mHealth Apps Research Articles

Impact of Digital Health Interventions on Birth Equity: A Review.

The rise in smartphone utilization and technology uptake has popularized digital health interventions as a means of supporting healthy pregnancies and optimizing maternal and child health. Digital health interventions include several modalities, such as telemedicine, remote patient monitoring, smartphone applications, web-based interventions, wearables, and health information technology. However, the impact of these interventions on improving maternal and infant health outcomes by race and socioeconomic status to achieve birth equity is unknown. This review summarizes current literature on the impact of digital health interventions on the outcomes of communities of color and lower socioeconomic status in the United States. We demonstrate there is emerging evidence of the impact of digital health interventions on maternal health outcomes, particularly for telemedicine, but evidence specifically focused on assessing outcomes by race and ethnicity and for other modalities, like mHealth apps or wearables, is limited. Digital health interventions may play a part in birth equity initiatives, but should not be considered a standalone solution, and instead should be integrated into other existing efforts to achieve birth equity, like diversifying the clinician workforce, expanding access to high-quality prenatal and postpartum care, or delivering respectful maternity care.

Health Maintenance Organization-mHealth Versus Face-to-Face Interaction for Health Care in Israel: Cross-Sectional Web-Based Survey Study.

Health maintenance organization-mobile health (HMO-mHealth) services have a direct impact on patients' daily lives, and HMOs regularly expand their range of mHealth services. HMO-mHealth apps are saving HMOs time and money, as services are becoming more accessible to patients. However, the willingness to use mHealth apps depends on user perception. Although mHealth apps can change the relationship dynamic between HMOs and patients, patients prefer to use them to facilitate face-to-face interactions rather than replace them. This study aims to examine the extent to which Israeli adults prefer adopting health care services using HMO-mHealth as a replacement for face-to-face interaction. Israeli adults aged ≥18 years completed an electronic questionnaire. Data were collected from December 2020 to February 2021. All services in the main HMO-mHealth apps of the 4 Israeli HMOs were mapped. The 29 health care services used in this study were identical in all 4 HMO-mHealth apps in Israel. The association between sociodemographic characteristics and health condition with preference for HMO-mHealth or face-to-face interaction was analyzed separately for each health service by using a logistic model. A total of 6321 respondents completed the questionnaire (female: 4296/6321, 68%; male: 2025/6321, 32%). Approximately 80.9% (5115/6321) to 88.2% (5578/6321) of the respondents preferred using HMO-mHealth apps for administrative matters. However, 55.3% (3498/6321), 52.2% (3301/6321), and 46.9% (2969/6321) preferred face-to-face meetings for the initial medical diagnosis, medical treatment, and medical diagnosis results, respectively. Seven main variables were found to be associated with HMO-mHealth adoption, including gender, age, education, marital status, religious affiliation, and subjective health condition. Female respondents were more likely than male respondents to prefer HMO-mHealth apps for administrative matters and face-to-face interaction for personal medical diagnosis and treatment (odds ratio [OR] 0.74, 95% CI 0.67-0.83; P<.001 and OR 0.82, 95% CI 0.74-0.92; P<.001, respectively). Married individuals preferred using HMO-mHealth apps over face-to-face meetings for a new medical diagnosis (OR 1.31, 95% CI 1.15-1.49; P<.001) or treatment (OR 1.34, 95% CI 1.18-1.52; P<.001). Improved health perception was associated with higher preference for HMO-mHealth apps across all health care services in this study (OR 1.11, 95% CI 1.02-1.22; P<.02 to OR 1.38, 95% CI 1.25-1.53; P<.001). No significant association was found between the presence of a chronic disease and the preferred mode of interaction for most services. HMO-mHealth is proving to be a robust and efficient tool for health care service delivery. However, there are barriers that affect vulnerable populations when adopting HMO-mHealth. Therefore, it is important to tailor HMO-mHealth apps for older adults, the chronically ill, and minorities in society, as these groups have a greater need for these services. Future studies should focus on identifying the barriers that affect the utilization of HMO-mHealth in these groups.

MHealth Apps for Hypertension Self-Management: Interview Study Among Patient-Users.

