Framing the Development of a Gamified App for m-Health and Well-Being

This paper lays out the theoretical and design rationale for a gamified mobile application, developed under the WE CARE project, that aims to support mental health and well-being among health professionals. The authors argue that although health professionals generally understand the value of healthy lifestyles, workplace demands and workload make it difficult to act on that knowledge, and that web-based interventions suffer from high dropout rates, ranging from 35% to 99%. Gamification is presented as a way to boost motivation and adherence, but the paper notes that prior gamified health apps have often lacked a theoretical grounding, relied heavily on extrinsic rewards, and been inconsistently categorised, which limits comparability of findings.

To address these gaps, the design draws on Self-Determination Theory, including Organismic Integration Theory and Basic Psychological Needs Theory, along with Nicholson's framework for meaningful gamification and Cugelman's mapping of gamification strategies to behavioural-change techniques. Game elements were selected from Hervas et al.'s taxonomy and supplemented by feedback and personalisation categories, then matched to competence, autonomy, and relatedness needs. The application uses an initial questionnaire, based on a preliminary survey of 161 health professionals and a matrix combining Transtheoretical Model stages with stress levels, to place users in guided 7- or 14-day pathways or open mode. A greenhouse-to-tree narrative, in which points are converted into water drops that grow a plant, ties the rewards to the health content.

The authors acknowledge that the work is conceptual and that its conclusions are limited, since no meaningful feedback from diverse user groups had yet been gathered. They offer three recommendations for designers: draw game elements from existing taxonomies, ground gamification in established theory, and provide a narrative context to support engagement and reflection.