Sports Medicine, 49(9), 1425-1447. https://doi.org/10.1007/s40279-019-01128-3.
Istepanian, R.S.H., Al-Anzi, T. 2018. m-Health 2.0: New perspectives on mobile health,
machine learning and big data analytics. Methods, 151, 34-40.
https://doi.org/10.1016/j.ymeth.2018.05.015.
Istepanian, R.S.H., Woodward, B. 2016. m-Health: Fundamentals and Applications. John
Wiley and Sons.
Iurchenko, A. 2017. An Exploratory Study of Health Habit Formation Through Gamification.
ArXiv. https://www.semanticscholar.org/paper/An-Exploratory-Study-of-Health-
Habit-Formation-Iurchenko/4efe53a6202d9610806545c2fbf8bd4f1c69cb1d.
Jagieła, K., Lech, A., Szymańska, K., Wójcik, R. 2023. Propozycja włączania aplikacji
zdrowotnych do opieki nad pacjentem w Polsce w celu ograniczania konsekwencji
występowania chorób przewlekłych [Studia podyplomowe ‘SGH-WUM MBA w
ochronie zdrowia’, Szkoła Główna Handlowa w Warszawie; Warszawski
Uniwersytet Medyczny]. https://api.kamsoft.pl/app-
params/promos/000000/Propozycja_w_aplikacji_zdrowotnych_e-07112023.pdf.
Johnson, D., Deterding, S., Kuhn, K.A., Staneva, A., Stoyanov, S., Hides, L. 2016.
Gamification for health and wellbeing: A systematic review of the literature. Internet
Interventions, 6, 89-106. https://doi.org/10.1016/j.invent.2016.10.002.
Kajzer, S., Szlachetka, N. 2017. Mobilne aplikacje medyczne jako narzędzia wspierające
organizację polskiego systemu ochrony zdrowia. Ekonomia. Wrocław Economic
Review, 23(4), 275-292.
Kaonga, N.N., Morgan, J. 2019. Common themes and emerging trends for the use of
technology to support mental health and psychosocial well-being in limited resource
settings: A review of the literature. Psychiatry Research, 281, 112594.
https://doi.org/10.1016/j.psychres.2019.112594.
Iwona Czerska
1003
Kasraszwili, D. 2023. Które aplikacje medyczne są najlepsze na telefon w 2023 roku?
https://www.hardreset.info/pl/articles/which-medical-apps-are-the-best-for-phone-
in-2023/.
Knight, E., Stuckey, M.I., Prapavessis, H., Petrella, R.J. 2015. Public Health Guidelines for
Physical Activity: Is There an App for That? A Review of Android and Apple App
Stores. JMIR mHealth and uHealth, 3(2), e4003.
https://doi.org/10.2196/mhealth.4003.
Koivisto, J., Hamari, J. 2014. Demographic differences in perceived benefits from
gamification. Computers in Human Behavior, 35, 179-188.
https://doi.org/10.1016/j.chb.2014.03.007.
Korczak, K. 2016. Gry dla zdrowia—Koncepcja, przykłady zastosowań oraz potencjał
społeczno-ekonomiczny. Roczniki Kolegium Analiz Ekonomicznych / Szkoła
Główna Handlowa, 42, 313-326.
Kuczabski, M. 2019. Wpływ nowoczesnych technologii i ich bezpieczeństwa na rozwój
inteligentnej opieki zdrowotnej. In: Nowoczesne technologie a bezpieczeństwo
sektora ochrony zdrowia. Akademia Sztuki Wojennej.
Kwon, B.C., VanDam, C., Chiuve, S.E., Choi, H.W., Entler, P., Tan, P.N., and Huh-Yoo, J.
2020. Improving Heart Disease Risk Through Quality-Focused Diet Logging: Pre-
Post Study of a Diet Quality Tracking App. JMIR mHealth and uHealth, 8(12),
e21733. https://doi.org/10.2196/21733.
Laranjo, L., Ding, D., Heleno, B., Kocaballi, B., Quiroz, J.C., Tong, H.L., Chahwan, B.,
Neves, A.L., Gabarron, E., Dao, K.P., Rodrigues, D., Neves, G.C., Antunes, M.L.,
Coiera, E., Bates, D.W. 2021. Do smartphone applications and activity trackers
increase physical activity in adults? Systematic review, meta-analysis and
metaregression. British Journal of Sports Medicine, 55(8), 422-432.
https://doi.org/10.1136/bjsports-2020-102892.
