Serious Game for Wellness: A Gamified Toolkit for Enhancing Physical Activity and Well-Being in Workplace

This paper introduces a creative approach aimed at empowering desk-bound occupational groups to address the issue of physical inactivity at workplaces. The approach involves a gamified toolkit called Workplace Vitality Mapping (WVM) (see Figure 1) designed to encourage self-reflection in sedentary contexts and foster the envision of physical vitality scenarios. This hybrid toolkit comprises two main components: A Card Game (on-site) for context reflection and a Co-design Canvas (Online) for co-designing vitality solutions. Through the card games, participants reflect on key sedentary contexts, contemplating their preferable physical vitality scenarios with relevant requirements. The co-design canvas facilitates the collaborative construction and discussion of vitality scenarios’ development. The perceptions and interactions of the proposed toolkit from the target group were studied and observed through a hybrid workshop, which demonstrated promising results in terms of promoting participants’ engagement experience in contextual reflections and deepening their systemic understanding to tackle the physical inactivity issue. As physical inactivity becomes an increasingly pressing concern, this approach offers a promising participatory way for gaining empathetic insights toward community-level solutions.

reflection and a Co-design Canvas (Online) for co-designing vitality solutions.Through the card games, participants reflect on key sedentary contexts, contemplating their preferable physical vitality scenarios with relevant requirements.The co-design canvas facilitates the collaborative construction and discussion of vitality scenarios' development.The perceptions and interactions of the proposed toolkit from the target group were studied and observed through a hybrid workshop, which demonstrated promising results in terms of promoting participants' engagement experience in contextual reflections and deepening their systemic understanding to tackle the physical inactivity issue.As physical inactivity becomes an increasingly pressing concern, this approach offers a promising participatory way for gaining empathetic insights toward community-level solutions.

INTRODUCTION
As society increasingly recognizes the imperative of maintaining an active and healthy lifestyle, the repercussions of physical inactivity on health have gained substantial attention [17].Nonetheless, this issue continues to prevail prominently within workspaces where a combination of high sedentary behavior (SB) and low physical activity (PA) engenders severe health risks [15], [16].While various interventions exist, our previous study found that many predominantly focus on reminders and awareness enhancement, often failing to account for the intricacies of daily workplaces [27].For instance, after a day of prolonged desk work, a notification from your wearable device urging you to stand up and move might appear in stark contrast to the group members engrossed in their tasks around you, creating a sense of awkwardness in such a context.Additionally, existing SB/PA interventions and academic concepts fail to offer ecosystem-level solutions to workplace physical inactivity challenges.Despite the availability of fitness applications and interactive technology-enabled prototypes that track activity data [5], [24], provide sedentary reminders [11], and offer tailored workplace vitality exercises, the current work environment, and culture lack a broader perspective to support desk-bound workers to tackle physical inactivity problem during working time [7].
To bridge the gap between physical inactivity solutions and deskbound workers' working hour contexts, we propose a participatory behavior change approach.This approach harnesses a gamified toolkit to empower sedentary desk-bound workers to reflect upon their key sedentary contexts and engage in collaborative design [18] and relevant communication activities.By placing individuals within key sedentary contexts at the heart of their behavior change journey, we aim to acquire empathetic insights for co-creating effective solutions to address physical inactivity problems.
To gather feedback and suggestions from the target group regarding the approach's usefulness and applicability, we designed a conceptual toolkit and organized a hybrid workshop for testing.This hybrid workshop provided convenient participatory ways for online/onsite toolkits scenarios, and a chance to explore the perceptions of the toolkits from young generation desk-bound workers engaging in the "Vitality Transition" activities ("Vitality Transition" refers to the process of making a deliberate and comprehensive shift from a physical inactivity state towards a more energetic, active, and health-conscious lifestyle).Preliminary results from the workshop indicated that participants experienced engagement and gained a broad vision in reflecting on their own physical inactivity/physical vitality contextual concerns.The card game toolkit effectively facilitated systemic exploration, enabling participants to envision preferable vitality scenarios in the workplace.Our contribution involves developing a hybrid gamified toolkit that offers a broad vision to address issues related to physical inactivity at the workplace.This work not only contributes to workplace physical inactivity solutions but also underscores the significance of user-centered behavior change methods.

RELATED WORK 2.1 Systemic Challenge of Physical Inactivity in Workplaces
Previous research indicates that the issue of physical inactivity in the workplace is fundamentally a systemic challenge, involving various core contextual factors such as mind, behavior, support, and environmental conditions [4].The existing array of SB/PA interventions in workplace environments predominantly addresses specific concerns, often neglecting the holistic understanding of users' workplace contexts.While wearable devices (e.g., Apple Watch [25]) for awareness reminders and exercise applications (e.g., Keep Application [1]) for physical exercise guidance exist, extensive studies affirm that a comprehensive approach also requires attention to individual vitality mindset, the organization's vitality culture, proper vitality-related built environment, and the integration of light exercise equipment [13].Essentially, a user-centered solution should encompass the dynamic interplay of these factors to stimulate effective and enduring behavioral change.

