Adding social gaming elements to a behavior tracking program led people to exercise more frequently and helped them decrease their body mass index, according to new research from the USC School of Cinematic Arts, the Keck School of Medicine of USC, the USC School of Social Work and the University at Buffalo, SUNY.

The project was funded by a grant from the Robert Wood Johnson Foundation's Pioneer Portfolio through its national program, Health Games Research. The results suggests that “gamification” may improve the effectiveness of traditional health interventions for motivating behavior change and can lead to better health outcomes.

For the 10-week program, researchers studied young and middle-aged adults across a range of lifestyles, from sedentary to very active. Study participants invited someone they knew, usually friends or family members, to participate with them.

One group of participants was randomly assigned to keep an online diary of physical activity, a commonly used strategy for activity adherence and weight management. The diary is part of Wellness Partners, a program developed at USC to explore the role of socially networked games in encouraging lifestyle changes.

A second group was asked to keep a version of the Wellness Partners diary that included social gaming such as earning points for exercise reporting, redeeming them for animated activities performed by a virtual character, collecting memories and earning gifts participants shared with others in the network. After five weeks, the groups switched programs.

The results revealed that a combination of the diary and social gaming helped the participants exercise more frequently, leading to decreased body mass index, a strong wellness indicator. The effects were stronger in the groups that started with gaming and were sustained after gaming elements were removed.

“A big part of its success is that this program required the engagement of friends and family in tracking open-ended health goals,” said lead researcher Marientina Gotsis, director of the Creative Media & Behavioral Health Center at USC. “We wanted to see how different people would react to it, and the results demonstrate that there is great potential in using even casual digital games to promote healthy lifestyles."

“The game itself was designed to inspire wellness through participation in outdoor activities. We featured the virtual character participating in activities like going snorkeling, playing in the park, raking a zen garden and many other ideas that could increase physical activity,” she added.

Participants who started with either version of the Wellness Partners program had modest, but statistically significant increases in self-reported physical activity, especially those who started with the version containing social gaming. Participants also had decreases in body mass index at their first follow-up compared to baseline (-0.19). The effects were larger for those who started with the version that contained social gaming elements (-0.26). Interestingly, body mass index did not change at the 10-week mark, which suggests participants sustained the benefits of the Wellness Partners program.

“Wellness Partners: Design and Evaluation of a Web-Based Physical Activity Diary with Social Gaming Features for Adults” is published by the Journal of Medical Internet Research: Research Protocols.

Gotsis led the research study in collaboration with Donna Spruijt-Metz and Thomas W. Valente of the Keck School of Medicine of USC; Maryalice Jordan-Marsh of the USC School of Social Work; and Hua Wang, who was at the time of study a doctoral student at the USC Annenberg School for Communication and Journalism and is now at the University at Buffalo, SUNY. John Gaspari, director of the USC Center for Work and Family Life, provided support for recruitment and data collection resources.

“Wellness Partners is a dynamic example of the USC model of innovation that engages partners across disciplinary and faculty-student boundaries. That synergy enabled us to create something not previously explored in digital interactive games for health,” Marsh said.