=Paper=
{{Paper
|id=Vol-2055/paper1
|storemode=property
|title=Anthropomorphism-Based Focus Group Protocol to Select Gamification Mechanics
|pdfUrl=https://ceur-ws.org/Vol-2055/paper1.pdf
|volume=Vol-2055
|authors=Robin De Croon,Davina Wildemeersch,Joris Wille,Katrien Verbert,Vero Vanden Abeele
|dblpUrl=https://dblp.org/rec/conf/chiplay/CroonWWVA17
}}
==Anthropomorphism-Based Focus Group Protocol to Select Gamification Mechanics==
https://ceur-ws.org/Vol-2055/paper1.pdf
Anthropomorphism-Based Focus Group Protocol to Select
Gamification Mechanics
Robin De Croon Davina Wildemeersch Joris Wille
KU Leuven Antwerp University Hospital BeWell Innovations
Celestijnenlaan 200A, Wilrijkstraat 10, Lievevrouwestraat 10,
BE-3001 Leuven BE-2650 Edegem BE-2520 Ranst
robin.decroon@kuleuven.be davina.wildemeersch@uza.be joris.wille@bewellinnovations.com
Katrien Verbert Vero Vanden Abeele
KU Leuven KU Leuven
Celestijnenlaan 200A, Andreas Vesaliusstraat 13,
BE-3001 Leuven BE-3000 Leuven
katrien.verbert@kuleuven.be vero.vandenabeele@kuleuven.be
ABSTRACT there are still actions that are left up to the patient. Typically,
In this position paper, we propose a focus group protocol patients need to setup a Bluetooth connection, wear the sensor
based on an anthropomorphism approach that can be used appropriately, and charge the battery. A lack of adherence to
with both patients and caregivers to select suitable gamification telemonitoring actions in eHealth (“an emerging field in the
mechanics in an eHealth or well-being context. In our current intersection of medical informatics, public health and business,
project, where we will apply this protocol, we are investigating referring to health services and information delivered or
whether the combination of gamification and context-aware enhanced through the Internet and related technologies” [7])
recommender techniques can increase the motivation of people is therefore well documented. For example, Eysenbach [8]
to adhere to telemonitoring actions. This proposed focus group states that there “is the observation that in any eHealth trial
protocol might also be useful in other domains, for example to a substantial proportion of users drop out before completion
select gamification mechanics in a well-being and flourishing and stop using the application. [...] for many eHealth trials,
context. in particular those conducted on the Internet and in particular
with self-help applications, high dropout rates may be a
ACM Classification Keywords natural and typical feature.” The Economist’s Intelligence
H.5.m. Information Interfaces and Presentation : Unit [6] reported on drop-out rates of 144 mobile health
Miscellaneous companies: 67% of the users of fitness or mobile health
apps that needed to enter data manually, stopped within 6
Author Keywords months. Surprisingly, in the case of automated data capturing,
Gamification Mechanics, Focus Group, Anthropomorphism e.g., tracking via sensors, even a higher dropout was reported,
namely 74% [22].
INTRODUCTION
To maximize the effect of telemonitoring, it is important
The objective of our current project is to investigate whether patients are motivated (and kept motivated) to adhere to their
the combination of gamification mechanics and context-aware therapy. Research suggests gamification can have a positive
recommender techniques can increase the motivation of people impact on health and well-being when it targets behavioral
to adhere to telemonitoring actions as part of their therapy, and outcomes [13]. Gamification mechanics might thus be able
hence, whether these ‘intelligent’ gamification mechanics can to motivate patients to adhere to their telemonitoring actions.
reduce drop out. Telemonitoring is defined in this context However, it can be difficult to select appropriate gamification
as the usage of information technology for the tracking mechanics. To help researchers and designers select suitable
and monitoring of the physical well-being of patients, at a gamification mechanics in an eHealth context, we propose
distance [21]. Although telemonitoring is highly automated, a focus group protocol based on an anthropomorphism
approach.
