Attrition from Web-Based Cognitive Testing: A Repeated Measures Comparison of Gamification Techniques
Journal of Medical Internet Research
Copyright © Jim Lumsden, Andy Skinner, David Coyle, Natalia Lawrence, Marcus Munafo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.11.2017. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
Background: The prospect of assessing cognition longitudinally and remotely is attractive to researchers, health practitioners and pharmaceutical companies alike. However, such repeatedtesting regimes place a considerable burden on participants, and with cognitive tasks typically being regarded as effortful and unengaging, these studies may experience high levels of participant attrition. One potential solution is to gamify these tasks to make them more engaging: increasing participant willingness to take part and reducing attrition. However, such an approach must balance task validity with the introduction of entertaining gamelike elements. Objectives: We set out to investigate the effects of gamelike features on participant attrition using a between-subjects, longitudinal online testing study. Methods: We used three variants of a common cognitive task, the stop signal task, with a single gamelike feature in each: one variant where points were rewarded for performing optimally, another where the task was given a graphical theme, and a third variant which was a standard stop signal task and served as a control condition. Participants completed four compulsory test sessions over four consecutive days before entering a six-day voluntary testing period where they faced a daily decision to either drop out or continue taking part. Participants were paid for each session they completed. Results: 482 participants signed up to take part in the study, with 265 completing the requisite four consecutive test sessions. We saw no evidence for an effect of gamification on attrition. A log-rank test showed no evidence of a difference in dropout rates between task variants (X 2 (2, N = 265) = 3.022, p = .22) and a one-way ANOVA of the mean number of sessions completed per participant in each variant also showed no evidence for a difference (F [2,262] = 1.534, p = .21, partial η2 = 0.012. Conclusions: Our findings raise doubts about the ability of gamification to reduce attrition from longitudinal cognitive testing studies.
Funding from British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This work was supported by the Medical Research Council (MC_UU_12013/6 and MC_UU_12013/7), and a PhD studentship to JL funded by the Economic and Social Research Council and Cambridge Cognition Limited.
This is the author accepted manuscript. The final version is available from JIMR Publications via the DOI in this record.
Vol. 19 (11), article e395