Privacy and data governance in gamified health apps in Latin America

Health apps that use game elements such as points, badges and leaderboards collect behavioral and health data continuously, and the rules governing those data differ across Latin American countries. This narrative review synthesizes what 55 publications and two national data protection laws report about privacy practices and data governance of health apps in the region, with attention to gamified designs. Studies published from 2012 to 2024 were identified in five bibliographic sources with English, Spanish and Portuguese queries; 18 included publications are in Spanish or Portuguese. The evidence falls into four groups: audits of apps and policies in Peru, Mexico and Brazil; legal and institutional analyses, mostly of Brazil; pandemic contact-tracing apps; and surveys and reviews of clinicians and telehealth. Peruvian and Mexican audits described apps that collected data with weak safeguards or limited transparency, and a corpus of 82 Brazilian privacy policies showed poor readability and weak alignment with the national data protection law. Few studies described gamified health apps from the region, and none evaluated their data handling as an outcome; the best documented case, a Mexican crowdsourcing and gamification app, reported encryption, a privacy notice and electronic consent. Legal analyses repeatedly describe a gap between statute and application for apps outside clinical settings. Evidence on privacy in gamified health apps in Latin America is therefore indirect. Audits of leaderboards, social features and data sharing, specific attention to children's data and app-level regulatory guidance are proposed.