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This article analyzes the connection between gamification and business success, focusing on customer retention, new customer acquisition, and transforming user perceptions. Based on a qualitative comparative analysis of 40 high-profile gamification projects, it shows that a combination of three key features—virtualization, social comparison, and tangible rewards—explain the various pathways to success. Each pathway requires the presence—and sometimes absence—of different design features, and firms do best when they focus on one or two objectives rather than all three at once. The article presents a framework for designing and implementing gamification more strategically and effectively, noting the ethical questions that arise. [ABSTRACT FROM AUTHOR]

Background: Low-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala. Methods: This qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model. Results: Three themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology. Conclusion: Despite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts. [ABSTRACT FROM AUTHOR]

Introduction. The coronavirus disease 2019 (COVID-19) pandemic necessitated the suspension of most educational activities and a shift from face-to-face (FTF) education to virtual education (VE). These changes were associated with new educational experiences for both instructors and students. This study aimed to explore nursing instructors' and students' experiences of VE during the COVID-19 pandemic. Method. This descriptive qualitative study was carried out in 2021. Participants were 21 bachelor's, master's, and Ph.D. nursing students and six nursing instructors purposively selected from the Faculty of Nursing and Midwifery of Tehran University of Medical Sciences, Tehran, Iran. Data were gathered through FTF or online in-depth semistructured interviews and were analyzed through conventional qualitative content analysis as proposed by Graneheim and Lundman (2004). Results. Eight subthemes and three main themes were developed during data analysis. The main themes and subthemes were VE as a double-edged sword (VE as a threat, VE as an opportunity, and necessity to improve VE), weaknesses in clinical education (reduced quality of clinical education and necessity to compensate for students' retarded clinical learning), and reduced reliability of virtual student evaluation (cheating as a problem of virtual evaluation, stresses and tensions of virtual evaluation, and necessity to use new strategies in virtual evaluation). Conclusion. Despite the different shortcomings and challenges of VE during the COVID-19 pandemic, educational experiences gained in this period can be used to improve the quality of nursing VE in future epidemics and pandemics. [ABSTRACT FROM AUTHOR]

Digital health interventions have been shown to be clinically-effective for type 2 diabetes mellitus (T2DM) and hypertension prevention and treatment. This study synthesizes and compares the cost-effectiveness of text-messaging, smartphone application, and websites by searching CINAHL, Cochrane Central, Embase, Medline and PsycInfo for full economic or cost-minimisation studies of digital health interventions in adults with or at risk of T2DM and/or hypertension. Costs and health effects are synthesised narratively. Study quality appraisal using the Consensus on Health Economic Criteria (CHEC) list results in recommendations for future health economic evaluations of digital health interventions. Of 3056 records identified, 14 studies are included (7 studies applied text-messaging, 4 employed smartphone applications, and 5 used websites). Ten studies are cost-utility analyses: incremental cost-utility ratios (ICUR) vary from dominant to €75,233/quality-adjusted life year (QALY), with a median of €3840/QALY (interquartile range €16,179). One study finds no QALY difference. None of the three digital health intervention modes is associated with substantially better cost-effectiveness. Interventions are consistently cost-effective in populations with (pre)T2DM but not in populations with hypertension. Mean quality score is 63.0% (standard deviation 13.7%). Substandard application of time horizon, sensitivity analysis, and subgroup analysis next to transparency concerns (regarding competing alternatives, perspective, and costing) downgrades quality of evidence. In conclusion, smartphone application, text-messaging, and website-based interventions are cost-effective without substantial differences between the different delivery modes. Future health economic studies should increase transparency, conduct sufficient sensitivity analyses, and appraise the ICUR more critically in light of a reasoned willingness-to-pay threshold. Registration: PROSPERO (CRD42021247845). [ABSTRACT FROM AUTHOR]

Background: UK cancer survival rates are much lower compared with other high-income countries. In primary care, there are opportunities for GPs and other healthcare professionals to act more quickly in response to presented symptoms that might represent cancer. ThinkCancer! is a complex behaviour change intervention aimed at primary care practice teams to improve the timely diagnosis of cancer. Aim: To explore the costs of delivering the ThinkCancer! intervention to expedite cancer diagnosis in primary care. Design & setting: Feasibility economic analysis using a micro-costing approach, which was undertaken in 19 general practices in Wales, UK. Method: From an NHS perspective, micro-costing methodology was used to determine whether it was feasible to gather sufficient economic data to cost the ThinkCancer! intervention. Owing to the COVID-19 pandemic, ThinkCancer! was mainly delivered remotely online in a digital format. Budget impact analysis (BIA) and sensitivity analysis were conducted to explore the costs of face-to-face delivery of the ThinkCancer! intervention as intended pre-COVID-19. Results: The total costs of delivering the ThinkCancer! intervention across 19 general practices in Wales was £25 030, with an average cost per practice of £1317 (standard deviation [SD]: 578.2). Findings from the BIA indicated a total cost of £34 630 for face-to-face delivery. Conclusion: Data collection methods were successful in gathering sufficient health economics data to cost the ThinkCancer! intervention. Results of this feasibility study will be used to inform a future definitive economic evaluation alongside a pragmatic randomised controlled trial (RCT). [ABSTRACT FROM AUTHOR]

