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A Systematic Review of the Integration of Motivational and Behavioural Theories in Game-Based Health Interventions

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Innovative Systems for Intelligent Health Informatics (IRICT 2020)

Part of the book series: Lecture Notes on Data Engineering and Communications Technologies ((LNDECT,volume 72))

Abstract

M-Health interventions designed for healthcare can potentially increase participation and behaviour outcomes. However, interventions need to incorporate a theoretical perspective of behavioural change to enhance their perceived efficacy. Although behavioural outcome theories have gained interest in the health and fitness literature, the implementation of theoretical integration remains largely under-studied. Therefore, we reviewed the efficacy of behavioural gamified interventions based on integrated theories in various contexts, such as healthcare and fitness. Studies were included if an integrated theoretical intervention was implemented to change behaviour in specific contexts. The review aims to uncover the effectiveness of integrated theory in predicting behaviour outcome in interventions. Our findings reveal that in 39 studies, Self Determination Theory (n = 19) and Theory of Planned Behaviour (n = 16) outnumbered other theories in integrated models. Overall, 77% of studies showed evidence that integrated theoretical-based behaviour change interventions can be successful for a short time, with only a few studies that tested these interventions’ long term effects. We discuss the implication of our findings, and also propose potential future directions.

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References

  1. Trigueros, R., Aguilar-Parra, J.M., Cangas, A.J., Lopez-Liria, R., Alvarez, J.F.: Influence of physical education teachers on motivation, embarrassment and the intention of being physically active during adolescence. Int. J. Environ. Res. Public Health 16(13), 2295 (2019)

    Article  Google Scholar 

  2. Sola, D., Couturier, J., Voyer, B.: Unlocking patient activation in chronic disease care. Br. J. Healthc. Manag. 21(5), 220–225 (2015)

    Article  Google Scholar 

  3. Wu, X.Y., Han, L.H., Zhang, J.H., Luo, S., Hu, J.W., Sun, K.: The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: a systematic review. PloS One 12(11), e0187668 (2017)

    Article  Google Scholar 

  4. Deterding, S., Dixon, D., Khaled, R., Nacke, L.: From game design elements to gamefulness: defining “gamification”. In: Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments, pp. 9–15, September 2011

    Google Scholar 

  5. Landers, R.N., Armstrong, M.B., Collmus, A.B.: How to use game elements to enhance learning: applications of the theory of gamified learning. In: Serious Games and Edutainment Applications, pp. 457–483. Springer, Cham (2017)

    Google Scholar 

  6. Khalil, M., Wong, J., de Koning, B., Ebner, M., Paas, F.: Gamification in MOOCs: a review of the state of the art. In: 2018 IEEE Global Engineering Education Conference (EDUCON), pp. 1629–1638IEEE, April 2018

    Google Scholar 

  7. Antonaci, A., Klemke, R., Specht, M.: The effects of gamification in online learning environments: a systematic literature review. Informatics 6(3), 32 (2019)

    Article  Google Scholar 

  8. Suh, A., Cheung, C.M., Ahuja, M., Wagner, C.: Gamification in the workplace: the central role of the aesthetic experience. J. Manag. IS 34(1), 268–305 (2017)

    Google Scholar 

  9. Yen, B.T., Mulley, C., Burke, M.: Gamification in transport interventions: another way to improve travel behavioural change. Cities 85, 140–149 (2019)

    Article  Google Scholar 

  10. Bhattacherjee, A.: Understanding information systems continuance: an expectation-confirmation model. MIS Q. 25, 351–370 (2001)

    Article  Google Scholar 

  11. Sailer, M., Hense, J., Mandl, H., Klevers, M.: Fostering development of work competencies and motivation via gamification. In: Competence-Based Vocational and Professional Education, pp. 795–818. Springer, Cham (2017)

    Google Scholar 

  12. Greaves, C.J., Sheppard, K.E., Abraham, C., Hardeman, W., Roden, M., Evans, P.H., Schwarz, P.: Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health 11(1), 1–12 (2011)

    Article  Google Scholar 

  13. Davis, R., Campbell, R., Hildon, Z., Hobbs, L., Michie, S.: Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol. Rev. 9(3), 323–344 (2015)

    Article  Google Scholar 

  14. Richards, J.A., Johnson, M.P.: A case for theoretical integration: combining constructs from the theory of planned behavior and the extended parallel process model to predict exercise intentions. SAGE Open 4(2) (2014). https://doi.org/10.1177/2158244014534830

