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A Self-Determination Theory-Informed Gamification Framework for Preventive Wellness
Ayesha Thanthrige1, Nilmini Wickramasinghe1
1School of Computing, Engineering and Mathematical Sciences, La Trobe University, Melbourne, Australia.
Studies in Health Technology and Informatics
|July 16, 2026
Summary
This study introduces a gamification framework based on self-determination theory (SDT) to improve engagement in digital wellness programs for prediabetes management. Findings highlight the need for structured guidance to support user autonomy and reduce dropout rates.
Area of Science:
- Digital health
- Behavioral science
- Health informatics
Background:
- Digital wellness interventions for preventive health, like prediabetes management, suffer from high dropout rates.
- Insufficient personalization and motivational support are key barriers to sustained engagement.
Purpose of the Study:
- To present a self-determination theory (SDT)-informed gamification framework to enhance engagement in digital preventive health interventions.
- To address challenges of personalization and motivational support in digital wellness programs.
Main Methods:
- A systematic literature review identified engagement barriers and facilitators.
- A gamification framework was developed based on SDT constructs (autonomy, competence, relatedness).
- The framework was co-designed with young adults and validated by multidisciplinary experts.
Main Results:
- The framework integrates strategies for autonomy (guided goal setting), competence (badges, points), and relatedness (progress sharing).
- Co-design revealed that 60% of participants found fully open goal setting overwhelming, emphasizing the need for structured guidance.
- Findings informed the development of the MiCARE progressive web app.
Conclusions:
- The study offers a replicable, theory-driven approach for designing engaging preventive wellness interventions.
- Structured guidance is crucial for supporting autonomy in digital health applications.
- The developed framework and MiCARE app aim to reduce dropout rates and improve health outcomes.
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