Decision-making pathways for adopting, implementing, and scaling gamified physical activity interventions in municipal policy and practice in the Netherlands
- 1Consumption & Healthy Lifestyles, Wageningen University, Wageningen, the Netherlands.
- 2Utrecht School of Governance, Utrecht University, Utrecht, the Netherlands.
Abstract
Municipalities increasingly pilot gamified physical activity (PA) interventions, yet few progress beyond pilots. This qualitative study examined decision-making pathways through which Dutch municipalities adopt, implement, and scale digital gamified PA interventions, using the case of ‘Missie Master’. A two-phase design was applied, combining exploratory interviews with policymakers, health professionals, and a company (phase 1), followed by two multi-stakeholder workshops and follow-up interviews with municipalities new to gamification (phase 2). Thematic analysis showed that adoption was driven by informal processes, enthusiastic individuals, trust in product reliability, and peer recommendations, while generic company outreach was ignored. Implementation relied on early preparatory capacity, such as designated coordinators, marketing plans, and timely app updates. Scaling was rare and cyclical, dependent on political support, cross-domain alignment, and short communication lines. The study offers a practical decision guide and highlights monitoring needs. Policy implications include transparent evaluation pathways, structured early implementation, and strengthened public-private co-development. Author summary: Municipalities increasingly experiment with digital tools that use game elements to encourage, especially children, to be more physically active. While many of these initiatives show promise, most remain small pilot projects and do not become part of long-term local policy or everyday practice. In this study, we wanted to understand why this happens and what helps municipalities move beyond experimentation. We studied how Dutch municipalities decided whether to adopt, use, and continue a gamified physical activity app. By talking with policymakers, health professionals, and an app developer, we explored how decisions were made in practice. We found that adoption often depended on enthusiastic individuals and informal recommendations rather than formal evaluation procedures. Successful implementation required early preparation, such as clear coordination, communication, and ongoing support. Scaling initiatives beyond pilots proved difficult and usually depended on political support, cooperation across policy domains, and close collaboration between those making policy and those delivering activities. Our findings show that moving from pilots to sustained policy requires clearer decision pathways, better preparation, and stronger collaboration between public and private partners. These insights can help municipalities make more effective use of digital health innovations in the future.
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BibTeX
@article{schwarz2026decisionmaking,
title = {{Decision-making pathways for adopting, implementing, and scaling gamified physical activity interventions in municipal policy and practice in the Netherlands}},
author = {Ayla Schwarz and Maarten van Bottenburg and Monique Simons},
journal = {PLOS Digital Health},
year = {2026},
month = oct,
doi = {10.1371/journal.pdig.0001792},
url = {https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001792},
note = {CC BY},
}
RIS
TY - JOUR
TI - Decision-making pathways for adopting, implementing, and scaling gamified physical activity interventions in municipal policy and practice in the Netherlands
AU - Ayla Schwarz
AU - Maarten van Bottenburg
AU - Monique Simons
PY - 2026
DA - 2026/10/26
JO - PLOS Digital Health
DO - 10.1371/journal.pdig.0001792
UR - https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001792
AB - Municipalities increasingly pilot gamified physical activity (PA) interventions, yet few progress beyond pilots. This qualitative study examined decision-making pathways through which Dutch municipalities adopt, implement, and scale digital gamified PA interventions, using the case of ‘Missie Master’. A two-phase design was applied, combining exploratory interviews with policymakers, health professionals, and a company (phase 1), followed by two multi-stakeholder workshops and follow-up interviews with municipalities new to gamification (phase 2). Thematic analysis showed that adoption was driven by informal processes, enthusiastic individuals, trust in product reliability, and peer recommendations, while generic company outreach was ignored. Implementation relied on early preparatory capacity, such as designated coordinators, marketing plans, and timely app updates. Scaling was rare and cyclical, dependent on political support, cross-domain alignment, and short communication lines. The study offers a practical decision guide and highlights monitoring needs. Policy implications include transparent evaluation pathways, structured early implementation, and strengthened public-private co-development. Author summary: Municipalities increasingly experiment with digital tools that use game elements to encourage, especially children, to be more physically active. While many of these initiatives show promise, most remain small pilot projects and do not become part of long-term local policy or everyday practice. In this study, we wanted to understand why this happens and what helps municipalities move beyond experimentation. We studied how Dutch municipalities decided whether to adopt, use, and continue a gamified physical activity app. By talking with policymakers, health professionals, and an app developer, we explored how decisions were made in practice. We found that adoption often depended on enthusiastic individuals and informal recommendations rather than formal evaluation procedures. Successful implementation required early preparation, such as clear coordination, communication, and ongoing support. Scaling initiatives beyond pilots proved difficult and usually depended on political support, cooperation across policy domains, and close collaboration between those making policy and those delivering activities. Our findings show that moving from pilots to sustained policy requires clearer decision pathways, better preparation, and stronger collaboration between public and private partners. These insights can help municipalities make more effective use of digital health innovations in the future.
SN - 2767-3170
ER -