=Paper=
{{Paper
|id=Vol-2055/paper5
|storemode=property
|title=Using Technology to Boost Employee Wellbeing? How Gamification Can Help or Hinder Results
|pdfUrl=https://ceur-ws.org/Vol-2055/paper5.pdf
|volume=Vol-2055
|authors=Ekaterina Pogrebtsova,Gustavo F. Tondello,Hardy Premsukh,Lennart E. Nacke
|dblpUrl=https://dblp.org/rec/conf/chiplay/PogrebtsovaTPN17
}}
==Using Technology to Boost Employee Wellbeing? How Gamification Can Help or Hinder Results==
https://ceur-ws.org/Vol-2055/paper5.pdf
Using technology to boost employee wellbeing? How
gamification can help or hinder results
Ekaterina Pogrebtsova1, Gustavo F. Tondello2, Hardy Premsukh3, Lennart E. Nacke2
1
Department of Psychology, University of Guelph, ON, Canada
2
HCI Games Group, University of Waterloo, ON, Canada
3
FlourishiQ Inc., Waterloo, ON, Canada
epogrebt@uoguelph.ca, gustavo@tondello.com, hpremsukh@flourishiq.com, lennart.nacke@acm.org
ABSTRACT Positive psychology is the study of optimal human potential
Research can help improve the lives of employees by re- and wellbeing, or what is called flourishing in life [39].
vealing ways in which technology can be leveraged to pro- Many techniques from positive psychology—from showing
gress innovative, time and cost-effective ways to promote gratitude to practicing mindfulness meditations—are quick,
their wellbeing. However, even with the trends of building easy to learn, and can be self-practiced by employees [42].
“positive organizations” and promoting employees’ wellbe- Combining positive psychology with technology is advan-
ing using the latest technologies in today’s best companies tageous for health promotion because it can further help
worldwide, there has been a lack of rigorous research to with cost-effectiveness, accessibility, motivation, and cus-
provide solid evidence for these decisions. In this review, tomization for users as compared to in-person programs.
we present a call for future research to integrate and test
technologically facilitated positive psychology interven- Organizations worldwide have been investing increasing
tions with gamification elements to better understand how amounts of time and money into the latest wellbeing tech-
to minimize harm and promote user benefits. We review the nologies to promote their employees’ wellbeing and per-
current online positive psychology intervention research, formance [9,29]. For example, in 2015 alone, 580,000
which we argue provides a critical guide for the develop- companies in the United States implemented wellness pro-
ment of future wellbeing technology. We also explore how grams involving wearable health and wellbeing trackers for
gamification shows promise for promoting the benefits of employees [20]. Moreover, it is expected that organizations
positive psychology interventions (e.g., user enjoyment, will implement 13 million Workplace Self-tracking Tech-
autonomous motivation), as well as areas where gamifica- nologies (WSTT) between 2014–2019 [2]. However, there
tion can pose a threat to wellbeing. There may be a fine line is currently an absence of rigorous research to ground this
between harmful and helpful wellbeing solutions in our hype around WSTT in promoting positive employee and
connected and technologically driven world of work; re- organizational outcomes [30]. This trend towards wellbeing
search now needs to uncover where to draw that line. technology in organizations now requires evidence-based
guidance more than ever before. Despite evidence from
Author Keywords randomized controlled trials that online positive psychology
Wellbeing, positive psychology, positive organizations, interventions can be effective over and above controls, such
gamification. as with online mindfulness programs [10,23] and online
ACM Classification Keywords positive reflection journals and exercises [8,11], much more
J.4. Computer Applications: Social and Behavioral research is needed to explore how and why different types
Sciences—Psychology; K.4.3. Computers and Society: of technologies and software elements can help or hinder
Organizational Impacts. users’ long-term benefits [17].
INTRODUCTION One promising avenue for discovering and understanding
In the modern working world, employees face the burden of improved ways to deliver positive psychology interventions
“telepressures,” or the endless stream of emails, adapting to via technology is with the addition of gamification: the use
ever-changing technologies, and constant pressure to be of game design elements in non-game contexts [14]. Add-
available online [5]. However, if wisely applied, technology ing gameful elements to digital applications can help to
can instead be leveraged to facilitate employees’ wellbeing. increase users’ motivation and engagement with the system
This can be accomplished by using technology to apply a [19,38], but research in this area is still preliminary. There
range of feasible, evidence-based wellbeing interventions is promise that gameful applications may help motivate
from the burgeoning field of positive psychology [39]. users to adopt positive behaviour change that could benefit
their health and wellbeing [25]. Conversely, research also
suggests that certain aspects of gamification, in particular
extrinsic rewards, may inadvertently thwart motivation and
sustained improvements for positive behaviour change
Positive Gaming: Workshop on Gamification and Games for Wellbeing
A CHI PLAY ’17 Workshop [1,9]. In this review, we present a call for future research to
October 15, 2017, The Netherlands
© 2017 Copyright held by the authors/owners.
