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Physical activity (PA) is critical to health, but PA level declines dramatically in young adulthood. This study aims to compare the effectiveness of different social gamification designs (i.e. cooperation and competition) in mobile fitness applications among occasional exercisers among young adults. A mobile fitness application featuring competitive, cooperative, or individualistic gamification was designed and their effectiveness in promoting PA behaviours and socio-cognitive factors among occasional exercisers was compared through a four-week (i.e. one week for baseline and three weeks for use) field experiment involving 49 participants. The participants used one of the gamified applications with one or more friends in daily life during the experimental period. The results showed that cooperation and competition stimulate different types of social support: cooperation improves companion support, whereas competition improves appraisal support. Both gamification significantly increased daily steps in the first week, but after three-week usage, the increase of the cooperation groups reclined, whereas that of the competition groups was maintained. The application usage in cooperation also declined significantly after three weeks, while that of the other two conditions did not change significantly. The current study provided insights into gamification design for occasional exercisers among Chinese young adults. [ABSTRACT FROM AUTHOR]

Background: Gaming can serve as an educational tool to allow trainees to practice surgical decision-making in a low-stakes environment. LapBot is a novel free interactive mobile game application that uses artificial intelligence (AI) to provide players with feedback on safe dissection during laparoscopic cholecystectomy (LC). This study aims to provide validity evidence for this mobile game. Methods: Trainees and surgeons participated by downloading and playing LapBot on their smartphone. Players were presented with intraoperative LC scenes and required to locate their preferred location of dissection of the hepatocystic triangle. They received immediate accuracy scores and personalized feedback using an AI algorithm ("GoNoGoNet") that identifies safe/dangerous zones of dissection. Player scores were assessed globally and across training experience using non-parametric ANOVA. Three-month questionnaires were administered to assess the educational value of LapBot. Results: A total of 903 participants from 64 countries played LapBot. As game difficulty increased, average scores (p < 0.0001) and confidence levels (p < 0.0001) decreased significantly. Scores were significantly positively correlated with players' case volume (p = 0.0002) and training level (p = 0.0003). Most agreed that LapBot should be incorporated as an adjunct into training programs (64.1%), as it improved their ability to reflect critically on feedback they receive during LC (47.5%) or while watching others perform LC (57.5%). Conclusions: Serious games, such as LapBot, can be effective educational tools for deliberate practice and surgical coaching by promoting learner engagement and experiential learning. Our study demonstrates that players' scores were correlated to their level of expertise, and that after playing the game, most players perceived a significant educational value. [ABSTRACT FROM AUTHOR]

With the increasing reliance on digital platforms, mobile game-based phone applications provide avenues to enhance learning of complex chemical concepts. This research developed a mobile game-based phone application designed to simulate the qualitative inorganic analysis of cations, determine its effects on learning, and examine students’ insights on using the mobile application. The developed app showed a Content Validity Index of 1, suggesting acceptable validity and relevance. Data analysis revealed an increase in the pre-test to post-test scores in terms of students’ metacognitive self-regulation skills, self-efficacy, and conceptual understanding after the intervention. This study offers essential implications for the potential of mobile game-based applications as valuable educational resources in chemistry. [ABSTRACT FROM AUTHOR]

Background: The impact of digital gamified language learning on language achievement has been corroborated in the literature; however, its impact on language achievement, especially in the English as a foreign language (EFL) context needs further investigation. In addition, the related literature has not sufficiently confirmed the impact of digital gamified language learning on some psychological domains of EFL learning. Objectives: This study, therefore, employed a sequential explanatory mixed‐methods approach to explore the effects of digital gamified language learning using a mobile application (app) affordances on EFL learners' language achievement, foreign language enjoyment (FLE), and ideal second language (L2) self. Methods: To this end, 36 EFL learners were randomly divided into two groups; one group was randomly assigned to the digital class, including 19 EFL learners, and the other group was assigned to the non‐digital class, consisting of 17 EFL learners. The digital learners did the digital gamified language learning activities individually and interactively and received peer and instructor feedback, whilst the non‐digital learners did the same language learning activities in printed format and received peer and instructor feedback. A language achievement test, the FLE scale, and the ideal L2 self‐scale were used to collect the quantitative data and an individual semi‐structured interview was carried out to gather the qualitative data. Results and Conclusions: One‐way ANCOVA, used to analyse the quantitative data, revealed that the digital and non‐digital classes improved the EFL learners' language achievement, FLE, and ideal L2 self; however, the digital learners outperformed their non‐digital counterparts in all the measures. Thematic analysis, utilised to analyse the qualitative data, uncovered some themes about the digital learners' positive and negative attitudes and perceptions towards the digital gamified language learning activities, clarifying the quantitative findings. Implications: Pedagogical implications are discussed. Lay Description: What is already known about this topic: Digital gamification involves employing game‐supported activities to interact with other learners, improving their language learning.Several studies have been carried out focusing on the salient role of digital gamified language learning activities in improving learners' language learning.As elements of positive psychology, foreign language enjoyment and ideal L2 self can improve learners' enthusiasm and involvement in digital gamified language learning activities. What this paper adds: Digital gamification using a mobile app's gamified affordances develops English language learners' language achievement, foreign language enjoyment, and ideal L2 self.Digital gamification is more effective than non‐digital gamification in improving English language learners' language achievement, foreign language enjoyment and ideal L2 self.English language learners in digital classes hold positive attitudes and perceptions towards the effects of digital gamification on their language learning. Pedagogical implications: Digital gamified language learning activities can be an effective and engaging supplement to non‐digital classroom teaching, especially in English language contexts where learners may have limited opportunities for authentic language learning collaboration.English language learners can utilise digital gamified language learning affordances for language development, particularly for their collaborative language learning activities with other classmates. [ABSTRACT FROM AUTHOR]

This study aims to examine the influence of gamification on brand loyalty through the mediating role of customer engagement. Gamification, the application of game elements in non-game contexts, is hypothesized to increase customer engagement, which ultimately strengthens brand loyalty. This study involved 180 respondents residing in Jabodetabek who are active users of the Alfapets gamification feature on the Alfagift mobile application. Data was collected through online questionnaires and analyzed using Structural Equation Modeling (SEM). The results show that gamification has a positive impact on customer engagement and brand loyalty. Furthermore, customer engagement was proven to be a significant mediating variable in the relationship between gamification and brand loyalty. The findings of this study provide implications for marketers and mobile application developers in designing strategies to enhance customer engagement and loyalty through the effective implementation of gamification elements. [ABSTRACT FROM AUTHOR]