The Contextual Gap Between Behavior Change Intervention and Target User
Within the realm of academic research, insights derived from a scoping review [4] conducted by researchers Ida et al. underscore that only a limited portion of vitality interventions influenced by technological empowerment are designed based on behavior change theories.Even more rare are interventions that encompass the four core vitality contextual factors mentioned above within the methodology.Furthermore, the majority of theoretical approaches [14] predominantly elucidate application scenarios from the perspective of designers or design researchers, positioning users as a minor component within the linear research or design process.Rarely do these approaches employ a user-centered behavior change approach to underpin intervention designs within this domain.As a consequence, the current landscape of design interventions often remains confined to the laboratory stage, struggling to transition into the authentic workplace environments of users seamlessly.Notably, James Levine's research highlights that even a simple alteration, such as changing the lighting or wall art in two workplaces, can result in increased physical activity among office workers [19].Nevertheless, achieving enduring vitality behavior change within an organization's internal dynamics necessitates a more systematic and long-term approach that revolves around the user.This approach must provide support for systematic reflection around key sedentary contexts and the design of vitality solutions.

User-Centered Behavior Change Approach: Gaining Empathetic Insights for Holistic Solution
Considering the above challenges, it is clear that a user-centered behavior change approach is essential to effectively address the complexities of physical inactivity and enhance physical vitality in the workplace.The approach should enable users to dig deep into their potential physical well-being needs from all four core contextual dimensions (mind, behavior, support, environment), thereby facilitating the construction of a tailor-made vitality ecosystem.

THE WVM TOOLKIT
In order to adjust the design requirements for the WVM toolkit before formal testing, we developed a topic-relevant toolkit for a pilot study and discovered that due to users' general lack of expertise in vitality transition, the toolkit we proposed for vitality transformation incurred a high learning cost during practical implementation [27].Serious games have positive effects on users' motivation and cognitive load [23], [21], which in turn can encourage the user to pursue the task and reduce the high learning cost mentioned above.
The user might experience the gaming approaches as enjoyable and is willing to see how the game narratives unfold [9].Serious games can also provide opportunities for behavior change and learning, such as offering an immersive experience to the user and providing a rich sensory environment to support learning, allowing users to try new skills, as well as behavioral modeling and social learning [8], [3].Besides, serious games can present current states of real-world issues, facilitating the user's involvement in and comprehensive learning about the real issues [2].In our case, the user can be guided step-by-step to understand their own sedentary issues in the real world, and the complexities of physical inactivity can be cut down in this way.Consequently, we integrated serious gaming with theoretical knowledge of vitality transition and designed the Vitality Mapping Toolkit, led by the first author.Sebastian et al. 's [6] research delved into the application of gamification in the realm of education, particularly exploring its impact on intrinsic motivation.The comprehensive review [12] examined the practical implementation of gamification in higher education and highlighted how meaningful gamification can stimulate users' intrinsic motivation, ultimately leading to sustained behavioral changes.In alignment with this, Scott Nicholson and his team's research [20] emphasized that meaningful gamification harnesses elements of playfulness and engagement, and introduces six key concepts-reflection, articulation, choice, information, game, and engagement-to guide gamification system designers reliant on non-reward game elements to facilitate individuals in finding personal relevance and meaning in the real world.

Two Main Components in WVM toolkit
Card Game (Onsite) for Context Reflection: This game utilizes cards that inspire participants to share contextual stories, enabling them to engage in reflective practices regarding their sedentary behavior and physical activity needs.It consists of two types of cards: 1.Four prolonged sedentary context monster cards, representing four typical workplace prolonged sedentary contexts; 2. Fifty-three vitality reflection trigger cards are reflection triggers based on the four key elements of workplace physical activity: mind, behavior, support, and environment.These trigger cards present factor-related illustrations to empower participants to actively engage in introspection and associations using images.Co-design Canvas (Online) for Concept Development: This toolkit introduces an online canvas tool (we utilized the interactive tool Miro [22] to mock up this tool) that consists of three components: 1. Vitality vision collages, utilizing emoji collages to empower participants without a design background to visualize their envisioned interactive vitality scenarios; 2. Vitality voting, using digital post-its to facilitate discussions around the vitality visions; 3. Vitality mapping, where participants build and discuss potential vitality ecosystems by identifying suitable solution images based on the vitality visions.

