{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:59:36Z","timestamp":1790607576021,"version":"4.1.0"},"reference-count":93,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Serious Games"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Physical inactivity affects approximately 1.4 billion adults globally, representing a major public health challenge. Gamification shows potential in addressing global inactivity by boosting motivation. The widely recognized Gamification Octalysis Framework, which emphasizes human motivation over mere functionality, can be used to summarize gamification elements in physical activity (PA) applications. However, previous reviews have mainly examined the effectiveness of gamified PA interventions, with limited attention to how gamification elements are linked to motivational mechanisms and behavior change techniques (BCTs). Additionally, the integration of identified BCTs can help connect game elements and health behavior change.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This scoping review aimed to map and categorize gamification elements used in PA interventions according to the Octalysis Framework, identify associated BCTs, and describe reported outcome domains and design gaps to inform future gamified PA intervention development.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The review protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251077817). The scoping review was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A total of seven databases (ie, PubMed, Embase, Cochrane Library, Web of Science, CINAHL, SPORTDiscus, and Psychological Information) were selected and searched for relevant randomized controlled trials (RCTs) published in English from inception to July 7, 2026. Two reviewers (SJL and LQ) independently conducted study selection and gamification-element coding. Data charting was performed by one reviewer (SJL) and verified by another (LQ).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 53 RCTs and 34 unique interventions were included in this review. The studies reported a variety of outcomes, including user retention, behavioral changes, psychological impacts, and health-related indicators. The most frequently adopted BCT elements were \u201c2.2 feedback on behavior\u201d and \u201c1.1 goal setting (behavior).\u201d Moreover, using the Octalysis framework, a taxonomy was developed, identifying 48 gamification elements (eg, narrative, mentoring, and points loss) across 8 core motivational drives. The majority of BCTs were mapped to 2 core motivations (ie, empowerment and accomplishment), while some BCTs were not supported by gamification elements.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This scoping review complements previous effectiveness-focused reviews by examining how gamified PA interventions are designed and which motivational and behavior change functions they target. By developing an Octalysis-based taxonomy of 48 gamification elements and mapping these elements against BCTs, this review provides a descriptive, design-oriented evidence map of commonly used design patterns and underrepresented behavior change functions. The findings may support more deliberate and transparent selection, combination, and reporting of gamification elements in future PA interventions. However, they should not be interpreted as evidence of the effectiveness of individual gamification elements, and further research is needed to evaluate how specific design configurations influence engagement and PA outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/85804","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T08:55:07Z","timestamp":1784969707000},"page":"e85804-e85804","source":"Crossref","is-referenced-by-count":0,"title":["Gamification Elements in Physical Activity Interventions: Scoping Review and Taxonomy Based on the Octalysis Framework"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0740-5858","authenticated-orcid":false,"given":"Sijia","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7208-7745","authenticated-orcid":false,"given":"Li","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2327-6807","authenticated-orcid":false,"given":"Rui-Ning","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8190-2477","authenticated-orcid":false,"given":"Runyuan","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0271-8409","authenticated-orcid":false,"given":"Hao-Ming","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2436-6870","authenticated-orcid":false,"given":"Mei-Hua","family":"Piao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"issue":"9838","key":"R1","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/S0140-6736(12)61031-9","article-title":"Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy","volume":"380","author":"Lee","journal-title":"Lancet"},{"issue":"9","key":"R2","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/S2215-0366(18)30227-X","article-title":"Association