The accessibility of mobile technologies opens a new world of possibilities for parents to support their children's learning through game-based numeracy apps. Carefully designed numeracy apps can be effective at improving children's foundational numeracy skills. In the absence of industry standards for quality, however, it is important to understand how parents choose numeracy apps for their children. Forty-five parents of children 3 to 6 years old completed a survey and explored four numeracy apps of varying quality and instructional supports. Parent ratings were consistent with trained coders in identification of the highest rated app. However, ratings for the three remaining apps differed from the coders' ratings. Other factors apart from quality influenced parental ratings. For example, parents who had higher perceived math teaching confidence and those whose children used technology more often generally were more favorable in their app ratings. Overall, the study revealed strengths and challenges parents have evaluating numeracy apps. [ABSTRACT FROM AUTHOR]

Purpose: By integrating stimulus-organism-response theory and uses and gratifications theory, this study explored the salient gamification factors that satisfy the gratifications of conference attendees in the context of an event gamification mobile app and their relationships with conference engagement, continuance intention and word-of-mouth. Design/methodology/approach: The questionnaire was developed in Qualtrics and administered on a gamification application called Goosechase during an annual hospitality conference. The proposed hypotheses were tested using the partial least square-structural equation modeling (PLS-SEM). Findings: The gratifications of social presence, education and entertainment through a gamification mobile app influences attendees' engagement during the conference while achievement gratification does not. Positive effects of conference engagement on their continuous intention and WOM have been also validated. Originality/value: By adopting a unique integrated approach that utilizes UGT and S-O-R framework, while considering conference engagement as work-related engagement, this study offers a fresh perspective on gamification apps and discusses its theoretical and practical implications in depth. [ABSTRACT FROM AUTHOR]

Improving individuals' low-carbon awareness has become an important research topic. Gamification design is regarded as a potential IT solution to this social problem. Although much research is concerned with the effect of low-carbon awareness to improve individuals' behaviour, little attention has been paid to exploring how to improve low-carbon awareness, especially in the context of green gamification. To fill this research gap, our study uses the cognitive dissonance theory to build a theoretical model for exploring the impacts of green gamification factors on individuals' low-carbon awareness. The model is also used to explore the mediating role of cognitive dissonance and the moderating effect of emotional dependence. Empirical results reveal that visibility of achievement, competition, and interactivity have positive impacts on users' cognitive dissonance, which further positively affect users' low-carbon awareness. In addition, users' emotional dependence positively moderates the relationship between green gamification factors and users' cognitive dissonance. These results extend the cognitive dissonance theory and the literature on green gamification. New insights and practical implications for the designers of gamification application and environmental protection organisations are also provided in our study. [ABSTRACT FROM AUTHOR]

Background Study: Several meta‐analysis studies have investigated the effects of mobile learning on learning performance. However, limited attention has been paid to pedagogy in mobile learning, making quantitative evidence of the effects of pedagogical approaches on learning performance in mobile learning scarce. Filling this gap can therefore help stakeholders understand which mobile pedagogical approaches might work or not under which learning conditions, hence achieving better learning experience and performance. Objectives: To address this gap, this study conducted a meta‐analysis and research synthesis of the effects of integrated pedagogical approaches on students' learning performance in mobile learning. Additionally, this study analysed the field of education, level of education, learning setting, sample size, and mobile device as moderating variables of the effect of pedagogical approaches. Methods: The software Comprehensive Meta‐Analysis V.3 was used for this meta‐analysis, where Hedges' g was calculated for the effect sizes. Specifically, 70 quantitative studies (N = 5575 participants) were coded and analysed. Results: The results indicate that pedagogical approaches in mobile learning have a large effect on students' learning performance (g = 0.93, p < 0.001). The most effective pedagogical approach was project‐based learning (huge effect), while collaborative learning, situated learning and game‐based learning had large effects. Finally, cognitive theory of multimedia learning and inquiry‐based learning had medium effects. The results also indicate that the effect is moderated by the field of education, the level of education, the learning setting, the sample size, and the mobile device. Finally, it is found that study quality might influence the overall effect size. Conclusions: The findings of this study can be beneficial to both researchers and practitioners as they highlight and discuss which pedagogical approaches could be more effective in mobile learning under specific conditions. Further research, on the other hand, should focus on covering additional moderators of learning performance like mobile device type and screen size which is one of the limitations of this study. Lay Description: What is already known about this topic: Mobile learning is widely adopted in education.Mobile learning can enhance learning outcomes. What this paper adds: Pedagogical approaches in mobile learning have different effects on students' learning performance.The most effective pedagogical approach in mobile learning is project‐based learning (huge effect).Which pedagogical approaches could be more effective in mobile learning under specific conditions. Implications for practice and/or policy: This study enriches the ongoing debate on how to design effective mobile learning interventions.This study provides substantial evidence about which pedagogical approaches in mobile learning would be more effective under which circumstances. [ABSTRACT FROM AUTHOR]

Background: Although gamified sustainable consumption apps (SCAs) have been on the rise, only a few have survived longer than two years. While most existing research focuses on how gamification contributes to engagement and the formation of more sustainable consumption habits, there is little about how their survival is secured. Intervention's Purpose: Twenty-one SCA creators shared their considerations and experiences managing SCAs, providing valuable insights into the field of gamified sustainable consumption and practical insights for their stakeholders. Methods: Ideal-type and narrative analyses of the interviews unraveled some relevant survival strategies and lessons learned. Results: The creators' motivation and background play a role in the app's survival. Their experiences exposed several aspects affecting their gamification strategies and their relevance for the apps, highlighting traps to avoid and opportunities to improve their standing in an increasingly competitive market. Discussion: Most creators shared stories of "learn as you go," presenting how the flexibility to adjust the apps' business models rather than the creators' professional background is a critical success factor. Since their apps represent their understanding of sustainability, SCA creators should find practical and emotional ways to engage their users while considering the objectives of their apps. Conclusion: Awareness of the risks and pitfalls when creating an SCA may not be enough for successfully undertaking this enterprise. The creators should be capable of strategically plan for all the activities that creating and managing an SCA convey even before the app is conceptualized. [ABSTRACT FROM AUTHOR]