  15. Gucciardi, D.F., Jackson, B.: Understanding sport continuation: an integration of the theories of planned behaviour and basic psychological needs. J. Sci. Med. Sport 18(1), 31–36 (2015)

    Article  Google Scholar 

  16. Tsai, C.H.: Integrating social capital theory, social cognitive theory, and the technology acceptance model to explore a behavioral model of telehealth systems. Int. J. Environ. Res. Public Health 11(5), 4905–4925 (2014)

    Article  Google Scholar 

  17. Schoeppe, S., Alley, S., Van Lippevelde, W., Bray, N.A., Williams, S.L., Duncan, M.J., Vandelanotte, C.: Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int. J. Behav. Nutr. Phys. Act. 13(1), 127 (2016)

    Article  Google Scholar 

  18. Sweet, S.N., Fortier, M.S., Strachan, S.M., Blanchard, C.M.: Testing and integrating self-determination theory and self-efficacy theory in a physical activity context. Can. Psychol./Psychologie Canadienne 53(4), 319 (2012)

    Article  Google Scholar 

  19. Noar, S.M., Zimmerman, R.S.: Health behavior theory and cumulative knowledge regarding health behaviors: are we moving in the right direction? Health Educ. Res. 20(3), 275–290 (2005)

    Article  Google Scholar 

  20. Marteau, T., Dieppe, P., Foy, R., Kinmonth, A.L., Schneiderman, N.: Behavioural medicine: changing our behaviour. BMJ J. 332(7539), 437–438 (2006)

    Article  Google Scholar 

  21. Hagger, M.S., Hamilton, K.: Changing behaviour using integrated theories. In: The Handbook of Behavior Change (2020)

    Google Scholar 

  22. Liebana-Cabanillas, F., Munoz-Leiva, F., Sanchez-Fernandez, J.: A global approach to the analysis of user behavior in mobile payment systems in the new electronic environment. Serv. Bus. 12(1), 25–64 (2018)

    Article  Google Scholar 

  23. Hagger, M.S.: Theoretical integration in health psychology: unifying ideas and complementary explanations. Br. J. Health. Psychol. 14(2), 189–194 (2009)

    Article  Google Scholar 

  24. David, M., Sutton, C.D.: Social Research: The Basics, vol. 74, no. 3. Sage, Thousand Oaks (2004)

    Google Scholar 

  25. Cugelman, B.: Gamification: what it is and why it matters to digital health behavior change developers. JMIR Serious Games 1(1), e3 (2013)

    Article  Google Scholar 

  26. Al-Jubari, I., Hassan, A., Liñán, F.: Entrepreneurial intention among university students in Malaysia: integrating self-determination theory and the theory of planned behavior. Int. Entrep. Manag. J. 15(4), 1323–1342 (2019)

    Article  Google Scholar 

  27. Al-Jubari, I.: College students’ entrepreneurial intention: testing an integrated model of SDT and TPB. Sage Open 9(2), 2158244019853467 (2019)

    Article  Google Scholar 

  28. Al-Maroof, R.S., Salloum, S.A.: An Integrated model of continuous intention to use of google classroom. In: Recent Advances in Intelligent Systems and Smart Applications, pp. 311–335. Springer, Cham (2020)

    Google Scholar 

  29. Al-Maroof, R.S., Salloum, S.A., AlHamadand, A.Q.M., Shaalan, K.: A unified model for the use and acceptance of stickers in social media messaging. In: International Conference on Advanced Intelligent Systems and Informatics, pp. 370–381. Springer, October 2019

    Google Scholar 

  30. Aryee, S., Walumbwa, F.O., Mondejar, R., Chu, C.W.: Accounting for the influence of overall justice on job performance: integrating self-determination and social exchange theories. J. Manag. Stud. 52(2), 231–252 (2015)

    Article  Google Scholar 

  31. Asnakew, Z.S.: Customers’ continuance intention to use mobile banking: development and testing of an integrated model. Rev. Socionetwork Strateg. 14, 123–146 (2020)

    Article  Google Scholar 

  32. Barkoukis, V., Hagger, M.S., Lambropoulos, G., Tsorbatzoudis, H.: Extending the trans-contextual model in physical education and leisure-time contexts: examining the role of basic psychological need satisfaction. Br. J. Educ. Psychol. 80(4), 647–670 (2010)