between physical exercise and mental health in 1\u00b72 million individuals in the USA between 2011 and 2015: a cross-sectional study","volume":"5","author":"Chekroud","journal-title":"Lancet Psychiatry"},{"issue":"24","key":"R3","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","journal-title":"Br J Sports Med"},{"issue":"8","key":"R4","doi-asserted-by":"publisher","first-page":"e1232","DOI":"10.1016\/S2214-109X(24)00150-5","article-title":"National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5\u00b77 million participants","volume":"12","author":"Strain","journal-title":"Lancet Glob Health"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1136\/bjsports-2020-103640","article-title":"Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries","volume":"56","author":"Katzmarzyk","journal-title":"Br J Sports Med"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"e32","DOI":"10.1016\/S2214-109X(22)00464-8","article-title":"The cost of inaction on physical inactivity to public health-care systems: a population-attributable fraction analysis","volume":"11","author":"Santos","journal-title":"Lancet Glob Health"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2022.107336","article-title":"Motivations and barriers towards optimal physical activity level: a community-based assessment of 28 EU countries","volume":"164","author":"D\u0117del\u0117","journal-title":"Prev Med"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cedpsych.2020.101860","article-title":"Intrinsic and extrinsic motivation from a self-determination theory perspective: definitions, theory, practices, and future directions","volume":"61","author":"Ryan","journal-title":"Contemp Educ Psychol"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Deterding S Sicart M Nacke L O\u2019Hara K Dixon D . Gamification. using game-design elements in non-gaming contexts. Presented at: CHI \u201911; May 7-12, 2011:2425-2428; Vancouver, BC. May 7, 2011.[doi: 10.1145\/1979742.1979575]","DOI":"10.1145\/1979742.1979575"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Jent S Janneck M . Using gamification to enhance user motivation in an online-coaching application for flexible workers. In: Proceedings of the 12th International Conference on Web Information Systems and Technologies - Volume 2: WEBIST. SciTePress; 2016:35-41. [doi: 10.5220\/0005898400350041]","DOI":"10.5220\/0005898400350041"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.2196\/26779","article-title":"Evaluating the effectiveness of gamification on physical activity: systematic review and meta-analysis of randomized controlled trials","volume":"24","author":"Mazeas","journal-title":"J Med Internet Res"},{"issue":"2","key":"R12","doi-asserted-by":"publisher","DOI":"10.2196\/27794","article-title":"The effects of mHealth-based gamification interventions on participation in physical activity: systematic review","volume":"10","author":"Xu","journal-title":"JMIR Mhealth Uhealth"},{"key":"R13","unstructured":"Zichermann G Cunningham C . Gamification by Design: Implementing Game Mechanics in Web and Mobile Apps. O\u2019Reilly Media; 2011. URL: https:\/\/books.google.co.in\/books?id=Hw9X1miVMMwC&printsec=frontcover#v=onepage&q&f=false [Accessed 31-08-2026]"},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Deterding S Dixon D Khaled R Nacke L . From game design elements to gamefulness: defining \"gamification. In: MindTrek \u201911: Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments. 2011:9-15. [doi: 10.1145\/2181037.2181040]","DOI":"10.1145\/2181037.2181040"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1057\/s41599-023-02243-3","article-title":"A bibliometric analysis of the use of the Gamification Octalysis Framework in training: evidence from Web of Science","volume":"10","author":"Mohanty","journal-title":"Humanit Soc Sci Commun"},{"key":"R16","unstructured":"Y-k C . Actionable Gamification: Beyond Points, Badges, and Leaderboards. Packt Publishing Ltd; 2019. URL: https:\/\/books.google.com.hk\/books\/about\/Actionable_Gamification.html?id=jFWQrgEACAAJ&redir_esc=y [Accessed 31-08-2026] ISBN: 183921077X"},{"issue":"5","key":"R17","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1177\/1932296818822998","article-title":"Gamification and behavior change techniques in diabetes self-management