Effects of Different Gamification Delivery Strategies on Physical Activity in Young Adults: An RCT

Physical inactivity is rising globally, particularly among young adults. Gamification is increasingly used to promote physical activity, but the effectiveness of different gamified elements and delivery strategies remains unclear. This study evaluated the effects of different gamification delivery strategies on increasing young adults' physical activity.

This 12-week parallel RCT (1-week baseline, 7-week intervention, 4-week follow-up) was conducted from April 2024 to January 2025 and registered on ClinicalTrials.gov (NCT06818071, https://clinicaltrials.gov/study/NCT06818071) on January 17, 2025. Healthy university students aged 18-35 years were recruited through on-campus and online advertisements and randomized to 1 of 4 conditions: (1) sequential delivery of gamified elements, (2) cumulative delivery, (3) explicit gamification through a commercial mobile game, or (4) tracking-only control. Gamified elements included points, leaderboards, and social interaction. The primary outcome, daily step count, was measured in a free-living context using app-based self-reports. Secondary outcomes included changes in biometric measures. Between-group differences in daily step count were analyzed using mixed-effects linear regression.

Among 246 participants, all intervention groups increased daily step count significantly; cumulative delivery achieved the largest gain (+2,326 steps, SD=303). Increases were sustained at follow-up. Mixed-effects estimates confirmed that cumulative delivery's strongest effect and suggested social interaction (sequential delivery of gamified elements: +981 steps, p=0.080) and explicit gamification (sequential delivery of gamified elements: +1,304, p=0.055) were particularly effective. Explicit gamification through a commercial mobile game showed delayed but longer-lasting effects, suggesting sustained engagement in mobile games after initial acclimation.

Delivering gamified elements cumulatively rather than overwhelming users produced daily step count increases exceeding thresholds previously associated with lower mortality risk. Such strategies should be integrated into public health efforts to address physical inactivity in young adults.