Investigating Avatar Customization as a Motivational Design Strategy for Improving Engagement with Technology-Enabled Services for Health

Technology-enabled services for physical and mental health are a promising approach to improve healthcare globally. Unfortunately, the largest barrier for effective technology-based treatment is participants' gradually fading engagement with effective novel training applications, such as exercise apps or online mental health training programs. Engaging users through design presents an elegant solution to the problem; however, research on technology-enabled services is primarily focused on the efficacy of novel interventions and not on improving adherence through engaging interaction design. As a result, motivational design strategies to improve engagement---both in the moment of use and over time---are underutilized. Drawing from game-design, I investigate avatar customization as a game-based motivational design strategy in four studies. In Study 1, I examine the effect of avatar customization on experience and behaviour in an infinite runner game. In Study 2, I induce different levels of motivation to research the effects of financial rewards on self-reported motivation and performance in a gamified training task over 11 days. In Study 3, I apply avatar customization to investigate the effects of attrition in an intervention context using a breathing exercise over three weeks. In Study 4, I investigate the immediate effects of avatar customization on the efficacy of an anxiety reducing attentional retraining task. My results show that avatar customization increases motivation over time and in the moment of use, suggesting that avatar customization is a viable strategy to address the engagement barrier that thwarts the efficacy of technology-enabled services for health

The Effects of an Erotic Video on Exercise

This study investigated how an erotic video affects submaximal and maximal exercise in heterosexual college-aged men. [This is an excerpt from the abstract. For the complete abstract, please see the document.

Virtual and live social facilitation while exergaming: Competitiveness moderates

This study evaluated the effects of virtual and live social facilitation on exercise behavior using a cybercycle, a virtual reality-enhanced stationary bike, with 3D scenery and interactive races. Research has shown that social presence can enhance performance (Zajonc, 1965). Research with the cybercycle found that more competitive participants increased exercise intensity with the introduction of a virtual competitor (Snyder et al., 2010). The current study extended the prior experimental design by comparing virtual with live social presence. After training to ride the cybercycle, female college students rode in the presence of a virtual rider and live rider (randomly ordered); a gender-matched confederate adjusted performance to keep the level of challenge in both conditions consistent. It was hypothesized that more competitive riders would exhibit greater exercise intensity (watts) in the virtual vs. live condition. Competitiveness, mood and exercise attitudes were measured. Results from 23 female participants indicate that competitiveness moderated exercise effort, such that more competitive riders rode more intensely in the presence of a virtual vs. live competitor (p=.04). Implications suggest that for more competitive persons, exercising with a live competitor yields greater exercise effort and may be recommended for maximizing the benefit of workouts

DESIGNING BETTER EXERGAMES: APPLICATION OF FLOW CONCEPTS AND THE FITT PRINCIPLE TO FULL BODY EXERTION VIDEO GAMES AND FLEXIBLE CHALLENGE SYSTEMS

Exercise video games have a recognized potential for widespread use as tools for effective exercise. Current exergames do not consistently strike a successful balance between the “fun gameplay” and “effective exercise” aspects of the ideal exergame. Our research into the design of better exergames applies existing gameflow research and established exercise guidelines, such as those published by the American College of Sports Medicine, to a collection of four custom exergames: Astrojumper, Washboard, Sweet Harvest and Legerdemain implement full-body motion mechanics that support different types of exercise, and vary in intended duration of play, game complexity, and level of physical challenge. Each game also implements a difficulty adjustment system that detects player performance from in-game data and dynamically adjusts game difficulty, in order to balance between a player’s fitness level and the physical challenge presented by the game. We have evaluated the games produced by our design approach through a series of user studies on players’ physiological and psychological responses to gameplay, finding that balance between challenge types (cognitive or physical) is an important consideration along with challenge-skill balance, and further, that game mechanics able to support creativity of movement are an effective means of bridging between gameplay and exercise in order to improve the player experience

Combatting digital addiction: Current approaches and future directions

In recent years, the notion of digital addiction has become popular. Calls for solutions to combat it, especially in adolescents, are on the rise. Whilst there remains debate on the status of this phenomenon as a diagnosable mental health condition; there is a need for prevention and intervention approaches that encourage individuals to have more control over their digital usage. This narrative review examines digital addiction countermeasures proposed in the last ten years. By countermeasures, we mean strategies and techniques for prevention, harm reduction, and intervention towards addictive digital behaviours. We include studies published in peer-reviewed journals between 2010 and 2021 and based on empirical evidence. In total, 87 studies were included in the review. The findings show that the main countermeasures could be grouped under four categories: psycho-social, software mediated, pharmacological, and combined. Overall, it has been shown that the proposed countermeasures were effective in reducing addictive digital use. However, a general statement on the efficacy of proposed countermeasures cannot be made due to inconsistent conceptualisation of digital addiction and methodological weaknesses. Accordingly, this review highlights issues that need to be addressed in future studies

