The gamification of risk: how health apps foster self-confidence and why this is not enough

Weight loss apps enable users to quantify many aspects of food consumption, beginning with calories intake. Users of weight loss apps can also participate in online forums that act as digital self-help groups. These apps also include several features related to game playing or gamification such as avatars, points and virtual awards. Gamification has the aim of strengthening motivation to carry out a (boring) task. We downloaded the 20 most popular free weight loss apps in Google Play. We analysed app descriptions provided by developers, comments about the selected apps in online forums and user reviews. We focused on four of these apps, since they had some special functions. We found that users’ risk management was based on a mixed method that combined quantification and gamification, that is, rationality and emotions. Quantification, which includes self-tracking, data analysis and graphic layout, provides the ‘rational’ basis for dietary regimes, while gamification provides the emotional support needed to maintain motivation and continue with the diet. Our analysis provides support for the emotion–risk assemblage theory and the in-between strategy. Our analysis reinforces the importance of emotions in risk management. However, these dieting apps are based on a reductionist approach to obesity and weight loss, as obesity is framed as an individual problem, while weight loss is seen as dependent on individual motivation. Such framing tends to conceal the social determinant of health and the social and political causes of obesity.

[1]  Hermann Engesser,et al.  Reality broken? , 2012, Informatik-Spektrum.

[2]  Joy Hirsch.  Magnetic appeal: MRI and the myth of transparency , 2009 .

[3]  A social change model of the obesity epidemic , 2010 .

[4]  A. Mackenzie.  From Validating to Verifying: Public Appeals in Synthetic Biology , 2013 .

[5]  Deborah Lupton,et al.  'It's like having a physician in your pocket!' A critical analysis of self-diagnosis smartphone apps. , 2015, Social science & medicine.

[6]  Minna Ruckenstein,et al.  Visualized and Interacted Life: Personal Analytics and Engagements with Data Doubles , 2014 .

[7]  D. Lupton.  The digitally engaged patient: Self-monitoring and self-care in the digital health era , 2013 .

[8]  Deborah Lupton.  Quantified sex: a critical analysis of sexual and reproductive self-tracking using apps , 2015, Culture, health & sexuality.

[9]  Peter Conrad,et al.  The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders , 2007 .

[10]  Jennifer R. Whitson.  Gaming the Quantified Self , 2013 .

[11]  Deborah Lupton,et al.  Apps as Artefacts: Towards a Critical Perspective on Mobile Health and Medical Apps , 2014 .

[12]  Wanda Pratt,et al.  Understanding quantified-selfers' practices in collecting and exploring personal data , 2014, CHI.

[13]  P. Sztompka.  Trust: A Sociological Theory , 2000 .

[14]  M. Gail,et al.  Efficacy and Tolerability of Long-Acting Injectable Naltrexone for Alcohol Dependence: A Randomized Controlled Trial , 2005, Gynecologic oncology.

[15]  J. Habermas.  Theory of Communicative Action , 1981 .

[16]  A. Bryman.  The debate about quantitative and qualitative research: A question of method or epistemology? , 1984 .

[17]  Juliet B. Schor,et al.  Born to buy , 2005 .

[18]  Zachary H Morford,et al.  Gamification: The Intersection between Behavior Analysis and Game Design Technologies , 2014, The Behavior Analyst.

[19]  D. Lupton,et al.  The commodification of patient opinion: the digital patient experience economy in the age of big data. , 2014, Sociology of health & illness.

[20]  J. Morgan,et al.  A critical epistemology of analytical statistics: addressing the sceptical realist , 2005 .

[21]  R. Pease.  Magnetic appeal , 1988, Nature.

[22]  C. V. Ford,et al.  The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders , 2010 .

[23]  L. Toledo-Pereyra.  Trust , 2006, Mediation Behaviour.

[24]  Pedro Jacobetty,et al.  Digital sociology , 2016, New Media Soc..

[25]  Antonio Maturo.  Social Justice and Human Enhancement in Today’s Bionic Society , 2012 .

