Case study of a gamified health application. The study applies an evidence-based approach to influence user behavior and promote healthier lifestyles with engagement and motivation.
I started this study prompted from an excerpt from the book, The Next Billion Users by Payal Arora. In the book she states that the main contributors to the next billion users are from poverty-stricken regions. Development agencies have viewed this as an opportunity to provide services that may be able to address poverty and enhance the quality of life in these regions.
However, even with these services in place, studies and statistics on online browsing patterns reveal that the most visited sites are related to social networking, pornography, romance, and gaming. This observation implies that the digital consumption habits of these individuals predominantly revolve around entertainment and leisure activities.
In the past decade, a significant number of individuals outside the West have rapidly adopted and integrated mobile phones into their lives. Labelled as the “Next Billion Users” many of these users are from poverty-stricken regions. Countries in Asia and Africa will be the main contributors to the next billion internet users, including India, China, Philippines, Pakistan, Indonesia and Nigeria.
With more people coming online over the next few years, there has been growing focus to provide essential services to populations such as education, healthcare, employment, and government services. Development agencies have viewed this surge in mobile phone usage as an opportunity to address poverty and enhance the quality of life in these regions.
However, studies and statistics on online browsing patterns reveal that the most visited sites are related to social networking, pornography, romance, and gaming.
(Arora, 2019)
With this context in mind, I developed the problem that would provide the direction for the study:
“How might we leverage the digital consumption habits of the next billion users to improve their quality of life?”
The goal was to provide an enjoyable experience where users could indirectly improve their health through the use of the application. I wanted to create an application that catered to the interests and motivations of the next billion users.
The research would build upon evidence from literature review and user research to explore and integrate a combination of features and strategies in providing improvement of habits.
The Double Diamond serves as a methodology framework for the project, even though the process is not strictly linear but more iterative. The study follows 4 distinct phases, namely the Discover, Define, Develop, and Deliver phases.
In the discovery phase, I began by reviewing relevant literature that could explain the underlying motivations and correlation between digital consumption and a preference for entertainment and leisure.
During the study, multiple studies in the educational and workplace context reference the Self-System Model of Motivational Development (SSMMD)
The Self-System Model of Motivational Development (SSMMD), based on Self-Determination Theory (SDT), states that human motivation requires a consideration of three fundamental psychological needs - competence, autonomy, and relatedness.
refers to one’s perception in their ability to perform tasks effectively.
involves having the freedom to make choices and control actions.
is the sense of connection and belonging with others.
Studies in educational and workplace contexts confirm that an individuals' self-perceptions of these needs significantly influence cognitive, emotional, and behavioral engagement. When these psychological needs are met, engagement arises, and while unmet can hinder motivation.
With this in mind, I wanted to find studies that have been able to successfully provide evidence of fulfilling these psychological needs for engagement.
During my research, I found studies on gamification and its impact on engagement. Gamification has become an increasingly growing feature of mobile apps that is used to enhance user experience.
While research involving student engagement was the most common, studies that demonstrated evidence of gamification’s effectiveness in enhancing customer engagement, brand engagement, employee engagement, and user engagement had also come up.
Gamification has been defined as "a process of enhancing a service with affordances for gameful experiences to support users' overall value creation". To be specific, in gamification, affordances refer to the game elements and mechanics that structure interactive experiences, fostering user motivation and engagement.
Therefore, through voluntary interaction with affordances, gamification drives psychological outcomes such as enhanced motivation and engagement, ultimately influencing the user’s behaviors.
Research proposed that the affordances in a gamified system also satisfies the fundamental psychological needs - competence, autonomy, and relatedness (as outlined in the SSMMD model) for motivation and engagement.
These motivational affordances were listed into 3 categories of game elements:
From these insights, I came up with an idea to implement gamification (using motivational affordances) to enhance user engagement with a health application.
In order to understand the current market, I conducted a review of existing mobile health applications to identify effective features for health improvement, analyze potential shortcomings, and evaluate how well they incorporate motivational affordances for gamification. Fortunately, there is extensive literature on mobile health applications.
Research indicates that diet and nutrition apps account for over half of mobile health applications, with key features focusing on caloric intake tracking and exercise logging. However, high abandonment rates are commonly reported due to usability and perceived usefulness issues.
Studies have shown that gamification elements play a crucial role in improving user engagement and nutritional habits. Game-based interventions have led to increased fruit and vegetable consumption, improved knowledge of food groups, and healthier dietary choices among children and adolescents.
Since I would be focused on game-based interventions for my health application, I also wanted to research on the current market for mobile games for my target audience.
The mobile gaming market continues to grow, with the Asia-Pacific region becoming the biggest mobile player base worldwide. Within the region, in the ranking by revenue in the ‘Mobile Games’ segment of the digital market is led by the Philippines and is forecasted to continue leading the region at 1.72 billion US dollars. Strategy and RPG games remained the top revenue-generating genres, accounting for 24% and 23% of total revenue, respectively.
