Developing and evaluating MindMax: promoting mental wellbeing through an Australian Football League-themed app incorporating applied games (including gamification), psychoeducation, and social connectedness

Gamification is increasingly being used as a behavioural change strategy to increase engagement with apps and technologies for mental health and wellbeing. While there is promising evidence supporting the effectiveness of individual gamification elements, there remains little evidence for its overall effectiveness. Furthermore, a lack of consistency in how ‘gamification’ and related terms (such as ‘applied games’, an umbrella term of which gamification is one type) are used has been observed within and across multiple academic fields. This contributes to the difficulty of studying gamification and decreases its accessibility to people unfamiliar with applied games. Finally, gamification has also been critiqued by both game developers and by academics for its reliance on extrinsic motivators and for the messages that gamified systems may unintentionally convey. In this context, the aims of this thesis were fourfold: 1) to iteratively co-design and develop a gamified app for mental health and wellbeing, 2) to evaluate the eventuating app, 3) to consolidate literature on gamification for mental health and wellbeing, and 4) to synthesise findings into practical guidelines for implementing gamification for mental health and wellbeing. Chapter 2 reports the first study which addresses the first aim of this thesis. Six participatory design workshops were conducted to support the development of MindMax, an Australian Football League (AFL)-themed mobile phone app aimed at AFL fans (particularly male ones) that incorporates applied games, psychoeducation, and social connectedness. Findings from these workshops were independently knowledge translated and fed back to the software development team, resulting in a MindMax prototype. This prototype was further tested with 15 one-on-one user experience testing interviews at three separate time points to iteratively refine MindMax’s design and delivery of its content. The findings of this study suggest that broadly, participants endorsed a customisable user experience with activities requiring active user participation. These specifications were reflected in the continual software updates made to MindMax. Chapters 3 and 4 report the second and third studies which address the second aim of this thesis. As regular content, performance, and aesthetic updates were applied to MindMax (following the model of the wider tech industry), a naturalistic longitudinal trial, described in Chapter 3, was deemed to be the most appropriate systematic evaluation method. In this study, participants (n=313) were given access to MindMax and asked to use it at their leisure, and surveys were sent out at multiple time points to assess their wellbeing, resilience, and help-seeking intentions. Increases in flourishing (60-day only), sense of connection to MindMax, and impersonal help-seeking intentions were observed over 30 and 60 days, suggesting that Internet-based interventions like MindMax can contribute to their users’ social connectedness and encourage their help-seeking. The third study, described in Chapter 4, reports a secondary analysis of data collected for Chapter 3, and further explores participants’ help-seeking intentions and their links to wellbeing, resilience, gender, and age. An explanatory factor analysis was conducted on Day 1 General Help-Seeking Questionnaire (GHSQ) data (n=530), with the best fitting solution resulting in three factors: personal sources, health professionals, and distal sources. In addition to providing more evidence that younger people aged 16–35 categorise apps and technologies for mental health and wellbeing like MindMax alongside other distal social sources such as phone helplines and work or school, our findings also suggest that the best way to target individuals who are least likely to seek help, particularly men, may be through these distal sources as well. Chapter 5 reports the fourth study, which addresses the third aim. In order to consolidate literature on gamification for mental health and wellbeing, this systematic review identified 70 papers that collectively reported on 50 apps and technologies for improving mental health and wellbeing. These papers were coded for gamification element, mental health and wellbeing domain, and researchers’ justification for applying gamification to improving mental health and wellbeing. This study resulted in two major findings: first, that the current application of gamification for mental health and wellbeing does not resemble the heavily critiqued mainstream application that relies on extrinsic motivators; and second, that many authors of the reviewed papers provided little or no justification for why they applied gamification to their mental health and wellbeing interventions. While the former finding is encouraging, the latter suggests that the gamification of mental health and wellbeing is not theory-driven, and is a cause for concern. Finally, to address the final aim of this thesis, all study learnings were synthesised into practical guidelines for implementing gamification for mental health and wellbeing. First, it is important to assess the suitability of implementing gamification into the intervention. Second, this implementation should ideally be integrated at a deeper, systemic level, with the explicitly qualified intention to support users, evidence-based processes, and user engagement with these processes. Third, it is important to assess the acceptability of this gamified intervention throughout its development, involving all relevant stakeholders (particularly representative end user populations). Fourth, it is important to evaluate the impact of this gamified intervention. Fifth, and finally, comprehensive and detailed documentation of this process should be provided at all stages of this process. This thesis contributes to a growing literature on the increasing importance and relevance of Internet-based resources and apps and technologies for mental health and wellbeing, particularly for young people. Given the dominance of games in society and culture across history, and the increasing contemporary prominence of digital games (also known as video games) in particular, gamification is uniquely positioned to have the potential to make large contributions to mental health and wellbeing research. In this context, this thesis contributes a systematically derived operationalisation of gamification, an evaluation of a gamified app for mental health and wellbeing, and best practice guidelines for implementing gamification for mental health and wellbeing, thereby providing frameworks that future implementations of gamified mental health and wellbeing interventions and initiatives may find useful