integrate and test technologically facilitated positive psy- week intervention, training was provided to employees on a
chology interventions with gamification elements to better number of core positive psychology topics taught one week
understand how to minimize harm and promote user bene- at a time: self-awareness, positive emotions, self-
fits. We begin by reviewing the current online positive psy- compassion, strengths, autonomy, meaning, positive rela-
chology intervention research to date, deducing key ele- tionships, and savouring positive moments [24]. Each week,
ments to help guide future technologies to promote employ- participants received a 9–10-minute introductory video on a
ee wellbeing. Further, we critique the preliminary research topic, as well as a 10-minute daily guided meditation and a
on gameful wellbeing technology. We end with implica- 2-minute daily experiential activity (e.g., expressing grati-
tions for future research and use of gameful wellbeing tech- tude or bringing loving kindness to daily interactions). Re-
nology in organizations. sults showed that intervention participants showed signifi-
cant increases in wellbeing indicators (e.g., self-
ONLINE POSITIVE PSYCHOLOGY INTERVENTIONS FOR
EMPLOYEE WELLBEING PROMOTION compassion, engagement, mindfulness, and positive rela-
Positive psychology interventions aim to teach positive tionships) and decreases in ill-being (e.g., stress and depres-
psychology activities, known as the “simple, intentional, sion) over time compared to the waitlist control, and these
and regular practices meant to mimic the myriad healthy effects held true one month later. Overall, it appears that
thoughts and behaviors associated with naturally happy grounding technology in positive psychology principles is a
people.” [28, p. 57]. Because these activities are simple, practical and evidence-based way to promote wellbeing in
cost-effective, and easy to learn, there has been an increase organizations.
in positive psychology interventions implemented with em- BEST PRACTICES LEARNED FROM ONLINE POSITIVE
ployees via technology, mainly in the form of websites and PSYCHOLOGY INTERVENTIONS AND BEYOND
mobile applications. These programs are broadly referred to Given the substantial meta-analytic evidence in support of
as Online Positive Psychology Interventions (OPPIs; [7]), OPPIs and related online wellbeing programs [18,42], the
and show benefits over and above control conditions, with question now becomes, which elements of OPPIs work best
some interventions finding effects comparable to traditional and why? Exemplary interventions and meta-analyses help
in-person wellbeing and stress-management programs [31]. uncover this question to show that certain core elements can
Overall, a large amount of randomized controlled trials improve the effectiveness of OPPIs: longer programs, fre-
have shown that OPPIs and related wellbeing promotion quent and varied practice, enjoyment and person-
online interventions are beneficial and produce small to intervention-fit, user-friendliness, and virtual support.
moderate effect sized improvements in wellbeing (for meta-
Longer interventions, frequent practice, and variety
analyses, see van Genugten et al. [18] and Sin and Lyubo- In general, longer interventions and more frequent practice
mirsky [42]). Many OPPIs have been tested with employees of OPPIs promote greater effectiveness. One study found
across various organizations and sectors, showing wide that although a 2-week gratitude “count your blessings”
promise for application outside of the lab. intervention practiced daily led to increases in positive af-
In a recent example of a brief OPPI with employees, Clauss fect, a longer 10-week version practiced on a weekly basis
et al. [11] randomly assigned 90 caregivers to a 5–10- led to psychological wellbeing improvements as well as
minute positive reflection intervention practiced on an iPad lowered physical health complaints [15]. In another inter-
for only 10 days, or a control exercise. The intervention was vention with over 3,000 participants using the “Live Hap-
simple; participants were guided to select a positive and py” mobile application providing a number of grounded
meaningful work-related event that took place that day, positive psychology exercises, the frequency of application
establish deep breathing and a mindful state, and reflect on usage was significantly related to increased mood over time
the meaningful and positive details of the event. The iPad [33].
sent a reminder to employees to practice the exercise every Of course, it should be noted that increasing the sheer fre-
day during a break. Results showed reductions in emotional quency of exercise practice can be futile or may even harm
exhaustion and fatigue in the intervention group, and in- user engagement. Another intervention randomly assigned
creased hope and optimism in employees who indicated participants to savour (i.e., think about positive aspects) of
they needed more recovery from work the most at baseline. one through 10 events from the day, generating 10 condi-
Similar effects have been found with a multitude of brief tions of varying savouring frequency. Unexpectedly, higher
online mindfulness training programs with employees. For frequency of events savoured did not have any effect on
example, Hülsheger et al. [23] found that compared to a decreasing negative affect [3]. This is why intervention
waitlist control, education and healthcare employees who variety, in addition to practice length and frequency, has
participated in a brief 2-week online mindfulness interven- been deemed necessary for OPPIs to be effective [28]. Ex-
tion showed significantly less emotional exhaustion and emplifying the importance of activity variety, the “Live
increased job satisfaction. Happy” mobile application intervention results also found
Not surprisingly, longer OPPIs tend to show more substan- that the number of different types of activities that partici-
tial results and involve training in a range of wellbeing pants engaged in was related to increased mood and happi-
skills via modules, videos, and guided exercises. In one 8- ness scores. This is in line with research from the broader
health promotion literature showing the important of varie- greater changes in subjective wellbeing over the course of
ty. For example, using a variety of physical activities [44] the week-long intervention (i.e., lower negative affect,
and positive thinking strategies in daily life [34] is associat- higher positive affect and life satisfaction) than the un-
ed with greater wellbeing and health. matched group with a medium-sized effect. Interestingly,
there were no differences in time spent practicing between
However, it should also be cautioned that other OPPI re-
the two groups, suggesting that differences in wellbeing
search has shown that increased options and variety may
were attributable specifically to the exercise enjoyment
actually overwhelm participants. Schueller and Parks [37]
factor. Therefore, over and above exercise practice, it ap-
witnessed this counter-effect when exploring empirically-
pears that user enjoyment is fundamental for users to reap
supported positive psychology exercises (e.g., gratitude,
the most benefits from their wellbeing technologies.
