Mapping Mobile Health Gamification Interventions for Physical Activity to the Octalysis Framework: A Design-Oriented Systematic Review (Preprint)

BACKGROUND While research on using gamification interventions to promote physical activity (PA) is increasing, related reviews remain at the descriptive level of intervention effects and element usage, lacking a systematic analysis of motivational mechanisms. It is difficult to support a motivation-oriented intervention design, thereby limiting the potential of gamification in stimulating users’ intrinsic motivation and maintaining long-term behavior change. OBJECTIVE This systematic review aims to systematically identify and analyze the motivational mechanisms that promote PA in mobile health (mHealth) gamification interventions, and attempts to construct a structured design framework from a motivation-driven perspective to support more targeted intervention development. METHODS This study searches for English literature published between January 2010 and October 2024 in five databases: PubMed, Web of Science, Embase, Scopus, and SPORTDiscus (EBSCOhost). Original empirical studies assessing the impact of gamification interventions on PA were included. Two researchers independently conducted a mapping of motivational mechanisms for the gamification interventions included in the study according to the definitions of the eight core drives in the Octalysis framework. Subsequently, thematic analysis was used to code and cluster the mapping results, in order to extract representative types of gamification design and further analyze their adaptability within specific populations. RESULTS A total of 67 studies were included. Mapping the motivational mechanisms revealed that most interventions (53/67, 79.1%) activated two or three core drives, with Development and Accomplishment, Social Influence and Relatedness, and Loss and Avoidance being the most frequently triggered. Through coding and clustering the mapping results, we extracted 20 representative gamification design types. The preliminary adaptability analysis suggested that certain design types (such as the social support type and the level maintenance reward type) were more suitable for older adults or patients with chronic conditions, while others (such as the virtual mission type and the game progress-driven type) were better aligned with the preferences of children and adolescents who are more exploratory and drawn to immersive virtual contexts. CONCLUSIONS This study develops a three-dimensional design framework of “core drives-gamification design types-suitable populations,” which can offer theoretical references for future personalized and motivation-oriented gamification intervention designs. CLINICALTRIAL (registration number: CRD42025638455)