Gamification in Child and Adolescent Health: Trends, Applications, and Policy Relevance for Mental Well-Being, Physical Activity, and Nutrition

Ahmed S.  Alamer

doi:10.6000/1929-4247.2025.14.03.7

Authors

Ahmed S. Alamer Health Education and Promotion Unit, Department of Public, College of Nursing and Health Scienced, Jazan University, Jazan, Saudi Arabia

DOI:

https://doi.org/10.6000/1929-4247.2025.14.03.7

Keywords:

Gamification, Mental health, Bibliometrics, Science mapping, ADHD

Abstract

Aim: This study presents a bibliometric analysis of the use of gamification in mental health research (GMHR), aiming to provide a comprehensive quantitative evaluation of publication trends, key contributors, collaboration networks, thematic development, and emerging research themes in this field.

Methods: Relevant literature was retrieved from the Scopus database and analyzed using bibliometric tools, including VOSviewer and RStudio. The analysis focused on identifying publication outputs, author collaborations, co-word networks, and thematic evolution from 2013 to 2024.

Results: A total of 276 documents were identified, with an annual growth rate of 32.98%. The average number of co-authors per document was 4.99, indicating robust collaborative activity, including international partnerships. Leading contributors included Cheng VWS, Hickie IB, and Fleisch E, who are affiliated with prominent research institutions. Key research themes included gamification, mHealth, anxiety, and ADHD. The findings revealed a dynamic and expanding field responding to contemporary societal mental health needs.

Conclusion: Gamification is increasingly being integrated into mental health interventions, showing promise in addressing psychological well-being, particularly among children, adolescents, and individuals with ADHD. Interventions utilizing serious games and mobile health apps have been shown to enhance user engagement, adherence, and cognitive outcomes, especially when targeting anxiety and attention disorders. Empirical studies within the most cited GMHR publications demonstrate effectiveness in areas such as cognitive-behavioral therapy (CBT) delivery, biofeedback-based regulation, and emotion recognition training through game mechanics.

References

Dennis TA, O’Toole LJ. Mental health on the go: Effects of a gamified attention-bias modification mobile application in trait-anxious adults. Clinical Psychological Science 2014; 2: 576-590. DOI: https://doi.org/10.1177/2167702614522228

Cheng VWS, Davenport T, Johnson D, Vella K, Mitchell J, Hickie IB. Naturalistic evaluation of a sport-themed mental health and well-being app aimed at men (MindMax), that incorporates applied video games and gamification. Internet Interventions 2020; 20. DOI: https://doi.org/10.1016/j.invent.2020.100306

Sardi L, Idri A, Fernández-Alemán JL. A systematic review of gamification in e-Health. Journal of Biomedical Informatics 2017; 71: 31-48. DOI: https://doi.org/10.1016/j.jbi.2017.05.011

Fleming TM, de Beurs D, Khazaal Y, Gaggioli A, Riva G, Botella C, et al. Maximizing the impact of E-Therapy and Serious Gaming: Time for a paradigm shift. Frontiers in Psychiatry 2016; 7. DOI: https://doi.org/10.3389/fpsyt.2016.00065

Chow CY, Riantiningtyas RR, Kanstrup MB, Papavasileiou M, Liem GD, Olsen A. Can games change children's eating behavior? A review of gamification and serious games. Food Quality and Preference 2020; 80: 103823. DOI: https://doi.org/10.1016/j.foodqual.2019.103823

Brown M, O'Neill N, Van Woerden H, Eslambolchilar P, Jones M, John A. Gamification and adherence to web-based mental health interventions: A systematic review. JMIR Mental Health 2016; 3. DOI: https://doi.org/10.2196/mental.5710

Mak WW, Tong AC, Yip SY, Lui WW, Chio FH, Chan AT, Wong CC. Efficacy and moderation of mobile app-based programs for mindfulness-based training, self-compassion training, and cognitive behavioral psychoeducation on mental health: Randomized controlled noninferiority trial. JMIR Mental Health 2018; 5. DOI: https://doi.org/10.2196/mental.8597

Zhao L, Agazzi H, Du Y, Meng H, Maku R, Li K. et al. A Digital Cognitive-Physical Intervention for Attention-Deficit/Hyperactivity Disorder: Randomized Controlled Trial. J Med Internet Res 2024; 26: e55569. DOI: https://doi.org/10.2196/55569

Gkintoni E, Vantaraki F, Skoulidi C, Anastassopoulos P, Vantarakis A. Promoting physical and mental health among children and adolescents via gamification—A conceptual systematic review. Behavioral Sciences 2024; 14: 102.