strengths, savouring) randomly assigned in toolkits of two,
four, or six exercises, or a control. Results showed no dif- User-friendliness and virtual support
ference between the 6-exercise condition and control, with Beyond creating enjoyable interventions that fit each user,
only the 2–4-exercise conditions showing improvements. developers of wellbeing technology should also remember
Overall, although further research is required to explore to make content easy, clear, and informative to ensure that
some of the mixed findings, most of the studies suggest that the most benefits are reaped. Although an absence of OPPIs
a moderate amount of exercise versatility can help reduce to date have examined the incremental benefits of user-
habituation and promote intervention benefits, in addition to friendly software and virtual social support, implications
longer-term and frequent practice. can be drawn from the multitude of interventions conducted
in the online health behaviour and clinical psychology liter-
Enjoyment and person-intervention fit
ature. One meta-analysis of 52 internet-based interventions
Another key insight from OPPI research is the importance
aimed at improving health behaviours found that interven-
of exercise enjoyment and person-activity fit [28]. In one
tions that were rated as more “efficient,” meaning that they
study, Schueller [36] found that users’ higher preference for
required less time to understand and were easier to use,
various positive activities, as indicated by enjoyment, per-
were more likely to produce behaviour change and benefits
ceived benefits, and perceived ease of exercise completion,
than interventions that were rated as less efficient [18]. An-
were related to greater use of these activities and subse-
other randomized controlled intervention for hepatitis pre-
quent improvements. Similar results were found in a study
vention examined how various website elements influence
of a mindfulness smartphone application—Headspace On-
outcomes. Results found that users visited more webpages,
The-Go’s “Take 10” program—in which participants prac-
spent more time on, and scored higher on a hepatitis
ticed 10 minutes of guided mindfulness exercises for 10
knowledge questionnaire after one week of using a “tun-
days and learned about the science behind mindfulness
neled” website with a pre-set flow of modules and infor-
[22]. Results showed that the “Take 10” program led to
mation as opposed to a “freedom-of-choice” version in
increases in positive affect and decreases in depressive
which participants freely explored all of the same infor-
symptomology in the intervention but not in a placebo con-
mation but on their own [12]. These findings solidify the
dition using a list-making mobile application. Importantly,
importance of putting substantial effort into user-friendly
ratings of task enjoyment were positively correlated with
and simple design of wellbeing technology. This is essential
the increases in positive affect in the intervention but not in
to help users learn materials easily on their own, given that
the placebo group.
most online wellbeing interventions do not involve any in-
Given the importance of enjoyment, how can technology person training.
appeal to users best when there are so many different posi-
Aside from making clear and concise materials to ensure
tive psychology exercises to choose from? One solution is
user-friendliness, an innovative way to help users learn is
to personalize an intervention to each user to promote per-
by providing options for virtual social support. A meta-
son-activity fit. Schueller [36] randomly assigned partici-
analysis of online mindfulness interventions found overall
pants to one of three empirically-supported positive psy-
larger effect sizes in improvements in interventions provid-
chology exercises administered online (i.e., active-
ing users with access to therapist guidance via telephone,
constructive responding, gratitude visit, and counting your
online chat, or email as compared to unguided interventions
blessings) and asked them to rate whether they liked the
[43].
exercise. In the second phase of the study, participants were
randomly assigned to either a “matched” or an “unmatched” Moreover, research suggests that automated support and
activity group. The matched activity group received a sec- reminders may be just as effective for health behaviour
ond exercise that was most likely to suit their preferences, change as support from a romantic partner. In a 10-day ran-
based on their feedback on the first exercise, whereas the domized controlled intervention, participants received in-
unmatched group received a randomly assigned second formation on physical health recommendations (i.e., to en-
exercise. Results showed that matched participants reported gage in 30 minutes of physical activity per day in at least
significantly greater enjoyment and perceived benefits with 10-minute intervals) along with either an automated daily
their “personalized” exercise compared to the unmatched text message reminder to engage in the activity, or the same
group. Moreover, matched participants showed a trend of daily reminder text message but received from their roman-
tic partners in a more personalized way [6]. Both messages iours, knowledge, and psychological wellbeing variables.
involved goal awareness, self-monitoring, and encouraged The two most common elements across the video games
self-regulation. Results found that in both conditions partic- were the use of a health-behaviour storyline and health-
ipants achieved their recommended amount of physical behaviour goal-setting. However, given the single-group
activity on 32% of the days as measured by a wearable ac- studies in this review, the added benefit of such game ele-
tivity tracker, as compared to only 21% of the days in a ments compared to controls or other game elements was not
control condition with the same health information but no clear.
text message reminders. Importantly, no significant differ-
Other studies show that users give positive feedback for
ences in physical activity were found between the automat-
wellbeing interventions incorporating gameful elements
ed text messages and the personalized text from a romantic
such as fun and engaging storylines, metaphors, and visu-
partner. Implications show that automated reminders may
als. One digital gameful application—“This Is Your Life!”
