Serious Games and Gamification in Healthcare: A Meta-Review

A serious game is a type of game that is designed for a primary purpose other than entertainment. Instead, serious games are intended to achieve specific goals, such as education, training, or health promotion. The goal of serious games is to engage players in a way that is both enjoyable and effective in achieving the intended learning or behavior change outcomes. Recently, several systematic reviews on the development and application of serious games and on the application of gamification techniques have been published, which indicate high activity and ongoing progress in this area of research. Such an extensive body of review papers raises the need to analyze and extract the current state and the prevailing trends of the serious games and gamification (SGG) domain by analyzing and summarizing the systematic review articles. This study presents a systematic meta-review, i.e., a review of the 53 survey papers on the domain of serious games and gamification. The systematic review follows the PRISMA guidelines, while constructive and cross-sectional methods are used to analyze and present the results. Finally, this study identifies the future trends and challenges for the domain. As a result, the meta-review helps the reader to quickly assess the present status of SGG and serves as a reference for finding further information on each technology utilized in SGG. Using the criterion of the citations, the meta-review analysis provides insight into the quantity and academic relevance of the published SGG articles. Moreover, 53 articles published in journals were selected as important surveys in the research field. The study found that serious games and gamification techniques are increasingly being used for a wide range of health conditions and the focus is shifting towards the use of mobile and digital platforms, virtual reality, and machine learning to personalize and adapt interventions. The existing research gaps include the lack of standardization in development and evaluation, insufficient understanding of underlying mechanisms of action, limited understanding of integration into existing healthcare systems, limited understanding of specific game mechanics and design elements for promoting health behaviors, and limited research on scalability, adoption, and long-term effects. These research gaps highlight the need for further research to fully understand the potential and limitations of serious games and gamification for health and how to effectively apply them.