To complement the findings from the literature review, I conducted primary research through a survey questionnaire with the target users as the main respondents. The primary objective was to uncover user motivations, challenges, preference for health and game applications and any information that I could use for the application.
On the open-ended questions, I was able to gather information on the features that users found effective for health applications, and features that they found enjoyable in mobile games.
Similarities with the responses came up, which I categorized into key themes:
These preferences align closely with the motivational affordances outlined in the literature review, including achievement and progression-oriented affordances, social-oriented affordances, and customization for immersion-oriented affordances.
To clearly summarize the research supporting the application’s features, I had outlined the relationship between the literature’s findings which would serve as the framework for the application’s design. This ensures that the application’s features are grounded in validated evidence.
The theoretical framework is based on Self-Determination Theory (SDT), which emphasizes the three fundamental psychological needs - competence, autonomy, and relatedness - as essential for motivation and engagement. In gamification, motivational affordances translate into achievement, social interaction, and immersion elements, which influence user behavior.
The conceptual framework builds on this by proposing that gamification elements commonly found in mobile games can be integrated into mobile health applications to enhance user experience and engagement. This framework serves as the foundation for developing Health360, ensuring that its features are designed to foster motivation and sustained user interaction.
I continued to evaluate existing health and mobile game applications against the psychological needs outlined in the SSMMD and the motivational affordances for gamified systems.
In this study I identified that while most mobile health applications effectively incorporate achievement and progression-oriented affordances with progress bars, badges, and challenges, they fail to provide immersion-oriented affordances needed for user engagement and retention.
Fitness applications like Fitbit and Strava integrate maps and 3D destinations, but broader immersion features are missing in these health applications.
The study had also given insight on the gamification elements from popular mobile games already in the market - such as avatars, character progression, and rankings.
I identified this as a potential market gap and an opportunity to create a differentiator. In my proposal for the application, successful gamification elements from mobile game applications can be replicated to enhance user engagement and retention in health applications.
I developed user personas that follow the archetype of the target audience which are the next billion users prodominantly from Southeast Asia.
In the concept development for the application, I listed the features in a matrix diagram to prioritize the user flows depending on how often each feature will be used and by how many users.
Users are expected to interact regularly with these features the most. These will promote daily engagement, reinforce habits, and provide users with consistent rewards and tracking to promote user retention.
These will be frequently used or features that will be used my many. These are important to create an interactive and social component that will encourage users to be in the platform more often. These will help build a community around the application and healthy competition among the users. Successful application of the features will help user engagement through the shared challenges and achievements.
With consideration for all the user flows, I mapped out the information architecture of the application to understand the screens and interactions required for the application.
I created initial sketches in the ideation process to test different layouts, focusing on the positioning of the elements on each screen. The sketches would be a flexible foundation with room for further refinement and improvement.
The sketches are then created digitally for the low-fidelity wireframe. In the process, I further refined the screens to create the basic structure and flow of the user interface. These screens will allow visualization and iteration on the placement of elements, navigation paths, and key functions.
Before creating the high-fidelity wireframes, I developed the brand identity that could serve as the style guide for the application.
The logo, inspired by East Asian cultural aesthetics, features a lotus at its center symbolizing growth and resilience. The circular layered structure draws inspiration from moon cake patterns, a traditional element of unity and celebration. Complemented by a harmonious color palette derived from traditional Korean and Chinese design principles, the visual identity embodies balance, vitality, and tradition.
The core palette is derived from Obangsaek, the five cardinal colours in Korean tradition, signifying harmony and balance. Vibrant tones such as ocean blue, warm orange, and bright red are complemented by soft, secondary colours to provide versatility and accessibility in designing. These colours evoke a sense of vitality and wellness.
The pairing of ZCool Xiaowei for headings and Inter for body text reflects a blend of cultural heritage and modern simplicity, ensuring both aesthetic elegance and practical readability.
As the differentiator against mobile health applications that lacked immersion-oriented affordances, the core of the visual design for the application are the 3D assets and imagery that I created and curated for the application.
The environment is inspired by traditional East Asian architecture, set on a floating sky island to create an immersive and visually engaging experience. The design integrates distinct zones connected by stairwells, incorporating water features, greenery, and individually crafted buildings that align with the brand color palette.
The architectural influences include the zoning structure of the Forbidden City, the stacked layout of Himeji Castle, and fortifications inspired by the Great Wall of China. While the designs do not strictly follow historical architectural principles, they blend cultural elements to enhance functionality and aesthetics within the gamified experience.
The buildings populating the scene were modelled individually, with particular attention given to traditional architectural elements such as the roof designs. Props and foliage were carefully crafted and scattered throughout the model to enhance the vibrancy of the environment.
The interior environment extends this immersion, featuring an isometric room inspired by East Asian aesthetics. Custom furniture assets were curated and re-materialized to match the brand’s visual identity, ensuring cohesion and authenticity.
Avatars in Health360 serve as personalized representations of users, fostering engagement, agency, and ownership in their health journey inspired by East Asian RPG aesthetics.
