To get her two children to spend less time on the couch and more time moving their bodies, Jen Keskey adopted a new strategy.

She made a game of it.

She gave her kids, Preston, 9, and Marin, 7, activity monitors that recorded their steps and synced them to a mobile app. What really got them going, Keskey said, was the chance to acquire digital “coins.” The more they moved using the iBitz monitors, the more coins they earned. They could then spend their virtual bounty on Disney’s Club Penguin, a popular interactive website for children.

“They have gotten coins twice,” Keskey recalled. “Those were big days.”

Add iBitz to the proliferation of tracking devices, apps and websites tied to a new approach to wellness. A growing number of employers, app makers and health organizations are leveraging gaming principles to lure people into making healthy decisions. Supporters say it’s a powerful way to motivate people. In the process, it might be transforming one of the hardest things to change — behavior.

Often called health gamification, the aim is to offer virtual incentives, such as digital currency, points and top ranking on competitive “leaderboards.” While exercise is a big driver, people are using gamification to quit smoking, count calories and even take their medication.

Incentive-based apps and websites are a growing segment of the overall health gaming market, estimated at $1.2 billion. Critics wonder if this approach will have staying power, but in the never-ending battle to improve health, some doctors are cautiously optimistic.

“Clearly, whatever we’ve been doing hasn’t been working,” aid Dr. Philip Hagen, vice chair of the Mayo Clinic’s Division of Preventive and Occupational and Aerospace Medicine. For him, gamification shows promise. “This is really catching hold, and I hope we will learn from it and figure out how to help people get healthier.”

Inside the game

At this time of year, many employers are asking their workers to fill out benefit enrollment information. It’s a tedious but necessary task, but one possibly made more palatable by gamifying.

UnitedHealth Group, a national health care organization based in Minnetonka, offers companies a gamified way to engage more employees in understanding their benefit plans. Called “Scavenger Hunt,” it’s an online game that invites users to find information that will help educate them about their health and benefits.

On average, people spend between 7 and 11.5 minutes on the site — that’s much longer than most people spend reading explanation-of-benefits packages they receive in the mail, said Nick Martin, vice president for UnitedHealth Group’s Innovation and Research and Development team.

The company also is piloting a new health gamification program called “Reward Me.” The program, housed in UnitedHealth’s Health4Me mobile app, offers discounts on workout gear and other products as a reward for healthy choices.

These types of rewards seem to work well, especially when there is a social-networking component.

“People like a pat on the back,” said Keskey, who is also the program manager for technology at Life Time Fitness. “They like to have [their achievements] highlighted and share it with their friends.”

Games increase people’s engagement — a key to causing behavior change, said Monika Heller, a child and adolescent psychiatrist who works for CogCubed, a local company that uses gamification to diagnose attention deficit hyperactivity disorder and other cognitive conditions.

The longer we play a game, the deeper our sense of anticipation grows — and that keeps us motivated, Heller explained.

Does gamification work?

But critics charge that while games are good at hooking us into new healthy behaviors for a time, we go back to our unhealthy habits once the novelty wears off.

The problem with creating healthy behaviors, Hagen said, is that it takes work to make them last.

“Just doing them for a month or two months — or six months even — is not enough,” he said. “We need that to carry over for a year or two.”

For Keskey, the gamification of her children’s health has been an eye opener. Their behavior has changed, they’ve become more conscious of their decisionmaking and they also realized how inactive they’d become.

“It was neat to see them connect the dots,” Keskey said.

Brady Anderson sees gamification as the initial push that drives a new habit.

The self-described “tech nerd” from Rockford started a new health gamification site called for both individuals and employers. Users log their fitness activity and receive text messages of encouragement for their achievements.

“We try to make them fun and playful,” Anderson said. “So it’ll be like: ‘Shut the front door! You just hit 10,000 steps!’ Kind of goofy stuff like that.”

They also get points when they reach a designated healthy milestone, and they can cash in those points — called “sweat equity” — for rewards, such as the ability to download a digital song.

“I want to provide a reward long enough to create a lasting behavior,” said Anderson. “If the reward serves that purpose, then it’s successful.”

Allie Shah • 612-673-4488