Superintelligence as a Cause or Cure for Risks of Astronomical Suffering

Discussions about the possible consequences of creating superintelligence have included the possibility of existential risk, often understood mainly as the risk of human extinction. We argue that suffering risks (s-risks) , where an adverse outcome would bring about severe suffering on an astronomical scale, are risks of a comparable severity and probability as risks of extinction. Preventing them is the common interest of many different value systems. Furthermore, we argue that in the same way as superintelligent AI both contributes to existential risk but can also help prevent it, superintelligent AI can both be a suffering risk or help avoid it. Some types of work aimed at making superintelligent AI safe will also help prevent suffering risks, and there may also be a class of safeguards for AI that helps specifically against s-risks

Gamification for Health and Wellbeing : A Systematic Review of the Literature

Background: Compared to traditional persuasive technology and health games, gamification is posited to offer several advantages for motivating behaviour change for health and well-being, and increasingly used. Yet little is known about its effectiveness. Aims: We aimed to assess the amount and quality of empirical support for the advantages and effectiveness of gamification applied to health and well-being. Methods: We identified seven potential advantages of gamification from existing research and conducted a systematic literature review of empirical studies on gamification for health and well-being, assessing quality of evidence, effect type, and application domain. Results: We identified 19 papers that report empirical evidence on the effect of gamification on health and well-being. 59% reported positive, 41% mixed effects, with mostly moderate or lower quality of evidence provided. Results were clear for health-related behaviors, but mixed for cognitive outcomes. Conclusions: The current state of evidence supports that gamification can have a positive impact in health and wellbeing, particularly for health behaviors. However several studies report mixed or neutral effect. Findings need to be interpreted with caution due to the relatively small number of studies and methodological limitations present in many studies (e.g., a lack of comparison of gamified interventions to non-gamified versions of the intervention)

Emerging technologies for learning in occupational safety and health: the experience of the videogame “Becoming safe”

[EN] In the paths for transversal skills and orientation (PCTO), italian students are considered like workers and therefore they must receive adequate information and training on occupational safety and health (OSH). These methods allow the students not to be excluded from the preventive measures of the health and safety at work by directing them towards self-protection.Today, this process can be supported through the use of digital tools such as videogames. The study describes a participative research and co-design work in 7 Italian high schools of agricultural, construction and manufacturing sectors, in order to co-create an educational tool (videogame) to promote OSH during the PCTO. The format could be a support for training and usable both in the classroom and in internship, according to the indications for the serious game’s design.The study applied qualitative and quantitative methods: survey (277 students), word cafés/focus groups (50 students), 10 semi-structured interviews and 3 WhatsApp groups (12 students) to facilitate the participation and the engagement of teachers, students and OSH experts. Learning by playing has always been an activity, technologies today make it easy and funny, while gaming can offer cognitive and operational elements suitable for recognizing and therefore preventing the occupational risks.Pietrafesa, E.; Bentivenga, R.; Stabile, S. (2021). Emerging technologies for learning in occupational safety and health: the experience of the videogame “Becoming safe”. En 7th International Conference on Higher Education Advances (HEAd'21). Editorial Universitat Politècnica de València. 1011-1018. https://doi.org/10.4995/HEAd21.2021.12936OCS1011101

East Midlands regional economic strategy 'creating a flourishing region together' - consultation document 2005.

This consultation document supports the development of the RES: A flourishing Region published in 2006

You Can\u27t Lose a Game If You Don\u27t Play the Game: Exploring the Ethics of Gamification in Education

Gamification has been hailed as a meaningful solution to the perennial challenge of sustaining student attention in class. It uses facets of gameplay in an educational context, including things such as points, leaderboards and badges. These are clearly efforts to make the student experience more entertaining and engaging, but nonetheless, they are also clearly digital nudges and attempts to change the students’ behaviours and attitudes to a specific set of concepts, and in which case they must, and should, be subject to the same ethical scrutiny as any other form of persuasion technique, as they may be unintentionally eroding the choices that students feel they have. This research therefore discusses some of the key ethical considerations and concerns associated with gamification, and presents a new framework that incorporates ethical tests into each stage of a pre-existing model of instructional design, that can be used when introducing gamification into an educational process

Non-Serious Serious Games

Serious games have been shown to promote behavioural change and impart skills to players, and non-serious games have proven to have numerous benefits. This paper argues that non-serious digital games played in a ‘clan’ or online community setting can lead to similar real world benefits to serious games. This paper reports the outcomes from an ethnographic study and the analysis of user generated data from an online gaming clan. The outcomes support previous research which shows that non-serious games can be a setting for improved social well-being, second language learning, and self-esteem/confidence building. In addition this paper presents the novel results that play within online game communities can impart benefits to players, such as treating a fear of public speaking. This paper ultimately argues that communities of Gamers impart ‘serious’ benefits to their members

More than Just a Game: Ethical Issues in Gamification

Gamification is the use of elements and techniques from video game design in non-game contexts. Amid the rapid growth of this practice, normative questions have been under-explored. The primary goal of this article is to develop a normatively sophisticated and descriptively rich account for appropriately addressing major ethical considerations associated with gamification. The framework suggests that practitioners and designers should be precautious about, primarily, but not limited to, whether or not their use of gamification practices: (1) takes unfair advantage of workers (e.g., exploitation); (2) infringes any involved workers’ or customers’ autonomy (e.g., manipulation); (3) intentionally or unintentionally harms workers and other involved parties; or (4) has a negative effect on the moral character of involved parties