Suleiman-Martos N, García-Lara RA, Martos-Cabrera MB, Albendín-García L, Romero-Béjar JL, Cañadas-De la Fuente GA, Gómez-Urquiza JL. Gamification for the Improvement of Diet, Nutritional Habits, and Body Composition in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2021; 13: 2478. DOI: https://doi.org/10.3390/nu13072478

Gkintoni E, Vantaraki F, Skoulidi C, Anastassopoulos P, Vantarakis A. Promoting Physical and Mental Health among Children and Adolescents via Gamification-A Conceptual Systematic Review. Behav Sci (Basel) 2024; 14. DOI: https://doi.org/10.3390/bs14020102

Rosati R, Regini L, Pauls A, Strafella E, Raffaelli F, Frontoni E. Gamification in nutrition education: the impact and the acceptance of digital game-based intervention for improving nutritional habits. Journal of Computers in Education 2025; 12: 367-390. DOI: https://doi.org/10.1007/s40692-024-00314-1

Leshi O, Ande B, Desmennu A, Leshi M, Sosanya M. Game-Based Intervention to Improve Knowledge on the Benefits of Fruits and Vegetables of In-School Adolescents Attending the International School, Ibadan, Nigeria. Current Developments in Nutrition 2022; 6: 849. DOI: https://doi.org/10.1093/cdn/nzac065.033

Yoshida Y, Ahmed M, Ezezika O. Does gamification improve fruit and vegetable intake in adolescents? A systematic review. Nutrition and Health 2020; 26: 026010602093614. DOI: https://doi.org/10.1177/0260106020936143

Kato-Lin YC, Kumar UB, Sri Prakash B, Prakash B, Varadan V, Agnihotri S, et al. Impact of Pediatric Mobile Game Play on Healthy Eating Behavior: Randomized Controlled Trial. JMIR MHealth Uhealth 2020; 8: e15717. DOI: https://doi.org/10.2196/15717

Cheng VWS. Recommendations for Implementing Gamification for Mental Health and Well-being. Frontiers in Psychology 2020; 11. DOI: https://doi.org/10.3389/fpsyg.2020.586379

Burnham JF. Scopus database: a review. Biomedical Digital Libraries 2006; 3: 1-8. DOI: https://doi.org/10.1186/1742-5581-3-1

Wang S, Scells H, Koopman B, Zuccon G. Automated MeSH Term Suggestion for Effective Query Formulation in Systematic Reviews Literature Search. Intelligent Systems with Applications 2022; 200141. DOI: https://doi.org/10.1016/j.iswa.2022.200141

Rogers G, Szomszor M, Adams J. Sample size in bibliometric analysis. Scientometrics 2020; 125: 777-794. DOI: https://doi.org/10.1007/s11192-020-03647-7

Van Eck N, Waltman L. Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics 2010; 84: 523-538. DOI: https://doi.org/10.1007/s11192-009-0146-3

Aria M, Cuccurullo C. bibliometrix: An R-tool for comprehensive science mapping analysis. Journal of Informetrics 2017; 11: 959-975. DOI: https://doi.org/10.1016/j.joi.2017.08.007

Bul KCM, Franken IHA, Van Der Oord S, Kato PM, Danckaerts M, Vreeke LJ, et al. Development and User Satisfaction of "Plan-It Commander," a Serious Game for Children with ADHD. Games for Health Journal 2015; 4: 502-512.

Fleming TM, Bavin L, Stasiak K, Hermansson-Webb E, Merry SN, Cheek C, et al. Serious games and gamification for mental health: Current status and promising directions. Frontiers in Psychiatry 2017; 7. DOI: https://doi.org/10.3389/fpsyt.2016.00215

Jakob R, Harperink S, Rudolf AM, Fleisch E, Haug S, Mair JL, et al. Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review. Journal of Medical Internet Research 2022; 24. DOI: https://doi.org/10.2196/35371

Lau HM, Smit JH, Fleming TM, Riper H. Serious games for mental health: Are they accessible, feasible, and effective? A systematic review and meta-analysis. Frontiers in Psychiatry 2017; 7. DOI: https://doi.org/10.3389/fpsyt.2016.00209

Cheng VWS, Davenport T, Johnson D, Vella K, Hickie IB. Gamification in apps and technologies for improving mental health and well-being: systematic review. JMIR Mental Health 2019; 6: e13717. DOI: https://doi.org/10.2196/13717

Cheng VWS. Studying the effectiveness of game-based solutions in a well-being app. CHI PLAY 2017 Extended Abstracts 2017; 691-694. DOI: https://doi.org/10.1145/3130859.3133231

Cheng VWS, Davenport T, Johnson D, Vella K, Hickie IB. Gamification in apps and technologies for improving mental health and well-being: Systematic review. JMIR Mental Health 2019; 6. DOI: https://doi.org/10.2196/preprints.13717

Cheng VWS, Davenport TA, Johnson D, Vella K, Mitchell J, Hickie IB. An app that incorporates gamification, mini-games, and social connection to improve Men's mental health and well-being (MindMax): Participatory design process. JMIR Mental Health 2018; 5. DOI: https://doi.org/10.2196/preprints.11068

Xie H. A scoping review of gamification for mental health in children: uncovering its key features and impact. Archives of Psychiatric Nursing 2022; 41: 132-143. DOI: https://doi.org/10.1016/j.apnu.2022.07.003

Rathfelder C, Hipp N. Combining smart sensor systems with gamification to increase the efficiency of therapies. EMBC Workshop Telemedicine and Telemonitoring in AAL Home Environments 2019; 39-41.

