Investigating behavior change indicators and cognitive measures in persuasive health games

Most outcome-driven studies designed to evaluate health games or Apps either target usability factors, or are merely measure healthbased outcomes in the short-term. Invariably, thus, evaluative studies remain limited in revealing factors affecting long-term behavior change. In this paper, we tackle this issue through adopting a comprehensive approach to investigate the effect of a health game in a 3-month longitudinal study. Using generalized multilevel linear models of outcome changes in BMI, engagement with the game and participants’ cognitive precursors after playing the game we found that in-game factors (e.g. certain social activities) were strong predictors for a forward momentum in participants’ motivation to change behavior related to physical activity and nutrition. We also found regularity in gameplay to be strong a predictor for BMI changes. This paper contributes (a) these results to further advance the design of games for health and health apps, and (b) presents an evaluation method to advance empirical approaches for assessing health benefits from using games and health apps.