# Designing Personalized Persuasive Game Elements for Older Adults in Health Apps
## 1 Introduction  
With the increased popularity of smartphone use among seniors, mobile health apps have become an important health management tool to help seniors prevent disease [1]. The World Health Organization reports that China is aging at a faster rate than other countries with low and middle income [2]. The rapid demographic changes have made the health of the elderly an important social issue [3]. Research indicated that the percentage of elderly people using smartphones is 60% [4]. [PERSON] et al. [5] showed that 39% of middle-aged and elderly people use smartphones to search for health information. Studies have shown that the use of mobile health apps can promote healthy lifestyles and increase public health awareness [6, 7]. Persuasive games are a non-coercive intervention method whose main purpose is to change the user's behavior or attitude using various persuasive technologies [8] and strategies [9]. Gamification was defined as the use of game design elements in a non-game environment [10]. [PERSON] [11] mentioned that gamification could be a style of persuasive design and might be effective in promoting motivation and ability in persuasion. [PERSON] et al. [12] argued that gamification design strategies can motivate health behavior change and have a positive impact on health. Gamification design has been studied and proven to increase users' intrinsic motivation and positively influence their attitudesand behaviors [13]. It can lead users to increase their performance and motivation in a subtle game experience [14]. Gamification design has been widely used in the fields of education [15] and health [16], and its use in health applications has become very popular [17]. Although there is a lack of extensive experimental evidence on the effects of gamification designs, some studies indicate that gamification has the potential to positively influence more effective medication adherence and self-management in patients with chronic diseases [18]. Some researchers used gamified mobile medical diabetes apps to help adolescents improve blood glucose monitoring frequency and indicated that the use of gamified rewards was associated with improvements in blood glucose monitoring frequency [19]. [PERSON] et al. [20] evaluated the effectiveness of apps that used gamified dentistry to help children with oral self-care. Behavior change is a complex process. Despite the ability of gamification elements to engage users and motivate their behavior, there is a risk that individuals will lose interest in long-term use of gamified applications [21]. Research generally agrees that different game design elements trigger different motivations [22]. To ensure that serious games meet the expectations of users, they must be designed using a user-centered approach [23]. However, most current gamification designs largely ignore the demographic characteristics of the target users [24] and thus fail to provide appropriate solutions to relevant groups [25]. Therefore, it is necessary to analyze the gamification mechanics and design elements preferred by different users. To improve the persuasiveness and user satisfaction of health education apps, this paper takes the \"People's Health\" app (an existing health education application) as an example to explore the combination of gamification elements chosen by older people due to age, gender, education, and income. Section 2 of this paper is a review of related work and literature. Section 3 is the research process, which presents the research methodology and analyzes the preferences of older adults for gamification design elements. Section 4 contains the results of the study, which uses conjoint analysis to segment the preferences for gamification elements among the elderly. Section 5 is a discussion of the results and presents aging health app design suggestions and the modified aging gamification model. Section 6 presents the conclusion and outlook.