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Gamification has been widely applied in mobile fitness apps to motivate users to exercise continuously. Based on the affordances–psychological outcomes–behavioral outcomes framework, this study explores the roles of three specific gamification affordances (competition, visibility of achievement and interactivity) in self-health management (continuous use behavior and health behavior) from the perspectives of achievement satisfaction and gamification exhaustion.

We test the research model using a structural equation model (SEM) with 505 self-reported data points. Furthermore, we apply fuzzy-set qualitative comparative analysis (fsQCA) to explore configurations of gamification affordances associated with self-health management behavior, reinforcing the SEM results.

Results indicate that competition, visibility of achievement and interactivity can enhance achievement satisfaction, which further boosts self-health management behavior. However, competition and interactivity can also cause gamification exhaustion, which undermines self-health management behavior to some extent. Overall, the positive impacts of the three affordances outweigh the negative impacts.

This study provides new insights for relevant practitioners on designing gamification affordances, aiding the sustainable development of mobile fitness apps and their long-term effects on self-health management. Visibility of achievement should be emphasized, and competition and interactivity should be thoughtfully designed to minimize their negative effects.

This study extends the affordances–psychological outcomes–behavioral outcomes framework and the literature on gamification and health management by applying both SEM and fsQCA methodologies to examine the relationship between specific gamification affordances and self-health management behavior.