We all want to live long and healthy lives. As such, we often intend to act in the best interests of our health. We hope to schedule that annual check-up, run that extra mile, eat more vegetables, be better about taking our medicines. But real life is more complicated. It is full of competing priorities that can make it difficult to make the right choices for our health.
For this reason, a major focus of public health programmes, and healthcare programmes in general, is to leverage our understanding of the underlying motivations of health-related behaviours to increase the likelihood that people will engage in them. Traditional methods for motivating behaviour change, such as the Health Belief Model, assume people will act in the best interests of their health if they are given the proper information and a clear path toward behaviour change. Yet this isn’t always the case, as human beings tend to behave irrationally — our beliefs and attitudes are not always congruous with how we behave. For example, one may value exercise and healthy living, but have difficulty finding the time and energy to go for a run before or after work.
Although our choices are irrational, these behaviours and their influences are predictable. An understanding of human tendencies, preferences, environment, and other influences can all serve as tools to nudge individuals towards healthier choices.
More recently, perspectives such as this have come to the centre of discussions surrounding behaviour change. Interventions have begun to form around concepts such as Social Norms, the Social- Ecological Model, and Gamification. All are focused on making it easier for individuals to make healthier choices. Gamification, in particular, is an enticing notion that is focused around engaging individuals in unique ways and building on the basic human tendency toward play.
Health-focused companies in the private sector have capitalised on combining gamification, technology and digital media to make engaging in health-related behaviours both easier and fun. Numerous health-related apps, websites, and social networks have used the core elements of games — competition, encouragement and, in some cases, an element of fantasy — to create engaging ways of supporting exercise, nutritious diets, and a healthy lifestyle.
The creation of socially interactive achievement systems is one of the more popular methods of healthrelated gamification. Fitocracy embodies this by using competition and social encouragement to help users feel engaged with their workouts.
Users log their exercise, complete quests, and earn achievement badges. A social networking component also creates a support network where users can seek encouragement and share their progress. One Google Play Store reviewer noted that, “The people on this site [Fitocracy] are some of the coolest you’ll ever meet. I owe a ton of my fitness progress and knowledge to these guys.” Fitocracy and other programs motivate participants by denoting status and affirming user activities. They also introduce a competitive, social element by allowing comparison of personal achievements to friends or the broader community.
The new trend toward wearable technology, such as FitBit, also highlights how the health sector harnesses modern tools to influence behaviour. These wrist monitors track metrics such as steps walked, sleep quality, and BMI. The constant presence of a FitBit is enough to encourage users to be more active, while a web platform also allows friends to connect and compete with each other. As one Amazon reviewer wrote, “Over the last 10 months of ownership, there have been nights when I’ve walked circles around the living room to get in the last of my 10,000 steps for the day… the physical reminder on my wrist remains a friend and a motivation to try again tomorrow.”
Other products use different types of incentives, which can be especially effective for promoting adherence behaviours. Some, such as Mango Health, provide monetary incentives — gift cards and discounts to stores such as Target. Still others, such as bedsider.org or text4baby.org, offer informational incentives — sending reminders and fun facts regarding particular topics (such as pregnancy-related health and contraception).
Some applications leverage the story lines of video games to more explicitly motivate health-related behaviours. Zombies, Run!, for example, is a unique app that creatively pushes people to have fun during their run. Users run during a zombie apocalypse; as they run, they’re given audio instructions to complete missions and to outrun the approaching zombies! The goal is to make fitness fun. Playful Bottle also uses this strategy to influence water intake. Users can play a single or multi-user cooperative TreeGame where drinking water helps to keep virtual trees alive. In these examples, entertainment is used as an incentive to influence behaviour across a broad range of health activities.
The whole premise of gamification is that making the process of engaging in health-related behaviours more competitive and fun, in turn increases utilisation of the apps and tools described above. This obviously has implications for market research, in particular for thinking about how to identify and assess drivers of and barriers to behaviour. Perhaps the biggest question it raises is, specifically, what should be the behavioural outcome of interest? Is it the purchase of the product itself, or whether it successfully promotes healthy behaviour?
Drivers of purchase may be entirely different than drivers of healthy behaviours, yet both of these outcomes are of critical importance in assessing the potential and overall value of a product. This is just one example — there are other implications as well. Yet the critical point is that the advent of this intersection between health, technology and gamification will necessitate newer, more creative ways of thinking about market research.