Background: The COVID-19 pandemic has significantly affected health care professionals, especially nurses, who have experienced elevated levels of stress, burnout, and physical health challenges. In the postpandemic era, supporting their well-being is crucial. Gamification, which is the application of game design elements in nongame contexts, has emerged as a promising strategy to promote engagement in health behaviors. This study explores the use of a gamified mobile app to support self-health management among nurses recovering from the COVID-19 experience.
Objective: This study aimed to evaluate the preliminary efficacy of a gamified mobile app for promoting self-health management among nurses who experienced the COVID-19 pandemic. The study examined whether gamification could enhance engagement, improve physical health outcomes, and encourage sustainable behavior change.
Methods: A single-arm pre-post intervention study was conducted using a user-centered design. The app was developed based on the Octalysis framework and goal-setting theory, incorporating personalized exercise prescriptions and health monitoring features. Nurses from a regional hospital in Hsinchu, Taiwan, participated in the 8-week intervention. Data were collected through interviews, pre- and postintervention surveys, and app usage analytics. Key outcomes included changes in step counts, BMI, and user engagement.
Results: After the intervention, BMI classification improved significantly. The proportion of participants classified as obese decreased from 38.5% (90/234) to 13.7% (32/234), and the proportion of those classified as overweight increased from 24.8% (58/234) to 34.6% (81/234). Overall, the combined proportion of overweight or obese participants declined from 63.2% (148/234) to 48.3% (113/234), and that of participants with normal BMI increased from 18.4% (43/234) to 33.8% (79/234) (χ24=29.98; P<.001). Octalysis tool results showed strong motivational engagement, with the highest scores in development and accomplishment (mean 7.29), epic meaning and calling (mean 7.05), and empowerment of creativity and feedback (mean 6.55).
Conclusions: The gamified mobile app demonstrated promising efficacy in enhancing self-health management among nurses in the post-COVID era by increasing physical activity and improving BMI. Gamification elements, such as achievement, purpose, and feedback, were effective in sustaining engagement. Further studies are recommended to assess long-term outcomes and broader applicability.
Keywords: behavioral intervention; digital health; exercise adherence; gamification; health care technology; health promotion; mobile health; nurse wellness; post-COVID; self-health management.
©Shao Huan Hsu, Li Jung Lu, Pei Chin Chou. Originally published in JMIR Serious Games (https://games.jmir.org), 03.07.2025.