In the next section, we will first introduce focus groups,
present some background on tailored gamification mechanics,
and discuss the tendency of people to anthropomorphize
technology. Then we will present the proposed protocol in
Positive Gaming: Workshop on Gamification and Games for Wellbeing detail. Before we conclude the paper, we present a brief
A CHI PLAY ’17 Workshop discussion on user types.
October 15, 2017, The Netherlands
© 2017 Copyright held by the authors/owners.
BACKGROUND issues adhering to their telemonitoring therapy. Using the
Focus groups
concept of supercoaches, participants do not need to be
familiar with technology, nor with gamification mechanics
Focus groups, sometimes referred to as group discussions [25],
to discuss motivational strategies that might help overcome
differ from in-depth interviews as most data comes from
the issues the designers try to address. These supercoaches
the interaction between participants. As indicated by [2],
thus serve as an anthropomorphism for the actual gamification
“descriptions of a focus group vary but usually include a
mechanics that designers want to implement in their system.
semistructured session, an informal setting, moderation by
a facilitator and possibly a co-facilitator, such as photos.”
FOCUS GROUP PROTOCOL
They serve to collect rich and detailed feedback. Based on the
group discussions, individual answers become sharped and Summary
refined. On the other hand, they might also expose differences The overall goal of the proposed focus group protocol is to
between participants that are important to address. determine: 1) which issues patients experience when they use
a telemonitoring platform; 2) which motivational strategies
Focus groups create a synergy [28] and have been used before are appropriate and which gamification mechanics are suitable
in a gamification context. Sepehr and Head [27] used focus to help patients adhere; and 3) how can we personalize and
groups to identify key gamification mechanics in ERPsim, use the context to optimize the use of these mechanics.
which is a gamified system to teach SAP ERP. Fitz-Walter
et al. [11] used focus groups to gather input for achievement The proposed protocol builds on the Anthropomorphism
related design elements. approach as proposed by Vandenberghe and Slegers [31].
Our protocol thus starts from the idea that users are
Tailored Gamification Mechanics tempted to humanize technology and software. This method
Gamification harnesses the motivational affordances of introduces the metaphor of an all-knowing, omnipotent
gameful experiences to influence psychological outcomes and virtual ‘supercoach’ who can, and wants to, do everything
further behavioral outcomes [12]. Effective gamification to motivate patients. Thanks to this abstraction, patients
is a combination of game design, behavioral economics, might be stimulated to think about the future and ideal use
motivational psychology, and user experience and user of the telemonitoring platform, without having full insights
interface design [3]. However, Hamari et al. [12] has shown into sensor or gamification mechanics, or personalization
that gamification is not a panacea. Research has shown techniques such as recommender algorithms.
that different user groups and personality types necessitate
In each step of the focus group different cards are used: 1) the
different gamification mechanics [4, 19, 30]. Where some
first card is used to list the issues participants experience when
users may be motivated by competition and leaderboards,
they are using the platform under evaluation (Figure 1A); 2) in
other users may be discouraged by competitive elements [26].
the second step, a supercoach is introduced to help overcome
Whereas some users may be encouraged by challenges and
the issue listed on the first card (Figure 1B); 3) feedback
quests, others may dislike the strong focus on achievement.
from the other group (patients vs. caregivers) is added
Hence, there is a need for intelligence with respect to which
using a third card (Figure 1C); 4) finally, this card trail
gamification mechanics are appropriate for specific personality
is extended with gamification mechanics heavily based on
types and user groups. Careful consideration is thus needed
Marczewski’s gamification inspiration cards [16]. However,
to select a set of gamification mechanics. In this work, we
for each mechanic we translated and adapted the text to the
build on Marczewski’s 52 gamification mechanics [17] to let
local language and searched for an appropriate example (see
participants of a focus group select gamification mechanics.
Figure 2 - for this paper, the original English text is used).