Introduction: Technology can improve the health care outcomes of the elderly. However, there are many barriers to the adoption of mobile monitoring and care systems (MMCs) by the elderly reported in literature. The main purpose of this research was to investigate why elderly people do not adopt MMCs to improve the quality of their health care. Methods: The study made use of semi-structured interviews to collect data in the Buffalo City Metropolitan Municipality, South Africa. The study sample consisted of 15 purposively chosen study participants, representing a diverse racial profile, in order to investigate the adoption of MMCs of the elderly in their home environment. The interviews were analysed thematically. Results: The study found that social challenges like technology anxiety, the intrusive nature of the technology and attitude towards the technology will affect adoption of MMCs. Government need to address the standardisation, data governance and interoperability of the systems. The cost of MMCs were seen as an inhibitor, but could be off set against the perceived return on investment of health care. While the elderly acknowledged that MMCs can improve their independence, the design of the MMCs and training to use it was identified as barriers to the adoption. Conclusion: The study, therefore, recommends collaborative engagements amongst government, business and the elderly to facilitate the adoption of MMCs in the elderly community to improve the quality of health care. [ABSTRACT FROM AUTHOR]

In view of the staggering disease and economic burden of mental disorders, internet and mobile-based interventions (IMIs) targeting mental disorders have often been touted to be cost-effective; however, available evidence is inconclusive and outdated. This review aimed to provide an overview of the cost-effectiveness of IMIs for mental disorders and symptoms. A systematic search was conducted for trial-based economic evaluations published before 10th May 2021. Electronic databases (including MEDLINE, PsycINFO, CENTRAL, PSYNDEX, and NHS Economic Evaluations Database) were searched for randomized controlled trials examining IMIs targeting mental disorders and symptoms and conducting a full health economic evaluation. Methodological quality and risk of bias were assessed. Cost-effectiveness was assumed at or below £30,000 per quality-adjusted life year gained. Of the 4044 studies, 36 economic evaluations were reviewed. Guided IMIs were likely to be cost-effective in depression and anxiety. The quality of most evaluations was good, albeit with some risks of bias. Heterogeneity across studies was high because of factors such as different costing methods, design, comparison groups, and outcomes used. IMIs for anxiety and depression have potential to be cost-effective. However, more research is needed into unguided (preventive) IMIs with active control conditions (e.g., treatment as usual) and longer time horizon across a wider range of disorders. Trial registration: PROSPERO Registration No. CRD42018093808. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To estimate the cost savings associated with a pedometer-based, web-mediated physical activity intervention in a cohort of US veterans with chronic obstructive pulmonary disease (COPD). STUDY DESIGN: Economic analysis. METHODS: We constructed a decision tree from the health care system perspective incorporating adjusted relative risk of a pedometer-based, web-mediated intervention for COPD- related acute exacerbations, acute exacerbation--related costs (ie, emergency department visits and hospitalizations), and intervention-related costs. Total COPD-related costs were estimated per patient across 12 months. Probabilistic sensitivity analysis with Monte Carlo simulation was used to estimate uncertainty in the model findings. RESULTS: In the deterministic (base case) model, the model estimated costs to be $4236 per participant who used the pedometer-based, web-mediated intervention compared with $7913 per participant in the control group (estimated $3677 saved in 1 year compared with the control group). The model findings were robust to probabilistic sensitivity analysis, with a difference in mean costs of $4582 (95% probability interval, $4084-$5080; P < .001). Cost savings in the model were driven by the adjusted relative risk of the web-based intervention, probability of a COPD-related acute exacerbation, rate of hospitalization, probability of hospitalization, and cost of hospitalization. CONCLUSIONS: A pedometer-based, web-mediated physical activity intervention yielded substantial cost savings. Increased implementation of the intervention could markedly reduce the economic burden of COPD for payers and patients. [ABSTRACT FROM AUTHOR]