Lifesum Food Tracker and Planner. 2023. App Store. https://apps.apple.com/pl/app/lifesum-
food-tracker-planner/id286906691.
Lifesum: Healthy Eating and Diet – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.sillens.shapeupclubandhl=pl.
Liu, P., Astudillo, K., Velez, D., Kelley, L., Cobbs-Lomax, D., Spatz, E.S. 2020. Use of
Mobile Health Applications in Low-Income Populations. Circulation:
Cardiovascular Quality and Outcomes, 13(9), e007031.
https://doi.org/10.1161/CIRCOUTCOMES.120.007031.
Łosiak-Pilch, J. 2018. Gamifikacja a subiektywna wartość wzmocnienia. Wskazania do
pracy w edukacji i promocji zdrowia. Edukacja - Technika - Informatyka, IX(2),
201-205. https://doi.org/10.15584/eti.2018.2.27.
Lugones-Sanchez, C., Recio-Rodriguez, J.I., Agudo-Conde, C., Repiso-Gento, I., Adalia, E.
G., Ramirez-Manent, J.I., Sanchez-Calavera, M.A., Rodriguez-Sanchez, E., Gomez-
Marcos, M.A., Garcia-Ortiz, L., Investigators, E. 2022. Long-term Effectiveness of a
Smartphone App Combined With a Smart Band on Weight Loss, Physical Activity,
and Caloric Intake in a Population With Overweight and Obesity (Evident 3 Study):
Randomized Controlled Trial. Journal of Medical Internet Research, 24(2), e30416.
https://doi.org/10.2196/30416.
Maher, C.A., Olds, T., Vandelanotte, C., Plotnikoff, R., Edney, S.M., Ryan, J.C., DeSmet,
A., Curtis, R.G. 2022. Gamification in a Physical Activity App: What Gamification
Features Are Being Used, by Whom, and Does It Make a Difference? Games for
Health Journal, 11(3), 193-199. https://doi.org/10.1089/g4h.2021.0207.
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
1004
Marston, H.R., Hall, A.K., Marston, H.R., Hall, A.K. 2016. Gamification: Applications for
Health Promotion and Health Information Technology Engagement. In: Handbook
of Research on Holistic Perspectives in Gamification for Clinical Practice
(gamification; pp. 78-104). IGI Global. https://www.igi-
global.com/gateway/chapter/www.igi-global.com/gateway/chapter/137823.
Matthews, J., Win, K.T., Oinas-Kukkonen, H., Freeman, M. 2016. Persuasive Technology in
Mobile Applications Promoting Physical Activity: A Systematic Review. Journal of
Medical Systems, 40(3), 72. https://doi.org/10.1007/s10916-015-0425-x.
Mauch, C.E., Wycherley, T.P., Laws, R.A., Johnson, B.J., Bell, L.K., Golley, R.K. 2018.
Mobile Apps to Support Healthy Family Food Provision: Systematic Assessment of
Popular, Commercially Available Apps. JMIR mHealth and uHealth, 6(12), e11867.
https://doi.org/10.2196/11867.
McKay, F.H., Wright, A., Shill, J., Stephens, H., Uccellini, M. 2019. Using Health and Well-
Being Apps for Behavior Change: A Systematic Search and Rating of Apps. JMIR
mHealth and uHealth, 7(7), e11926. https://doi.org/10.2196/11926.
Meixner, C., Baumann, H., Wollesen, B. 2020. Personality Traits, Gamification and Features
to Develop an App to Reduce Physical Inactivity. Information, 11(7), Article 7.
https://doi.org/10.3390/info11070367.
Mhd Salim, M., Mohamad Ali, N., Mohd Noah, S.A. 2017. Mobile Application on Healthy
Diet for Elderly based on Persuasive Design. International Journal on Advanced
Science, Engineering and Information Technology, 7, 222.
https://doi.org/10.18517/ijaseit.7.1.1725.
Middelweerd, A., Mollee, J.S., van der Wal, C.N., Brug, J., Velde, S.J. 2014. Apps to
promote physical activity among adults: A review and content analysis. International
Journal of Behavioral Nutrition and Physical Activity, 11(1), 97.
https://doi.org/10.1186/s12966-014-0097-9.
Mindbloom. 2024. App Store. https://apps.apple.com/us/app/mindbloom/id1587391820.
