Abstract
BackgroundWell-designed mobile health (mHealth) interventions support a positive user experience; however, a high rate of disengagement has been reported as a common concern regarding mHealth interventions. To address this issue, it is necessary to summarize the design features that improve user engagement based on research over the past 10 years, during which time the popularity of mHealth interventions has rapidly increased due to the use of smartphones.ObjectiveThe aim of this review was to answer the question “Which design features improve user engagement with mHealth interventions?” by summarizing published literature with the purpose of guiding the design of future mHealth interventions.MethodsThis review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. Databases, namely, PubMed, Web of Science, Cochrane Library, Ovid EMBASE, and Ovid PsycINFO, were searched for English and Chinese language papers published from January 2009 to June 2019. Thematic analysis was undertaken to assess the design features in eligible studies. The Mixed Methods Appraisal Tool was used to assess study quality.ResultsA total of 35 articles were included. The investigated mHealth interventions were mainly used in unhealthy lifestyle (n=17) and chronic disease (n=10) prevention programs. Mobile phone apps (n=24) were the most common delivery method. Qualitative (n=22) and mixed methods (n=9) designs were widely represented. We identified the following 7 themes that influenced user engagement: personalization (n=29), reinforcement (n=23), communication (n=20), navigation (n=17), credibility (n=16), message presentation (n=16), and interface aesthetics (n=7). A checklist was developed that contained these 7 design features and 29 corresponding specific implementations derived from the studies.ConclusionsThis systematic review and thematic synthesis identified useful design features that make an mHealth intervention more user friendly. We generated a checklist with evidence-based items to enable developers to use our findings easily. Future evaluations should use more robust quantitative approaches to elucidate the relationships between design features and user engagement.
Highlights
Mobile health is a means of providing medical and public health support to health care consumers via mobile devices, such as mobile phones, portable computers, and personal digital assistants [1]. mobile health (mHealth) interventions involve the adoption of mobile technologies to provide educational information, help users manage their own conditions and behaviors, and deliver health care to improve the health of users
In terms of the health topics discussed in these studies, 17 articles focused on unhealthy lifestyles, 10 studies focused on chronic diseases, 4 studies focused on mental health problems, and 4 studies focused on other health issues
To promote better application of the results of this study to future mHealth intervention development, we developed a checklist of the design features that enhance user engagement; this tool has 29 evidence-based items that are clearly described to make them easy to use by developers of mHealth interventions
Summary
Mobile health (mHealth) is a means of providing medical and public health support to health care consumers via mobile devices, such as mobile phones, portable computers, and personal digital assistants [1]. mHealth interventions involve the adoption of mobile technologies to provide educational information, help users manage their own conditions and behaviors, and deliver health care to improve the health of users. With regard to web-based physical activity interventions, reported dropout attrition rates vary between 0% and 62% [22,23] This is a common issue related to mHealth interventions; poor user engagement makes intervention effectiveness difficult because the users are not exposed to enough of the intervention content [24]. Well-designed mobile health (mHealth) interventions support a positive user experience; a high rate of disengagement has been reported as a common concern regarding mHealth interventions To address this issue, it is necessary to summarize the design features that improve user engagement based on research over the past 10 years, during which time the popularity of mHealth interventions has rapidly increased due to the use of smartphones
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