apps","volume":"13","author":"Priesterroth","journal-title":"J Diabetes Sci Technol"},{"issue":"10","key":"R18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012447","article-title":"Gamification for health promotion: systematic review of behaviour change techniques in smartphone apps","volume":"6","author":"Edwards","journal-title":"BMJ Open"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s12160-013-9486-6","article-title":"The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions","volume":"46","author":"Michie","journal-title":"Ann Behav Med"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0611-x","article-title":"Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach","volume":"18","author":"Munn","journal-title":"BMC Med Res Methodol"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"Arksey","journal-title":"Int J Soc Res Methodol"},{"issue":"7","key":"R22","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"Tricco","journal-title":"Ann Intern Med"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: an extension to the PRISMA statement for reporting literature searches in systematic reviews","volume":"10","author":"Rethlefsen","journal-title":"Syst Rev"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","journal-title":"Syst Rev"},{"key":"R25","doi-asserted-by":"crossref","unstructured":"Tondello GF Kappen DL Mekler ED Ganaba M Nacke LE . Heuristic evaluation for gameful design. In: CHI PLAY Companion \u201916: Proceedings of the 2016 Annual Symposium on Computer-Human Interaction in PLAY Companion Extended Abstracts. Association for Computing Machinery; 2016:315-323. [doi: 10.1145\/2968120.2987729]","DOI":"10.1145\/2968120.2987729"},{"issue":"7","key":"R26","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.16256","article-title":"Effect of gamification with and without financial incentives to increase physical activity among veterans classified as having obesity or overweight: a randomized clinical trial","volume":"4","author":"Agarwal","journal-title":"JAMA Netw Open"},{"issue":"132","key":"R27","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s40814-019-0523-5","article-title":"A feasibility study of \u201cThe StepSmart Challenge\u201d to promote physical activity in adolescents","volume":"5","author":"Corepal","journal-title":"Pilot Feasibility Stud"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1186\/s12889-017-4697-6","article-title":"Promoting physical activity in worksite settings: results of a German pilot study of the online intervention Healingo fit","volume":"17","author":"Dadaczynski","journal-title":"BMC Public Health"},{"issue":"8","key":"R29","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4568","article-title":"Apps for IMproving FITness and increasing physical activity among young people: the AIMFIT pragmatic randomized controlled trial","volume":"17","author":"Direito","journal-title":"J Med Internet Res"},{"issue":"11","key":"R30","doi-asserted-by":"publisher","DOI":"10.2196\/14645","article-title":"User engagement and attrition in an app-based physical activity intervention: secondary analysis of a randomized controlled trial","volume":"21","author":"Edney","journal-title":"J Med Internet Res"},{"issue":"21","key":"R31","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1161\/CIRCULATIONAHA.124.069531","article-title":"Effect of gamification, financial incentives, or both to increase physical activity among patients at high risk of cardiovascular events: the BE ACTIVE randomized controlled trial","volume":"149","author":"Fanaroff","journal-title":"Circulation"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2021.101426","article-title":"Gamifying accelerometer use increases physical activity levels of individuals pre-disposed to type II diabetes","volume":"23","author":"Francis","journal-title":"Prev Med Rep"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/g4h.2017.0023","article-title":"A 0multi-week assessment of a mobile exergame intervention in an elementary school","volume":"7","author":"Garde","journal-title":"Games Health J"},{"issue":"3","key":"R34","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1089\/cyber.2015.0281","article-title":"Evaluation of a novel mobile exergame in a school-based environment","volume":"19","author":"Garde","journal-title":"Cyberpsychol Behav Soc Netw"},{"issue":"8","key":"R35","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1097\/RHU.0000000000002148","article-title":"A remote behaviorally designed intervention to promote physical activity in patients with knee osteoarthritis: results of a pilot randomized clinical trial","volume":"30","author":"Gillcrist","journal-title":"J