[26]  R. Wilkinson,et al.  The spirit level : why greater equality makes societies stronger , 2011 .

[27]  W. Velicer,et al.  The Transtheoretical Model of Health Behavior Change , 1997, American journal of health promotion : AJHP.

[28]  D. Secondulfo.  Born to buy. The socialization of young consumers , 2014 .

[29]  Csr Young,et al.  How to Do Things With Words , 2009 .

[30]  A. Maturo.  Network Governance as a Response to Risk Society Dilemmas: A Proposal from the Sociology of Health , 2004 .

[31]  Antonio Maturo,et al.  Fatism, Self-Monitoring and the Pursuit of Healthiness in the Time of Technological Solutionism , 2015 .

[32]  S. Hewa.  Medical technology: A pandora's box? , 1994, The Journal of medical humanities.

[33]  D. Lupton.  M-health and health promotion: The digital cyborg and surveillance society , 2012, Social Theory & Health.

[34]  L. Lunsky.  Childhood and Society. , 1965 .

[35]  D. Lupton,et al.  Risk and emotion: towards an alternative theoretical perspective , 2013 .

[36]  J. Zinn.  Heading into the unknown: Everyday strategies for managing risk and uncertainty , 2008 .

[37]  F. Setiffi.  Becoming Consumers: Socialization into the World of Goods , 2014 .

[38]  R. D'amico.  Discipline and Punish: The Birth of the Prison , 1978, Telos.

[39]  F. C. P. Motta.  The theory of communicative action , 1991 .

[40]  A. Petersen,et al.  Consumerism in health care. , 1976, The Investor-owned hospital review.

[41]  D. Lupton,et al.  Playing pregnancy: the ludification and gamification of expectant motherhood in Smartphone apps , 2015 .

[42]  Mitchell H Gail,et al.  Excess Deaths Associated With Underweight, Overweight, and Obesity: An Evaluation of Potential Bias. , 2005, Vital & health statistics. Series 3, Analytical and epidemiological studies.

[43]  William C. Cockerham,et al.  The Wiley Blackwell Encyclopedia of Health, Illness, Behavior and Society , 2014 .

[44]  Scott Nicholson,et al.  A RECIPE for Meaningful Gamification , 2015 .

[45]  M. van Manen,et al.  The Pedagogy of Momus Technologies: Facebook, Privacy, and Online Intimacy , 2010, Qualitative health research.

[46]  Roland Bal,et al.  Studying Design and Use of Healthcare Technologies in Interaction: The Social Learning Perspective in a Dutch Quality Improvement Collaborative Program , 2014 .

[47]  Evgeny V. Morozov,et al.  To Save Everything, Click Here: Technology, Solutionism and the Urge to Fix Problems that Don't Exist by E. Morozov, ed., , 2013, Inf. Polity.

[48]  Susan C. Herring,et al.  Web Content Analysis: Expanding the Paradigm , 2009 .

[49]  Mitchell L. Stevens,et al.  A Sociology of Quantification* , 2008, European Journal of Sociology.

[50]  M. Weber,et al.  The Protestant Ethic and the Spirit of Capitalism , 1937 .

[51]  E. Erikson.  Childhood and Society , 1965 .

[52]  Lucy Suchman,et al.  Practice and its Overflows: Reflections on Order and Mess , 2011 .

[53]  Bruce G. Link,et al.  Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications , 2010, Journal of health and social behavior.

[54]  Deborah Lupton,et al.  Digitizing diagnosis: a review of mobile applications in the diagnostic process , 2015, Diagnosis.

[55]  Robert Liebendorfer.  Mind, self and society , 1960 .

[56]  The Last Well Person: How to Stay Well Despite the Health-Care System , 2006 .

[57]  M. Foucault,et al.  Discipline and Punish: The Birth of the Prison. , 1978 .

[58]  Benjamin F. Hadis.  Risk, social protection and trust amidst cuts in welfare spending , 2014 .

[59]  Good Pharma: The Public-Health Model of the Mario Negri Institute , 2017 .