Background Substance use disorders (SUDs) contribute significantly to global rates of morbidity and mortality. Internet- and mobile-based interventions (IMIs) have been suggested as an adjunct to face-to-face health services. However, the evidence for the cost-effectiveness of IMIs for SUDs is scant. Methods A comprehensive literature search in PubMed, PsycINFO, the Cochrane Central Register of Controlled Trials, NHS Economic Evaluations Database, NHS Health Technology Assessment Database, Office of Health Economics Evaluations Database and EconLit was conducted. We included economic evaluations alongside randomized controlled trials of IMIs for SUDs compared with a control group. Results Of 1687 abstracts identified, 11 studies met the inclusion criteria. Targeted conditions were alcohol use disorder (four studies) and tobacco smoking (five studies) whereas two studies included any SUD. Cost-effectiveness results demonstrated that IMIs had a firm probability of being more cost-effective than TAU (e.g. less costs per additional abstinent person). Compared with (online) psycho-education, evidence towards an additional benefit of IMIs was less clear. Regarding cost-utility (e.g. costs per quality-adjusted life year gained), except for one study, results suggested that TAU and online psycho-education would probably be more preferable than IMIs. Quality of study reporting was at least adequate. Conclusions The likelihood of IMIs being more cost-effective than TAU looks promising but more economic evaluations are needed in order to determine the economic merit of IMIs. With an increasing pressure on health care budgets, strategies to disseminate effective interventions at affordable costs are required. This review suggests that IMIs might carry that promise and have potential as a cost-effective strategy to scale-up existing evidence-based treatments for SUDs. Systematic review registration The systematic review has been registered in the PROSPERO database (no. CRD42018099486). [ABSTRACT FROM AUTHOR]

Objective: To examine whether Society for Assisted Reproductive Technology (SART) member in vitro fertilization (IVF) centers adhere to the Society's new advertising policy, updated in January 2018, and evaluate other services advertised by region, insurance mandate and university affiliation status. Historically, a large percentage of IVF clinics have not adhered to SART guidelines for IVF clinic website advertising and have had variability in how financial incentives and other noncore fertility services are advertised.Design: Cross-sectional study.Setting: Not applicable.Patient(s): None.Intervention(s): None.Main Outcome Measure(s): Adherence of SART participating websites to objective criteria from the 2018 SART advertising guidelines.Result(s): All 361 SART participating clinic websites were evaluated. Approximately one third of clinics reported success rate statistics directly on their websites, but only 52.6% of those clinics reported current statistics. Similarly, only 67.5% of SART member clinics included the required disclaimer statement regarding their outcome statistics. Only 10.5% of websites were wholly compliant with SART guidelines regarding presentation of supplemental data. There were no significant differences between academic and nonacademic centers, programs in mandated versus nonmandated states, or East versus West Coast clinics in any of these areas.Conclusion(s): Many of the SART member websites failed to adhere to core guidelines surrounding reporting IVF clinic success rates. Consideration for additional education and streamlining as well as simplifying success rate advertising guidelines is recommended. [ABSTRACT FROM AUTHOR]

Exponential technologies, if blended with advantageous conceptual setups, enable innovative developments for Internet-based production ecosystems. The focus of this study is on developing a support mechanism for homeostatic and evolutionary abilities in large-scale production environments. Starting from a reflection on the state-of-the-art, a suitable framework was developed for the conceptualization of Internet-based production ecosystems. Based on augmented context awareness and eco-systemic intelligence, homeostatic and adaptive abilities were designed, and used along with the operational controls to maintain the homeostasis of loads, workflows, and variability, and facilitate the long-term adaptation of the actors. The latter may comprise self-made adaptation of human and digital actors, as well as externally supported modification of functions operated by cyber-agents. The advantage of the proposed solutions is twofold: firstly, stakeholders can improve their performance and adaptability; and secondly, they can also benefit from non-selfish behaviors. [ABSTRACT FROM AUTHOR]

Aggregate idiosyncratic volatility spiked nearly fivefold during the Internet boom of the late 1990s, dwarfing in magnitude a moderately increasing trend. While some researchers argue that this rise in idiosyncratic risk was the result of changes in the characteristics of public firms, others argue that it was driven by the changing sentiment of irrational traders. We present evidence that the marketwide decline in maturity of the typical public firm can explain most of the increase in firm-specific risk during the Internet boom. Controlling for firm maturity, we find no evidence that investor sentiment drives idiosyncratic risk throughout the Internet boom. [ABSTRACT FROM AUTHOR]