Businesses add gamification to their mobile shopping applications to increase customer interaction and their continuance intention. It has been observed that, with gamification based mobile shopping activities, consumers have positive experiences, and their customer loyalty has increased. Therefore, it is crucial to research the effects of gamification content used in mobile shopping applications on consumers' tendencies to use or not use technology. This research aims to determine the effect of gamification activities offered in mobile shopping applications on users' perceived ease of use, perceived usefulness, attitude, and intention using the Technology Acceptance Model (TAM). The research used a convenience sample of 442 mobile shopping applications users living in Turkey and an online survey method was used to collect the research data. Considering the analyses of the research, the relationship levels between the variables were determined. There are significant relationships between PEOU and GAM (r =.939), PU and PEOU (r =.874), ATT and PU (r =.827), INT and ATT (r =.969). Reliability and validity analyses were applied. The factor loadings of the scales, and AVE value above.50, Cronbach's Alpha (Cα), and CR value above.70 were considered statistically reliable and valid. The technique of structural equation modeling (SEM) was used to estimate the variables' effect and mediation levels. Then, it was found that perceived ease of use had a positive and significant mediating effect (β =.339) between gamification and attitude variables. Similarly, perceived usefulness had a positive and significant (β =.827) mediating effect between gamification and attitude variables. [ABSTRACT FROM AUTHOR]

Mobile apps have become a go-to solution for interventions in many health areas that aim to influence user behavior, such as physical activity or nutrition. However, many apps still fail to bind users long-term. Although research has been conducted on individual mechanisms aiming to improve long-term user adoption, such as gamification, we lack an understanding of different approaches at the time of this research. Thus, in this research, we investigate different approaches and persuasive technology that aim to keep the users' engagement with the app in use. Therefore, this study reviews existing literature and tries to identify how motivational mechanisms can be successfully implemented. In the course of this, identify 14 major motivational mechanisms to increase long-term user adoption of mobile apps. Based on these insights, we want to give advice on how to improve their impact through combination as well as give advice on future implementation. [ABSTRACT FROM AUTHOR]

Prenatal care and health promotion play a fundamental role in assisting pregnant women in dealing with fear, anxiety, and insecurity. To address this need, the mobile application Higia Way was developed, providing content on prenatal care, childbirth, and postpartum period, while utilizing gamification as a strategy to facilitate information absorption. The application underwent validation by public health nurses who work with pregnant and postpartum women, utilizing the Technology Acceptance Model (TAM) methodology, which assesses aspects such as usability, usefulness, and interaction. The application was deemed an appropriate educational resource to improve pregnant women's adherence. The study demonstrated that Higia Way offers reliable and relevant information and functionalities for care during the prenatal and postpartum period. However, to establish a more conclusive understanding of its effectiveness, further testing with pregnant women as the target audience is necessary. [ABSTRACT FROM AUTHOR]

Background: Research on caregivers for children with intellectual disabilities, particularly those with autism spectrum disorder (ASD), has highlighted several obstacles to achieving better oral health. These include challenges with tolerating oral care, sensory processing differences, uncooperative behaviors, and communication impairments. There is limited understanding of what caregivers would consider "successful assistance" in improving oral health for these children. Objectives: This pilot study aimed to examine caregivers' and user's experiences with a Kids Smart Electric Toothbrush used by children with ASD. Methods: It involved open-ended interviews and questionnaires with caregivers prior to utilization of the toothbrush and after 4 weeks of product use by the child. Results: Seventeen children with ASD, aged 5–12, participated. A total of 58.8% of caregivers said their child brushed more often, and all reported brushing at least twice a day by week 4. Caregivers reported that children became more independent while brushing their teeth and achieved better quality brushing. Caregivers' frustration with the brushing process, satisfaction with the device, and need to assist the child with brushing were improved. Caregivers did encounter some technical difficulties with the app. Conclusion: This study will assist in exploring "smart" toothbrush technologies for oral hygiene in children with ASD. [ABSTRACT FROM AUTHOR]

College students often face difficulties managing their time due to a lack of basic organizational skills. The research proposes the implementation of a mobile application to improve time management based on gamification as a solution to promote compliance with academic activities. For the correct development of these academic activities, the SOAR study method (Select, Organize, Associate and Regulate) was used. For the development, the TypeScript programming language was used, the framework NestJS and MongoDB as a database. The experiment was carried out with 22 students from the UPC’s Faculty of Engineering, collecting data on the time spent carrying out academic activities related to the SOAR method, registering an increase in the 4 dimensions: 55% in selection, 51% in organization, 58% in association and 64% in regulation. Furthermore, regarding the number of students who agreed to carry out activities based on the proposed method, an increase of 23% was observed in the selection of activities, 14% in organization, 14% in association and 18% in regulation. Students expressed satisfaction with the app’s functionalities and their willingness to recommend it. We finalize the results by carrying out an analysis of the academic performance of the students in the academic semester 2023-1, before the experiment, and 2023-2, after the experiment; obtaining that the grade point average has improved from 13.87 to 14.65 points, respectively. With the data obtained, it has been shown that gamification applied with an appropriate study method significantly improves time management in university students, and positively influences their academic results.

In the field of automation technology education, the primary emphasis is on instructing students in the use of programmable logic controllers (PLCs). Practical training for beginners includes sessions on wiring and programming. However, the training on wiring lacks resources for additional practice outside the laboratory. Recognizing the potential of mobile devices and digital game-based learning, this study aims to create a mobile game app for practicing basic PLC wiring at any time and in any location. The study also seeks to examine the impact of using the game app on student performance and user satisfaction. The game app underwent expert assessment and received a high suitability rating, garnering an overall score of 4.43. Subsequently, it was employed in an experiment involving an experimental group comprising 18 students and a control group consisting of 22 students. To address non-normal data, we utilized both parametric and non-parametric methods to ensure more robust data analysis. The study found that both the independent sample t-test and the Mann-Whitney U test yielded consistent results, with p-values of 0.009 and 0.01, both below 0.05. This led to the conclusion that additional practice with the game app improved students' performance in wiring. The user experience received positive feedback, with an overall score of 4.25. Based on the results, we consider this game app to be an effective learning tool that can enhance student performance and the learning experience in basic PLC wiring. [ABSTRACT FROM AUTHOR]

It has become an emerging idea for fitness apps to be gamified to intrinsically and extrinsically motivate user's usage intention or behavior. For the longterm success of gamified fitness apps, understanding what and how various motivations affect continued use is critical. A combination of qualitative and quantitative methodologies was used to explore two research questions concerning gamified fitness applications. Specifically, the research questions focused on understanding the impacts of intrinsic and extrinsic motivations on continued usage. Additionally, the study aimed to investigate whether extrinsic motivations enhance or diminish the influence of intrinsic motivations. Results from qualitative study identified three intrinsic motivations (selfdevelopment, self-control and hedonic motivation) and two extrinsic motivations (social recognition and financial reward) in gamified fitness apps. Results from quantitative study indicated that intrinsic motivations (formed by self-development, self-control and hedonic motivation), financial reward and social recognition could significantly improve intention for continued use; and further, both financial reward and social recognition could crowd-in intrinsic motivations. This research offers insights into the phenomenon of motivation crowding effects on the intention to continue using gamified fitness apps. [ABSTRACT FROM AUTHOR]