Four character roles - Archer, Assassin, Mage, and Warrior - were developed to showcase gameplay potential, with future expansions allowing for more archetypes. Additionally, customization options include varied hairstyles and colors, with planned enhancements for eye color, skin tone, and further personalization features.
As part of the gamified system, players could engage in battles. Enemy monsters were curated, re-materialized, and slightly edited to match the application's overall visual design.
The mobile application’s user interface (UI) design progresses into the high-fidelity wireframes, representing a fully realized visual design of Health360. These wireframes incorporate all key elements of the application including the gamified system and immersive-oriented affordances.
The central hub for users, presenting the floating sky island environment that features various zones. The design is intended to fulfil the immersive-oriented affordances, enhancing user engagement and exploration.
Users can customize their avatars with a range of options, including different character roles (e.g., Archer, Mage, Warrior) and hairstyles. The customization create a sense of ownership and personalization, allowing users to tailor their ingame representation to their preferences.
These features focuses on fostering a sense of collaboration and competition among users. Features such as leaderboards, clan quests, and social interactions encourage users to connect with others while pursuing their health goals.
The nutrition screens provide detailed insights into users' dietary habits, offering actionable recommendations and progress tracking. From daily nutritional intake to specific food group insights, these screens empower users to make informed decisions about their health.
Quests and achievements are motivates users to engage with their health and wellness goals. Rewards for completing daily tasks are clearly presented, adding an element of fun and accountability. These are implemented to support user engagement and retention.
This is designed to simplify the process of tracking meals and exercises, featuring barcode and meal scanning functionalities for added convenience. Users can log items quickly and view comprehensive nutritional information, ensuring that tracking remains effortless.
The home interior features a customizable isometric room that users can personalize with furniture and other assets purchased from the marketplace. In-game currency, earned through completed quests and achievements, allows users to unlock these items. This feature seamlessly blends achievement-oriented progression and personalization into the overall user experience.
The marketplace allows users to purchase furniture and character skins using in game currency. The screen design emphasizes ease of navigation and aligns with the gamified elements of the application.
The combat feature brings the Health360 application to life, featuring an interactive experience to enhance the user experience.
As part of the evaluation process, a survey was conducted through an online questionnaire. The participants are given the opportunity to explore the artefact through the prototype and answer questions regarding the application’s overall experience. The usability testing and feedback survey provided significant insights into the user experience of the Health360 application.
I think this app definitely has a lot of potential! Gamifying health motivates me in ways I hadn’t expected - I didn’t realize how effective it could be until I experienced it. If it encourages people, even just a little, to be more active and mindful of their health, it’s already fulfilling its purpose. I was also pleasantly surprised to discover that my character’s stats are based on the data recorded, like water intake, meals, exercise, and runs. It’s like taking care of my own little Sim, except the Sim is actually me!
(Participant 16, 2024)
To summarize the findings, I used a SWOT analysis to identify the project’s core advantages and areas for improvement while considering external factors that could impact its success. The insights gained from the analysis will guide future development and implementation strategies.
The study had allowed me to take full ownership of developing a product from scratch, where I took on multiple roles throughout the research, design, and testing.
As part of my proposal, I focused on creating immersive-oriented features to differentiate the app from existing health applications. This had proved to be a challenge, but it had allowed me to expand on my design capabilities, all whilst working within a set timeline.
Due to time constraints, the artefact only provides a minimum viable product with limited functionality. However, it provides a foundational framework and exploration for integrating gamified systems into health applications, and opens up numerous opportunities for future refinement and expansion.
If there is an opportunity to further develop the product, there are a few recommendations that I thought would be great to work on. Future research and development should focus on enhancing the application’s features and interactivity, ensuring a more immersive and engaging user experience.
The current battle system can be improved by implementing more advanced interactive mechanics, such as dynamic turn-based gameplay or real-time combat strategies. Additional user testing and feedback should be conducted to determine the most engaging and accessible gameplay mechanics.
The customization features can be broadened to include additional attributes, such as facial shape, skin tone, eye color, and hair styles. Future versions of the app could also include clothing items, accessories, and equipment customization, enabling users to create avatars that reflect their identity and preferences. Introduction of achievement exclusive equipment may also be introduced.
The application could incorporate personalized recommendations based on user data, fostering a deeper connection between the app and its users. Features such as daily health insights, motivational challenges, and customized progress tracking could further engage users.
Adding multiplayer elements, leaderboards, and collaborative quests would foster community-building and social interaction, encouraging long-term app usage.
Future iterations of the application could explore compatibility with wearable health devices or smartwatches, allowing for real-time data tracking and seamless integration into users’ lifestyles.
Further exploring the gacha mechanic could increase user engagement and provide revenue opportunities. This system could enable users to unlock new character classes, skins, and items, offering a sense of progression and excitement.
You can view the prototype by
scanning the QR code on your mobile device.
You can view the prototype by clicking the link or scanning the QR code on your mobile device.
You can view the prototype below, through the link, or by scanning the QR code on your mobile device.
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Case study of an improved diet and nutrition application catered to the next billion users of the digital age.