not actually be as much of a nuisance to participant as they
[26]—was aimed at teaching positive psychology exercises
may appear; in fact, they are a feasible and cost-effective
to primary school teachers. The users’ path towards optimal
strategy to help individuals engage in goal-oriented health
wellbeing was presented through a metaphor of an interac-
behaviours.
tive “flourishing journey” on a map with topics presented as
APPLYING GAMIFICATION TO POSITIVE PSYCHOLOGY different locations. Initial feedback data demonstrated that
PROGRAMS: HELPFUL OR HARMFUL? users found the application and the metaphor motivating for
Given what is known from the OPPI research to date—that promoting their wellbeing.
longer and more engaged practice, variety, enjoyment, user-
friendliness and virtual support are beneficial for improve- Some gameful technologies take the playful element even
ments—researchers can now examine ways to further pro- further and develop interventions involving a physical toy.
mote these helpful elements in new technologies. One in- In an innovative example, Roo et al. [35] designed a mixed-
novative way forward is with the application of gamifica- reality sandbox to train mindfulness meditation. The system
tion to OPPIs. Theory on gamification and emerging inter- featured a sandbox with real sand that users could play with
ventions suggest that adding playful or gameful 1 elements to express their feelings. Gathering information from the
such as fun rewards, stories, and interactive games has po- movements users created in the sandbox and their breathing
tential to increase intervention effectiveness [4,9]. Howev- patterns as tracked by physiological sensors, the system
er, most health-related gameful applications only focus on created a virtual world simulation with water, vegetation,
physical health, nutrition, or disease management [25]. An- and wildlife all seen through a virtual reality headset. The
other limitation is that unlike the OPPI literature, there are weather and water levels in this virtual world fluctuated in
fewer randomized controlled trials testing specific gamifi- sync with the users’ breathing. This generated a form of
cation elements, making implications for practice less clear biofeedback to help users enter a deep and meditative
with many questions left unanswered. Nevertheless, several breathing pattern. Although results are preliminary, an
notable wellbeing applications and technologies using gam- evaluation with 12 participants showed that most users en-
ification elements have been tested in recent years showing joyed the experience and felt that it could help them medi-
positive user feedback, high engagement, and some prelim- tate and reach a calm and mindful state. In a similar playful
inary wellbeing benefits [25]. light, Ludden and Meekhof [27] designed the “Break Trig-
ger”: a small lighting device for employees to use on their
Promoting user enjoyment with games, stories, and desks as a fun, playful reminder to take regular breaks. The
virtual worlds Break Trigger would slowly fade to dark at the end of every
One of the most fruitful uses for gamification in wellbeing hour to encourage users to get up and out of their desks for
technology is to increase user engagement and enjoyment a short respite every hour. Results showed that users of the
with stories, games, and other playful and gameful ele- Break Trigger scored higher on positive affect and motiva-
ments. Several such interventions have been tested. For tion and lower on negative affect and frustration after tak-
example, Baranowski et al. [4] found 27 studies involving ing a break. Overall, despite small sample sizes and mostly
video games aimed at promoting a variety of health behav- feedback-based findings, it appears that various playful and
iours, such as diet, exercise, and medication adherence. gameful technologies and programs can help bring users
Although large idiosyncrasies between the studies prevent- more enjoyment.
ed a meta-analysis, Baranowski et al. [4] did conclude that
the majority of studies showed pre-post increases in various How motivating is “winning” at wellbeing?
health-related outcomes, including change in health behav- Although there is much promise that incorporating more
play, games, and stories into wellbeing interventions can be
helpful and engaging for users, another element worth not-
1
In the context of gamification research, playful elements ing is the very purpose of many games: to win. Winning at
refer to unstructured, free-form activities, such as narra- games used for leisure is often seen as harmless and fun,
tives, comic visuals, or animations, whereas gameful ele- but does this hold true when a game aims to improve well-
ments refer to activities structured around goals and rules, being? This question seeps into a major topic of debate in
such as challenges, points, levels, and leaderboards. [14] the positive psychology and health behaviour change litera-
ture on motivation: how do we motivate users to gain sus- ercises, which showed improvements in users’ stress and
tainable benefits? The grounding theory behind much of life satisfaction after one month. However, when partici-
this research is Deci and Ryan’s [13] Self-Determination pants were asked their opinion on the possibility of future
Theory, which suggests that humans are more likely to en- iterations of the application including gamification elements
gage in, persist at, and develop positive physical and psy- such points, achievements, and rewards, feedback was not
chological health behaviours when they experience more supportive. Overall, participants felt these features would
autonomous and less controlled motivation. According to not fit well with the context of the application and would be
Deci and Ryan [13, p. 14], “Autonomous motivation in- detrimental to their autonomous motivation for self-
volves behaving with a full sense of volition and choice, improvement due to focus on external rewards. In another
whereas controlled motivation involves behaving with the study, Orji et al. [32] investigated participants’ preferences
experience of pressure and demand towards specific out- for different persuasive strategies frequently used in games
comes that comes from forces perceived to be external to and gameful applications for health behaviour change.
the self.” Research from positive psychology shows that While strategies such as competition and social comparison
users’ degree of autonomous motivation to engage in their were deemed motivational for some participants, others
assigned exercises leads to more frequent exercise practice reported that they would actually feel demotivated by these
and subsequently greater improvements in wellbeing out- elements, mentioning that they would feel stressed, dis-
comes [41]. The question for research now becomes, how couraged, and less self-confident in case of a lower perfor-
can we apply gameful design to wellbeing interventions to mance in comparison with their friends.
promote more autonomous, and less controlled motivation?
