Health Empirics

Digital and gamified tools are increasingly used to assess health, wellbeing, cognition, and engagement among young people. Interactive tasks may encourage participation, but game elements can introduce demands unrelated to the construct being measured. This systematic review and meta-analysis examined engagement, measurement validity, health and wellbeing outcomes, methodological quality, and cultural suitability among adolescents and young adults.PubMed, Scopus, PsycINFO, Web of Science, and Google Scholar were searched for English-language studies published between January 2010 and March 2025 involving participants aged 10-24 years. Reporting followed PRISMA 2020. Cochrane and JBI guidance informed the review, and JBI tools assessed quality. Continuous outcomes were pooled using a random-effects model and reported as Hedges'g. The search identified 1,842 records; 117 studies entered the qualitative synthesis and 72 the quantitative synthesis, covering approximately 38,qualitatives across 26 countries. The overall effect was small and positive (g = 0.28, 95% CI [0.18, 0.37]; I² = 47.2%). Engagement showed the largest estimate (g = 0.41), followed by measurement validity (g = 0.33) and health and wellbeing (g = 0.22). Findings suggest benefits for engagement. Differences across designs and outcomes require cautious interpretation. Future research should examine usability, psychometric quality, cultural suitability, accessibility, and transparent scoring.