Background: Finding innovative methods to enhance Tuberculosis treatment adherence in Malaysia is imperative, given the rising trend of non-adhere TB patients. Direct Observed Therapy (DOTS) has been used to ensure Tuberculosis (TB) drug compliance worldwide. However, due to its inconvenience, digitalizing this system into a virtual monitoring system via a mobile app can help deliver a more efficient tuberculosis management system. A gamified video-observed therapy is developed that connects three users the patient, supervisor, and administrator, allowing drug monitoring and patient loss to follow up with the patient tracking system. Thus, the objective of this study is to determine the impact of Gamified Real-time Video Observed Therapy (GRVOTS) mobile apps on patient medication adherence rates and motivation. Methods: 71 patients from 18 facilities participated in the 8-week single-arm intervention study. GRVOTS mobile apps were installed in their mobile apps, and patients were expected to fulfill tasks such as providing Video Direct Observe Therapy (VDOTS) daily as well as side effect reporting. At 3-time intervals of baseline,1-month, and 2-month intervals, the number of VDOT taken, the Malaysian Medication Adherence Assessment Tool (MyMAAT), and the Intrinsic Motivation Inventory (IMI) questionnaire were collected. One-sample t-test was conducted comparing the VDOT video adherence to the standard rate of 80%. RM ANOVA was used to analyze any significant differences in MyMAAT and IMI scores across three-time intervals. Results: This study involved 71 numbers of patients from 18 healthcare facilities who showed a significantly higher treatment adherence score of 90.87% than a standard score of 80% with a mean difference of 10.87(95% CI: 7.29,14.46; p < 0.001). The participants' MyMAAT and IMI scores significantly increased over 3-time intervals with the IMI Interest domain showing the highest mean difference 19.76 (95% CI: 16.37, 21.152: p < 0.001). Conclusions: By utilizing GRVOTS, a mobile application based on gamification and real-time features, we can enhance motivation and medication adherence among TB patients, while also addressing the limitations of physical DOTS. Trial registration: IRCT20230308057657N1, Registered on (15/03/23). [ABSTRACT FROM AUTHOR]

Interest in gamified physical activity has been driven by its potential to benefit student mental health. Integrating gamified practices for mental health improvement represents a significant innovation within multidisciplinary approaches to enhancing mental well-being. This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was conducted using the Scopus and Web of Science (WOS) databases, primary sources for education-related studies. Thirteen papers were analyzed, yielding important insights into the relationship between gamified physical activity and mental health. The findings indicate that gamified physical activity positively influences adolescents' mental health and well-being. Additionally, there is a need for improved application and game design to enhance learning within school contexts. Tailoring exergames to fit specific disciplines and school-related characteristics can promote healthier mobile application usage and offer significant benefits for the mental health of young individuals. The difference between this study and previous ones is that it focuses on mobile applications for encouraging active living to improve quality of life and mental health. [ABSTRACT FROM AUTHOR]

Though digital platforms (e.g., social media) are often used to promote unhealthy, calorie‐dense foods, the dynamics characterizing consumers' engagement with healthy nutrition‐based content (e.g., as stimulated trough gamification) on these platforms remains tenuous, warranting further exploration. Addressing this gap, we deploy a qualitative field study and two experiments to show that challenge, a gamification mechanic that relies on rewarding incremental behavioral (e.g., food choice) improvements, shapes consumers' enjoyment of, and engagement with, digital healthy food‐based content. Study 1 (n = 95) shows that challenge induces consumer enjoyment, boosting their engagement with healthy food‐related digital content. Study 2 (n = 94) corroborates these findings by revealing a serial mediation effect of gamification‐based challenge on consumers' enjoyment of, and engagement with, healthy food‐based content. Extending Study 1, we also identify engagement's positive effect on consumers' app reuse intent. Moreover, we identify a moderating role of consumers' stage of change‐based action (i.e., readiness to act on their health), which strengthens the association of gamification‐based challenge/enjoyment. Overall, the findings substantiate gamification's role in boosting consumers' engagement with digital healthy food‐based content. We conclude by deriving pertinent implications from our analyses. [ABSTRACT FROM AUTHOR]

Background: Improving the quality of emergency nursing care requires enhancing triage competency through education programs that integrate the content of the Korean Triage and Acuity Scale, a triage system specifically developed for the Korean context. Thus, this study developed a competency-based triage education application (CTEA), based on the Korean Triage and Acuity Scale, and evaluated its effectiveness through usability testing. Method: The CTEA used various teaching methods and game mechanisms, including lectures, case studies, and video-based scenarios, to improve triage competency. Results: In the usability testing phase, the CTEA was refined through expert heuristic evaluation and user interviews conducted with the think-aloud method. Six themes were derived from the interviews, highlighting the need for a well-structured program with realistic scenarios, easy accessibility, gamification, functional improvements, and future triage educational applications. Conclusion: These findings suggest that the CTEA is effective and satisfactory for users and can contribute to improving the triage competency of emergency nurses. [J Contin Educ Nurs. 2024;55(1):33–41.] [ABSTRACT FROM AUTHOR]

Background: Taiwan's higher education institutions prioritize interdisciplinary knowledge and cultural competence in cultural design, emphasizing the value of immersion in the local environment to develop cultural competence. However, challenges arise from the disappearance of traditional local lifestyles and limitations of traditional outdoor lectures such as group size and learning environment. Mobile augmented reality technology serves as a personal learning tool to overcome these challenges, enabling learners to uncover hidden knowledge in scenic locations and improving learning efficiency. Objective: The study utilized learning analytics to investigate the impact of using mobile augmented reality on enhancing learners' cultural competence. Methods: The study used both qualitative and quasi‐experimental quantitative research to evaluate the effects of mobile augmented reality on cultural competence. A total of 78 third‐year university students participated in the study, with 37 of them using mobile augmented reality to learn about culture. The researchers utilized both the Mann–Whitney U test and interviews to compare the effectiveness of mobile augmented reality with that of a 'real' tour guide in field courses. Results: The experimental results indicate that learners were able to continuously seek and find information about local culture through field exploration with mobile augmented reality, resulting in similar effects to those of attending a live lecture. Conclusions: It showed that incorporating mobile AR into field visits can create gamified and active learning scenarios that enhance immersion and drive active learning in local culture. The results in greater cultural knowledge and understanding, leading to the development of cultural competence in students. Lay Description: What is already known about this topic: There is a heightened emphasis on cultivating and demonstrating cultural competence across various fields due to the significantly grow of cultural and creative industries.Relying solely on traditional classroom teaching for learning about local culture may result in a diminished impact, as a comprehensive understanding of culture necessitates a keen sense of life.To address the limitations of traditional classroom lectures, educators continuously strive to enhance teaching methodologies by developing innovative approaches, such as experiential learning and community‐based learning, which involve hands‐on activities and real‐world engagement to foster increased learning motivation and improved effectiveness.Augmented reality (AR), a technology that overlays virtual images onto real scenes in real time, has gained extensive usage in diverse fields such as medicine, national defence, education, and entertainment, offering interactive gaming experiences and providing an opportunity to experience the culture and past lives of locals in the field, enhancing learners' understanding of cultural history and creating immersive encounters during visits.Particularly in digital learning, the integration of AR enables learners to engage with additional content through mobile devices, fostering an immersive and gamified learning experience. What this paper adds: The use of the AR app for learning about the local culture yielded comparable outcomes to traditional guided tours.Participants actively engaged in self‐directed learning and demonstrated a sense of initiative while utilizing AR.The flexibility and autonomy provided by field learning, which extended beyond the course period, allowed participants to revisit the field and explore at their own pace using AR.Demonstrates that participants took control and responsibility for their own learning, leading to an enhancement in learner autonomy.Participants who utilized the Roaming Jingliao AR system to explore cultural scenarios exhibited enhanced knowledge and attitudes regarding cultural competence, specifically in areas such as cultural understanding, rice food cultural knowledge, Songjiang folk arts, and skills and practices, which can be attributed to the immersive and autonomous nature of AR‐based knowledge learning in outdoor guided courses, minimizing the influence of external environmental factors and facilitating a deeper understanding of the content compared to traditional guided tours. Implications for practice and/or policy: The findings of this study highlight the importance of considering the limitations associated with a relatively small sample size when conducting research within a university curriculum. To enhance the validity and reliability of future studies, practitioners and policymakers should prioritize the inclusion of larger and more diverse samples, enabling a more comprehensive understanding of the impact of AR technology on cultural learning and informing evidence‐based practices and policies.The study's focus on a specific group of participants and their contextual background highlights the need for future research to include participants from diverse educational settings and cultural backgrounds, ensuring that the findings are more applicable and relevant to a broader population. Practitioners and policymakers should consider the importance of inclusivity and diversity when designing and implementing cultural learning interventions using AR technology.The recognition of technological limitations highlights the importance of considering the specific AR system used in cultural learning interventions. Practitioners and policymakers should be cautious when adopting AR technologies and recognize that different AR systems or platforms may yield different outcomes. Future research should focus on evaluating the effectiveness of various AR systems and platforms to inform decision‐making regarding the selection and implementation of AR technologies for cultural learning initiatives. [ABSTRACT FROM AUTHOR]

Extended Reality (XR) is an emerging technology that enables enhanced interaction between the real world and virtual environments. In this study, we conduct a scoping review of XR engines for developing gamified apps and serious games. Our study revolves around four aspects: (1) existing XR game engines, (2) their primary features, (3) supported serious game attributes, and (4) supported learning activities. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model to conduct the scoping review, which included 40 primary studies published between 2019 and 2023. Our findings help us understand how current XR engines support the development of XR-enriched serious games and gamified apps for specific learning activities. Additionally, based on our findings, we suggest a set of pre-established game attributes that could be commonly supported by all XR game engines across the different game categories proposed by Lameras. Hence, this scoping review can help developers (1) select important game attributes for their new games and (2) choose the game engine that provides the most support to these attributes. [ABSTRACT FROM AUTHOR]

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The main objective of this research is to determine the perception of teachers about the elements that increases the educational effectiveness of gamified apps in primary education. A methodology based on an importance-performance analysis was daeveloped, using a structural equations model to calcuate the degree of importance of each variable. The sample was formed of 212 Spanish teachers with experience using educational apps in the teaching–learning process. Six categories were identified as precursors of educational effectiveness: (1) curriculum connection, (2) feedback and operational experience, (3) assessment and learning analytics, (4) sustainability (Protection Personal data), (5) equal access and (6) flow. These six categories enhance the three traditional areas of gamification intervention: cognitive, emotional and social. In this sense, the design and adoption of an educational gamified app should: (1) establish a clear link between the game and curricular content and competence development; (2) promote self-regulated learning through individual and collaborative activities; (3) offer adapted learning by integrating differentiated personalized learning pathways; (4) integrate learning analytics that can be consulted by teacher, student and family; (5) comply with data protection regulation and promote a safe, sustainable and ethical use of the information generated; (6) take into account different levels of functional diversity. When the gamified app design incorporates these attributes, primary education teachers perceive that such resources can be integrated effectively into the teaching–learning processes. [ABSTRACT FROM AUTHOR]

Medication non-adherence is a prevalent healthcare problem with poor health outcomes and added healthcare costs. MedScrab, a gamification-based mHealth app, is the first attempt to deliver crucial life-saving medication information to patients and increase their medication adherence. The paper presents the development of MedScrab and a two-phase mixed-method usability evaluation of MedScrab. Phase I qualitatively evaluated MedScrab using a think-aloud protocol for its usability. With 51 participants, qualitative data analysis of Phase I revealed two themes: positive functionality of the app and four areas of improvement. The improvement recommendations were incorporated into MedScrab's design. Phase I also validated a widely used mHealth App Usability Questionnaire (MAUQ). Quantitative data analysis of Phase I reduced the original 18-item MAUQ scale to a 15-item scale with two factors: ease of use (4 items) and usefulness and satisfaction (11 items). Phase II surveyed 83 participants from Amazon's Mechanical Turk using a modified MAUQ. The modified MAUQ scale showed strong internal consistency (Cronbach alpha = 0.959) and high factor loadings (between 0.623 and 0.987). The study design of the usability evaluation can serve as a methodological guide for designing, evaluating, and improving mHealth apps. The usability study showed that MedScrab was perceived as ease of use (6.24 out of 7) with high usefulness and satisfaction (5.72 out of 7). The quantitative data analysis results support the use of the modified MAUQ as a valid instrument to measure the usability of the MedScrab. However, the instrument should be used with adaptation based on the app's characteristics. [ABSTRACT FROM AUTHOR]

