Gamifying Fitness Corners

There has been a rise in chronic diseases among the elderly in Singapore, and it is often caused by poor diet and a sedentary lifestyle. A team of three physiotherapists from National University Hospital (NUH) is determined to tackle this issue by proposing their solution at  Health Innovation Technology (HIT) Challenge 2017.

I worked together with the team through the discover, define and design phases within a two-week period to prepare for their competition. 

Refining the problem statement 

The team's initial aim was to encourage early adoption of a healthy lifestyle to prevent chronic diseases. However this was a relatively broad scope and needed refinement before we could arrive at a more targeted solution.

We started by asking ourselves a few simple questions:

1. What does it mean to have a "healthy lifestyle"?
2. Who do we want to target first and why?

We knew that a healthy lifestyle consists of a balanced diet, sufficient exercise, and good mental health. Due to the team's expertise, we chose to focus on helping people achieve sufficient exercise (150 minutes of moderate intensity exercise per week).

Ideally we would  want everyone to lead a healthy lifestyle and that's the long-term goal, but everyone's motivation is different and will need different approaches. The team decided to concentrate initial efforts on the group that is most at-risk and underserved. Our initial assumption led us to target senior citizens (aged 65 and above).  

With that, the refined problem statement became:

How might we encourage senior citizens to exercise sufficiently?

Talking to the elderlies

With a more refined problem statement, we went on to speak to senior citizens to understand why they exercise and categorized the 'job' of exercising into its functional and emotional components:

We also uncovered some common reasons why elderlies do not exercise:

Observation at a fitness corner

Through daily interactions with elderly patients at work, our team of physiotherapists also noticed that fitness corners are something of interest to them since it's free and readily accessible. However some of these elderly patients are apprehensive about using the equipments because they aren't sure how to use them and are afraid it might aggravate their pain.

We made a trip down to a fitness corner to observe and chat with a few elderly folks, and gathered that:

• Some cannot read the instructions because they are in English, but use the machines as long as they don't cause any pain
• Some would come up with new ways to use the machines, to make it more interesting
• Many are motivated to exercise because they have experienced severe pain or discomfort in the past due to health problems
• Many only spends 10-15 minutes at the fitness corner doing light exercises, which isn't sufficient
• The fitness corner is not fully utilized; among those who were there, less than half were senior citizens

Refining the problem statement, again

Through conversations with senior citizens and our observation at the fitness corner, the team saw a lot of potential in increasing the usage of fitness corners to achieve our goal, and decided to refine the problem statement further to:

How might we encourage senior citizens to exercise sufficiently through the gamification of fitness corners?

Initial idea

The team's initial idea was to incorporate virtual reality to create an immersive gaming experience for the elderly as they use the machines at the fitness corners. Imagine using the cycling machine to cycle through Gardens by the Bay, or pretend to be an olympic swimmer while using the arm pedal machine.

However we soon realize that our target group is not technologically savvy enough. The extra hardware necessary might intimidate instead of encourage the elderlies to exercise. Virtual reality is also unsuitable for public outdoor spaces.

Environmental scan

We decided to look outwards for inspiration to see if there are similar solutions in the market and found that we would be competing in the space of digital fitness solutions. There are many solutions in the market to make exercising more fun for the general public, but very little of those are designed for old folks. This validates our earlier assumption that the elderlies are underserved.

The gap in the "fun for older users" quadrant signals potential for our solution. Also, none of the existing solutions focuses on fitness corners, making it a possible differentiating factor for us. 

Among the existing solutions, Zombies, Run!, Gym Tonic andCasper stood out and served as good references:

User personas and journeys

To bring clarity to the user information gathered earlier, we came up with two personas:

The first persona, Mdm Ong is a patient currently seeking physiotherapy treatment. She hopes to recover quickly, gaining back her ability to walk without help, so that she can live independently again. To speed up her recovery, she is interested to try out the gym machines at the fitness corner near her house, in addition to at-home exercises assigned by her physiotherapist.

However she cannot read the instructions on the machines since they are only in English. Coupled with her lack of physical strength and balance, she becomes afraid to use the machines.

Our second persona, Mr Ong, is a socially active elderly with the misconception that being socially active means he is physically active as well. He is disappointed that he has been diagnosed with diabetes despite his active lifestyle and decided to head to a fitness corner to exercise as advised by his doctor.

However he had trouble locating a fitness corner near his home, and when he found one, he thought the machines were rather boring. He tried to make it more interesting by experimenting with new ways of using the machines, but he might not be using them in a way that would benefit his health.

Based on these personas, I've also listed out key design considerations based on our target user to keep in mind as we continue into the design phase:

• May not have an email address, use phone number as the unique identifier
• May be afraid of technology, interfaces need to be simple, intuitive and friendly
• Fat fingers, need bigger buttons
• Potential language barrier, will need multiple languages and dialects, less text, more audio and visual communications

Revised idea

With a better idea of who to design for and taking inspiration from existing solutions, we moved forward with a simpler mobile application, focusing on:

• An intuitive interface suitable for the elderly
• An audio experience (instead of virtual reality) to enhance the exercises, in multiple languages
• Measurable goal of 150 minutes of moderate intensity exercise per week
• Pairing with heart rate monitors in fitness trackers to accurately measure exercise intensity
• Pairing with step counters in fitness trackers, making walking an alternative to fitness corner exercises
• Point system to reward the elderly when they achieve their weekly goal

Keeping the two personas in mind, we designed two approaches to onboard new users. The first being a physiotherapist-directed approach where patients are assessed and assigned specific exercises that suit their conditions, through a physiotherapist web interface. The second is a more general approach where elderlies can download the app, go through a short Q&A during the registration process for a quick assessment on their health condition before they start.

Mobile app design

After several quick rounds of iterations based on feedback from the team, the final design focuses on creating a simple yet fun experience for the elderly to achieve their weekly goal of 150-minute moderate intensity exercise, leveraging on the free and accessible gym machines at fitness corners.

Here are some of the highlights within the app: