Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications

Lorenzo J. James; Laura Genga; Raoul Nuijten; Barbara Montagne; Muriel M. Hagenaars; Pieter M.E. Van Gorp

doi:10.1007/978-3-031-85575-7_6

Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications

Lorenzo J. James^*, Laura Genga, Raoul Nuijten, Barbara Montagne, Muriel M. Hagenaars, Pieter M.E. Van Gorp

^*Corresponding author for this work

Eindhoven University of Technology

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution › Academic › peer-review

Abstract

Mobile health apps offer a promising approach to promoting holistic healthy behavior change, in the increasing shift toward preventive measures against lifestyle diseases. In this study, we explore the impact of level system structures on the engagement of participants in mHealth apps. Two level-system structures were designed to promote healthy behaviors across physical, mental, and social dimensions. The research used a mixed-method design consisting of a two-arm within-subject crossover experiment, surveys, and interviews. University students and staff members (n=73) were randomly assigned to receive goals in either a single-stream or multi-stream level structure. Participants given the multi-stream level structure were in multiple levels simultaneously, while the single-stream level structure contained one level at a time. The results showed that while participants preferred the multi-stream level structure, there was no significant difference in engagement between the two-level structures. The results also indicated that the preferred configuration of multi-stream level structures did not incentivize participants to engage in goals across all holistic health dimensions. Future research should explore alternative configurations of multi-stream level structures to increase participant engagement.

Original language	English
Title of host publication	Pervasive Computing Technologies for Healthcare - 18th EAI International Conference, PervasiveHealth 2024, Proceedings
Editors	Haridimos Kondylakis, Andreas Triantafyllidis
Publisher	Springer
Pages	104-120
Number of pages	17
ISBN (Electronic)	978-3-031-85575-7
ISBN (Print)	978-3-031-85574-0
DOIs	https://doi.org/10.1007/978-3-031-85575-7_6
Publication status	Published - 23 Apr 2025
Event	18th EAI International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2024 - Heraklion, Crete, Greece Duration: 17 Sept 2024 → 18 Sept 2024

Publication series

Name	Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, LNICST
Volume	612
ISSN (Print)	1867-8211
ISSN (Electronic)	1867-822X

Conference

Conference	18th EAI International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2024
Country/Territory	Greece
City	Heraklion, Crete
Period	17/09/24 → 18/09/24

Bibliographical note

Publisher Copyright:
© ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering 2025.

Keywords

gamification
health intervention
holistic health
level system
levels
mHealth
Non Communicable diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/978-3-031-85575-7_6

Cite this

James, L. J., Genga, L., Nuijten, R., Montagne, B., Hagenaars, M. M., & Van Gorp, P. M. E. (2025). Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications. In H. Kondylakis, & A. Triantafyllidis (Eds.), Pervasive Computing Technologies for Healthcare - 18th EAI International Conference, PervasiveHealth 2024, Proceedings (pp. 104-120). (Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, LNICST; Vol. 612). Springer. https://doi.org/10.1007/978-3-031-85575-7_6

James, Lorenzo J. ; Genga, Laura ; Nuijten, Raoul et al. / Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications. Pervasive Computing Technologies for Healthcare - 18th EAI International Conference, PervasiveHealth 2024, Proceedings. editor / Haridimos Kondylakis ; Andreas Triantafyllidis. Springer, 2025. pp. 104-120 (Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, LNICST).

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title = "Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications",

abstract = "Mobile health apps offer a promising approach to promoting holistic healthy behavior change, in the increasing shift toward preventive measures against lifestyle diseases. In this study, we explore the impact of level system structures on the engagement of participants in mHealth apps. Two level-system structures were designed to promote healthy behaviors across physical, mental, and social dimensions. The research used a mixed-method design consisting of a two-arm within-subject crossover experiment, surveys, and interviews. University students and staff members (n=73) were randomly assigned to receive goals in either a single-stream or multi-stream level structure. Participants given the multi-stream level structure were in multiple levels simultaneously, while the single-stream level structure contained one level at a time. The results showed that while participants preferred the multi-stream level structure, there was no significant difference in engagement between the two-level structures. The results also indicated that the preferred configuration of multi-stream level structures did not incentivize participants to engage in goals across all holistic health dimensions. Future research should explore alternative configurations of multi-stream level structures to increase participant engagement.",

