Gamification of eHealth Interventions to Increase User Engagement and Reduce Attrition

Approximately one in five people in the United States are affected by mental illness, with anxiety disorders being the most common. Barriers to treatment include limited access to trained professionals and high financial cost. eHealth applications are one alternative to treatment outside of a traditional clinical setting. Patients can readily access eHealth interventions on their own time via devices such as computers, tablets, and smartphones. Despite the scalability and accessibility of eHealth applications, their benefits are overshadowed by high attrition rates. MindTrails (MT), an existing eHealth platform, uses Cognitive Bias Modification (CBM) to treat anxiety through online interventions designed to change negative thinking patterns. The MindTrails program has the potential to treat a large population of anxious individuals. The objective of this work is to identify, analyze, and implement strategies to increase user engagement with MindTrails by exploring the integration of gamification/engagement strategies into the program. Our design for increasing engagement focuses on the Doherty Web Strategies, incorporating interactive, personal, supportive, and social elements. Using this new design, users will be able to set personalized goals that are clear, actionable, and reasonably challenging. To meet our objective, we developed high fidelity wireframes and prototypes, with the intent of utilizing user studies to evaluate the efficacy in MindTrails. Results of user tests are hypothesized to show the effectiveness of a personalized gamification feature in increasing user engagement while simultaneously reducing attrition. The improved design will be included in the next launch of the MindTrails program and demonstrates progress toward increasing the effectiveness of CBM treatment in eHealth applications.