    Article  Google Scholar 

  33. Biddle, S., Soos, I., Chatzisarantis, N.: Predicting physical activity intentions using goal perspectives and self-determination theory approaches. Eur. Psychol. 4(2), 83 (1999)

    Article  Google Scholar 

  34. Brooks, J.M., Iwanaga, K., Chiu, C.Y., Cotton, B.P., Deiches, J., Morrison, B., Moser, E., Chan, F.: Relationships between self-determination theory and theory of planned behavior applied to physical activity and exercise behavior in chronic pain. Psychol. Health Med. 22(7), 814–822 (2017)

    Article  Google Scholar 

  35. Chan, D.K.C., Fung, Y.K., Xing, S., Hagger, M.S.: Myopia prevention, near work, and visual acuity of college students: integrating the theory of planned behavior and self-determination theory. J. Behav. Med. 37(3), 369–380 (2014)

    Article  Google Scholar 

  36. Chung, P.K., Zhang, C.Q., Liu, J.D., Chan, D.K., Si, G., Hagger, M.S.: The process by which perceived autonomy support predicts motivation, intention, and behavior for seasonal influenza prevention in Hong Kong older adults. BMC Public Health 18(1), 1–9 (2018)

    Article  Google Scholar 

  37. Dishaw, M.T., Strong, D.M.: Extending the technology acceptance model with task–technology fit constructs. Inf. Manag. 36(1), 9–21 (1999)

    Article  Google Scholar 

  38. Jamshidifarsani, H., Tamayo-Serrano, P., Garbaya, S., Lim, T., Blazevic, P.: Integrating self-determination and self-efficacy in game design. In: International Conference on Games and Learning Alliance, pp. 178–190. Springer, Cham, December 2018

    Google Scholar 

  39. Hagger, M.S., Chatzisarantis, N.L., Harris, J.: From psychological need satisfaction to intentional behavior: testing a motivational sequence in two behavioral contexts. Pers. Soc. Psychol. Bull. 32(2), 131–148 (2006)

    Article  Google Scholar 

  40. Hamilton, K., Cox, S., White, K.M.: Testing a model of physical activity among mothers and fathers of young children: integrating self-determined motivation, planning, and the theory of planned behavior. J. Sport Exerc. Psychol. 34(1), 124–145 (2012)

    Article  Google Scholar 

  41. Hsu, M.H., Chiu, C.M., Ju, T.L.: Determinants of continued use of the WWW: an integration of two theoretical models. Ind. Manag. Data Syst. 104, 766–775 (2004)

    Article  Google Scholar 

  42. Jacobs, N., Hagger, M.S., Streukens, S., De Bourdeaudhuij, I., Claes, N.: Testing an integrated model of the theory of planned behaviour and self-determination theory for different energy balance-related behaviours and intervention intensities. Br. J. Health. Psychol. 16(1), 113–134 (2011)

    Article  Google Scholar 

  43. Khan, I.U., Hameed, Z., Yu, Y., Islam, T., Sheikh, Z., Khan, S.U.: Predicting the acceptance of MOOCs in a developing country: application of task-technology fit model, social motivation, and self-determination theory. Telematics Inform. 35(4), 964–978 (2018)

    Article  Google Scholar 

  44. Kim, B.: An empirical investigation of mobile data service continuance: incorporating the theory of planned behavior into the expectation–confirmation model. Expert Syst. Appl. 37(10), 7033–7039 (2010)

    Article  Google Scholar 

  45. Larsen, T.J., Sorebo, A.M., Sorebo, O.: The role of task-technology fit as users’ motivation to continue information system use. Comput. Hum. Behav. 25(3), 778–784 (2009)

    Article  Google Scholar 

  46. Lee, M.C.: Explaining and predicting users’ continuance intention toward e-learning: an extension of the expectation–confirmation model. Comput. Educ. 54(2), 506–516 (2010)

    Article  Google Scholar 

  47. Lu, H.P., Yang, Y.W.: Toward an understanding of the behavioral intention to use a social networking site: an extension of task-technology fit to social-technology fit. Comput. Hum. Behav. 34, 323–332 (2014)

    Article  Google Scholar 

  48. Luqman, A., Masood, A., Ali, A.: An SDT and TPB-based integrated approach to explore the role of autonomous and controlled motivations in “SNS discontinuance intention.” Comput. Hum. Behav. 85, 298–307 (2018)