How to Use WVM toolkit
The toolkit comprises three main stages: Context-reflection, Scenario-envision, and Ecosystem-design.Stage 1: Contextreflection: Participants take turns selecting their target cards from the "monster" card deck, identifying the specific sedentary contexts to address.They then choose vitality element cards that align with their vitality needs and narrate their context stories.Stage 2: Scenario-envision: In this stage, participants begin by creating interactive scenario mood boards using emojis in the co-design canvas tool.Finally, participants engage in discussions and summarization to refine the visual and textual expression of their vitality scenarios.Stage 3: Ecosystem design: In the first step, participants search online for solution images (mind, behavior, support, environment) that align with their targeted vitality scenarios.In the second step, these materials are discussed and filtered.In the third step, the mapping toolkit within the canvas is utilized to design the vitality ecosystem, aligning the chosen materials to create a holistic and user-centered approach.

METHODS
We assessed the efficacy and utilization of the WVM toolkit through hybrid workshops involving 13 students.This hybrid workshop was designed with the aim to explore a distributed-participatory way, enabling participants to gather at local venues and join in real-time online.Sessions were conducted on-site in a university studio, with one facilitator remotely joining via video conferencing, and another facilitator from the local community joining on-site.Detailed recordings of video and audio were transcribed for analysis.This study has been approved by the Ethics Review Board from the Eindhoven University of Technology (Reference No. ERB2023ID300), and participants provided informed consent without receiving incentives.

Tools and Procedure
Each workshop utilized a pre-designed toolkit for collaboration (see Figure 2), allowing participants to discuss and share ideas.An

Data Analysis
We utilized an open coding approach for data analysis, during which co-authors reviewed transcribed data to identify relevant sections.These sections were then categorized into themes using affinity diagrams.Both online and on-site facilitators conducted a cross-check of the observed data.

RESULTS
We assessed the efficacy and utilization of the WVM toolkit through hybrid workshops involving 13 students.These workshops employed a combination of digital and physical tools for idea generation, exchange, and presentation.Sessions were conducted on-site in a university studio, with one facilitator remotely joining via video conferencing, and another facilitator from the local community joining on-site.Detailed recordings of video and audio were transcribed for analysis.We have described the detailed observations and findings in Table 1 (see Table 1)

DISCUSSION CONCLUSION FUTURE WORKS
Applying gamified approaches to empower users in learning methods to reduce SB and increase PA At present, there are numerous methodologies [10], [26] focused on behavior change among individuals/communities.These approaches aid designers and researchers in devising intervention strategies, grounded in theory, to assist desk-bound professionals in reducing prolonged sitting or increasing physical activity.However, the application of these theoretical methods often follows a top-down approach, with few strategies accessible for target user groups to autonomously grasp and implement transformative techniques.Gamification provides a participatory avenue for these target groups to apprehend and apply intricate and abstract behavior change theories.Through this approach, desk-bound workers not only engage in reflection upon their past sedentary contexts during gameplay but also enjoy the process of carrying out solutions to enhance physical vitality in office environments.The immersive gameplay can offer the user a state of "flow" to support learning and behavior change, they then utilize the rules and task mechanisms within the game to guide the mapping of future vitality ecosystems, thereby creating a rational holistic solution for collective health.
Lessons learned and Opportunities for Hybrid Workshop with Hybrid Toolkits Due to geographical limitations, the workshop took on a hybrid structure (see Figure 3).While the workshop host engaged through video conferencing tools, a local community member was also present as an on-site facilitator.This local-remote facilitator-led hybrid session among the participants on-site significantly enhanced trust and enthusiasm.Nevertheless, we also drew some lessons.Firstly, as the on-site participants were divided into three groups, the on-site facilitator couldn't simultaneously address the challenges and valuable insights from each group's discussions.Secondly, although the on-site tools effectively promoted engagement, it was challenging to naturally bridge the relationship between the On-site and online sessions.The vitality solutions devised by most groups didn't align with the earlier reflections on sedentary contexts and vitality stories.Furthermore, we observed that the hybrid research approach involving online and on-site facilitators opens up numerous opportunities for launching similar services on a large scale remotely.Facilitators can leverage community training to significantly expand their service scale.Digital tools collected and digitized data throughout the research process, reducing the workload of researchers in data processing." We analyzed observations from both online and on-site facilitators, along with participant feedback data, to formulate several Optimization Recommendations for the toolkit (refer to Table 2).Example: In this stage, the G2 team selected the "lounger" card and conducted a reflection on the vitality needs around it, identifying the primary constraint in this context to be a lack of motivation for physical activity when alone.
Participants felt that it was like playing a card game during the workshop, especially during the context storytelling process.They would like to have a leader in the group who understood the rules and could guide them to do each step.The leader could also record the story they told.
Participants were encouraged to share their stories with group members, being attracted by the content on the cards.They had a better understanding of the four elements after making the story in this stage.Also observed by the online facilitator, participants could only write down the title of their story instead of the story itself.Besides, the sedentary issue they chose was not very related to their vitality context story.