Outside of gamification research, studies in health behav-
Various elements of gameful design promote “winning,” iour change further caution against too much focus on ex-
such as badges and trophies for achievements, increasing ternal rewards and outcomes, which may thwart autono-
levels, and competitions against other players. A case can mous user motivation. Fishbach and Choi [16] examined
be made for or against these approaches in promoting au- how health behaviour change may be promoted with expe-
tonomous, controlled, or both forms of motivation for well- riential goal pursuit, defined as focusing on the activities of
being. On the one hand, these gameful elements can pro- the goal itself, as opposed to instrumental goal pursuit, in
mote users’ psychosocial needs deemed essential for pro- which the focus is on the outcome of the goal. Grounded in
moting autonomous motivation, according to Self- Self-Determination Theory [13], the researchers posited
Determination Theory [13]: (1) relatedness with other users that experiential goal pursuit would channel more autono-
(e.g., competing in a game for fun with a group of friends), mous motivation, whereas instrumental goal pursuit would
(2) competency (e.g., seeing one’s skill development pro- channel more controlled motivation. They conducted four
gress), and (3) autonomy (e.g., choosing which awards and experiments to show that across a wide range of wellbeing
levels to strive towards). However, these very same psycho- behaviours such as physical exercise, dental care, and prac-
social needs and subsequent autonomous motivation can ticing yoga, having participants think about instrumental
just as easily be thwarted with extrinsic gameful rewards, goals (e.g., to lose weight, to boost health) as compared to
such as those that breed continuous comparison with others, experiential goal pursuit (e.g., I will first stretch, then run
discouraging difficultly, unwanted pressure, a “gimmicky” on the treadmill) led to more negative experiences and low-
feel, or too much focus on the benefits of the health behav- er intentions to continue the health behaviour in the future.
iour instead of the actual process. Thus, while much more research with long-term outcomes,
randomized conditions, and wellbeing technology is re-
Unfortunately, there is an absence of rigorous research to
quired, caution against too much of a “winning” focus is
date examining how various forms of “winning” and re-
warranted.
wards in gameful technologies can help or hinder autono-
mous motivation and subsequent benefits. Given that tech- IMPLICATIONS FOR GAMEFUL POSITIVE
nology with gameful rewards may seem like a standard PSYCHOLOGY DESIGN AND FUTURE RESEARCH.
practice in the world of workplace technology (e.g., Fitbit 2, It is time for technology to be leveraged to improve the
MUSE3, and Headspace4 provide points, levels, prizes, etc. lives of employees. Research has recently begun to show
for users’ health improvements), it is surprising that so little that innovative, time and cost effective online positive psy-
research has actually examined the specific effects of these chology programs and gameful technologies can reduce
elements. Studies that have examined this area present a stress and promote employees’ well-being. In this paper, we
cautionary tale. For example, Ahtinen et al. [1] tested a summarized key insights from the online positive psychol-
mental wellness mobile application, grounded in acceptance ogy intervention literature to help guide future wellbeing
and commitment therapy [21] and guided mindfulness ex- technologies: longer program length, frequent practice, ac-
tivity variety, enjoyment and person-intervention fit, user
2 friendliness, and virtual support. We also reviewed the lit-
https://www.fitbit.com
erature on gamification in wellbeing technology to see how
3 gamification can promote the beneficial elements of posi-
http://www.choosemuse.com
4 tive psychology interventions. From the research to date, it
https://www.headspace.com
appears that new technologies with various gameful ele-
ments (e.g., stories, interactive games, virtual reality expe- rankings with other users, and making social comparisons
riences) show promise in increasing user enjoyment, en- across rankings in a virtual world promotes or hinders well-
gagement, and wellbeing. Some exemplary studies have being across various conditions and different types of users.
even integrated gameful technology with positive psychol-
Moreover, because Self-Determination Theory [13] is a
ogy exercises such as practicing mindfulness and savouring
guiding theory behind the design of many technologically
positive moments (e.g., [26,35]), showing positive user
facilitated health behaviour and positive psychology inter-
feedback. However, lack of placebo-controlled experimen-
ventions [9], the extent to which gameful technologies can
tation curtails us from claiming that gameful versions of
foster autonomous versus controlled motivation is a critical
wellbeing programs and technologies are necessarily better
question for future research. Future research should explore
or worth the investment in organizations.
if different types of virtual reward environments, such as
Thus, many questions are still left unanswered. Rigorously providing options and customization for rewards, or a more
evaluating gameful technology’s added benefit over and social “team” winning environment, can help mitigate
above current programs, potential burdens, and areas for against controlled motivation and promote users’ sense of
improvement is needed more than ever in our tech-driven autonomous motivation. In addition to answering these
world of work. Despite progress to show that gameful tech- questions with empirical evidence (such as measuring au-
nologies can be effective, researchers now need to test the tonomous motivation across different gameful conditions),
incremental benefits of various gamification elements in richer qualitative accounts of users’ intervention experienc-
randomized controlled trials aimed at promoting psycholog- es using interviews and focus groups can help tap into the
ical wellbeing. There has been an increase in the online more complex and nuanced ways that wellbeing technology
positive psychology intervention research showing that influences motivation, enjoyment, and benefits seen in real
various elements such as user choice and customized exer- life.