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note = "Publisher Copyright: {\textcopyright} ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering 2025.; 18th EAI International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2024 ; Conference date: 17-09-2024 Through 18-09-2024",

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James, LJ, Genga, L, Nuijten, R, Montagne, B , Hagenaars, MM & Van Gorp, PME 2025, Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications. in H Kondylakis & A Triantafyllidis (eds), Pervasive Computing Technologies for Healthcare - 18th EAI International Conference, PervasiveHealth 2024, Proceedings. Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, LNICST, vol. 612, Springer, pp. 104-120, 18th EAI International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2024, Heraklion, Crete, Greece, 17/09/24. https://doi.org/10.1007/978-3-031-85575-7_6

Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications. / James, Lorenzo J.; Genga, Laura; Nuijten, Raoul et al.
Pervasive Computing Technologies for Healthcare - 18th EAI International Conference, PervasiveHealth 2024, Proceedings. ed. / Haridimos Kondylakis; Andreas Triantafyllidis. Springer, 2025. p. 104-120 (Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, LNICST; Vol. 612).

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution › Academic › peer-review

TY - GEN

T1 - Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications

AU - James, Lorenzo J.

AU - Genga, Laura

AU - Nuijten, Raoul

AU - Montagne, Barbara

AU - Hagenaars, Muriel M.

AU - Van Gorp, Pieter M.E.

N1 - Publisher Copyright: © ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering 2025.

PY - 2025/4/23

Y1 - 2025/4/23

N2 - Mobile health apps offer a promising approach to promoting holistic healthy behavior change, in the increasing shift toward preventive measures against lifestyle diseases. In this study, we explore the impact of level system structures on the engagement of participants in mHealth apps. Two level-system structures were designed to promote healthy behaviors across physical, mental, and social dimensions. The research used a mixed-method design consisting of a two-arm within-subject crossover experiment, surveys, and interviews. University students and staff members (n=73) were randomly assigned to receive goals in either a single-stream or multi-stream level structure. Participants given the multi-stream level structure were in multiple levels simultaneously, while the single-stream level structure contained one level at a time. The results showed that while participants preferred the multi-stream level structure, there was no significant difference in engagement between the two-level structures. The results also indicated that the preferred configuration of multi-stream level structures did not incentivize participants to engage in goals across all holistic health dimensions. Future research should explore alternative configurations of multi-stream level structures to increase participant engagement.

AB - Mobile health apps offer a promising approach to promoting holistic healthy behavior change, in the increasing shift toward preventive measures against lifestyle diseases. In this study, we explore the impact of level system structures on the engagement of participants in mHealth apps. Two level-system structures were designed to promote healthy behaviors across physical, mental, and social dimensions. The research used a mixed-method design consisting of a two-arm within-subject crossover experiment, surveys, and interviews. University students and staff members (n=73) were randomly assigned to receive goals in either a single-stream or multi-stream level structure. Participants given the multi-stream level structure were in multiple levels simultaneously, while the single-stream level structure contained one level at a time. The results showed that while participants preferred the multi-stream level structure, there was no significant difference in engagement between the two-level structures. The results also indicated that the preferred configuration of multi-stream level structures did not incentivize participants to engage in goals across all holistic health dimensions. Future research should explore alternative configurations of multi-stream level structures to increase participant engagement.

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KW - level system

KW - levels

KW - mHealth

KW - Non Communicable diseases

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James LJ, Genga L, Nuijten R, Montagne B , Hagenaars MM, Van Gorp PME. Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications. In Kondylakis H, Triantafyllidis A, editors, Pervasive Computing Technologies for Healthcare - 18th EAI International Conference, PervasiveHealth 2024, Proceedings. Springer. 2025. p. 104-120. (Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, LNICST). doi: 10.1007/978-3-031-85575-7_6

Evaluation of Level System Structures on the Engagement of Participants in mHealth Applications

Abstract

Publication series

Conference

Bibliographical note

Keywords

UN SDGs

Access to Document

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Cite this