Anthropomorphism
Practical
Technology can be hard to grasp, especially for non-technical
We aim to have six to eight patients and two to four caregivers
people. Therefore, some people tend to anthropomorphize
participate in each 2-hour focus group session. It is important
technology [1]. This does not only work well in the
to have both patients and caregivers participate. In this
field of Human-Robot interaction [9]: by attributing human
way, potential boundaries between the two groups can be
characteristics to complex systems, people can make them
exposed. Each group is asked to write with a distinct color, to
more understandable; but users can even consider the
easily determine which feedback originates from which group.
interaction with computers social [18]. Not only technology,
The focus group should be recorded, which will be used to
but also gamification mechanics applied in an eHealth domain
transcribe the results. Privacy and security of the collected
can be cumbersome to understand. Similar to Vandenberghe
data should be saved according to local legislation.
and Slegers [31], we anticipate “anthropomorphism to be
an interesting approach for so-called generative techniques
Introduction
that aim to gather insights into people’s tacit knowledge and
latent needs [32] that may be realized in future products or Time: 10 minutes
applications.” Setup and Explanation: Introduction to the concept.
In this focus group study, we want to determine how
Based on this vision, we introduce the concept of [application name] can motivate you to execute all operations
‘supercoaches’ - as an anthropomorphism for gamification and continue to perform them accurately. Over the next two
mechanics - who aim to motivate users when they experience hours, we will brainstorm on this topic using a specific method.
Imagine there is a supercoach at your disposal, an all-knowing,
omnipotent supercoach who can always motivate you at the
right time and who knows perfectly what to say and what to do.
This supercoach wants to make it easier for you to perform
your actions.
Potential Issues
Time: 15 minutes (5 minutes writing, 10 minutes discussion)
Setup and Explanation: Provide sample cards (see
Figure 1A) participants can use to list potential issues they
experienced.
You might already know [application name], so you might
be familiar with the actions you need to do. In this first
step, we want to determine a list of issues where you have
difficulties with or where you want more information on.
Possible questions are:
• Which actions do you find confusing?
• Which actions do you forget to apply?
• Which actions do you not understand?
• Which actions do you find annoying?
• Which actions have you already deliberately skipped?
We would like you to describe and explain this in a short
sentence. Also try to provide additional information, where,
when, with who, and why? So please do not just write “blood
pressure” but elaborate: “when I come home and want to feed
the dog, I find it hard to measure my blood pressure slowly.”
Examples:
• Yesterday, I forgot to measure my blood pressure. This
often happens when I have to work late.
• It is boring to measure my oxygen. Why does it take so
long before I can expel the SpO2 meter?
• I always forget what time I should measure my blood
pressure again.
Supercoaches
Time: 20 minutes (10 minutes writing, 10 minutes discussion)
Setup and Explanation: Attach a supercoach (see Figure 1B)
to an issue listed in the previous step.
Now choose a supercoach, and think how this supercoach
could coach and motivate you? What could this supercoach
say to you? What could the supercoach do for you? Why
would this help you? How would this motivate you? You can
now take a supercoach and write how this supercoach could
coach and motivate you. When done, choose another issue.
Examples:
• Supercoach can explain that ‘97%’ represents an
approximation of the amount of oxygen in your blood. He
can also tell you that normal values fall between 95% and
100%.
• Supercoach can send you a message to measure your blood
pressure when you are behind the TV and are sitting still
anyway.
Figure 1. A card trail. The top card (A) is used to document an issue • Supercoach advises you not to watch the screen of the
a participant experienced. The middle card (B) is the supercoach who device anymore, so you do not focus on your heart rate.
can help the participant to overcome the issue. The last card (C) is an • Supercoach can show you a screen with the timings you
additional viewpoint from the other group. have measured your blood pressure.
Wrap-up
Time: 30 minutes (10 minutes dot-voting, 20 minutes
discussion)
Setup and Explanation: Dot-voting.
We now have many supercoaches full of comments and ideas.