    Article  Google Scholar 

  49. Shang, D., Wu, W.: Understanding mobile shopping consumers’ continuance intention. Ind. Manag. Data Syst. 117, 213–227 (2017)

    Article  Google Scholar 

  50. Wei, J., Vinnikova, A., Lu, L., Xu, J.: Understanding and predicting the adoption of fitness mobile apps: evidence from China. Health Commun. 1–12 (2020)

    Google Scholar 

  51. Sweet, S.N., Fortier, M.S., Strachan, S.M., Blanchard, C.M., Boulay, P.: Testing a longitudinal integrated self-efficacy and self-determination theory model for physical activity post-cardiac rehabilitation. Health Psychol. Res. 2(1), 1008 (2014)

    Article  Google Scholar 

  52. Roca, J.C., Gagne, M.: Understanding e-learning continuance intention in the workplace: a self-determination theory perspective. Comput. Hum. Behav. 24(4), 1585–1604 (2008)

    Article  Google Scholar 

  53. Techatassanasoontorn, A.A., Tanvisuth, A.: The integrated self-determination and self-efficacy theories of ICT training and use: the case of the socio-economically disadvantaged. GlobDev 2008, p. 19 (2008)

    Google Scholar 

  54. Kamp, C.V.D.: Acceptance of MOOCs by Dutch university students. Extending the unified theory of acceptance and use of technology (UTAUT) model with the technology acceptance model (TAM) (2019)

    Google Scholar 

  55. Vanduhe, V.Z., Nat, M., Hasan, H.F.: Continuance intentions to use gamification for training in higher education: integrating the technology acceptance model (TAM), social motivation, and task technology fit (TTF). IEEE Access 8, 21473–21484 (2020)

    Article  Google Scholar 

  56. Lin, T.C., Huang, C.C.: Understanding knowledge management system usage antecedents: an integration of social cognitive theory and task technology fit. Inf. Manag. 45(6), 410–417 (2008)

    Article  Google Scholar 

  57. Williams, L.A., Sun, J., Masser, B.: Integrating self-determination theory and the theory of planned behaviour to predict intention to donate blood. Transfus. Med. 29, 59–64 (2019)

    Article  Google Scholar 

  58. Wu, B., Chen, X.: Continuance intention to use MOOCs: integrating the technology acceptance model (TAM) and task technology fit (TTF) model. Comput. Hum. Behav. 67, 221–232 (2017)

    Article  Google Scholar 

  59. Yu, T.K., Yu, T.Y.: Modelling the factors that affect individuals’ utilisation of online learning systems: an empirical study combining the task technology fit model with the theory of planned behaviour. Br. J. Educ. Technol. 41(6), 1003–1017 (2010)

    Article  Google Scholar 

  60. Yuan, S., Liu, Y., Yao, R., Liu, J.: An investigation of users’ continuance intention towards mobile banking in China. Inf. Dev. 32(1), 20–34 (2016)

    Article  Google Scholar 

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Acknowledgement

The authors would like to acknowledge the financial support of Universiti Tenaga Nasional under the Bold Research Grant (RJO10517844/012) and the Innovative Research Management Center (iRMC) UNITEN.

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Authors and Affiliations

  1. Universiti Tenaga Nasional, Selangor, Malaysia

    Abdulsalam S. Mustafa, Nor’ashikin Ali & Jaspaljeet Singh Dhillon

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  1. Abdulsalam S. Mustafa
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  2. Nor’ashikin Ali
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  3. Jaspaljeet Singh Dhillon
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Editors and Affiliations

  1. College of Computer Science and Engineering, Taibah University, Medina, Saudi Arabia

    Faisal Saeed

  2. School of Computing, Information Systems Department, Universiti Utara Malaysia, Sintok, Malaysia

    Fathey Mohammed

  3. Sanaa’a Community College, Sana'a, Yemen

    Abdulaziz Al-Nahari

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Mustafa, A.S., Ali, N., Dhillon, J.S. (2021). A Systematic Review of the Integration of Motivational and Behavioural Theories in Game-Based Health Interventions. In: Saeed, F., Mohammed, F., Al-Nahari, A. (eds) Innovative Systems for Intelligent Health Informatics. IRICT 2020. Lecture Notes on Data Engineering and Communications Technologies, vol 72. Springer, Cham. https://doi.org/10.1007/978-3-030-70713-2_26

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