The physical and cognitive benefits of casual exergame play

Exercise can provide both physical and cognitive benefits to overall health, including long-term and short-term effects on wellness. In order to get these benefits, it is recommended that people perform at least 30 minutes of moderate-intensity exercise a day; however, many people do not get the recommended amount of exercise per day, which can result in health problems such as obesity and chronic disease. In this thesis, we propose a new genre of games called casual exergames, which we define as exergames that are designed to motivate people to exercise in small chunks of time multiple times throughout the day. Casual exergames have three advantages. First, games have been shown to have a strong motivation pull to play (i.e., people enjoy playing games), and casual games – those designed to be played in small chunks of time – have seen huge market success. Thus, we feel that applying casual game design to exergames will provide players with an enjoyable experience while performing physical activity. Second, research supports the approach of breaking exercise into small chunks, as the physical benefits of three moderate-intensity short bouts of physical activity (each lasting about 10 minutes) are similar to those of one continuous 30-minute bout. Thus, there should be physical benefits of casual exergame play. Third, short bouts of exercise have been shown to yield acute cognitive benefits. Thus a well-designed casual exergame should also produce measurable benefits to cognition. Following this approach, we designed and implemented a causal exergame called GrabApple, using the Microsoft Kinect sensor to detect body movement. Through the evaluation of GrabApple (carried out in three research studies), we show that a well-designed casual exergame can: 1) yield physical activity levels (similar to exercise on a treadmill) that meet the guidelines for moderate-intensity physical activity; 2) produce significant acute benefits to cognition over playing a sedentary version of the game; and 3) be integrated into a school setting with the potential of helping kids achieve physical activity thresholds, while also helping them to refocus throughout the day. In general, our game may encourage adults and school-aged children to get the recommended levels of exercise throughout the day and also obtain the acute cognitive benefits provided by physical activity

Eye quietness and quiet eye in expert and novice golf performance: an electrooculographic analysis

Quiet eye (QE) is the final ocular fixation on the target of an action (e.g., the ball in golf putting). Camerabased eye-tracking studies have consistently found longer QE durations in experts than novices; however, mechanisms underlying QE are not known. To offer a new perspective we examined the feasibility of measuring the QE using electrooculography (EOG) and developed an index to assess ocular activity across time: eye quietness (EQ). Ten expert and ten novice golfers putted 60 balls to a 2.4 m distant hole. Horizontal EOG (2ms resolution) was recorded from two electrodes placed on the outer sides of the eyes. QE duration was measured using a EOG voltage threshold and comprised the sum of the pre-movement and post-movement initiation components. EQ was computed as the standard deviation of the EOG in 0.5 s bins from –4 to +2 s, relative to backswing initiation: lower values indicate less movement of the eyes, hence greater quietness. Finally, we measured club-ball address and swing durations. T-tests showed that total QE did not differ between groups (p = .31); however, experts had marginally shorter pre-movement QE (p = .08) and longer post-movement QE (p < .001) than novices. A group × time ANOVA revealed that experts had less EQ before backswing initiation and greater EQ after backswing initiation (p = .002). QE durations were inversely correlated with EQ from –1.5 to 1 s (rs = –.48 - –.90, ps = .03 - .001). Experts had longer swing durations than novices (p = .01) and, importantly, swing durations correlated positively with post-movement QE (r = .52, p = .02) and negatively with EQ from 0.5 to 1s (r = –.63, p = .003). This study demonstrates the feasibility of measuring ocular activity using EOG and validates EQ as an index of ocular activity. Its findings challenge the dominant perspective on QE and provide new evidence that expert-novice differences in ocular activity may reflect differences in the kinematics of how experts and novices execute skills

Mood Management and Video-Game Engagement: The Importance of User-Experience and Gender in Assessing the Psychological Effects of Video-Game Play

The overall purpose of this thesis was to investigate the psychological effects of video-game play. The two central goals were to (a) compare and contrast three classic media theories (Mood Management Theory, The Catharsis Hypothesis, and Excitation-Transfer Theory) as they apply to the effects of video-game play, and (b) investigate the importance of user-experience variables and gender in predicting psychological outcomes of play. In a two-group mixed experimental design, all participants underwent a frustration/stress mood-induction procedure before playing a violent or nonviolent video-game. Questionnaires were administered both pre- and post-play to assess affect, arousal, and dominance as well as the subjective game play experience. After playing the video-game, participants in both the violent and nonviolent game conditions reported a reduction in hostility, an improvement in affect, and an increase in arousal and dominance. Further, the self-reported user-experience variables (e.g., flow variables, performance, and enjoyment) accounted for more of the variance in post-play affect than did game content (violent vs. nonviolent). These findings demonstrate that both violent and nonviolent video-game play can lead to short-term psychological benefits as long as the player feels focused, competent, and positive about the game play experience