If you try to bribe patients into better health with points and prizes, you will fail. Sustainable behaviour change requires Autonomous Motivation.
A fascinating new paper in JMIR Formative Research provides evidence for this view. The study is titled “Autonomous Motivation Trajectory Following Adoption of a Team-Based Gamification App Among Adults With Diabetes.” It shifts the conversation from counting steps to understanding why people take them.
As a consultancy that champions Self-Determination Theory (SDT), we analysed this paper through the lens of SDT to see what the healthcare industry can learn.
The Study: Building Habits
Researchers followed adults with Type 2 diabetes for one year. The participants used Minchalle, a habit-formation app. Unlike standard challenges that pit users against each other, this intervention placed participants into anonymous teams of five.
The rules were simple:
- Choose a health habit (e.g. walking, healthy eating).
- Post a photo of your habit daily.
- Encourage your teammates.
The study tracked Autonomous Motivation alongside weight and blood sugar. Over six months, the participants’ internal drive to manage their health increased. They also lost a significant amount of weight. The team dynamic kept users engaged in an industry where abandonment rates are usually high.
Why It Worked: The Gamification+ Critique
For gamification to last, it must satisfy three psychological needs: Autonomy, Competence, and Relatedness. This intervention succeeded in all three areas.
1. Relatedness drives the experience
Minchalle uses small, anonymous teams. This creates a safe space. Diabetes management often brings shame. Peer support helps bypass that shame. Users exercised because their team counted on them. Connection drove adherence.
2. Competence through “Micro-Wins”
The app requires photo proof. When a user snaps a picture of their salad or walking shoes, they bank a moment of mastery. The app reinforces this with stamps and coins. These rewards act as feedback, not bribes. They signal success and make users feel capable.
3. Autonomy creates ownership
The study showed a rise in Autonomous Motivation. Users stopped feeling “forced” to manage their diabetes and took ownership of the process. If your gamification strategy relies on external pressure, it will fail when the pressure stops. The approach used here fostered intrinsic motivation.
Spotlight on the Provider: A10 Lab and “Minchalle”
The app behind the study is Minchalle (Minna no Challenge – “Everyone’s Challenge”). It is a standout example of Japanese gamification design with over 500,000 downloads.
A10 Lab Inc. is a Sony spin-off based in Japan. Their name comes from the “A10 nerve,” or the mesolimbic dopamine system. This nerve regulates reward and emotion. Their mission connects neurology directly to UX design.
You can find the app on the Google Play Store. It features “Nyanchalle,” a cat character that guides the teams. This playful element softens the clinical nature of diabetes management.
What This Means For Your Program
If you run a health app or corporate wellness program, you can learn from this study.
- Stop using leaderboards. Competition alienates the people who need help. Use cooperative team goals instead.
- Keep teams small. Minchalle limits teams to five people. This ensures no one hides in the crowd. It fosters genuine Relatedness.
- Measure motivation. Track how people feel about their habits. Motivation must shift to Autonomous for long-term success.
At Gamification+, we design systems that support autonomous motivation. Contact us if you want to create real behaviour change.