Alzahrani FKJ, Alhalafawy WS. Benefits and challenges of using gamification across distance learning platforms at higher education: A systematic review of research studies published during the COVID-19 pandemic. Journal of Positive School Psychology 2022; 6: 1948-1977. DOI: https://doi.org/10.30819/cmse.6-2.05

Pramana G, Parmanto B, Lomas J, Lindhiem O, Kendall PC, Silk J. Using mobile health gamification to facilitate cognitive behavioral therapy skills practice in child anxiety treatment: open clinical trial. JMIR Serious Games 2018; 6: e8902. DOI: https://doi.org/10.2196/games.8902

Deady M, Choi I, Calvo R, Glozier N, Christensen H, Harvey S. eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis. BMC Psychiatry 2017; 17: 1-14. DOI: https://doi.org/10.1186/s12888-017-1473-1

Temkin AB, Schild J, Falk A, Bennett SM. Mobile apps for youth anxiety disorders: A review of the evidence and forecast of future innovations. Professional Psychology: Research and Practice 2020; 51: 400. DOI: https://doi.org/10.1037/pro0000342

Peñuelas-Calvo I, Jiang-Lin LK, Girela-Serrano B, Delgado-Gomez D, Navarro-Jimenez R, Baca-Garcia E, Porras-Segovia A. Video games for the assessment and treatment of attention-deficit/hyperactivity disorder: a systematic review. European Child & Adolescent Psychiatry 2022; 31: 5-20. DOI: https://doi.org/10.1007/s00787-020-01557-w

Zhang M, Vallabhajosyula R, Fung D. Emotional Bias Modification for Individuals With Attention Deficit Hyperactivity Disorder: Protocol for a Co-Design Study. JMIR Research Protocols 2020; 9: e24078. DOI: https://doi.org/10.2196/24078

Alqithami S. A serious-gamification blueprint towards a normalized attention. Brain Informatics 2021; 8: 6. DOI: https://doi.org/10.1186/s40708-021-00127-3

Bul KC, Franken IH, Van der Oord S, Kato PM, Danckaerts M, Vreeke LJ, et al. Development and User Satisfaction of "Plan-It Commander," a Serious Game for Children with ADHD. Games Health J 2015; 4: 502-512. DOI: https://doi.org/10.1089/g4h.2015.0021

Friehs MA, Dechant M, Vedress S, Frings C, Mandryk RL. Effective Gamification of the Stop-Signal Task: Two Controlled Laboratory Experiments. JMIR Serious Games 2020; 8: e17810. DOI: https://doi.org/10.2196/17810

Gallagher R, Kessler K, Bramham J, Dechant M, Friehs MA. A proof-of-concept study exploring the effects of impulsivity on a gamified version of the stop-signal task in children. Front Psychol 2023; 14: 1068229. DOI: https://doi.org/10.3389/fpsyg.2023.1068229

Teruel MA, Sanchis J, Ruiz-Robledillo N, Albaladejo-Blázquez N, Ferrer-Cascales R, Trujillo J. Measuring attention of ADHD patients by means of a computer game featuring biometrical data gathering. Heliyon 2024; 10: e26555 DOI: https://doi.org/10.1016/j.heliyon.2024.e26555

Vajawat B, Varshney P, Banerjee D. Digital Gaming Interventions in Psychiatry: Evidence, Applications and Challenges. Psychiatry Research 2021; 295: 113585. DOI: https://doi.org/10.1016/j.psychres.2020.113585

Wiley K, Robinson R, Mandryk RL. The Making and Evaluation of Digital Games Used for the Assessment of Attention: Systematic Review. JMIR Serious Games 2021; 9: e26449. DOI: https://doi.org/10.2196/26449

Zhang M, Ranganath V. An Emotional Bias Modification for Children With Attention-Deficit/Hyperactivity Disorder: Co-design Study. JMIR Formative Research 2022; 6: e36390. DOI: https://doi.org/10.2196/36390

Thompson D, Bhatt R, Lazarus M, Cullen K, Baranowski J, Baranowski T. A Serious Video Game to Increase Fruit and Vegetable Consumption Among Elementary Aged Youth (Squire's Quest! II): Rationale, Design, and Methods. JMIR Research Protocols 2012; 1: e19. DOI: https://doi.org/10.2196/resprot.2348

Ezezika O, Oh J, Edeagu N, Boyo W. Gamification of nutrition: A preliminary study on the impact of gamification on nutrition knowledge, attitude, and behavior of adolescents in Nigeria. Nutrition and Health 2018; 24: 137-144. DOI: https://doi.org/10.1177/0260106018782211

Levels PA. Use of a Mobile Lifestyle Intervention App as an Early Intervention for Adolescents With Obesity: Single-Cohort Study.

Romero-Alemán MdM. A pilot study on gamified and conventional e-quizzes reinforcing human histology among first-year medical and physiotherapy students. Anatomical Sciences Education 2024; 17: 844-854. DOI: https://doi.org/10.1002/ase.2406