cises can provide incremental benefits over and above
Finally, how effective are technologies and gameful inter-
standard online interventions without these elements [7,36].
ventions in promoting wellbeing long-term? Findings from
The same level of methodological rigor would now be help-
online positive psychology literature show that users con-
ful to guide future gameful technology development by
tinue to see benefits up to six months after interventions end
better understanding which elements should be applied,
[40]. However, long-term study of most wellbeing technol-
when, and with whom.
ogies, particularly gameful technologies, is lacking. To pre-
Of course, there may be good reason for the lack of ran- vent the wellbeing technology trend from being cast as just
domized controlled trials in the wellbeing technology litera- a “quick fix,” future interventions are encouraged to ana-
ture; researchers face many challenges in conducting rigor- lyze cost-effectiveness and long-term sustainability in addi-
ous, long-term and large-scale interventions using new tion to pre-post effect sizes and immediate user feedback
technology, such as limited access to prototypes of the lat- [9]. In all, we encourage researchers to pursue these im-
est technology and the fact that technology may change portant questions on more nuanced and contextual aspects
before the study even concludes [29]. However, while it is of wellbeing technologies and how they affect employees’
understandable why the efficacy of each new mobile appli- lives. There may be a fine line between harmful and helpful
cation or technological breakthrough cannot be feasibly wellbeing solutions in our connected and technologically
tested with an experiment, there should be ample opportuni- driven world of work. If we do not discover where to draw
ty to conduct randomized controlled trials to test core gami- that line soon, the wellbeing technology craze may just as
fication elements and guiding theories that stay constant quickly fade from our workplaces.
even as technologies change. Thus, we encourage future
ACKNOWLEDGMENTS
researchers to rigorously test specific gamification princi- Author Pogrebtsova’s research is supported by the SSHRC
ples (e.g., rewards, points, social networks) with random- Joseph-Armand Bombardier CGS Doctoral Scholarship
ized trials to confirm whether they are truly beneficial over (767-2016-1727). Author Tondello’s research is supported
and above standard versions without these elements. by the CNPq, Brazil. This research was also partially fund-
One area in particular that requires more rigorous random- ed by SSHRC (895-2011-1014, IMMERSe), NSERC
ized trials is that of gameful rewards and the idea of “win- (RGPIN-418622-2012), CFI (35819), and Mitacs with
ning” at improving one’s wellbeing. This includes testing FlourishiQ Inc. (IT07255).
various elements such as badges, levels, and points, and
whether or not adding a social comparison element to these
rewards is helpful or harmful for promoting users’ autono-
mous motivation, engagement, and benefits. Previous ran- REFERENCES
domized controlled trials in OPPIs and other wellbeing 1. Aino Ahtinen, Elina Mattila, Pasi Välkkynen, et al.
technology studies showcase the added benefits of creating 2013. Mobile mental wellness training for stress
a social environment, such as in the form of virtual support management: Feasibility and design implications based
[43] and text message reminders [6]. However, it is still on a one-month field study. JMIR mHealth and
unknown the extent to which sharing one’s rewards and uHealth 1, 2: e11. http://doi.org/10.2196/mhealth.2596
2. Allied Business Research. 2013. Corporate Wellness is and reducing exhaustion through positive work
a 13 Million Unit Wearable Wireless Device reflection among caregivers. Journal of Occupational
Opportunity. ABI Research. Retrieved September 29, Health Psychology. http://doi.org/10.1037/ocp0000063
2017 from https://www.abiresearch.com/press/
corporate-wellness-is-a-13-million-unit-wearable-w/ 12. Rik Crutzen, Dianne Cyr, and Nanne K de Vries. 2012.
The role of user control in adherence to and knowledge
3. Štěpán Bahník, Marek Vranka, and Jana Dlouhác. gained from a website: randomized comparison
2015. X good things in life: Processing fluency effects between a tunneled version and a freedom-of-choice
in the “Three good things in life” exercise. Journal of version. Journal of Medical Internet Research 14, 2:
Research in Personality 55: 91–97. e45. http://doi.org/10.2196/jmir.1922
http://doi.org/10.1016/J.JRP.2015.02.005
13. Edward L. Deci and Richard M. Ryan. 2008.
4. Tom Baranowski, Richard Buday, Debbe I. Facilitating optimal motivation and psychological
Thompson, and Janice Baranowski. 2008. Playing for well-being across life’s domains. Canadian
Real. American Journal of Preventive Medicine 34, 1: Psychology/Psychologie Canadienne 49, 1: 14–23.
