Gamification: An effective way to improve health in India
By Arunima Rajan
Gamification has the potential to connect healthcare providers and consumers by promoting a healthy lifestyle and providing incentives.
Dr Vanissa Wanick has researched the use of gamification in health behaviours and its potential to influence behaviour change. She notes that gamification is a design process that incorporates elements from games, often with the goal of influencing behaviour. “One reason for this is that well-designed games are engaging and enjoyable but not necessarily easy. The value of studying the gamification of health behaviours is that it can be difficult for patients/users to feel motivated to change a particular behaviour or habit, especially when the health intervention involves self-management processes. Gamification can be an effective tool for helping patients/users stay motivated and adopt healthy behaviours,” she adds. Wanick is a senior lecturer in interaction design at Games, Design and Art at the University of Southampton.
The concept comes from Ryan and Deci’s research (published in 2000 but still relevant and built around Self-Determination Theory). Intrinsic motivation is the internal desire to do things for enjoyment or because they are interesting. In contrast, extrinsic motivation is about doing things to get something at the end of it (usually a separable outcome). “The debate between intrinsic/extrinsic motivation in gamification has called a lot of attention from academics for at least a decade. In gamification, these are usually represented by rewards. Extrinsic rewards are, for instance, points or just virtual ‘gifts’ given by the application to users. For that, users need to perform an action to be rewarded. Intrinsic rewards would be attached to the user when they feel better, when they can visualise their progress, etc. In this case, gamification can work as a tool for them to visualise how they are performing. These ‘rewards’ need to be well-balanced,” explains Wanick.
Would this work in India? How do cultural influences affect consumer behaviour, and how can these be taken into consideration when designing gamification applications and services? “Culture affects consumer behaviour due to social norms; people behave in a certain way because there are inherent rules on how to behave towards other people and be part of a community (what is acceptable behaviour, etc.). When designing gamification applications, it might be worth checking the current social norms and making sure that the behaviour you are ‘designing’ for your users is ‘acceptable’ for that culture. It is all about knowing who your user really is, as there is no ‘one-size-fits-all’ strategy,” says Wanick.
Dr Amit Nabar, Head, Dept. of Accident & Emergency Medicine & Surgical Intensive Care Unit, SL Raheja Hospital Mahim- A Fortis Associate, agrees with this view. “Indian healthcare is undergoing a sea of change. The public, especially after the COVID-19 pandemic, is now more receptive to newer and innovative methods of treatment & accepting digitalisation in clinical medicine. The Indian population is becoming more health-conscious and tech-savvy, especially in the metro cities. Our government, too, has undertaken many initiatives for encouraging the public to adopt healthy lifestyles. Gamification can tremendously encourage the masses to adopt a healthy lifestyle, incentivise their behaviour, and motivate them to attend higher health-related goals,” says Nabar.
He adds that In India, culture and social beliefs significantly impact the healthcare model and the acceptability of the treatment modalities. Gamification aims to engage with people and make them important stakeholders in health-related decisions. These games or tools must be in the Indian context and customised to the country’s cultural and social beliefs to make them more acceptable and viable. The regional variability will also need to be considered while designing the tools. Gamification involves initial and recurring expenses, as the cost is needed for its upgradation and sustenance. The insurance sector needs to accept this treatment modality and get it under its coverage umbrella.
There are many gamified mHealth apps in the market. Fitbit is a great example, as it has been in the market for a while. The app merges self-management data visualisation techniques with virtual rewards. Superbetter is a motivational app worth having a look at. By utilising game metaphors such as fighting ‘bad guys,’ the app has many fun and challenges to overcome your weaknesses. Headspace is another example of an app that uses gamification to reward users ‘piece of mind’ via achievable goals and short meditation sessions. mySugr is another example. mySugr is a diabetes management app that has been in the market for a while and has more than 4mi users. Dr Vanissa Wanick is currently involved in a project with NUCLEOLUS. They are developing an app called ‘The Amblios Club’, with interactive exercises to help children with amblyopia complete their daily eyepatch time.
Vishal Gondal is the founder and CEO of GOQii. He notes that GOQii is a preventive healthcare service. “The traditional healthcare system in India or the traditional healthcare apps offer very little to the users. User engagement is very less because it’s very boring to use. Here is where gamification plays a role by making it fun and engaging for the users to use the app. Gamification is at the core of what GOQii does because we believe that the challenge of healthcare is not about more information or data but motivation. It’s about making it interesting for the people to be engaged. Currently, people are not motivated as much to make a lifestyle change.GOQii uses gamification to engage, guide and motivate users to take charge of their health and make a lifestyle change. Just like in a game, you level up. Similarly, our philosophy is to help people level up. They can do this by scoring points by indulging in certain behavioural aspects such as being active, walking as many steps, eating healthy, sleeping well, meditating and focusing on mental health. The points earned are in the form of GOQii Cash which can be redeemed at the GOQii Health Store. GOQii has pioneered this approach of combining Gaming with Health,” he adds.
GOQii has created a four-layered tiered approach called the SAFE program (Sedentary, Active, Fit, Elite). A GOQii user can tier his/her lifestyle by following healthy habits and experience their health journey moving from Sedentary to Elite by staying Active and Fit. The outcome of maintaining a SAFE Score can get you to avail of both health and life insurance worth Rs 5 lakh and Rs 1 lakh, respectively.
“The biggest opportunity for healthcare is in the metaverse. As the world is getting connected with 3G etc. We believe healthcare is going to be one of the major applications which will be using web3 and metaverse. The Metaverse will combine the two worlds making living healthy in the real world more fun and rewarding. It will combine Preventive health + gaming + metaverse in 3D. Delivering unique user experiences through fitness gamification and healthcare rewards will have an advantage in the Health Metaverse, adds Gondal.
Gamification and India
The potential of gamification in addressing the rising rates of chronic diseases like obesity and diabetes in India is not being discussed enough. While it can help reduce healthcare costs for individuals by promoting healthy habits and preventing the development of these diseases, it is often viewed as less valuable than traditional healthcare interventions. This perception can make it challenging for healthcare providers to take it seriously. By ignoring the potential of gamification, India risks missing out on a valuable tool for improving public health. The implications of this could be a continued rise in chronic diseases and healthcare costs, as well as missed opportunities for improving population health. It is essential to start discussing the potential of gamification in healthcare and how it can help improve health outcomes in India.