Almost all attempts to date to monetize Internet applications targeted at individuals have focused on natural extensions of traditional media or traditional retailing. Most are either some form of consumer-focused advertising or of consumer-focused e-commerce. And yet the Net is far more powerful than traditional media on one hand, and far more liberating and thus inappropriate as an alternative to traditional media on the other. There are numerous potential online business models that are not based on advertising. This paper explores several such areas and divides them into two basic categories, those that sell some product, experience, content, or service and earn revenues from the sale, and those that provide access to consumers and charge for access. It further divides each of these major categories into subcategories, and for each subcategory reviews current experience, places it in the context of the relevant literature in competitive strategy, and uses that theory to make predictions. The paper concludes with strategic recommendations for corporations as well as with suggestions for further research. [ABSTRACT FROM AUTHOR]

The boom in online marketing research represents one of the fastest-growing segments of the research industry. Although the design and quality of online surveys has received widespread attention, little empirical research compares the effectiveness of online and offline qualitative research techniques. Therefore, this research compares offline focus groups, online focus groups and e-Delphi with respect to depth, breadth, efficiency, group dynamics, non-verbal impressions and attitudes of respondents. Results show that offline focus group results have the highest depth and breadth, and are most efficient, leading to high-quality outcomes. However, e-Delphi discussions provide very elaborate and relatively deep outcomes that give a good impression of respondents' feelings and attitudes. Results from online focus groups remain rather superficial, but experts value the spontaneous reactions and interactiveness, and consider online focus groups very efficient. [ABSTRACT FROM AUTHOR]

Word-of-mouth. (WOM) communication has received a great deal of attention from marketing academics and practitioners alike. Widespread use of the internet for shopping, information gathering and entertainment purposes has changed not only the ways that WOM can be studied and manipulated but also the very nature of the phenomenon. Published research into electronic WOM (eWOM) first appeared in the top-level marketing journals only about ten years ago. Since that time, there has been a great deal of research but no synthesis of the knowledge that would allow one to draw conclusions regarding the evolving nature of WOM and to extend the theory applied to this topic. This paper will address that gap, applying the paradigm funnel technique suggested by Nairn et al. (Í/MR, 49, 2), and will suggest some future research directions. [ABSTRACT FROM AUTHOR]

The Internet provides an additional channel for manufacturers to provide information about and sell their products. The electronic channel has the advantage of reduced search cost and its reach is increasing, but it has limited capability to provide product information. This paper examines how Internet technology affects a monopoly manufacturer's distribution problem in an environment where product information is important for consumers to identify their ideal product. The model suggests that a manufacturer uses the electronic channel in addition to the physical channel when the product information is very valuable and product information is largely about digital attributes, or when the product information is not valuable. The model also suggests that when the manufacturer chooses to sell through both channels, there is an increase in price competition between the two channels such that the manufacturer need not sell through the electronic retailer with the highest reach. Also, when a large proportion of consumers have access to both channels, the manufacturer may sell through only one channel. The paper also examines the case where the manufacturer operates in the electronic channel and the case where the retailers are integrated. [ABSTRACT FROM AUTHOR]

Theory indicates that frictions (e.g., information and transaction costs) could account for the lower than expected stock market participation rates. This paper examines the hypothesis that there has been a fundamental change in participation and links this change to the reduction of these frictions by the advent of the Internet. Using panel data on household participation rates over the past decade, the results show computer/Internet using households raised participation substantially more than non-computer using households. The increased probability of participation was equivalent to having over $27,000 in additional household income or over two more mean years of education. [ABSTRACT FROM AUTHOR]

Although research has shown that the Internet has lowered the prices in some established industries, little is known about how use of the Internet lowers prices. The authors address this issue for the automobile retailing industry with matched survey and transaction data on 1500 car purchases in California. They show that the Internet lowers prices for two distinct reasons: First, the Internet informs consumers about dealers' invoice prices. Second, the referral process of online buying services helps consumers obtain lower prices. The combined information and referral price effects are -1.5%, or 22% of dealers' average gross vehicle profit. The authors also find that the benefits of gathering information differ by consumer type. Buyers who have a high disutility of bargaining but who have collected information on the specific car they eventually purchase pay 1.5% less than they otherwise would. In contrast, buyers who like the bargaining process do not benefit from such information. [ABSTRACT FROM AUTHOR]