Clin Rheumatol"},{"issue":"10","key":"R36","doi-asserted-by":"publisher","DOI":"10.2196\/14322","article-title":"Use of a smartphone app to increase physical activity levels in insufficiently active adults: feasibility sequential multiple assignment randomized trial (SMART)","volume":"9","author":"Gonze","journal-title":"JMIR Res Protoc"},{"issue":"13","key":"R37","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007735","article-title":"Gamifying accelerometer use increases physical activity levels of sedentary office workers","volume":"7","author":"Gremaud","journal-title":"J Am Heart Assoc"},{"issue":"3","key":"R38","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.0952","article-title":"Effect of behaviorally designed gamification with a social support partner to increase mobility after hospital discharge","volume":"4","author":"Greysen","journal-title":"JAMA Netw Open"},{"issue":"8","key":"R39","doi-asserted-by":"publisher","first-page":"5450","DOI":"10.1002\/alz.14058","article-title":"Effect of gamification with a support partner to increase physical activity in older adults at risk for Alzheimer\u2019s disease: the STEP 4Life randomized clinical trial","volume":"20","author":"Greysen","journal-title":"Alzheimers Dement"},{"issue":"5","key":"R40","doi-asserted-by":"publisher","DOI":"10.2196\/15083","article-title":"A persuasive mHealth behavioral change intervention for promoting physical activity in the workplace: feasibility randomized controlled trial","volume":"4","author":"Haque","journal-title":"JMIR Form Res"},{"issue":"1","key":"R41","doi-asserted-by":"publisher","DOI":"10.2196\/11444","article-title":"Effectiveness of a behavior change technique-based smartphone game to improve intrinsic motivation and physical activity adherence in patients with type 2 diabetes: randomized controlled trial","volume":"7","author":"H\u00f6chsmann","journal-title":"JMIR Serious Games"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.amepre.2019.02.017","article-title":"Novel smartphone game improves physical activity behavior in type 2 diabetes","volume":"57","author":"H\u00f6chsmann","journal-title":"Am J Prev Med"},{"issue":"10","key":"R43","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1007\/s11606-018-4552-1","article-title":"Social incentives and gamification to promote weight loss: the LOSE IT randomized, controlled trial","volume":"33","author":"Kurtzman","journal-title":"J Gen Intern Med"},{"issue":"7","key":"R44","doi-asserted-by":"publisher","DOI":"10.2196\/35701","article-title":"Effects of a gamified, behavior change technique-based mobile app on increasing physical activity and reducing anxiety in adults with autism spectrum disorder: feasibility randomized controlled trial","volume":"6","author":"Lee","journal-title":"JMIR Form Res"},{"issue":"10","key":"R45","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.6675","article-title":"Feasibility of gamified mobile service aimed at physical activation in young men: population-based randomized controlled study (MOPO)","volume":"5","author":"Leinonen","journal-title":"JMIR Mhealth Uhealth"},{"issue":"6","key":"R46","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1001\/jamacardio.2022.0553","article-title":"Effectiveness of a text-based gamification intervention to improve physical activity among postpartum individuals with hypertensive disorders of pregnancy: a randomized clinical trial","volume":"7","author":"Lewey","journal-title":"JAMA Cardiol"},{"issue":"8","key":"R47","doi-asserted-by":"publisher","first-page":"3494","DOI":"10.1111\/jan.14924","article-title":"Long-term effectiveness of an mHealth-tailored physical activity intervention in youth with congenital heart disease: a randomized controlled trial","volume":"77","author":"Lin","journal-title":"J Adv Nurs"},{"issue":"7","key":"R48","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4086","article-title":"A web-based, social networking physical activity intervention for insufficiently active adults delivered via facebook app: randomized controlled trial","volume":"17","author":"Maher","journal-title":"J Med Internet Res"},{"issue":"4","key":"R49","doi-asserted-by":"publisher","DOI":"10.2196\/19875","article-title":"Combining web-based gamification and physical nudges with an app (MoveMore) to promote walking breaks and reduce sedentary behavior of office workers: field study","volume":"23","author":"Mamede","journal-title":"J Med Internet Res"},{"issue":"1","key":"R50","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-023-01530-1","article-title":"Harnessing technology and gamification to increase adult physical activity: a