Stage 2
Stage 2: Scenario Construction Using Emoji Collage.Example: G2 members utilized emojis to create a dynamic vision of "vitality companionship" composed of emojis representing a phone, diary, map, and friends.
Participants described the content on the cards as "creative".While they had concerns about the cards due to the different understandings among the group.They would like a clear description of each card and a guideline or a set of rules to lead them to use these cards.Participants were not willing to offer negative feedback to their team members.They also needed more time to think about each concept.
Participants liked using emoji to design the vitality concept, and it was easy to understand the concept with a simple description.The vitality concepts were not connected to their context story in the last stage, it seems that one concept could be used for any context story.What's more, participants skipped the voting for each other's vitality concept, and neither did they write down their agreements/concerns to others.It is speculated that apart from time constraints, they might not be accustomed to or feel hesitant to point out shortcomings in others' solutions face-to-face.Stage 3 Stage 3: Gathering visual materials to visualise the concepts on Canvas.Example: the G2 team devised the concept of a digital vitality companion in this stage.They created a radar interface within a mobile app that showcases nearby friends' activities, allowing users to send vitality invitations to friends.
Participants said that it might be difficult to find a proper image for the collage.The distance in the canvas was a maximum of 15 minutes of walking, which was not always the situation in Beijing.
Participants collected images for designing the vitality ecosystems.They enjoyed the process, however, the proposed vitality solutions still tend to be skewed towards specific solutions (e.g., awareness or tools), lacking a connection to the core factors in the ecosystem.The walking zone division set-up was overlooked.Again, they did not call back to their context story and vitality concept.
Figure 3: The image illustrates the hybrid workshop structure.It involves both an online facilitator and an on-site facilitator.It showcases how the workshop is co-hosted using the on-site "card toolkit" and the "online co-design canvas."Together, they organize participants to successfully complete the workshop activities.• Clear card game rules are needed, such as the design concepts of the cards and their usage guidelines.
• During the process of narrating dynamic stories, there's no need to restrict the number of cards participants can use to tell their stories.• When there's more than one group, it's recommended to have a facilitator/team leader for each group to guide group members in effectively following the rules and progressing through the group activity.• A tool is required to record the vitality stories of each participant, serving as a foundation for designing the subsequent section of vitality interactive scenarios and vitality ecosystem mapping.

Codesign canvas
• Participants liked the content on the cards, of which they described as "creative".
• The session of "envisioning vitality interaction scenario" requires starting with providing examples of what "interaction scenarios" entail, along with offering an anonymous feedback mechanism (such as independent completion online at another time).• Combining the card game and co-design segments requires a longer time frame, given the substantial shift in thinking.It might not be suitable for the completion of the whole approach within a single day.• Specific process instructions and case demonstrations are needed to showcase the relationship between the vitality ecosystem mapping and the preceding context story and vitality interaction scenario.• During the Ecosystem Mapping session, modular and collectable solution materials should be prepared based on the four elements' structure for participants to choose from/use.As an example of material discovery, this empowers participants to broaden their perspectives while maintaining a systemic view of the four key elements.
Adopt WVM toolkit in Large scale Organizations In this study, we invited non-design background university students, representing the new generation of desk-bound professionals, to test the conceptual toolkit.The study goal was to investigate their perceptions of the toolkit and the approach.We look forward to companies adopting this gamified toolkit to care for employees who work in sedentary contexts and shape a vibrant culture.Verlück, a health advocate at Adidas, stresses employee responsibility for a healthy lifestyle while companies create a positive work environment [20].STEELCASE presents a new vision for hybrid work, offering adaptable office furniture for employees to customize their workspace [21].Our vision aligns with this by empowering office workers to reflect and participate in creating vitality ecosystems using our toolkit.The future development plan of the WVM toolkit serves as a platform for collaboration among office workers, researchers, architects, and managers to find comprehensive solutions."

Figure 2 :
Figure 2: Interactive Outcomes of WVM toolkit in the Workshop.This figure highlights the interactive outcomes of the WVM toolkit within three workshop phases.In (a), participants share stories while selecting cards."Moving to (b), five emoji collages of "interaction vitality scenarios" are displayed on the co-design canvas.Finally, in (c), the co-design canvas showcases the concept mapping of three "vitality ecosystems."

Table 1 :
Observations and Insights from Participant Engagement

Table 2 :
Optimization Recommendations for "Card Game" and "Co-Design Canvas"