Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis
BackgroundPrevious research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health apps incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce dep...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2021-11-01
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| Series: | JMIR Mental Health |
| Online Access: | https://mental.jmir.org/2021/11/e32199 |
| _version_ | 1797735508522041344 |
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| author | Stephanie G Six Kaileigh A Byrne Thomas P Tibbett Irene Pericot-Valverde |
| author_facet | Stephanie G Six Kaileigh A Byrne Thomas P Tibbett Irene Pericot-Valverde |
| author_sort | Stephanie G Six |
| collection | DOAJ |
| description |
BackgroundPrevious research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health apps incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce depressive symptoms over and above mental health apps without gamification.
ObjectiveThe aim of this study was to determine whether mental health apps with gamification elements differ in their effectiveness to reduce depressive symptoms when compared to those that lack these elements.
MethodsA meta-analysis of studies that examined the effect of app-based therapy, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness, on depressive symptoms was performed. A total of 5597 articles were identified via five databases. After screening, 38 studies (n=8110 participants) remained for data extraction. From these studies, 50 total comparisons between postintervention mental health app intervention groups and control groups were included in the meta-analysis.
ResultsA random effects model was performed to examine the effect of mental health apps on depressive symptoms compared to controls. The number of gamification elements within the apps was included as a moderator. Results indicated a small to moderate effect size across all mental health apps in which the mental health app intervention effectively reduced depressive symptoms compared to controls (Hedges g=–0.27, 95% CI –0.36 to –0.17; P<.001). The gamification moderator was not a significant predictor of depressive symptoms (β=–0.03, SE=0.03; P=.38), demonstrating no significant difference in effectiveness between mental health apps with and without gamification features. A separate meta-regression also did not show an effect of gamification elements on intervention adherence (β=–1.93, SE=2.28; P=.40).
ConclusionsThe results show that both mental health apps with and without gamification elements were effective in reducing depressive symptoms. There was no significant difference in the effectiveness of mental health apps with gamification elements on depressive symptoms or adherence. This research has important clinical implications for understanding how gamification elements influence the effectiveness of mental health apps on depressive symptoms. |
| first_indexed | 2024-03-12T13:00:05Z |
| format | Article |
| id | doaj.art-0997b4f5bb17423fadad97ed07458d8d |
| institution | Directory Open Access Journal |
| issn | 2368-7959 |
| language | English |
| last_indexed | 2024-03-12T13:00:05Z |
| publishDate | 2021-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Mental Health |
| spelling | doaj.art-0997b4f5bb17423fadad97ed07458d8d2023-08-28T19:52:20ZengJMIR PublicationsJMIR Mental Health2368-79592021-11-01811e3219910.2196/32199Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysisStephanie G Sixhttps://orcid.org/0000-0002-7435-1773Kaileigh A Byrnehttps://orcid.org/0000-0002-3935-3108Thomas P Tibbetthttps://orcid.org/0000-0003-4845-6405Irene Pericot-Valverdehttps://orcid.org/0000-0001-5814-0397 BackgroundPrevious research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health apps incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce depressive symptoms over and above mental health apps without gamification. ObjectiveThe aim of this study was to determine whether mental health apps with gamification elements differ in their effectiveness to reduce depressive symptoms when compared to those that lack these elements. MethodsA meta-analysis of studies that examined the effect of app-based therapy, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness, on depressive symptoms was performed. A total of 5597 articles were identified via five databases. After screening, 38 studies (n=8110 participants) remained for data extraction. From these studies, 50 total comparisons between postintervention mental health app intervention groups and control groups were included in the meta-analysis. ResultsA random effects model was performed to examine the effect of mental health apps on depressive symptoms compared to controls. The number of gamification elements within the apps was included as a moderator. Results indicated a small to moderate effect size across all mental health apps in which the mental health app intervention effectively reduced depressive symptoms compared to controls (Hedges g=–0.27, 95% CI –0.36 to –0.17; P<.001). The gamification moderator was not a significant predictor of depressive symptoms (β=–0.03, SE=0.03; P=.38), demonstrating no significant difference in effectiveness between mental health apps with and without gamification features. A separate meta-regression also did not show an effect of gamification elements on intervention adherence (β=–1.93, SE=2.28; P=.40). ConclusionsThe results show that both mental health apps with and without gamification elements were effective in reducing depressive symptoms. There was no significant difference in the effectiveness of mental health apps with gamification elements on depressive symptoms or adherence. This research has important clinical implications for understanding how gamification elements influence the effectiveness of mental health apps on depressive symptoms.https://mental.jmir.org/2021/11/e32199 |
| spellingShingle | Stephanie G Six Kaileigh A Byrne Thomas P Tibbett Irene Pericot-Valverde Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis JMIR Mental Health |
| title | Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis |
| title_full | Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis |
| title_fullStr | Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis |
| title_full_unstemmed | Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis |
| title_short | Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis |
| title_sort | examining the effectiveness of gamification in mental health apps for depression systematic review and meta analysis |
| url | https://mental.jmir.org/2021/11/e32199 |
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