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Effect and feasibility of gamification interventions for improving physical activity and health-related outcomes in cancer survivors: an early systematic review and meta-analysis

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Abstract

Background

Despite the well-documented advantages of regular physical activity (PA), patients with cancer show suboptimal participation. By using game design elements, gamification could be used to motivate individuals to engage in PA. It has been demonstrated that gamification interventions positively affect children, adolescents and older adults in health-related contexts. There are, however, inconsistent findings regarding the impact of gamification interventions on cancer survivors’ PA and health-related outcomes, according to the literature.

Objectives

The aim of this study is to examine the effectiveness and feasibility of gamification interventions for improving PA and health-related outcomes among cancer survivors.

Methods

A systematic review and meta-analysis were conducted following the Cochrane Handbook and PRISMA guidelines. Eight English databases and three Chinese databases were searched to identify eligible articles from inception to February 2022. Two reviewers independently performed the literature screening and data extraction. The Cochrane Risk of Bias tool was used to assess the risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) Working Group levels of evidence was used to evaluate the certainty of the findings.

Results

Ten randomised controlled trials (RCTs) published between 2014 and 2022 were included. The meta-analysis revealed no significant differences in the step counts and for moderate to vigorous PA, and the certainty of the findings was very low, according to GRADE. Meta-analysis for most outcomes could not be performed owing to the fewer included studies and significant heterogeneity. Most studies reported positive effects in improving moderate PA, sedentary behaviour, fatigue and at least one domain of quality of life. This review proved that gamified interactions are associated with low adverse event rates.

Conclusion

Gamification interventions could be a feasible way to promote the adoption of mobile health (mHealth) technology in patients with cancer. Individual studies have demonstrated some positive effects of gamification interventions on PA and health-related outcomes. However, limited studies, small sample sizes and methodological heterogeneity weaken the evidence. Larger, well-designed RCTs are required to confirm the impact of gamification interventions on PA and health-related outcomes in cancer survivors.

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Data availability

The data and materials that support the findings of this study are available from the corresponding author on reasonable request.

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Funding

This work was supported by Research Project Supported by Shanxi Scholarship Council of China (2020–086).

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Authors and Affiliations

  1. School of Nursing, Shanxi Medical University, 56 Xinjian South Road, TaiyuanShanxi Province, 030001, China

    Yan Ning, Zehuan Jia, Yongxia Ding, Qian Wang & Shifan Han

  2. Editorial Department, First Hospital of Shanxi Medical University, Taiyuan, 030001, China

    Ruifang Zhu

  3. Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, Taiyuan, 030001, China

    Yongxia Ding

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  1. Yan Ning
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Contributions

YN, ZH J, and SF H had the idea and design of the study. YN, ZH J, RF Z, and QW performed the literature search and data analysis. YN, ZH J, QW, and YX D drafted the manuscript. SF H, RF Z, and YX D revised the work review and improvement of the manuscript. All the authors have checked and approved the final manuscript.

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Correspondence to Shifan Han.

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Ning, Y., Jia, Z., Zhu, R. et al. Effect and feasibility of gamification interventions for improving physical activity and health-related outcomes in cancer survivors: an early systematic review and meta-analysis. Support Care Cancer 31, 92 (2023). https://doi.org/10.1007/s00520-022-07550-0

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