Hypertension is a major risk factor for cardiovascular disease, affecting over a billion people worldwide. Mobile health (mHealth) apps have emerged as effective tools for managing hypertension, offering capabilities for monitoring blood pressure, fostering lifestyle changes, and improving treatment adherence. This study aimed to explore patient-users' perspectives on the hypertension care mHealth app Hypertension.APP, focusing on its accessibility, expected benefits, potential risks, and role in hypertension management in Germany. A qualitative study was conducted involving semistructured interviews with 20 patient-users of a hypertension care mHealth app, Hypertension.APP. Participants were recruited between January and June 2023 using purposive sampling. Verbatim transcripts were analyzed using qualitative content analysis. Participants primarily discovered the app independently, driven by recent hypertension diagnoses and insufficient information from health care professionals regarding effective self-management strategies for their blood pressure. They valued the app for its continuous monitoring and feedback capabilities, aiding in understanding their condition and making lifestyle adjustments. Risks were perceived as minimal, mainly concerning data privacy and potential overreliance on the app. The app became integral to patient-users' hypertension management by offering consistent information and support. The integration into formal health care was limited, as patient-users felt that health care professionals did not accept the use of the technology or might have even felt intimidated to use it. Among the sample studied, mHealth apps like Hypertension.APP were valued for their continuous monitoring and educational content, aiding in hypertension management. The findings suggest potential benefits of mHealth apps for effective hypertension care among patients who are health- and digitally literate as well as self-effective. There is a critical need for better integration of these apps into routine health care practices, as perceived by the app users. Given the small and specific sample of this qualitative study, further quantitative research with a broader and more varied participant group is necessary to validate these findings. Deutsches Register Klinischer Studien DRKS00029761; https://tinyurl.com/r33ru22s.

Knowledge structure and theme trends on mHealth apps for COVID-19: bibliometric analysis

Knowledge structure and theme trends on mHealth apps for COVID-19: bibliometric analysis

Mobile health apps for cardiovascular risk assessment: a systematic review.

mHealth apps (MHA) are emerging as promising tools for cardiovascular risk assessment, but few meet the standards required for clinical use. We aim to evaluate the quality and functionality of mHealth apps for cardiovascular risk assessment by healthcare professionals. We conducted a systematic review of MHA for cardiovascular risk assessment in the Apple Store, Play Store, and Microsoft Store until August 2023. Our eligibility criteria were based on the 2021 European Society Cardiology Guidelines on Cardiovascular Disease Prevention in Clinical Practice, the Framingham Risk Score, and the Atherosclerotic Cardiovascular Disease score. Our protocol was drafted using the Preferred Reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. To assess quality, we used the validated Mobile Apps Rating Scale (MARS) score, which includes 19 items across four objective scales (engagement, functionality, aesthetics, and information quality) and one additional subjective scale. For functionality evaluation, we used the IMS Institute for Healthcare Informatics functionality scale. We performed data synthesis by generating descriptive statistics. A total of 18 MHA were included in the review. The most common scores used were the Framingham score, ASCVD score, and Score 2. Only six apps achieved an overall score of 4 or greater in the MARS evaluation. The MHA with the highest MARS score was ESC CVD Risk Calculation (5 points), followed by ASCVD Risk Estimator Plus (4.9 points). In the IMS scale, four MHA had a high functionality score: ASCVD Risk Estimator Plus (5 points), ESC CVD Risk Calculation (5 points), MDCalc Medical Calculator (4 points), and Calculate by QsMD (4 points). A gap exists in the availability of high-quality MHA designed for healthcare professionals to facilitate shared decision-making in cardiovascular risk assessment. The International Prospective Register of Systematic Reviews, identifier CRD42023453807.

Decoding Millenial Preferences for M-Health App Features: Strategic Insights for Marketers

Utilizing user satisfaction as a mediating variable, this study attempts to investigate how the Unified Theory of Acceptance and Use of Technology (UTAUT) model affects millennial generation preferences for utilizing mobile health applications (m-health) and what it means for marketing tactics. Four primary UTAUT constructs—performance expectancy, effort expectancy, social influence, and facilitating conditions—are incorporated into this study methodology. For this study, 200 members of the millennial generation participated in a survey. Path analysis techniques were employed in the data analysis to examine the correlation between the variables in the study model. The analysis's conclusions demonstrate that, both directly and through the mediation of user satisfaction, the UTAUT variable significantly influences users' preferences for utilizing m-health applications. This research also highlights the significance of user happiness in influencing preferences. Marketers can utilize this information to inform the development of more successful marketing plans aimed at encouraging the millennial age to adopt mhealth apps. The results have practical significance for marketers creating more engaging and relevant marketing campaigns, as well as for m-health app developers and healthcare providers creating tactics that boost millennials' happiness and user uptake.

The user-centered design and development of a childhood and adolescent obesity Electronic Health Record tool, a mixed-methods study.

