UC-247 Using Dynamic Difficulty Adjustment (DDA) to improve health and wellness apps and programs

Physical inactivity, obesity and Type 2 Diabetes cost the United States’ economy more than $700 billion a year (CDC). Yet, individuals spend $137 billion dollars a year on gym memberships to get in shape and feel better, without attaining results and dropping out. “…63% of new members will abandon activities before the third month, and less than 4% will remain for more than 12 months of continuous activity.” (Sperandei et al). The personal training apps don’t fare better, with 71% of users disengaging within 90 days (Amagai et al). The higher chances of people dropping out are due to "a higher degree of discomfort and distress during exercise sessions" (Sperandei 919). Additionally, individuals with less than 2 training sessions per week have higher attrition rates (Garay et al 7). Our hypothesis is that Digital Difficulty Adjustment (DDA) could be used beyond videogames to create positive habits and to increase the amount of physical exercise by making the exercises’ intensity levels adapt to the physical levels of the person exercising in real-time. DDA is a technique used in video games to adaptively change the game's difficulty level in response to the player's performance and creates an engaging and tailored playing experience that lasts longer for the player. We expect the findings of this research can be applied to designs in other areas of healthcare and wellness programs to effectively improve adherence, and reduce attrition of these programs, potentially reducing the national and personal costs in poorly designed digital health and wellness products.