Background: The smartphone market is saturated with apps and games purporting to promote mental wellness. There has been a significant number of studies assessing the impact of these digital interventions. Motivation: The majority of review papers solely focussed on the impact of strict rules and award systems of the apps. There is comparatively little attention paid to other game techniques designed to encourage creativity, a lusory attitude, and playful experiences. Results: This gap is addressed in this paper in a consideration and analysis of a purposive selection of six mobile games marketed for wellbeing, our focus is on both external and internal motivations that these games offer. Our specific interest is how these games balance rule-based play with creativity. We find that ludic play is a highly-structured, rule-bound, goal-oriented play, in contrast to paedic play which a freeform, imaginative, and expressive. We argue that while ludic play is purposed towards the promotion of habit formation and generates feelings of accomplishment, it nonetheless relies heavily on extrinsic motivation to incentivise engagement. By contrast, paidic play, specifically role-playing, improvisation, and the imaginative co-creation of fictional game worlds, can be used effectively in these games to facilitate self-regulation, self-distancing, and therefore provides intrinsically-motivated engagement. In the context of games for mental wellbeing, ludic play challenges players to complete therapeutic exercises, while paidic play offers a welcoming refuge from real world pressures and the opportunity to try on alternate selves. Conclusion: Our intention is not to value paidic play over ludic play, but to consider how these two play modalities can complement and counterbalance each other to generate more effective engagement. [ABSTRACT FROM AUTHOR]

This study analyses how gamification motivates users of gamified mobile exercise apps and enhances their health.Data from 276 Fitbit users were analysed using structural equation modelling. The findings showed that feelings of competence and autonomy arise when exercise apps include achievement and progression-oriented affordances, and that feelings of relatedness arise with social, immersion and achievement and progression-oriented affordances. They also revealed that exercise apps should satisfy the needs for competence and relatedness to develop individuals’ intrinsic motivation, which in turn leads to greater physical, mental and social health. These findings offer insights for managers in this industry.

Purpose: There is clear benefit in designing and sending notifications to users that persuade them to interact with an app and marketer goals. The purpose of this study is to examine how different motivational affordances in notifications affects subsequent app use. Design/methodology/approach: The authors designed three studies to address the purpose: (1) an online experiment to test how individuals perceived notifications, which contained social affordances, progression-based affordances, and a combination of social and progression affordances; (2) a survey to gain a deeper understanding of why certain notification characteristics were effective and to unearth factors that jointly affected notification effectiveness; and (3) an in-app field experiment to test if the findings from studies 1 and 2 held up in a "real world" setting. Findings: The analysis revealed that progression incentives yielded the greatest increases in user behavior. Neither a social incentive, nor a combination of social and progression affordances was more effective than one progression affordance. This effect was heightened by consumers' involvement with the focal brand. Research limitations/implications: The contribution extends knowledge about the use of motivational affordances to gamify push notifications in high-involvement contexts. This implies that greater attention should be paid to how the: length of push notifications, affordances communicated and degree of consumers' relationship with a focal brand (i.e. involvement) impact notification effectiveness. These findings set out new avenues to investigate the uses of gamification and services marketing in future research. Practical implications: The authors provide marketers with insights into the most effective ways to gamify, structure and time the delivery of notifications. In high-involvement contexts where consumers decide whether to act on a gamified marketing affordance quickly, it pays to use push notifications that feature visible, immediate and tangible rewards. Understanding consumers' involvement with the brand allows marketers to turn notifications from a potential annoyance into a viable conduit for engagement. Originality/value: This research extends knowledge on gamification to the domain of push notifications. In doing so, the authors have demonstrated the communicated affordances and wording of the push notifications organizations send affect user behavior. The authors further expand knowledge of the role of consumer involvement on push notification effectiveness while controlling for app usage patterns. [ABSTRACT FROM AUTHOR]

Gamification, the use of game-like elements in non-game contexts, has gained popularity in the field of human resources. However, little research has been conducted on the use of gamification in the employee onboarding process, specifically in terms of socializing and assimilating new employees into an organization. This study aimed to explore the design, development, and implementation of a gamified smartphone application for employee onboarding in a manufacturing company. Ethnographic data was collected over the course of 60 weeks through participation at various field sites and analyzed using thematical analysis with a human-centered design focus, examining the meaning attributed to the gamified application by different stakeholders within the organization. The results showed that different stakeholder groups attributed different and sometimes conflicting meanings to various design elements. The key finding was the identification of four bipolar design dimensions that both supported and hindered the design among stakeholders. These findings have both academic and practical implications for the design of future gamified employee onboarding tools in large enterprises. [ABSTRACT FROM AUTHOR]

Because of the possibilities that it opens for a variety of fields and practices, gamification has increasingly garnered significant attention. This has put it at the forefront of many significant debates around its applicability and implications. In the case of its application to cultural heritage, although there is much trailblazing to do, the body of work has been growing and the field is gaining its maturity. As such, this paper aims to take stock of the directions the field has been moving towards—to provide orientation for future work and projects that are yet to be developed. To do this, the paper aims to map out the publications in the field of gamified cultural heritage, by conducting a broader and systematic literature review. The study has found that, with regards to who the main actors with publications in the field are, a prominence of European institutions and networks, namely from Italy, Greece and the United Kingdom, can be observed. Regarding what heritage is being gamified and for what purpose, the study found a prominence of focus on historical, architectural and archeological heritage values and a very significant focus on gamification being used for motivation/engagement and for creativity enhancement. When looking at the gamification design dimensions that are given prevalence, intrinsic motivation seems to be prioritized, and, with regards to the observed target publics, tourists and visitors and seem to prevail in gamified heritage projects, with children as a specific group coming in second. Regarding technologies and tools being used, Mobile Applications, Augmented Reality (AR) and Virtual Reality (VR) are particularly prevalent. Regarding mentioned future orientations, the study found that a vast majority of papers are self-contained, both in scope of work and discussion, with most of those that do mention future directions indicating continuation and/or expansion of their specific project. [ABSTRACT FROM AUTHOR]