cluster randomized controlled trial of the Columbia Moves pilot","volume":"20","author":"Monroe","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"1","key":"R51","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/1880-6805-33-35","article-title":"A pilot crossover study: effects of an intervention using an activity monitor with computerized game functions on physical activity and body composition","volume":"33","author":"Nishiwaki","journal-title":"J Physiol Anthropol"},{"issue":"3","key":"R52","doi-asserted-by":"publisher","DOI":"10.2196\/28801","article-title":"Evaluating the impact of adaptive personalized goal setting on engagement levels of government staff with a gamified mHealth tool: results from a 2-month randomized controlled trial","volume":"10","author":"Nuijten","journal-title":"JMIR Mhealth Uhealth"},{"issue":"12","key":"R53","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1001\/jamacardio.2021.3176","article-title":"Effect of goal-setting approaches within a gamification intervention to increase physical activity among economically disadvantaged adults at elevated risk for major adverse cardiovascular events: the ENGAGE randomized clinical trial","volume":"6","author":"Patel","journal-title":"JAMA Cardiol"},{"issue":"11","key":"R54","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1001\/jamainternmed.2017.3458","article-title":"Effect of a game-based intervention designed to enhance social incentives to increase physical activity among families: the BE FIT randomized clinical trial","volume":"177","author":"Patel","journal-title":"JAMA Intern Med"},{"issue":"12","key":"R55","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1001\/jamainternmed.2019.3505","article-title":"Effectiveness of behaviorally designed gamification interventions with social incentives for increasing physical activity among overweight and obese adults across the United States: the STEP UP randomized clinical trial","volume":"179","author":"Patel","journal-title":"JAMA Intern Med"},{"issue":"5","key":"R56","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.10255","article-title":"Effect of behaviorally designed gamification with social incentives on lifestyle modification among adults with uncontrolled diabetes: a randomized clinical trial","volume":"4","author":"Patel","journal-title":"JAMA Netw Open"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2017.02.032","article-title":"Effect of tailored, gamified, mobile physical activity intervention on life satisfaction and self-rated health in young adolescent men: a population-based, randomized controlled trial (MOPO study)","volume":"72","author":"Pyky","journal-title":"Comput Human Behav"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcci.2017.12.003","article-title":"Savouring our mistakes: learning from the FitQuest project","volume":"16","author":"Robertson","journal-title":"Int J Child Comput Interact"},{"issue":"11","key":"R59","doi-asserted-by":"publisher","DOI":"10.2196\/18364","article-title":"Gamified text messaging contingent on device-measured steps: randomized feasibility study of a physical activity intervention for cancer survivors","volume":"8","author":"Robertson","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R60","doi-asserted-by":"publisher","DOI":"10.2196\/16458","article-title":"Promoting physical activity in Japanese older adults using a social pervasive game: randomized controlled trial","volume":"9","author":"Santos","journal-title":"JMIR Serious Games"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychsport.2024.102590","article-title":"A randomized controlled mHealth trial that evaluates social comparison-oriented gamification to improve physical activity, sleep quantity, and quality of life in young adults","volume":"72","author":"Sa\u00f1udo","journal-title":"Psychol Sport Exerc"},{"issue":"14","key":"R62","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18147444","article-title":"Does dynamic tailoring of a narrative-driven exergame result in higher user engagement among adolescents? Results from a cluster-randomized controlled trial","volume":"18","author":"Schwarz","journal-title":"Int J Environ Res Public Health"},{"issue":"1-2","key":"R63","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1093\/milmed\/usae280","article-title":"Using a Fitbit-based walking game to improve physical activity among U.S. veterans","volume":"190","author":"Simmering","journal-title":"Mil Med"},{"key":"R64","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/746232","article-title":"Increasing physical activity efficiently: an experimental pilot study of a website and mobile phone