@Article{info:doi/10.2196/35132,
author="Moreira, Rui
and Silveira, Augusta
and Sequeira, Teresa
and Dur{\~a}o, Nuno
and Louren{\c{c}}o, Jessica
and Cascais, In{\^e}s
and Cabral, Rita Maria
and Taveira Gomes, Tiago",
title="Gamification and Oral Health in Children and Adolescents: Scoping Review",
journal="Interact J Med Res",
year="2024",
month="Apr",
day="4",
volume="13",
pages="e35132",
keywords="gamification; mechanisms of gamification; gamification components; intrinsic and extrinsic motivators; oral health care; health behavior; oral health care applications",
abstract="Background: Oral health is a determinant of overall well-being and quality of life. Individual behaviors, such as oral hygiene and dietary habits, play a central role in oral health. Motivation is a crucial factor in promoting behavior change, and gamification offers a means to boost health-related knowledge and encourage positive health behaviors. Objective: This study aims to evaluate the impact of gamification and its mechanisms on oral health care of children and adolescents. Methods: A systematic search covered multiple databases: PubMed/MEDLINE, PsycINFO, the Cochrane Library, ScienceDirect, and LILACS. Gray literature, conference proceedings, and WHOQOL internet resources were considered. Studies from January 2013 to December 2022 were included, except for PubMed/MEDLINE, which was searched until January 2023. A total of 15 studies were selected following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The eligibility criteria were peer-reviewed, full-text, and empirical research related to gamification in oral health care, reports of impact, and oral health care outcomes. The exclusion criteria encompassed duplicate articles; unavailable full texts; nonoriginal articles; and non--digital game--related, non--oral health--related, and protocol studies. Selected studies were scrutinized for gamification mechanisms and outcomes. Two main questions were raised: ``Does gamification in oral health care impact oral health?'' and ``Does oral health care gamification enhance health promotion and literacy?'' The PICO (Patient, Intervention, Comparison, Outcome) framework guided the scoping review. Results: Initially, 617 records were obtained from 5 databases and gray literature sources. After applying exclusion criteria, 15 records were selected. Sample size in the selected studies ranged from 34 to 190 children and adolescents. A substantial portion (11/15, 73{\%}) of the studies discussed oral self-care apps supported by evidence-based oral health. The most clearly defined data in the apps were ``brushing time'' (11/11, 100{\%}) and ``daily amount brushing'' (10/11, 91{\%}). Most studies (11/15, 73{\%}) mentioned oral health care behavior change techniques and included ``prompt intention formation'' (11/26, 42{\%}), ``providing instructions'' (11/26, 42{\%}), ``providing information on the behavior-health link'' (10/26, 38{\%}), ``providing information on consequences'' (9/26, 35{\%}), ``modeling or demonstrating behavior'' (9/26, 35{\%}), ``providing feedback on performance'' (8/26, 31{\%}), and ``providing contingent rewards'' (8/26, 31{\%}). Furthermore, 80{\%} (12/15) of the studies identified game design elements incorporating gamification features in oral hygiene applications. The most prevalent gamification features were ``ideological incentives'' (10/12, 83{\%}) and ``goals'' (9/16, 56{\%}), which were found in user-specific and challenge categories, respectively. Conclusions: Gamification in oral health care shows potential as an innovative approach to promote positive health behaviors. Most studies reported evidence-based oral health and incorporated oral health care behavior change techniques. ",
issn="1929-073X",
doi="10.2196/35132",
url="https://www.i-jmr.org/2024/1/e35132",
url="https://doi.org/10.2196/35132",
url="http://www.ncbi.nlm.nih.gov/pubmed/38573750"
}