This article presents a systematic review on autism care, diagnosis, and intervention based on mobile apps running on smartphones and tablets. Here, the term "intervention" means a carefully planned set of activities with the objective of improving autism symptoms. We guide our review on related studies using five research questions. First, who benefits the most from these mobile apps? Second, what are the primary purposes of these mobile apps? Third, what mechanisms have been incorporated in these mobiles apps to improve usability? Fourth, what guidelines have been used in the design and implementation of these mobile apps? Fifth, what theories and frameworks have been used as the foundation for these mobile apps to ensure the intervention effectiveness? As can be seen from these research questions, we focus on the usability and software development of the mobile apps. Informed by the findings of these research questions, we propose a taxonomy for the mobile apps and their users. The mobile apps can be categorized into autism support apps, educational apps, teacher training apps, parental support apps, and data collection apps. The individuals with autism spectrum disorder (ASD) are the primary users of the first two categories of apps. Teachers of children with ASD are the primary users of the teacher training apps. Parents are the primary users of the parental support apps, while individuals with ASD are usually the primary users of the data collection apps and clinicians and autism researchers are the beneficiaries. Gamification, virtual reality, and autism-specific mechanisms have been used to improve the usability of the apps. User-centered design is the most popular approach for mobile app development. Augmentative and alternative communication, video modeling, and various behavior change practices have been used as the theoretical foundation for intervention efficacy. [ABSTRACT FROM AUTHOR]

This study analyses how gamification motivates users of gamified mobile exercise apps and enhances their health. Data from 276 Fitbit users were analysed using structural equation modelling. The findings showed that feelings of competence and autonomy arise when exercise apps include achievement and progression-oriented affordances, and that feelings of relatedness arise with social, immersion and achievement and progression-oriented affordances. They also revealed that exercise apps should satisfy the needs for competence and relatedness to develop individuals’ intrinsic motivation, which in turn leads to greater physical, mental and social health. These findings offer insights for managers in this industry. [ABSTRACT FROM AUTHOR]

Purpose. Identification of the functions performed by bicycle mobile applications for individual groups of recipients (stakeholders). Method. The article is based on the analysis of scientific literature on the subject, enriched by Internet sources, a case study and a comparative analysis of Amistad's bicycle mobile applications, being their leading producer on the Polish market. Analysis has been carried out based on data from Google Play and App Store platforms, as well as information from the company's website, observation of activities in the field of B2A2C marketing of this company, as well as a diagnostic survey and unstructured interviews with its head director. Results. A model of functions regarding cycling mobile applications for individual stakeholders and their typification was formulated. The reasons for the limited effectiveness of the interface and business functions of cycling mobile applications are their limited popularity caused by variation in the attractiveness of combining functions, the frequency of updates and the effectiveness of the application promotion system. The most important functions of bicycle mobile applications are related to the mechanisms of accelerating interaction and information flow: social and gamification features related to bicycle navigation. Research and conclusions limitations. Local governments and non-governmental organisations were not examined from the point of view of their perception concerning the functions of cycling mobile applications and effectiveness in their implementation. Practical implications. They refer to the process of designing bicycle mobile applications and creating shared value with their use. They can also contribute to increasing the rationality of public (social) spending allocated to the procurement of mobile applications. Originality. So far, no other in-depth studies on bicycle applications of Polish developers have been conducted. [ABSTRACT FROM AUTHOR]

Objective: Microlearning and gamification through mobile technology can significantly enhance knowledge acquisition and satisfaction. Roozbehyar application, was designed using microlearning and gamification approaches for psychiatry clerkship training. Method: This quasi-experimental study was conducted in Roozbeh Hospital, in 2021. The intervention group was assigned to the Roozbehyar during a 4-week course. Knowledge and satisfaction were assessed after 4 weeks. Results: We recruited 27 (F/M: 19/8) and 35 students (F/M: 22/13) in the intervention and control groups, respectively. Learning through Roozbehyar was associated with higher scores in the final written exam (p value: 0.031). No difference was seen in the final global assessment scores. The satisfaction scores of the students regarding the content and learners' aspect of the application were above average, yet scores in structural and support aspects were below average. Conclusions: We highlighted the effect of a microlearning mobile application in increasing knowledge and satisfaction in psychiatry training in medical students. [ABSTRACT FROM AUTHOR]

There is a lack of research on how game-based learning apps should be designed for engineering education. This paper addresses two research questions: What do engineering students expect from a learning app? Which educational approach and learning app design can meet these requirements? A survey revealed the particular demands of engineering students when using learning apps. They prefer apps that promote transfer of learning. They value a diversified game environment that leaves room for self-determined decisions. They want to use learning apps during five-minute breaks or on-the-go. Social interaction is only of minor importance. Concrete design and content guidelines are derived. Perceptual learning is an appropriate educational approach to meet the requirements. Two universally applicable task types for engineering education are discussed. A case study was conducted to investigate their use in practice. Following the guidelines, an app for heat-and-mass-transfer was generated and its impact on teaching was evaluated. Students considered that their requirements were met. This is reflected in the usage statistics: During one semester, 545 different students played a total of 27,350 games. As a measure of learning progress, the average score per game almost tripled. Apps that follow the guidelines have the potential to become well-accepted learning tools. [ABSTRACT FROM AUTHOR]

Competition for use of different mobile applications (apps) is intense. How to improve user loyalty to mobile apps is an urgent issue for enterprises to solve. Gamification has become an important means of attracting users' attention to apps. In this study 357 participants completed a questionnaire assessing human–computer interaction, interpersonal interaction, perceived playfulness, user loyalty, and involvement with reference to the payment app Alipay and the game within it, Ant Farm. Structural equation modeling was performed and the results showed that both human–computer interaction and interpersonal interaction promoted perceived playfulness, which contributed to user loyalty. Finally, involvement played a positive role in the relationship between perceived playfulness and user loyalty. [ABSTRACT FROM AUTHOR]

This editorial provides an overview of the three accepted papers for the AIS THCI special issue on adaptive and intelligent gamification designs. The first paper examines conversational agents and how one can use gamification to make the design more engaging. The second study focuses on mobile fitness apps and analyzes the role that personality plays in apps and game designs. Finally, the third paper examines gamification in a virtual laboratory environment. Aligned with current work, we present future research directions that involve generative AI, the metaverse, and a shift in gamification research and practice in the future. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) apps are designed to support health behavior outcomes and improve well-being. The existing body of literature confirms mHealth's overall efficacy in promoting physical activity; however, more research on its utility in sustaining user engagement is needed. Understanding the determinants of an individual's willingness to continue using mHealth is vital to improving the intervention's success. This study developed a unified model and survey instrument adapted from extant literature while introducing new constructs to predict the sustained use of gamified mHealth. A pilot study was conducted to validate the survey instrument using 48 gamified fitness app users in Malaysia. The survey instrument was tested following rigorous guidelines for quantitative research in the information system context. According to the findings, the reliabilities of most measurement items met the criterion, and those items were retained. Overall, this paper contributes by integrating social comparison theory and the self-determination theory for sustaining user engagement with gamified mHealth through an extrinsic and intrinsic motivation perspective. [ABSTRACT FROM AUTHOR]

