{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:06:26Z","timestamp":1789751186712,"version":"4.0.1"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Shandong Second Medical University Scientific Research Development Fund","award":["2025FYM135"],"award-info":[{"award-number":["2025FYM135"]}]},{"name":"Liaocheng Key R&D Project Fund","award":["2025YD28"],"award-info":[{"award-number":["2025YD28"]}]},{"name":"Shandong Provincial Natural Science Foundation","award":["ZR2024QG117"],"award-info":[{"award-number":["ZR2024QG117"]}]},{"name":"Shandong Provincial Natural Science Foundation","award":["ZR2025QC1264"],"award-info":[{"award-number":["ZR2025QC1264"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["DIGITAL HEALTH"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Although gamification has been shown to enhance user motivation and engagement, its effects may vary across cultural contexts. This study examines how Confucian values shape users\u2019 continuance intention in leaderboard-based health gamification through positive and negative psychological pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an online survey of 300 WeChat Run users and analyzed the data using partial least squares structural equation modeling (PLS-SEM). Drawing on the Confucian values perspective and the dedication\u2013constraint model, we conceptualized self-cultivation as an enabling Confucian value and interpersonal harmony as a constraining Confucian value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Competition affordance positively affected continuance intention (\u03b2 = 0.135, p &lt; 0.01), whereas emotional exhaustion exerted a stronger negative effect on continuance intention (\u03b2 = \u22120.436, p &lt; 0.001). Self-cultivation positively influenced competition affordance (\u03b2 = 0.303, p &lt; 0.001), while interpersonal harmony positively affected emotional exhaustion (\u03b2 = 0.132, p &lt; 0.05). Furthermore, competition affordance mediated the positive relationship between self-cultivation and continuance intention (\u03b2 = 0.040, p &lt; 0.01), whereas emotional exhaustion mediated the negative relationship between interpersonal harmony and continuance intention (\u03b2 = \u22120.055, p &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Leaderboard-based health gamification activates both an enabling pathway, in which self-cultivation strengthens continuance intention through competition affordance, and a constraining pathway, in which interpersonal harmony increases emotional exhaustion and reduces continuance intention. Moving beyond the broad individualism\u2013collectivism framework, this study shows how specific Confucian values shape heterogeneous user responses and suggests that designers should encourage constructive competition while reducing harmony-related psychological strain in East Asia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552076261490673","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:19:36Z","timestamp":1789517976000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Confucian values and continuance intention in leaderboard-based health gamification"],"prefix":"10.1177","volume":"12","author":[{"given":"Zhuo","family":"Li","sequence":"first","affiliation":[{"name":"Liaocheng University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1673-5613","authenticated-orcid":false,"given":"Teng","family":"Wang","sequence":"additional","affiliation":[{"name":"Liaocheng University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingcui","family":"Song","sequence":"additional","affiliation":[{"name":"Liaocheng People\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_3_7_2_2","volume-title":"Gamification in Fitness Apps: How Do Leaderboards Influence Exercise?","author":"Wu Y","year":"2015","unstructured":"Wu Y, Kankanhalli A, Huang K-w. 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