Although the Web has grown to several billion pages over the past few years, just a few of the Web sites get most of the visits. Such sites, called portals, attract visitors and advertisers and provide a lot of valuable content at no charge to the visitors. The portals attract a disproportionate amount of the Internet advertising dollars and have the ability to influence the success of new electronic commerce ventures. Using monthly audience data, we examine relative market shares of Web sites in search engines, travel, financial, news, and other categories. We find clear evidence of increasing disparity in page views, with the top Web sites getting an increasing share of the market. Using economic modeling, we show that this disparity is a result of a development externality that exists in this industry: the sites that have more viewers get more revenues; this in turn allows them to develop more content and attract an even greater number of viewers. [ABSTRACT FROM AUTHOR]

This paper explores a model based on agents with heterogenous beliefs facing short sales restrictions, and its explanation for the rise, persistence, and eventual fall of Internet stock prices. First, we document substantial short sale restrictions for Internet stocks. Second, using data on Internet holdings and block trades, we show a link between heterogeneity and price effects for Internet stocks. Third, arguing that lockup expirations are a loosening of the short sale constraint, we document average, long-run excess returns as low as -33 percent for Internet stocks postlockup. We link the Internet bubble burst to the unprecedented level of lockup expirations and insider selling. [ABSTRACT FROM AUTHOR]

I present two models for exploring the impact of the emergence and diffusion of the internet on vertical and horizontal firm boundaries. I argue that the effect of the emergence and diffusion of the internet on a firm's boundaries is a function of the firm's determinants of costs, moderated by the information dependence and tacitness of the firm's value-adding activities and the organizational technology that underpins the firm's primary activities. Contrary to previous research, the models suggest that the emergence and diffusion of the internet should also expand some firm boundaries. [ABSTRACT FROM AUTHOR]

Price-comparison engines allow customers to compare product offerings of online sellers and reveal almost complete information on the alternatives, and hence create erosion in store loyalty. Consequently, the competitive dynamics of online sales are affected in markets where price-comparison shopping is diffusing rapidly. We develop a dynamic competitive pricing model that deals with an asymmetric duopolistic market where the segment sizes are determined through a diffusion process. Our diffusion-of-innovations approach allows us to dynamically capture the proportion of informed and uninformed customers in a homogenous goods market. We use this model to analyze how strategic profit-maximization behavior evolves over time. This analysis shows that the increasing numbers of price-comparison shoppers pull prices down, and the rate at which prices decrease is shaped by the diffusion curve and brand preference. Our analysis shows that stores with loyal customers, or with a preference for their brands, can attain higher profits further into the diffusion process. The direct implication is that firms should use their information technology, operations, and marketing capabilities to create, enhance, and cultivate stronger preferences for, and loyalty to, their brand names to survive the inevitable information-rich markets of tomorrow. [ABSTRACT FROM AUTHOR]

Literacy is a continuous, multidimensional indicator of proficiency in using written language. This essay reviews several recent books on literacy, and suggests some profound theoretical issues about consumer behavior inspired by a sociocultural perspective on literacy. In particular, ties between literacy and six diverse research programs on consumer behavior are highlighted: responses to persuasion; affect and decision making; the meanings of products and brands; social marketing of health behaviors; consumption, identity, and resistance; and the impact of the internet on consumer behavior. In addition, questions both interesting and troubling about the impact of consumption on literacy are raised in the hope of encouraging future research. [ABSTRACT FROM AUTHOR]

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To show how fast Internet affects employment in Africa, we exploit the gradual arrival of submarine Internet cables on the coast and maps of the terrestrial cable network. Robust difference-in-differences estimates from 3 datasets, covering 12 countries, show large positive effects on employment rates—also for less educated worker groups—with little or no job displacement across space. The sample-wide impact is driven by increased employment in higher-skill occupations, but less-educated workers' employment gain less so. Firm-level data available for some countries indicate that increased firm entry, productivity, and exporting contribute to higher net job creation. Average incomes rise. (JEL F14, J23, J24, J63, L86, O15, O33) [ABSTRACT FROM AUTHOR]

Advocates of the World Wide Web claim it is a great leveler and that participants have a more equal voice. This flatness of the Web creates a major challenge for many businesses: How do you attract visitors and prospective customers to the firm's Web site? The Web site that can attract more visitors, all other things being equal, is more likely to communicate its message to a wider audience or sell its product to more people. Organizations want to build mountains-or "attractors"-in the otherwise flat landscape of Web-based marketing and advertising. This article classifies existing approaches to creating attractors, identifies four basic types of attractors, and predicts that there will be a move towards creating highly interactive attractors as a device for mass customization. The article also addresses the notion of sustainable attractiveness and presents recommendations for designing an attractor [ABSTRACT FROM AUTHOR]