Gamification is the application of game principles and design elements in non-game contexts. Gamification services for generic health and fitness are now widespread, and market data suggests that 25 million wearable fitness monitors will be sold in 2017 [10,11].
Studies show that where participants ‘earn’ badges and ‘rewards’, gamification has a positive effect on direct engagement and behaviour of participants in online programs . Serious games have been defined as “games that are designed to entertain players as they educate, train, or change behaviour” [13,14].
When individuals choose to play a game, they generate a concentrated state of optimistic engagement . Playing games stimulates the physiological rewards, motivation, emotion and memory centres [15,16]. Play and interaction with serious games have been shown to help motivate changes in behaviour for health management and chronic paediatric disease management in children . They have also been shown to reduce emergency admissions, improve health awareness, increase self-confidence, self-efficacy and self-monitoring [17,18].