Designing game-based eHealth applications: strategies for sustainable engagement of older adults

Anna Frederiek Alberdien Noorman-de Vette

    Research output: ThesisPhD Thesis - Research UT, graduation UT

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    Digital healthcare applications, also called eHealth, can contribute to increasing the quality of healthcare and reducing the demand for care. A rapidly growing target group that can particularly benefit from eHealth is the older adult (65 years and up). It is of vital importance that these eHealth applications are used as they are intended: usually frequent and for a longer period of time. This so-called adherence leaves room for improvement, so that users can optimally benefit from the interventions offered. Games, or specific game elements, can be used in applications that have a primary goal other than entertainment for their natural power to engage people. This research describes how to deploy this strategy, to which refer to with ‘game-based design’, to engage users in productive activities, thereby meeting the demand for strategies to increase and improve the use of eHealth applications. The focus is mainly, but not exclusively, to address the older population. Research evolves around two lead incentives. Part one focused on a method to capture the elements of games that intrinsically motivate people to play, to investigate the elements that are motivating for elderly users, and how these can be translated into engaging design of gamified applications. A series of studies resulted in a practical tool for developers of gamified applications that enables assessment of any target group’s preferences: the 6D framework. Part two covered the development and evaluation of two gamified eHealth applications for the older adult, in which the results of the first section are applied. These studies provided insight in the development of game-based eHealth in practice. By creating transparency in this process and highlighting the rationale behind design choices and motivation strategies in game-based design, future and existing game-based applications can be optimised. By offering repeatable, practical methods, suitable content, principles and mechanisms can be selected and applied. A case study resulted in an effective, well-functioning and aesthetically attractive game-based eHealth application. Evaluations with end-users showed that the preferences as investigated with the 6D framework, and resulting strategies for long term engagement, have led to game content that engages the older adult user.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Twente
    • Vollenbroek-Hutten, Miriam M.R., Supervisor
    • Hermens, Hermanus J., Co-Supervisor
    • Tabak, Monique, Co-Supervisor
    Award date10 Jul 2019
    Place of PublicationEnschede
    Print ISBNs978-90-365-4799-4
    Publication statusPublished - 10 Jul 2019


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