74–82.e10. http://doi.org/10.1037/0708-5591.49.1.14
http://doi.org/10.1016/j.amepre.2007.09.027
14. Sebastian Deterding, Dan Dixon, Rilla Khaled, and
5. Larissa K. Barber and Alecia M. Santuzzi. 2015. Lennart E Nacke. 2011. From Game Design Elements
Please respond ASAP: Workplace telepressure and to Gamefulness: Defining “Gamification.”
employee recovery. Journal of Occupational Health Proceedings of the 15th International Academic
Psychology 20, 2: 172–189. MindTrek Conference, ACM, 9–15.
http://doi.org/10.1037/a0038278 http://doi.org/10.1145/2181037.2181040
6. Corina Berli, Gertraud Stadler, Jennifer Inauen, and 15. Robert A. Emmons and Michael E. McCullough.
Urte Scholz. 2016. Action control in dyads: A 2003. Counting blessings versus burdens: An
randomized controlled trial to promote physical experimental investigation of gratitude and subjective
activity in everyday life. Social Science & Medicine well-being in daily life. Journal of Personality and
163: 89–97. Social Psychology 84, 2: 377–389.
http://doi.org/10.1016/j.socscimed.2016.07.003 http://doi.org/10.1037/0022-3514.84.2.377
7. Linda Bolier and Katherina Martin Abello. 2014. 16. Ayelet Fishbach and Jinhee Choi. 2012. When
Online Positive Psychological Interventions: State of thinking about goals undermines goal pursuit.
the Art and Future Directions. In The Wiley Blackwell Organizational Behavior and Human Decision
Handbook of Positive Psychological Interventions, Processes 118, 2: 99–107.
Acacia C. Parks and Stephen M. Schueller (eds.). John http://doi.org/10.1016/J.OBHDP.2012.02.003
Wiley & Sons, Chichester, UK, 286–309.
http://doi.org/10.1002/9781118315927.ch16 17. Caroline Free, Gemma Phillips, Leandro Galli, et al.
2013. The Effectiveness of Mobile-Health
8. Joyce E. Bono, Theresa M. Glomb, Winny Shen, Technology-Based Health Behaviour Change or
Eugene Kim, and Amanda J. Koch. 2013. Building Disease Management Interventions for Health Care
Positive Resources: Effects of Positive Events and Consumers: A Systematic Review. PLoS Medicine 10,
Positive Reflection on Work Stress and Health. 1: e1001362.
Academy of Management Journal 56, 6: 1601–1627. http://doi.org/10.1371/journal.pmed.1001362
http://doi.org/10.5465/amj.2011.0272
18. Lenneke van Genugten, Elise Dusseldorp, Thomas
9. Rafael A. Calvo and Dorian Peters. 2014. Positive Llewelyn Webb, and Pepijn van Empelen. 2016.
Computing: Technology for Wellbeing and Human Which Combinations of Techniques and Modes of
Potential. MIT Press. Delivery in Internet-Based Interventions Effectively
Change Health Behavior? A Meta-Analysis. Journal of
10. Kate Cavanagh, Clara Strauss, Lewis Forder, and Medical Internet Research 18, 6: e155.
Fergal Jones. 2014. Can mindfulness and acceptance http://doi.org/10.2196/jmir.4218
be learnt by self-help?: A systematic review and meta-
analysis of mindfulness and acceptance-based self-help 19. Juho Hamari, Jonna Koivisto, and Harri Sarsa. 2014.
interventions. Clinical Psychology Review 34, 2: 118– Does gamification work? - A literature review of
129. http://doi.org/10.1016/J.CPR.2014.01.001 empirical studies on gamification. Proceedings of the
Annual Hawaii International Conference on System
11. Elisa Clauss, Annekatrin Hoppe, Deirdre O’Shea, M. Sciences (HICSS), 3025–3034.
Gloria González Morales, Anna Steidle, and http://doi.org/10.1109/HICSS.2014.377
Alexandra Michel. 2016. Promoting personal resources
20. Matt Hamblen. 2015. Wearables for workplace science-based innovations to transform practice.
wellness face federal scrutiny. ComputerWorld. Oxford University Press.
Retrieved September 29, 2017 from
https://www.computerworld.com/article/2937721/wear 30. Phoebe Moore and Lukasz Piwek. 2017. Regulating
ables/wearables-for-workplace-wellness-face-federal- wellbeing in the brave new quantified workplace.
scrutiny.html Employee Relations 39, 3: 308–316.
http://doi.org/10.1108/ER-06-2016-0126
21. Steven C. Hayes, Jason B. Luoma, Frank W. Bond,
Akihiko Masuda, and Jason Lillis. 2006. Acceptance 31. Thomas J. Morledge, Didier Allexandre, Emily Fox, et
and Commitment Therapy: Model, processes and al. 2013. Feasibility of an Online Mindfulness
outcomes. Behaviour Research and Therapy 44, 1: Program for Stress Management—A Randomized,
1–25. http://doi.org/10.1016/J.BRAT.2005.06.006 Controlled Trial. Annals of Behavioral Medicine 46, 2:
137–148. http://doi.org/10.1007/s12160-013-9490-x
22. Annika Howells, Itai Ivtzan, and Francisco Jose Eiroa-
Orosa. 2016. Putting the “app” in Happiness: A 32. Rita Orji, Lennart E. Nacke, and Chrysanne DiMarco.
