Cultural Contexts of Geroprotection: A Cross-National Study of Dietary Adherence, Social Norms, and Gamification in Italy and the Netherlands

Abstract

This study investigates how culture influences people's health practices and how gamified digital tools can improve these behaviors. It accomplishes this by contrasting two countries with different cultural perspectives: Italy and the Netherlands. While Italy is a collective culture where people embrace interdependence and shared traditions, the Netherlands reflect an individualist context, where people often focus on autonomy and personal goals. The research investigates differences in adherence to geroprotective behaviors, specifically diet and physical activity, and whether gamification changes these patterns. A structured online survey with 38 questions was used. It measured traditional and non-traditional dietary practices, physical activity levels, cultural orientation and gamification app use. Participants were born in or are currently living in Italy or the Netherlands and were aged 18 or older. Recruitment used snowball sampling and targeted posts on social media. To ensure inclusion, the survey was offered in both Dutch and Italian and written at a B1 reading level. A total of 200 responses were analyzed after quality checks. Multiple regression models tested the influence of cultural background on behavior and whether gamification moderated these effects. According to our findings, Italian individuals were more likely to participate in social, low-intensity physical activities and to adhere to traditional diets. Higher commitment to organized, performance-driven exercise and non-traditional diets could be seen in the Dutch participants. Despite being more popular among Dutch users, gamification applications had a bigger effect on changing behavior among Italian users, even if they did not moderate the effect of cultural background. These findings suggest that cultural factors influence how people engage with e-health services. If gamification mechanics align with the user's ideas, it may help to reduce cultural behavioral disparities. When developing public health interventions for healthy aging, cultural norms and levels of digital literacy should be considered.