Childhood and adolescent obesity are persistent public health issues in the United States. Childhood obesity Electronic Health Record (EHR) tools strengthen provider-patient relationships and improve outcomes, but there are currently limited EHR tools that are linked to adolescent mHealth apps. This study is part of a larger study entitled, CommitFit, which features both an adolescent-targeted mobile health application (mHealth app) and an ambulatory EHR tool. The CommitFit mHealth app was designed to be paired with the CommitFit EHR tool for integration into clinical spaces for shared decision-making with patients and clinicians. The objective of this sub-study was to identify the functional and design needs and preferences of healthcare clinicians and professionals for the development of the CommitFit EHR tool, specifically as it relates to childhood and adolescent obesity management. We utilized a user-centered design process with a mixed-method approach. Focus groups were used to assess current in-clinic practices, deficits, and general beliefs and preferences regarding the management of childhood and adolescent obesity. A pre- and post-focus group survey helped assess the perception of the design and functionality of the CommitFit EHR tool and other obesity clinic needs. Iterative design development of the CommitFit EHR tool occurred throughout the process. A total of 12 healthcare providers participated throughout the three focus group sessions. Two themes emerged regarding EHR design: (1) Functional Needs, including Enhancing Clinical Practices and Workflow, and (2) Visualization, including Colors and Graphs. Responses from the surveys (n = 52) further reflect the need for Functionality and User-Interface Design by clinicians. Clinicians want the CommitFit EHR tool to enhance in-clinic adolescent lifestyle counseling, be easy to use, and presentable to adolescent patients and their caregivers. Additionally, we found that clinicians preferred colors and graphs that improved readability and usability. During each step of feedback from focus group sessions and the survey, the design of the CommitFit EHR tool was updated and co-developed by clinicians in an iterative user-centered design process. More research is needed to explore clinician actual user analytics for the CommitFit EHR tool to evaluate real-time workflow, design, and function needs. The effectiveness of the CommitFit mHealth and EHR tool as a weight management intervention needs to be evaluated in the future.

Patient evaluation of Klick, a technology-enabled, nurse-delivered HIV outpatient pathway.

Klick is a clinic-specific, digitally supported outpatient pathway of care for people living with HIV (PLWH). It involves a smartphone application (app) for PLWH to self-manage their care, navigate access to the clinic and communicate with their healthcare provider. We present a patient evaluation of Klick. Patients use Klick to book/reschedule appointments, view laboratory results, request medication, access remote nurse-delivered consultations and communicate with clinicians. In October 2022, Klick was evaluated by PLWH through a questionnaire and interviews. Between August 2020 and April 2024, 5859 patients had registered to use Klick; during April 2024 alone, 2509 (43%) used Klick. In October 2022, 1661 PLWH were invited to complete surveys, of whom 362 (22%) responded. These respondents were 95% (340/358) male and 84% (298/354) white, and 63% (227/359) were in the age range 41-60 years. Respondents felt Klick was easy to use (average score 4.3/5), and 92% thought having a clinic-specific app was important/very important. Respondents valued the following app features as important/very important - online booking (93%); viewable results (94%); prescription requests (90%) - and rated their experience of using them highly - 91% for e-booking and 91% for viewable results. A total of 93% said they would recommend Klick to friends and 82% rated Klick as above average/excellent. PLWH reported high levels of satisfaction using a clinic-specific mHealth app to manage their HIV care and demonstrated sustained active use. Klick was rated easy to use, as helping to meet healthcare needs and as providing a superior experience for some aspects of care. Other HIV clinics or services managing chronic conditions could benefit from the adoption of personalized digital solutions to enhance patient care.

Effectiveness of an mHealth App That Uses Financial Incentives and Gamification to Promote Health Behavior Change in Adolescents and Caregivers: Protocol for a Clinic-Based Randomized Controlled Trial.

Adolescent and adult obesity continues to be a public health epidemic in the United States. Despite the popularity of mHealth apps with gamification among adolescents, there are insufficient studies to evaluate the efficacy of gamified mHealth apps and financial incentives to motivate sustained health behavior change in adolescents or their adult caregivers. This study aims to evaluate the effectiveness of gamification techniques and financial incentives used in the novel "CommitFit" mHealth app to motivate health behavior change and improve various mental and physical health metrics in adolescents and their caregivers. This study is a 3-month randomized controlled trial (RCT) with 30 adolescents (aged 13-15 years) and their adult caregivers (N=60). It evaluates "CommitFit," which uses gamification including points and leaderboards to motivate logging and achievement of self-selected health behavior goals (eg, more water, sleep, physical activity, fruits, or vegetables or fewer sugary beverages). The RCT had three arms, each with 10 dyads: (1) CommitFit-only users; (2) CommitFit$, where adolescents were paid US $0.05 for each point they earned; and (3) waitlist control. Intervention dyads used the app for 3 months and had the option to use it for the fourth month without prompts or extra financial incentives. User analytic software was used to evaluate the frequency of user logs and goal achievement. Monthly surveys evaluated self-reported change in the 5 CommitFit health behaviors. Changes in BMI and blood pressure were evaluated for all participants at 3 clinical visits. Mental health, gamification, and behavior economics surveys were completed during the clinical visits. Recruitment began in August 2023 and was completed in 10 weeks. The research team successfully recruited and enrolled 30 dyads. Researchers emailed and called 89 caregivers on a physician-approved adolescent patient list, a 33% recruitment rate. Data collection and analysis will be conducted in the spring and summer of 2024. The results of this study are anticipated to be published between late 2024 and early 2025. This RCT will expand knowledge of the effectiveness of gamification techniques, financial incentives, and mHealth apps to motivate sustained health behavior change among adolescents and caregivers. These results may offer new opportunities to caregivers, health insurers, health care systems, and clinicians to motivate health behavior change in adolescents and caregivers, with the ultimate goal of preventing or reducing obesity and obesity-related diseases. Additional gamification, mental health surveys, and app user analytics included in the study may provide further insight into the characteristics of adolescents or caregivers who would benefit the most from using a gamified mHealth app like CommitFit. DERR1-10.2196/63505.