Mindbloom – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.mindbloomandhl=pl.
Mindbloom: Ketamine therapy for anxiety and depression. (n.d.). Retrieved from:
https://www.mindbloom.com/.
Monkey, F. 2023. Enhancing User Experience With Gamification. In: Healthcare Apps.
CodeX. https://medium.com/codex/enhancing-user-experience-with-gamification-in-
healthcare-apps-dd12a6539812.
MyFitnessPal – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.myfitnesspal.androidandhl=pl.
MyFitnessPal: Licznik Kalorii. 2024. App Store. https://apps.apple.com/pl/app/myfitnesspal-
licznik-kalorii/id341232718?l=pl.
mySugr—Dzienniczek diabetyka. 2024. App Store. https://apps.apple.com/pl/app/mysugr-
dzienniczek-diabetyka/id516509211?l=pl.
mySugr—Dzienniczek diabetyka – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.mysugr.android.companionandhl
=pl.
Najlepsze aplikacje do monitorowania zdrowia w Polsce—Itech360. 2023.
https://itech360.pl/najlepsze-aplikacje-do-monitorowania-zdrowia-w-polsce3162-2/.
Navarro-Espinosa, J.A., Vaquero-Abellán, M., Perea-Moreno, A.J., Pedrós-Pérez, G.,
Martínez-Jiménez, M. del P., Aparicio-Martínez, P. 2022. Gamification as a
Promoting Tool of Motivation for Creating Sustainable Higher Education
Iwona Czerska
1005
Institutions. International Journal of Environmental Research and Public Health,
19(5), Article 5. https://doi.org/10.3390/ijerph19052599.
Neriah, D.B., Geliebter, A. 2019. Weight Loss Following Use of a Smartphone Food Photo
Feature: Retrospective Cohort Study. JMIR mHealth and uHealth, 7(6), e11917.
https://doi.org/10.2196/11917.
Olivas Martinez, G., Orso, V., Bettelli, A., Gamberini, L. 2023. Exploiting Mobile
Gamification to Foster Physical Activity: A Remotely-Managed Field Study.
Sensors, 23(5), Article 5. https://doi.org/10.3390/s23052598.
Ownby, R.L., Acevedo, A., Waldrop-Valverde, D., Caballero, J., Simonson, M., Davenport,
R., Kondwani, K., Jacobs, R.J. 2017. A Mobile App for Chronic Disease Self-
Management: Protocol for a Randomized Controlled Trial. JMIR Research
Protocols, 6(4), e7272. https://doi.org/10.2196/resprot.7272.
Pérez, Y.I.V., Medlow, S., Ho, J., Steinbeck, K. 2019. Mobile and Web-Based Apps That
Support Self-Management and Transition in Young People With Chronic Illness:
Systematic Review. Journal of Medical Internet Research, 21(11), e13579.
https://doi.org/10.2196/13579.
Ponzo, S., Morelli, D., Kawadler, J.M., Hemmings, N.R., Bird, G., Plans, D. 2020. Efficacy
of the Digital Therapeutic Mobile App BioBase to Reduce Stress and Improve
Mental Well-Being Among University Students: Randomized Controlled Trial.
JMIR mHealth and uHealth, 8(4), e17767. https://doi.org/10.2196/17767.
Pradal-Cano, L., Lozano-Ruiz, C., Pereyra-Rodríguez, J.J., Saigí-Rubió, F., Bach-Faig, A.,
Esquius, L., Medina, F.X., Aguilar-Martínez, A. 2020. Using Mobile Applications
to Increase Physical Activity: A Systematic Review. International Journal of
Environmental Research and Public Health, 17(21), Article 21.
https://doi.org/10.3390/ijerph17218238.
Rajani, N.B., Bustamante, L., Weth, D., Romo, L., Mastellos, N., Filippidis, F.T. 2023.
Engagement With Gamification Elements in a Smoking Cessation App and Short-
term Smoking Abstinence: Quantitative Assessment. JMIR Serious Games, 11(1),
e39975. https://doi.org/10.2196/39975.
Rathbone, A.L., Prescott, J. 2017. The Use of Mobile Apps and SMS Messaging as Physical
and Mental Health Interventions: Systematic Review. Journal of Medical Internet
Research, 19(8), e7740. https://doi.org/10.2196/jmir.7740.
