Flow and Grit by Design: Exploring Gamification in Facilitating Adherence to Swallowing Therapy Purpose Delivery of swallowing therapy is faced with challenges regarding access to in-clinic services and adherence to prescribed home programs. Mobile health (mHealth) technologies are being developed at a rapid pace to address these difficulties. Whereas some benefits to using these modern tools for therapy are obvious (e.g., electronic reminders), ... Viewpoint
Viewpoint  |   November 08, 2017
Flow and Grit by Design: Exploring Gamification in Facilitating Adherence to Swallowing Therapy
 
Author Affiliations & Notes
  • Gabriela Constantinescu
    Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
    Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
  • Jana Rieger
    Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
    Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
  • Kerry Mummery
    Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
  • William Hodgetts
    Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
    Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to William Hodgetts: bill.hodgetts@ualberta.ca
  • Editor-in-Chief: Krista Wilkinson
    Editor-in-Chief: Krista Wilkinson×
  • Editor: Julie Barkmeier-Kraemer
    Editor: Julie Barkmeier-Kraemer×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Viewpoint
Viewpoint   |   November 08, 2017
Flow and Grit by Design: Exploring Gamification in Facilitating Adherence to Swallowing Therapy
American Journal of Speech-Language Pathology, November 2017, Vol. 26, 1296-1303. doi:10.1044/2017_AJSLP-17-0040
History: Received April 3, 2017 , Revised June 16, 2017 , Accepted July 10, 2017
 
American Journal of Speech-Language Pathology, November 2017, Vol. 26, 1296-1303. doi:10.1044/2017_AJSLP-17-0040
History: Received April 3, 2017; Revised June 16, 2017; Accepted July 10, 2017

Purpose Delivery of swallowing therapy is faced with challenges regarding access to in-clinic services and adherence to prescribed home programs. Mobile health (mHealth) technologies are being developed at a rapid pace to address these difficulties. Whereas some benefits to using these modern tools for therapy are obvious (e.g., electronic reminders), other advantages are not as well understood. One example is the potential for mHealth devices and apps to enhance adherence to treatment regimens.

Method This article introduces a number of psychological concepts that relate to adherence and that can be leveraged by mHealth. Elements that contribute to flow (optimal experience) during an activity and those that reinforce grit (perseverance to achieve a long-term goal) can be used to engage patients in their own rehabilitation.

Results The experience of flow can be targeted by presenting the rehabilitation exercise as an optimally challenging game, one that offers a match between challenge and ability. Grit can be supported by reinforcing routine and by varying the therapy experience using different games.

Conclusions A combination of hardware and software design approaches have the potential to transform uninteresting and repetitive activities, such as those that make up swallowing therapy regimens, into engaging ones. The field of gamification, however, is still developing, and gamified mHealth apps will need to withstand scientific testing of their claims and demonstrate effectiveness in all phases of outcome research.

Acknowledgments
This work was supported by Alberta Innovates Clinician Fellowship. The authors would also like to thank Ashley McKillop for her thoughtful feedback on the ideas expressed in this article.
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