The aim of this study is to design and implement an e-learning course for distributors of fast-moving consumer goods using gamification. In the first step, the components of the in-store assortment are extracted using a systematic literature review, and customer preferences in each of these factors were determined as users' opinions of 387 customers. In the next step, the game is designed based on the persuasive game design (PGD) model, and the mechanics, dynamics, and aesthetics (MDA) of the game were determined by an experts' panel, and a mobile app is designed as a learning tool. In the following step, the designed game was carried out by the distributors and the game prizes are awarded to the winners. Finally, the effects of the gamified e-learning are evaluated using the IMI questionnaire and analyzing the players' points. Findings show that enjoyment, perceived competence, effort importance, pressure tension, perceived choice, and usefulness of this course are significantly higher than average. Besides, the average of points gets higher during repetition rounds while the dispersion of the points gets lower. As a result, it seems that gamification could be a valuable alternative to learning operational tricks for marketing staff, especially distributors. [ABSTRACT FROM AUTHOR]

Physical inactivity is a plague for public health, especially in Western Countries. Among the countermeasures, mobile applications promoting physical activity seem particularly promising, thanks to the spread and adoption of mobile devices. However, the dropout rates of users are high, thereby calling for strategies to increase retention rates. Moreover, user testing can be problematic, because it is typically conducted in a laboratory, leading to a limited ecological validity. In the present research, we developed a custom mobile app to promote physical activity. Three versions of the app were implemented, each featuring a different pattern of gamification elements. Moreover, the app was designed to work as a self-managed experimental platform. A remote field study was conducted to investigate the effectiveness of the different versions of the app. Behavioral log data of physical activity and interaction with the app were collected. Our results show the feasibility of using a mobile app running on personal devices as an independently managed experimental platform. Moreover, we found that gamification elements per se do not ensure higher retention rates, rather it emerged that the richer combination of gamified elements was effective. [ABSTRACT FROM AUTHOR]

This study proposes a mobile application as a new approach for first-year student orientation to promote knowledge of library services using the gamification concept. The application is based on mobile devices with GPS to locate students, allowing them to catch, collect, and battle monsters around the library with questions on library service instructions. To evaluate the learning effectiveness of the approach, we performed a comparative experiment in which the control group used e-learning, while the experimental group used the mobile application of the CMU Journey. We evaluated the pre-and post-test scores, delayed 1-month post-test scores, and intrinsic motivation based on the IMI questionnaire. The results demonstrated that the preference for gamified experience among students can enhance knowledge retention and intrinsic motivation compared to other groups. [ABSTRACT FROM AUTHOR]

In higher education institutions (HEI), particularly in biology and medical education, the use of 3D animation, virtual reality, and simulation offers great potential in terms of enhancing learning and engaging students. Higher education researchers are still investigating virtual reality's possibilities and outcomes in various fields. This study focuses on the effects of 3D gamification using an Artificial Intelligence integrated Internet of Medical Things (AIoMT) implemented with virtual reality application for biology and medical students to learn about the human brain. Nowadays, both theoretical and practical education frequently incorporate virtual reality and augmented reality. Virtual tours of the human body's systems are offered to biology students so that they may comprehend such systems' functions. This study focuses on the use of 3D animation, virtual reality, and simulation in medical education, with a specific focus on the effects of a 3D gamification app using the Internet of Medical Things (AIoMT) on medical professionals' passion for learning. This study uses the ARCS model and SEM analysis to examine the impact of virtual reality on students' motivation and learning. The results show that virtual reality positively impacts motivation and the understanding of the concept-to-execution process through practice and simulation-based training. To assess how well students are learning, what they are analyzing, and how well they can understand the objects of analysis, a 3D-simulation-based and user-feedback-based design has been developed using the proposed research methodology. According to this article's findings, a smartphone app that uses virtual reality can help medical professionals better understand the concept-to-execution process through practice. VR simulation-based training, as well as Biology teachers or medical colleges, can offer high-definition 3D VR models rather than organs in jars to understand the human anatomy and its functions more experientially and effectively. [ABSTRACT FROM AUTHOR]

The digital assistant "Vigo" is a computer-generated artificial intelligence-based application that serves as a digital assistant to a stroke patient and his family. With its conversational chatbot and gamification elements it counsels, educates, and trains the stroke patient and patient's family on stroke, rehabilitation, care, and other related issues. This study describes insights about The digital assitant "Vigo" usability from a patients' perspective. Twelve patients tested the application at their home environment. Three semi-structured interviews were conducted with each participant to obtain information on the usability of the application. Deductive thematic analyses were used to analyze trancripts. Participants expressed their opinions on music, pictures, video and audio files, chat options, layout, text, name of application and stand that is used for placement of devices on which "Vigo" is installed on. All participants generally evaluated application as transparent, understandable, and handy. The overall design of the application was rated as good. Participants were mostly unsatisfied with difficulty level and diversity of exercises. Participants had a positive attitude towards using tablet tehchnologies in their home environment. Users of digital assistant "Vigo" acknowledged its ability to support, give educational information and increase participation in therapeutic activities. Tablet application can support, give educational information, and increase participation in therapeutic activities for persons after stroke. As home-based rehabilitation tool, the content of the application must be simple, flexible, and diverse, to face the challenges of meeting each individual's goals, functional needs and abilities. [ABSTRACT FROM AUTHOR]

Gamification, the application of gaming elements to increase enjoyment and engagement, has the potential to improve the effectiveness of digital health interventions, while the effectiveness of competition gamification components remains poorly understood on residency. To address this gap, we evaluate the effect of smartphone-based gamified team competition intervention on daily step count and sleep duration via a micro-randomized trial on medical interns. Our aim is to assess potential improvements in the factors (namely step count and sleep) that may help interns cope with stress and improve well-being. In 1779 interns, team competition intervention significantly increases the mean daily step count by 105.8 steps (SE 35.8, p = 0.03) relative to the no competition arm, while does not significantly affect the mean daily sleep minutes (p = 0.76). Moderator analyses indicate that the causal effects of competition on daily step count and sleep minutes decreased by 14.5 steps (SE 10.2, p = 0.16) and 1.9 minutes (SE 0.6, p = 0.003) for each additional week-in-study, respectively. Intra-institutional competition negatively moderates the causal effect of competition upon daily step count by −90.3 steps (SE 86.5, p = 0.30). Our results show that gamified team competition delivered via mobile app significantly increases daily physical activity which suggests that team competition can function as a mobile health intervention tool to increase short-term physical activity levels for medical interns. Future improvements in strategies of forming competition opponents and introducing occasional competition breaks may improve the overall effectiveness. [ABSTRACT FROM AUTHOR]