Randomised Controlled Trial of a Smartphone-Based 2017. Towards Personality-driven Persuasive Health
Mindfulness Intervention to Enhance Wellbeing. Games and Gamified Systems. Proceedings of the
Journal of Happiness Studies 17, 1: 163–185. SIGCHI Conference on Human Factors in Computing
http://doi.org/10.1007/s10902-014-9589-1 Systems (CHI '17), ACM, 1015–1027.
http://doi.org/10.1145/3025453.3025577
23. Ute R. Hülsheger, Hugo J. E. M. Alberts, Alina
Feinholdt, and Jonas W. B. Lang. 2013. Benefits of 33. Acacia C. Parks, Matthew D. Della Porta, Russell S.
mindfulness at work: The role of mindfulness in Pierce, Ran Zilca, and Sonja Lyubomirsky. 2012.
emotion regulation, emotional exhaustion, and job Pursuing happiness in everyday life: The
satisfaction. Journal of Applied Psychology 98, 2: characteristics and behaviors of online happiness
310–325. http://doi.org/10.1037/a0031313 seekers. Emotion 12, 6: 1222–1234.
http://doi.org/10.1037/a0028587
24. Itai Ivtzan, Tarli Young, Janis Martman, et al. 2016.
Integrating Mindfulness into Positive Psychology: a 34. Jordi Quoidbach, Moïra Mikolajczak, and James J.
Randomised Controlled Trial of an Online Positive Gross. 2015. Positive interventions: An emotion
Mindfulness Program. Mindfulness 7, 6: 1396–1407. regulation perspective. Psychological Bulletin 141, 3:
http://doi.org/10.1007/s12671-016-0581-1 655–693. http://doi.org/10.1037/a0038648
25. Daniel Johnson, Sebastian Deterding, Kerri-Ann 35. Joan Sol Roo, Renaud Gervais, Jeremy Frey, and
Kuhn, Aleksandra Staneva, Stoyan Stoyanov, and Martin Hachet. 2017. Inner Garden: Connecting Inner
Leanne Hides. 2016. Gamification for health and States to a Mixed Reality Sandbox for Mindfulness.
wellbeing: A systematic review of the literature. Proceedings of the 2017 CHI Conference on Human
Internet Interventions 6: 89–106. Factors in Computing Systems (CHI ’17), ACM,
http://doi.org/10.1016/j.invent.2016.10.002 1459–1470. http://doi.org/10.1145/3025453.3025743
26. Geke D. S. Ludden, Saskia M. Kelders, and Bas H. J. 36. Stephen M. Schueller. 2011. To each his own well-
Snippert. 2014. “This Is Your Life!”: The Design of a being boosting intervention: using preference to guide
Positive Psychology Intervention Using Metaphor to selection. The Journal of Positive Psychology 6, 4:
Motivate. PERSUASIVE 2014: International 300–313.
Conference on Persuasive Technology, Springer, 179– http://doi.org/10.1080/17439760.2011.577092
190. http://doi.org/10.1007/978-3-319-07127-5_16
37. Stephen M Schueller and Acacia C Parks. 2012.
27. Geke D. S. Ludden and Linda Meekhof. 2016. Disseminating self-help: Positive psychology exercises
Slowing down: introducing calm persuasive in an online trial. Journal of Medical Internet Research
technology to increase wellbeing at work. Proceedings 14, 3: e63. http://doi.org/10.2196/jmir.1850
of the 28th Australian Conference on Computer-Human
Interaction (OzCHI ’16), ACM, 435–441. 38. Katie Seaborn and Deborah I. Fels. 2014. Gamification
http://doi.org/10.1145/3010915.3010938 in theory and action: A survey. International Journal
of Human-Computer Studies 74: 14–31.
28. Sonja Lyubomirsky and Kristin Layous. 2013. How http://doi.org/10.1016/j.ijhcs.2014.09.006
Do Simple Positive Activities Increase Well-Being?
Current Directions in Psychological Science 22, 1: 39. Martin E. P. Seligman and Mihaly Csikszentmihalyi.
57–62. http://doi.org/10.1177/0963721412469809 2000. Positive psychology: An introduction. American
Psychologist 55, 1: 5–14.
29. Lisa Marsch, Sarah Lord, and Jesse Dallery (eds.).
2014. Behavioral healthcare and technology: Using
40. Martin E. P. Seligman, Tracy A. Steen, Nansook Park, 43. M.P.J. Spijkerman, W.T.M. Pots, and E.T. Bohlmeijer.
and Christopher Peterson. 2005. Positive Psychology 2016. Effectiveness of online mindfulness-based
Progress: Empirical Validation of Interventions. interventions in improving mental health: A review
American Psychologist 60, 5: 410–421. and meta-analysis of randomised controlled trials.
Clinical Psychology Review 45: 102–114.
41. Kennon M. Sheldon and Sonja Lyubomirsky. 2006. http://doi.org/10.1016/J.CPR.2016.03.009
How to increase and sustain positive emotion: The
effects of expressing gratitude and visualizing best 44. Benjamin D. Sylvester, Martyn Standage, A. Justine
possible selves. The Journal of Positive Psychology 1, Dowd, Luc J. Martin, Shane N. Sweet, and Mark R.
2: 73–82. http://doi.org/10.1080/17439760500510676 Beauchamp. 2014. Perceived variety, psychological
needs satisfaction and exercise-related well-being.
42. Nancy L. Sin and Sonja Lyubomirsky. 2009. Psychology & Health 29, 9: 1044–1061.
Enhancing well-being and alleviating depressive http://doi.org/10.1080/08870446.2014.907900
symptoms with positive psychology interventions: a
practice-friendly meta-analysis. Journal of Clinical
Psychology 65, 5: 467–487.
http://doi.org/10.1002/jclp.20593