intervention","volume":"2014","author":"Thorsteinsen","journal-title":"Int J Telemed Appl"},{"issue":"5","key":"R65","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1016\/j.smr.2018.10.005","article-title":"Walking for fun or for \u201clikes\u201d? The impacts of different gamification orientations of fitness apps on consumers\u2019 physical activities","volume":"22","author":"Tu","journal-title":"Sport Manag Rev"},{"issue":"5","key":"R66","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1001\/jamaneurol.2022.0231","article-title":"Effect of gamification with social incentives on daily steps after stroke: a randomized clinical trial","volume":"79","author":"Waddell","journal-title":"JAMA Neurol"},{"issue":"9","key":"R67","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1177\/1357633X221150943","article-title":"Smartphone-based gamification intervention to increase physical activity participation among patients with coronary heart disease: a randomized controlled trial","volume":"30","author":"Xu","journal-title":"J Telemed Telecare"},{"issue":"7","key":"R68","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1007\/s00779-014-0783-2","article-title":"Deconstructing gamification: evaluating the effectiveness of continuous measurement, virtual rewards, and social comparison for promoting physical activity","volume":"18","author":"Zuckerman","journal-title":"Pers Ubiquit Comput"},{"issue":"24","key":"R69","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.038921","article-title":"Effect of gamification plus automated coaching to increase physical activity among patients with peripheral artery disease: the GAMEPAD randomized controlled trial","volume":"14","author":"Fanaroff","journal-title":"J Am Heart Assoc"},{"issue":"7","key":"R70","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1016\/j.jaccao.2025.10.001","article-title":"Behaviorally designed gamification and physical activity among breast and prostate cancer survivors","volume":"7","author":"Fanaroff","journal-title":"JACC CardioOncol"},{"key":"R71","doi-asserted-by":"publisher","DOI":"10.2196\/65558","article-title":"A refined mobile health intervention (SMARTFAMILY2.0) to promote physical activity and healthy eating in a family setting: randomized controlled trial","volume":"13","author":"Fiedler","journal-title":"JMIR Mhealth Uhealth"},{"issue":"8","key":"R72","doi-asserted-by":"publisher","DOI":"10.1002\/ejsc.70027","article-title":"Time to move: a 4-week gamified mobile application intervention to promote physical activity in secondary school students","volume":"25","author":"Ha\u015f\u0131l Korkmaz","journal-title":"Eur J Sport Sci"},{"key":"R73","doi-asserted-by":"publisher","DOI":"10.2196\/60185","article-title":"Effect of a gamified family-based exercise intervention on adherence to 24-hour movement behavior recommendations in preschool children: single-center pragmatic trial","volume":"13","author":"Legarra-Gorgo\u00f1on","journal-title":"JMIR Serious Games"},{"key":"R74","doi-asserted-by":"publisher","DOI":"10.2196\/78376","article-title":"Effect of a digital health physical activity program integrating gamification for obesity management in comparison with usual care: randomized controlled trial with an ideographic approach","volume":"27","author":"Maz\u00e9as","journal-title":"J Med Internet Res"},{"key":"R75","doi-asserted-by":"publisher","DOI":"10.2196\/73388","article-title":"Effects of using a smartphone app combined with behavior change techniques on the level of physical activity among adults and older adults: sequential multiple assignment randomized trial","volume":"28","author":"Simoes","journal-title":"J Med Internet Res"},{"issue":"1","key":"R76","doi-asserted-by":"publisher","first-page":"108297","DOI":"10.1016\/j.amepre.2026.108297","article-title":"Effects of different gamification delivery strategies on physical activity in young adults: an RCT","volume":"71","author":"Liu","journal-title":"Am J Prev Med"},{"issue":"1-13","key":"R77","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/17483107.2026.2671844","article-title":"Promoting healthy behaviours in young people with intellectual disabilities: a pilot RCT of an mHealth-based intervention targeting physical activity and sedentary behaviour","volume":"15","author":"Sa\u00f1udo","journal-title":"Disabil Rehabil Assist Technol"},{"key":"R78","doi-asserted-by":"publisher","DOI":"10.2196\/82769","article-title":"A gamified mobile health intervention to promote physical activity, executive function, and mental health in college students: randomized controlled trial","volume":"28","author":"Yang","journal-title":"J Med Internet