Abstract Background Anxiety-related symptoms are prevalent and can negatively affect concentration, motivation, and overall well-being. Traditional treatments such as cognitive behavioral therapy and medication work well for clinical anxiety disorders. However, individuals with anxiety often struggle with access, adherence, and staying engaged in treatment. Emerging technologies such as virtual reality (VR) and gamification offer new opportunities to enhance user engagement and motivational processes within digital mental health applications. Objective This study introduces Cleanify , a gamified VR cleaning simulation designed using the Octalysis framework and the persuasive system design model. The objective was to evaluate whether gamification elements improve user engagement, focus, and satisfaction compared to a nongamified version among individuals experiencing anxiety symptoms. We hypothesized that the gamified version would outperform the nongamified version in enhancing user engagement, immersion, and overall user experience. Methods A pilot experimental study was conducted with 50 participants aged 18 to 39 years recruited from the general population in northern Sweden. Participants were randomly assigned to either a gamified or nongamified version of the Cleanify VR application and completed a single 15-minute VR session using the Oculus Quest headset. Baseline anxiety symptoms were assessed using the Generalized Anxiety Disorder–7 scale for descriptive purposes only. Postintervention outcomes included focus and immersion measured using the Flow State Scale and user experience measured using the short version of the User Experience Questionnaire. Group differences were analyzed using 2-tailed independent-sample t tests. Results Participants using the gamified VR version demonstrated higher engagement and immersion than those using the nongamified version. The gamified group reached higher in-game levels overall, with a greater proportion of participants reaching level 3 (17/25, 68% vs 8/25, 32%), and reported higher recommendation scores (mean 4.20, SD 0.76 vs 3.36, SD 0.86). Significant group differences were observed for overall flow ( t 48 =3.87; P <.001), fluency ( t 48 =4.36; P <.001), and absorption ( t 48 =2.80; P =.008). User Experience Questionnaire results indicated higher pragmatic quality, hedonic quality, and overall user experience in the gamified condition. Conclusions Integrating gamification into a VR environment significantly enhanced user engagement, focus, and immersion in this pilot sample. These findings provide preliminary evidence that gamified VR design elements can positively influence user experience outcomes. Further research incorporating longitudinal designs and clinical outcome measures is needed to determine potential relevance.
Argaw et al. (Wed,) studied this question.
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