Rickard, N., Arjmand, H.A., Bakker, D., Seabrook, E. 2016. Development of a Mobile Phone
App to Support Self-Monitoring of Emotional Well-Being: A Mental Health Digital
Innovation. JMIR Mental Health, 3(4), e6202. https://doi.org/10.2196/mental.6202.
Runtastic, adidas. (n.d.). Adidas Running app | Fitness Activity Tracker. Retrieved from:
https://www.runtastic.com/.
Rzuć Palenie! – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.despdev.quitsmokingandhl=pl.
Rzucić palenie. 2023. App Store. https://apps.apple.com/pl/app/rzuci%C4%87-
palenie/id1185502772?l=pl.
Safran Naimark, J., Madar, Z., Shahar, D.R. 2015. The impact of a Web-based app
(eBalance) in promoting healthy lifestyles: Randomized controlled trial. Journal of
Medical Internet Research, 17(3), e56. https://doi.org/10.2196/jmir.3682.
Sardi, L., Idri, A., Fernández-Alemán, J.L. 2017a. A systematic review of gamification in e-
Health. Journal of Biomedical Informatics, 71, 31-48.
https://doi.org/10.1016/j.jbi.2017.05.011.
Gamification in Ηealth Promotion in the Context of Creating the Concept of Health 2.0 -
A Comparative Analysis of Selected Health Mobile Applications
1006
Sardi, L., Idri, A., Fernández-Alemá., J.L. 2017b. A systematic review of gamification in e-
Health. Journal of Biomedical Informatics, 71, 31-48.
https://doi.org/10.1016/j.jbi.2017.05.011.
Schmidt-Kraepelin, M., Toussaint, P.A., Thiebes, S., Hamari, J., Sunyaev, A. 2020.
Archetypes of Gamification: Analysis of mHealth Apps. JMIR mHealth and
uHealth, 8(10), e19280. https://doi.org/10.2196/19280.
Shameli, A., Althoff, T., Saberi, A., Leskovec, J. 2017. How Gamification Affects Physical
Activity: Large-scale Analysis of Walking Challenges in a Mobile Application.
Proceedings of the 26th International Conference on World Wide Web Companion,
455-463. https://doi.org/10.1145/3041021.3054172.
Sidekick Health. 2024. App Store. https://apps.apple.com/us/app/sidekick-
health/id924860283.
Sidekick Health – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.goodlifeme.sidekickandhl=pl.
Smarżewska, D. 2018. Wykorzystanie mobilnych aplikacji (m-health) w zarządzaniu
systemem ochrony zdrowia. Akademia Zarządzania, 2(2), 6-20.
Spillers, F., Asimakopoulos, S. 2014. Does Social User Experience Improve Motivation for
Runners? In: A. Marcus (Ed.), Design, User Experience, and Usability. User
Experience Design Practice (pp. 358-369). Springer International Publishing.
https://doi.org/10.1007/978-3-319-07638-6_35.
Stawarz, K., Preist, C., Coyle, D. 2019. Use of Smartphone Apps, Social Media, and Web-
Based Resources to Support Mental Health and Well-Being: Online Survey. JMIR
Mental Health, 6(7), e12546. https://doi.org/10.2196/12546.
Stinson, J.N., Jibb, L.A., Nguyen, C., Nathan, P.C., Maloney, A.M., Dupuis, L.L., Gerstle, J.
T., Alman, B., Hopyan, S., Strahlendorf, C., Portwine, C., Johnston, D.L., Orr, M.
2013. Development and Testing of a Multidimensional iPhone Pain Assessment
Application for Adolescents with Cancer. Journal of Medical Internet Research,
15(3), e2350. https://doi.org/10.2196/jmir.2350.
SuperBetter: Mental Health. 2023. App Store. https://apps.apple.com/pl/app/superbetter-
mental-health/id536634968.
SuperBetter: Mental Health – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.superbetter.paidandhl=pl.
Switzer, E. 2023. I’ve Been Waiting 10 Years For Marvel Move, And It Sounds Better Than
I Expected. TheGamer. https://www.thegamer.com/marvel-move-zombies-run-
fitness-app/.
Takahashi, D. 2011. Mindbloom Life game teaches you how to live better. VentureBeat.
https://venturebeat.com/games/mindbloom-life-game-teaches-you-how-to-live-
better/.