In this final step, we will sort these supercoaches. Please look
at all the supercoaches and observe what has been written
down. Everyone gets five stickers that you can divide over
what you think is the most relevant issue and solution. You
also get one veto sticker for something you really do not want.
On a veto sticker, you will need to write your initials or name
so that we can ask you for more explanation. You will get ten
minutes to do this, after which we will discuss this further.
DISCUSSION ON USER TYPES
Although this proposed focus group protocol might help to
select an initial set of gamification mechanics, there is still
a need for added intelligence to adapt to user profiles [29].
Figure 2. A sample gamification mechanics card that participants can Moreover, there are contexts in which users may be less
choose. Text and icon from [17], leaderboard image from [5]. inclined or simply unable to follow up on certain gamification
mechanics. It simply might not be the right place or time to
follow up on a challenge or start a competition.
Switch roles There are multiple frameworks available that help to determine
Time: 15 minutes (5 minutes writing, 10 minutes discussion) the users’ type [3, 14, 24]. A well-known example is the
Setup and Explanation: Ask feedback (see Figure 1C) on Hexad framework [15] of which Tondello et al. [30] “created
the supercoach from the other group (patients vs. caregivers). a 24-items survey response scale to score users’ preferences
We are now going to split the caregivers and patients towards the six different motivations in the Hexad framework.”.
temporarily into two groups. We ask to give the supercoaches Marczewski [15] suggests different game mechanics that
to the other group so that you continue working on the may support different user types. Orji et al. [20] “reveal
other group’s supercoaches. Take a card and think how the that people’s personality traits play a significant role in the
supercoach’s response might look like for you. When, how perceived persuasiveness of different strategies.”
and in what situation would you expect an answer? Is there
anyone with you? Attach this new card to the supercoach. A potential extension to our protocol is to measure the
Examples: participants personality. Participants might be asked to
complete a short Big Five test [23]. In the focus group, this test
• A video can be too stimulating and affect the results. could be a survey. However, in the eventual implementation
• Beware of the nocebo effect by showing too much this could be automated. For example, by linking social media
information. profiles of the user [10].
Gamification Mechanics CONCLUSION AND FUTURE WORK
Time: 30 minutes (12 minutes explanation of gamification In this position paper, we proposed a protocol that can
mechanics, 11 minutes writing, 7 minutes discussion) be used to select suitable gamification mechanics in an
Setup and Explanation: Introduce the gamification eHealth context. We make use of the tendency of people
mechanics and allow participants to choose a gamification to anthropomorphize technology, which makes it easier for
mechanic to attach to the card trail (as shown in Figure 1). participants to brainstorm on issues and, more importantly,
We are now moving to the penultimate phase. We will show on motivational design techniques such as gamification
you some mechanics that might motivate [application name] mechanics.
users. We are asking you to take some of these cards with
proposals and then paste them on the card trail. We are scheduling multiple focus groups with pain patients
Examples: who are asked to use a telemonitoring platform for 10 weeks
after their operation. Although we focus on telemonitoring
• Earn a badge when you go to sleep on time. actions in our work, we do see an added value of our work for
• Earn experience points when you measure your blood the related well-being and flourishing domains. For example, it
pressure at a certain time. might be hard for people to report on gamification mechanics
• Show a leaderboard that shows how many users recorded that might motivate them to become more autonomous or
their measurements correctly this week. pursue additional personal growth. However, using this
• Show a visualization that shows how well you are doing. proposed ‘supercoach’ protocol, participants do not need to be
• Provide a clear goal in which you try to use the activity aware of these gamification mechanics before they can start
trackers at least during the weekdays. the discussion.
ACKNOWLEDGMENTS International Conference on System Sciences.
We would first like to acknowledge Marczewski as this work 3025–3034.
depends heavily on his gamification inspiration cards [16]. We
13. Daniel Johnson, Sebastian Deterding, Kerri-Ann Kuhn,
would also like to thank the project partners and medical staff
Aleksandra Staneva, Stoyan Stoyanov, and Leanne Hides.
from the pain center who provided feedback on this proposed
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