SuperBetter gets highest score among physical activity game apps for including proven health behavior theory practices

From left: Zombies, Run! 5K, SuperBetter, and Yoga Retreat were three of the apps/serious games assessed for health behavior theory (HBT) practices.

SuperBetter builds resilience to overcome tough situations and achieve goals that matter most. While best known for benefits related to mental health and recovery, one of the top 5 reasons for playing SuperBetter is to achieve epic wins related to working out or getting fit. 

In this study that analyzed and rated 52 exercise and physical activity games and apps for the inclusion of health behavior theory (HBT) principles, SuperBetter received the highest score by far, 76 out of a maximum score of 100. The average score across all apps included in the study was 14.98 out of 100. The study was published in the journal JMIR Serious Games.  

Screen capture of GPS Invaders (via JMIR Serious Games, 13 July 2015, Vol.3[2] )

Health behavior theory (HBT) refers to theories and research about the factors that influence people’s health-related behavior—essentially, why they do (or do not) engage in behaviors that are good for their health and, conversely, why they may engage in behavior that is detrimental to their health. Health behavior theories also seek to understand the factors that can lead people to change their health-related behaviors in positive ways (quitting smoking, eating more vegetables, getting more exercise, etc.). 

According to the authors of the study, they focused on physical activity game apps for two reasons: (1) physical activity is an important but neglected health behavior, and (2) the use of smartphone apps in physical activity interventions is a growing area of interest in health research. 

The researchers started by screening a pool of 500 popular apps and games found on the Apple App Store that were related to physical activity and exercise and that were either games or apps with game-like elements. They eventually narrowed the pool down to 52 apps that met their criteria for what they considered a “serious game” or an app with game-like aspects intended to promote physical activity. The term serious games refers to games or apps with game-like elements that are designed for primary purposes other than entertainment such as health, training, and education.   

The apps were then analyzed to see how much their content included components of health behavior theory such as goal setting, self-monitoring, self-rewarding, self-efficacy, and overcoming barriers. Finally, each app was given a score based on a number of parameters set by the researchers. Possible scores ranged from 0 to 100, with 100 being the highest possible score. As previously noted, the average score was 14.98.

(via JMIR Serious Games, 13 July 2015, Vol.3[2] )

However, SuperBetter was described by the study authors as the “outlier” with a “much higher HBT score than the sample average” (76 out of 100). The authors wrote:

“SuperBetter was unique in its heavy inclusion of educational elements, including individually tailored assistance; it required feedback on not only whether users completed each exercise, but also how well users completed each exercise, as well as tips for improvement. SuperBetter stands in stark contrast to physical activity app games focused more on entertainment with few educational elements, such as GPS Invaders.” 

The apps / serious games with the next highest scores were Yoga Retreat (37) and Zombies, Run! 5k (37). Interestingly, even though many of the apps’ health behavior theory scores in this study were low, they were higher on average than the HBT levels in health apps without any game elements that were analyzed in other studies (West et al., 2013; Breton et al., 2011). This suggests there may be aspects of games and apps with game-like mechanics that intrinsically apply HBT principles—such as goal setting and performance feedback—more than health apps that do not have game-like elements. The study authors propose that their research provides preliminary evidence to support this hypothesis.

Given that preexisting research shows that health interventions that integrate HBT are more effective at changing behavior than those that do not (Noar & Zimmermann, 2005; Glanz et al., 2008), the findings of this study are exciting and relevant. 

At SuperBetter, we’re proud that our app received what was by far the highest HBT score in this study, particularly considering the care taken to integrate the latest scientific research into its design. And we look forward to more research that yields additional insights into the ways that mobile technology and gameful design can unlock whole-person human potential and enhance the health, wellbeing and lives of people everywhere.  

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