Abstract
Purpose: Mobile health (mHealth) interventions have great potential to promote health. To increase consumer engagement in mHealth interventions it is necessary to address factors that influence the target demographic. The Growing healthy (GH) program is the first obesity prevention program delivered via a smartphone app and website offering evidence-based information on infant feeding from birth until 9 months of age. This sub-study aimed to explore how the design features, quality of the app and participant characteristics influenced parents' engagement with the GH app.Methods: A sequential mixed methods design was used. The GH app participants (225/301) were considered for this sub-study. Participant app engagement was measured through a purpose-built Engagement Index (EI) using app metrics. Participants were categorized as low, moderately or highly engaged based on their EI score upon completing the 9 months program and were then invited to participate in semi-structured telephone interviews. Participants who used the app program, given an EI score and expressed interest to participate in these interviews were eligible. The interviews explored factors that influenced app engagement including delivery features and quality. Thematic analysis networks was used for analysis.Results: 108/225 expressed interest and 18 interviews were conducted from low (n = 3), moderately (n = 7), or highly (n = 8) engaged participants based on purposeful sampling. Participants defined as highly engaged were likely to be a first-time parent, felt the app content to be trustworthy and the app design facilitated easy navigation and regularly opened the push notifications. Participants defined as having low or moderate engagement were likely to have experience from previous children, felt they had sufficient knowledge on infant feeding and the app did not provide further information, or experienced technological issues including app dysfunction due to system upgrades.Conclusions/Implications: This study demonstrated a novel approach to comprehensively analyse engagement in an mHealth intervention through quantitative (Engagement Index) and qualitative (interviews) methods. It provides an insight on maximizing data collected from these programs for measuring effectiveness and to understand users of various engagement levels interaction with program features. Measuring this can determine efficacy and refine programs to meet user requirements.
Highlights
Over the past decade there has been global proliferation in ownership of mobile and wireless technology
Three participants were subsequently excluded from the study sample; one due to poor audio quality, and two because their infant was identified as being premature only after the interviews were conducted and were excluded from the larger Growing heathy (GH) study
The findings from this study have demonstrated the application of a novel approach to comprehensively analyse engagement in an mobile health (mHealth) intervention through a multi-method approach including quantitative (Engagement Index) and qualitative research methods
Summary
Over the past decade there has been global proliferation in ownership of mobile and wireless technology. In 2013, more than half (56.5%) of the adult population worldwide owned a mobile phone and ownership grew to two thirds (66%, 4.7 billion people) in 2017 [1]. Mobile health is defined as the “emerging mobile communications and network technologies for healthcare systems” [2]. MHealth provides ease and practicality in delivering health information including the potential to engage with hard-to-reach populations who traditionally do not participate in interventions. Further as a relatively inexpensive intervention they may reduce health care costs, such as reducing hospital visits, address inefficient practices or costs for patients or healthcare workers [3,4,5]. MHealth provides the opportunity to encourage healthy behaviors in participants’ natural environment without impacting daily routine [6, 7]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call