Abstract: Design and Development of a Gamified Mobile Application to Improve Adherence to Dietary Self-Monitoring

◆ Mia Liza A. Lustria, Florida State University
◆ Sylvie Naar, Florida State University
◆ Stephanie M. Carpenter, University of Michigan
◆ Inbal Nahum-Shani, University of Michigan

The obesity problem in the US has reached epidemic proportions with about 72% of Americans being classified as overweight or obese[1]. Overweight and obese are associated with an increase in risk for a number of chronic diseases including diabetes, cardiovascular disease and some forms of cancer. This epidemic also has profound economic impact in the US. Healthcare costs for obesity and associated diseases has increased to $149 billion annually.

Dietary self-monitoring (DSM) is a major component of many efficacious behavioral weight loss interventions. In fact, continuous and long-term self-monitoring has been particularly advantageous for weight management [2-4]. DSM may involve a number of strategies including calorie counting and food logging. Research, however, shows that the method and accuracy of self-monitoring may not be as important as the frequency and consistency of self-monitoring[5]. Self-monitoring activities, however, can be burdensome and research has shown that adherence typically decreases over time. There are a number of mHealth solutions on the market that may facilitate better and more frequent self-monitoring and health tracking as well as improve the scalability of behavioral weight-loss interventions. One advantage of mobile-based weight loss interventions is that these allow for self- monitoring to occur more proximal to the actual behavior being tracked (e.g., eating behavior)[2]. Despite these promising developments, a large proportion of users abandon mHealth apps and wearables quickly and after minimal use.[6, 7] Research has shown that these apps may still present some degree of user burden because they require users to log caloric intake or food consumption. Thus, there is a critical need to develop strategies that sustain user engagement with mHealth interventions. Research in psychology and behavioral science highlights useful engagement strategies, including goal attainment strategies that motivate people to engage in healthy behaviors.[8, 9] However, research has yet to investigate ways to optimally capitalize on and integrate various theoretically-grounded strategies[10] to promote and maintain engagement.

One promising solution for promoting spontaneous SM of dietary intake and physical activity is through the use of an interactive SM application to optimally capitalize on and integrate goal-setting strategies. Gamification,[11, 12] which integrates game-related design components and principles, provides a unique opportunity to use meaningful and sophisticated techniques to engage participants in mobile-based health behavior interventions.[13] Our team is currently drawing on theoretically-based engagement principles to modify existing mobile apps and improve engagement by employing various transdisciplinary strategies (e.g., goal-setting) . The SM application under development translates meeting one’s daily SM of dietary intake and physical activity goal into earning points for allocation toward care of a virtual creature (pet) (e.g., iguana, whale) available within the SM app (Figure 1). Not meeting one’s daily goal of SM means that points will not be earned toward care of the virtual pet. This paper will elaborate on the development and pilot testing of this gamified interactive SM application. This project involves a multi-disciplinary team of experts in the areas of translational behavioral interventions. eHealth, psychology and decision sciences.