Harvard Heart Letter

If exercise feels like work, make it more like a game

Friendly competition and other aspects of “gamification” may help people become more active.

If you’re one of those people who meet their goal of 10,000 steps on most days, good for you. If you’re not — and if exercising feels like a chore — maybe you just need to get your game on.

People who turned their step counts into a competition boosted their daily walking distance by almost a mile, according to a new study. The six-month-long study included 94 families who tracked their daily step counts with a wearable device or a smartphone. Half were randomly chosen for the “gamification” arm of the study, which was designed to encourage collaboration, accountability, and team spirit. These families received small prizes tied to achieving daily and weekly step goals. Just over half of the participants were women, and their average age was 55.

“Gamification helps motivate people by making the hard stuff in life more fun,” says Dr. Ichiro Kawachi, chair of the department of social and behavioral sciences at the Harvard T.H. Chan School of Public Health. Exercise can feel like a duty, especially if your doctor lectures you about it, he says.

Harnessing team spirit

When you “gamify” health advice, the idea is to introduce elements of games into people’s daily routines. In this study, participants earned points by meeting physical daily activity goals, progressing through higher levels by keeping up that behavior, and ultimately winning prizes. But games are not just for single players. “Being on a team encourages cooperation, and people egg each other on. And when different teams compete against one another, that adds another layer of incentive. It’s like the difference between playing solitaire versus bridge,” Dr. Kawachi explains.

The study, published online Oct. 2, 2017, by JAMA Internal Medicine, relied on practices inspired by behavioral economics. People dislike losing even more than they like gaining, so the families were awarded 70 points every Monday, which they stood to lose if they did not meet their exercise goals. Every day, the family would keep or lose 10 points based on whether the group met their daily step goal. The added hitch: the step goal was based only on one randomly chosen family member, which helped to encourage everyone to try hard, notes Dr. Kawachi, who wrote an invited commentary on the study.

Measurable gains

The gaming period of the study lasted three months, during which the gaming families boosted their activity levels by about 1,700 steps—more than twice the gains achieved by the nongaming control families. Over the next three months, everyone kept tracking his or her steps. The gamers lost some of their initial gains but still continued to outperform the nongamers.

The popular smartphone game Pokémon Go had a similar effect on boosting players’ activity levels soon after it was released in July 2016 (see “Pokémon Go: Catch this trailblazing activity app”). In fact, a study Dr. Kawachi coauthored in The BMJ found that people who’d downloaded the game took an average of 955 more steps per day than nonusers. But the effect dwindled over time as the novelty wore off.

Although these initial results are promising, experts are still in the early stages of understanding how to apply gamification effectively. Right now, there’s a gap: game app developers aren’t really focused on health, and health promotion experts aren’t thinking about games, says Dr. Kawachi. “I’d like to see health insurance plans collaborate with app developers to offer these types of things through their health promotion initiatives,” he says.

In the meantime, you can use the same principles to make your walking or exercise regimen more like a game. Invite your family, friends, or colleagues to play along, and make up your own goals and rewards.

Pokémon Go: Catch this trailblazing activity app

When you play a game on your smartphone, you’re usually lounging around. Not so with Pokémon Go. To play, you walk around in the real world to find virtual cartoon characters (or “pocket monsters,” as the name Pokémon suggests) that appear on your phone’s screen. The goal is to “catch” the characters by swiping on the phone’s touchscreen. To advance, you have to walk (sometimes long distances) to get bonuses and “hatch” new characters. You can also compete against other players in virtual “gyms.” The game takes advantage of a smartphone’s integrated global positioning system (GPS) and step-counter features to make sure people aren’t cheating.

Worldwide, more than 750 million people downloaded Pokémon Go during its first year. Young people fueled much of this craze, which has since died down somewhat. But the game still has some 65 million active users each month, including middle-aged and older people, according to Niantic, the company that developed the game.

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