Tang, J., Abraham, C., Stamp, E. Greaves, C. 2015. How can weight-loss app designers’ best
engage and support users? A qualitative investigation. British Journal of Health
Psychology, 20(1), 151-171. https://doi.org/10.1111/bjhp.12114.
Tong, H. L., Coiera, E., Laranjo, L. 2018. Using a Mobile Social Networking App to
Promote Physical Activity: A Qualitative Study of Users’ Perspectives. Journal of
Medical Internet Research, 20(12), e11439. https://doi.org/10.2196/11439.
Tredrea, M.S., Dalbo, V.J., Scanlan, A.T. 2017. Lifesum: Easy and effective dietary and
activity monitoring. British Journal of Sports Medicine, 51(13), 1042-1043.
https://doi.org/10.1136/bjsports-2015-095535.
Iwona Czerska
1007
Uechi, H., Tan, N., Honda, Y. 2018. Effects of gamification-based intervention for
promoting health behaviors. The Journal of Physical Fitness and Sports Medicine,
7(3), 185-192. https://doi.org/10.7600/jpfsm.7.185.
UpToDate. 2023. App Store. https://apps.apple.com/pl/app/uptodate/id334265345?l=pl.
UpToDate – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.uptodate.androidandhl=pl.
Van De Belt, T.H., Engelen, L.J.L.P.G., Berben, S.A.A., Schoonhoven, L. 2010. Definition
of Health 2.0 and Medicine 2.0: A systematic review. Journal of Medical Internet
Research, 12(2), e18. https://doi.org/10.2196/jmir.1350.
Vasiloglou, M.F., Christodoulidis, S., Reber, E., Stathopoulou, T., Lu, Y., Stanga, Z.,
Mougiakakou, S. 2021. Perspectives and Preferences of Adult Smartphone Users
Regarding Nutrition and Diet Apps: Web-Based Survey Study. JMIR mHealth and
uHealth, 9(7), e27885. https://doi.org/10.2196/27885.
Villinger, K., Wahl, D.R., Boeing, H., Schupp, H.T., Renner, B. 2019. The effectiveness of
app-based mobile interventions on nutrition behaviours and nutrition-related health
outcomes: A systematic review and meta-analysis. Obesity Reviews, 20(10), 1465-
1484. https://doi.org/10.1111/obr.12903.
Wang, Q., Egelandsdal, B., Amdam, G.V., Almli, V.L., Oostindjer, M. 2016. Diet and
Physical Activity Apps: Perceived Effectiveness by App Users. JMIR mHealth and
uHealth, 4(2), e5114. https://doi.org/10.2196/mhealth.5114.
West, J.H., Belvedere, L.M., Andreasen, R., Frandsen, C., Hall, P.C., Crookston, B.T. 2017.
Controlling Your “App”etite: How Diet and Nutrition-Related Mobile Apps Lead to
Behavior Change. JMIR mHealth and uHealth, 5(7), e7410.
https://doi.org/10.2196/mhealth.7410.
Whitehead, L., Seaton, P. 2016. The Effectiveness of Self-Management Mobile Phone and
Tablet Apps in Long-term Condition Management: A Systematic Review. Journal of
Medical Internet Research, 18(5), e4883. https://doi.org/10.2196/jmir.4883.
Włodarczyk, E. 2019. Psychologia zachowań zdrowotnych a promocja zdrowia – wybrane
zagadnienia. Medyczna Wokanda, 12(12), 61-90.
https://doi.org/10.32055/mw.2019.12.4.
Wolny, B., Wojtasik, T. 2023. Promocja zdrowia w szkołach i placówkach oświatowych.
Ośrodek Rozwoju Edukacji.
Yang, H., Li, D. 2021. Health management gamification: Understanding the effects of goal
difficulty, achievement incentives, and social networks on performance.
Technological Forecasting and Social Change, 169, 120839.
https://doi.org/10.1016/j.techfore.2021.120839.
Zichermann, G., Cunningham, C. 2011. Gamification by Design: Implementing Game
Mechanics in Web and Mobile Apps (1st ed.). O’Reilly Media, Inc.
ZRX: Zombies Run + Marvel Move. 2024. App Store. https://apps.apple.com/pl/app/zrx-
zombies-run-marvel-move/id503519713.
ZRX: Zombies Run + Marvel Move – Aplikacje w Google Play. (n.d.). Retrieved from:
https://play.google.com/store/apps/details?id=com.sixtostart.zombiesrunclientandhl=
pl.
