How Gamification and Social Support Drive Behavior Change in mHealth Apps
By: Kristen Metcalf, Ph.D.
Changing health behaviors—like becoming more physically active—is no easy feat. While motivation plays a key role, research shows that long-term success can be influenced by two powerful forces: gamification and social support.1,2,3 However, the research also shows that these elements are currently being under-utilized in mHealth apps. In the world of mHealth apps, these elements should not be considered just add-ons, rather they are essential features for sustainable (and enjoyable!) behavior change.
Gamification: Making Health Fun and Engaging
What is gamification anyway? Gamification brings game-like elements, such as competition, points, badges, leaderboards, and challenges, into mHealth apps to make physical activity more enjoyable and more motivating. Apps like Zombies, Run! turn a jog into a thrilling escape from virtual zombies. If the zombies are closing in, you’ve got to run faster! Other, less menacing apps, such as Strava use weekly challenges, competition and achievement badges to keep users engaged.
Why does this work? According to behavior change theories like Social Cognitive Theory and the Theory of Planned Behavior, people are more likely to stick with behaviors when they feel competent, receive positive reinforcement, and see others doing the same. Gamification taps into all of these by providing instant feedback and rewards, encouraging friendly competition, and creating a sense of progress and accomplishment—together.
Social media platforms can amplify gamification. Viral challenges like the Plank Challenge on TikTok or step-count competitions on Facebook have the ability to engage millions in collective movement, turning fitness into a shared, playful experience.
Social Support: The Secret Weapon for Long-Term Change
While gamification gets people started, social support helps them stay the course. mHealth a
pps increasingly integrate social features that foster connection, accountability, and encouragement. These features include emotional support—such as sending and receiving encouraging messages from friends or group members; informational support—sharing tips, workouts, or healthy recipes; instrumental support—offering tangible help (even virtually!), like coordinating workouts; and appraisal support—providing and receiving honest feedback and recognition of progress.
Apps like Strava and Nike Run Club allow users to join virtual communities, share milestones, and cheer each other on. These features not only boost motivation but also reduce feelings of isolation—which is especially important when the behavior change feels tough.
Community Engagement: Going Beyond the Individual
Social support doesn’t stop at one-on-one interactions. Community engagement—whether in-person or online—creates a collective environment that reinforces healthy behaviors. Programs like This Girl Can (https://www.thisgirlcan.co.uk/) in the UK use social media to build inclusive, empowering communities where users share stories, celebrate wins, and support each other’s journeys. The value of social support doesn’t end with large-scale community engagement programs. Even local walking groups or faith-based fitness initiatives can be enhanced with digital tools. For example, wearable-integrated apps can track group progress, while Facebook groups or Zoom workouts keep members connected and accountable.
Designing mHealth Apps That Work
While mHealth apps hold great promise for the health and wellness sector, not all are equally beneficial or engaging. To be truly effective, mHealth apps must be grounded in behavior change theory. Effective apps draw on theoretical constructs such as reciprocal determinism and self-efficacy from Social Cognitive Theory, or autonomy, competence, and relatedness from Self-Determination Theory. Building on a theoretical foundation ensures that every feature serves a purpose and supports users in reaching their goals.
Apps must also be personalized and adaptive. This means they should meet users’ needs and preferences, and evolve alongside changes in users’ health, fitness levels, and goals. Additionally, apps must be accessible and user-friendly—especially for individuals with limited digital literacy. If an app is difficult to use or navigate, users are likely to abandon it. Finally, mHealth apps must be engaging. Gamified features and social components can help sustain user interest and encourage continued use.
Importantly, these apps should not feel like “one more thing” to do. Instead, they should integrate seamlessly into daily life—offering support, encouragement, and a little fun along the way.
Final Thoughts
I’ll leave you with one final thought: behavior change is hard—but it doesn’t have to be lonely or boring. By combining the motivational power of gamification with the emotional and practical strength of social support, mHealth apps can help people not only begin their health journey but stick with it for the long haul.
As digital health technologies continue to evolve, the most successful interventions will be those that embrace a simple truth: we’re more likely to thrive when we’re supported—and when we’re enjoying the process.
Footnotes
1 Alzghoul B. The Effectiveness of Gamification in Changing Health-Related Behaviors: A Systematic Review and Meta-Analysis. Open Public Health Journal. 2024 Sep;17. (e18749445234806)
2 Edwards EA, Lumsden J, Rivas C, Edwards L, Caton H. ‘Gamification’ for Health Behavior Change in Smartphone Apps. Front Public Health. 2015 Sep;4.
3 Greaney ML, Puleo E, Sprunck-Harrild K, Haines J, Houghton SC, Emmons KM. Social Support for Changing Multiple Behaviors: Factors Associated with Seeking Support and the Impact of Offered Support. Health Educ Behav. 2018 Apr;45(2):198-206.