Res"},{"issue":"12","key":"R79","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1016\/j.mayocp.2023.05.003","article-title":"Health disparities, clinical trials, and the digital divide","volume":"98","author":"Adedinsewo","journal-title":"Mayo Clin Proc"},{"key":"R80","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.116341","article-title":"Effectiveness of behavioural economics-informed interventions to promote physical activity: a systematic review and meta-analysis","volume":"338","author":"Reisgies","journal-title":"Soc Sci Med"},{"issue":"38","key":"R81","doi-asserted-by":"publisher","first-page":"633","DOI":"10.3238\/arztebl.m2022.0275","article-title":"Behavioral economics interventions to improve medical decision-making","volume":"119","author":"Hallek","journal-title":"Dtsch Arztebl Int"},{"issue":"22","key":"R82","doi-asserted-by":"publisher","first-page":"2631","DOI":"10.1001\/jama.2008.804","article-title":"Financial incentive-based approaches for weight loss: a randomized trial","volume":"300","author":"Volpp","journal-title":"JAMA"},{"issue":"1","key":"R83","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1108\/IJWHM-12-2014-0060","article-title":"The promise of tailoring incentives for healthy behaviors","volume":"9","author":"Kullgren","journal-title":"Int J Workplace Health Manag"},{"key":"R84","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.688192","article-title":"Maintaining or losing intervention-induced health-related behavior change. a mixed methods field study","volume":"12","author":"Skarin","journal-title":"Front Psychol"},{"issue":"2","key":"R85","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1002\/jclp.20758","article-title":"Stages of change","volume":"67","author":"Norcross","journal-title":"J Clin Psychol"},{"key":"R86","doi-asserted-by":"crossref","unstructured":"Nystrom T . Gamification of persuasive systems for sustainability. In: Nystr\u00f6m T , editor. Presented at: 2017 Sustainable Internet and ICT for Sustainability (SustainIT); Dec 6-7, 2017; Funchal, Portugal. [doi: 10.23919\/SustainIT.2017.8379815]","DOI":"10.23919\/SustainIT.2017.8379815"},{"issue":"Suppl 4","key":"R87","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13258","article-title":"Effective behavior change techniques to promote physical activity in adults with overweight or obesity: a systematic review and meta-analysis","volume":"22 Suppl 4","author":"Carra\u00e7a","journal-title":"Obes Rev"},{"key":"R88","doi-asserted-by":"publisher","DOI":"10.2196\/54978","article-title":"Behavior change techniques used in self-management interventions based on mHealth apps for adults with hypertension: systematic review and meta-analysis of randomized controlled trials","volume":"26","author":"Zhou","journal-title":"J Med Internet Res"},{"key":"R89","doi-asserted-by":"publisher","DOI":"10.2196\/54375","article-title":"Digital behavior change intervention designs for habit formation: systematic review","volume":"26","author":"Zhu","journal-title":"J Med Internet Res"},{"key":"R90","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241265217","article-title":"Developing cue-behavior association for habit formation: a qualitative study to explore the role of avatar in hypertension","volume":"10","author":"Zhu","journal-title":"Digit Health"},{"issue":"5","key":"R91","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1093\/iwc\/iwz028","article-title":"User-centered gamification for e-learning systems: a quantitative and qualitative analysis of its application","volume":"31","author":"Klock","journal-title":"Interact Comput"},{"key":"R92","doi-asserted-by":"publisher","DOI":"10.1016\/j.lindif.2024.102470","article-title":"Personalized gamification versus one-size-fits-all gamification in fully online learning: effects on student motivational, behavioral and cognitive outcomes","volume":"113","author":"Xiao","journal-title":"Learn Individ Differ"},{"key":"R93","unstructured":"Ishaq K Alvi A . Personalization,cognition, and gamification-based programming language learning: a state-of-the-art systematic literature review. arXiv. Preprint posted online on Sep 5, 2023. [doi: 10.48550\/ARXIV.2309.12362]"}],"container-title":["JMIR Serious Games"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:36:55Z","timestamp":1790606215000},"score":1,"resource":{"primary":{"URL":"https:\/\/games.jmir.org\/2026\/1\/e85804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":93,"URL":"https:\/\/doi.org\/10.2196\/85804","relation":{},"ISSN":["2291-9279"],"issn-type":[{"value":"2291-9279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"article-number":"v14i9838e85804"}}