How Patient-Generated Data Enhance Patient-Provider Communication in Chronic Care: Field Study in Design Science Research.

Modern approaches such as patient-centered care ask health care providers (eg, nurses, physicians, and dietitians) to activate and include patients to participate in their health care. Mobile health (mHealth) is integral in this endeavor to be more patient centric. However, structural and regulatory barriers have hindered its adoption. Existing mHealth apps often fail to activate and engage patients sufficiently. Moreover, such systems seldom integrate well with health care providers' workflow. This study investigated how patient-provider communication behaviors change when introducing patient-generated data into patient-provider communication. We adopted the design science approach to design PatientHub, an integrated digital health system that engages patients and providers in patient-centered care for weight management. PatientHub was developed in 4 iterations and was evaluated in a 3-week field study with 27 patients and 6 physicians. We analyzed 54 video recordings of PatientHub-supported consultations and interviews with patients and physicians. PatientHub introduces patient-generated data into patient-provider communication. We observed 3 emerging behaviors when introducing patient-generated data into consultations. We named these behaviors emotion labeling, expectation decelerating, and decision ping-pong. Our findings show how these behaviors enhance patient-provider communication and facilitate patient-centered care. Introducing patient-generated data leads to behaviors that make consultations more personal, actionable, trustworthy, and equal. The results of this study indicate that patient-generated data facilitate patient-centered care by activating and engaging patients and providers. We propose 3 design principles for patient-centered communication. Patient-centered communication informs the design of future mHealth systems and offers insights into the inner workings of mHealth-supported patient-provider communication in chronic care.

Penetration of M-Health Apps and Devices among Undergraduate Medical Students in Puducherry: A Cross-Sectional Study

Background: With advance in technologies, there is a notable shift in healthcare industry towards integrating mobile health solutions. Medical students are at the forefront to be proficient in the use of cutting-edge medical technologies. This study gives insight about the penetration of m-health among the budding young doctors of Puducherry. Materials and Methods: A facility based analytical cross-sectional study was conducted among 390 undergraduate medical students over a period of two months (Aug-September 2023). Pre-tested semi-structured questionnaire was used to estimate the m-health app/device user, usage pattern and attitude towards m-health apps/devices. Data collected in google form and descriptive statistics was done using MS Excel 2019. Chi square test was applied to find the association between study participant characteristic and m-health app/device user. Results: Proportion of the participants using m-health app was 31.8%. The M-health devices used by the participants were smartphone (100.0%), smartwatch (54%), wrist band (32.2%), blood pressure monitoring device (13.7%). They were using for physical fitness (85.5%), clinical training (32.3%) and disease monitoring (26.6%). Around half 46% of the participants were using it for at least once in a day. Majority (91.1%) were highly confident and confident on the results provided by m-health apps/devices. Proportion of male participants using were higher compared to the female participants. Conclusion: Around one-third of the participants are using mhealth. Almost majority for physical fitness. Male gender was associated with m-health app use. Though there are few downsides with the advancing technology it will be addressed with its evolution.

Predicting Long-Term Engagement in mHealth Apps: Comparative Study of Engagement Indices.

Digital health care apps, including digital therapeutics, have the potential to increase accessibility and improve patient engagement by overcoming the limitations of traditional facility-based medical treatments. However, there are no established tools capable of quantitatively measuring long-term engagement at present. This study aimed to evaluate an existing engagement index (EI) in a commercial health management app for long-term use and compare it with a newly developed EI. Participants were recruited from cancer survivors enrolled in a randomized controlled trial that evaluated the impact of mobile health apps on recovery. Of these patients, 240 were included in the study and randomly assigned to the Noom app (Noom Inc). The newly developed EI was compared with the existing EI, and a long-term use analysis was conducted. Furthermore, the new EI was evaluated based on adapted measurements from the Web Matrix Visitor Index, focusing on click depth, recency, and loyalty indices. The newly developed EI model outperformed the existing EI model in terms of predicting EI of a 6- to 9-month period based on the EI of a 3- to 6-month period. The existing model had a mean squared error of 0.096, a root mean squared error of 0.310, and an R2 of 0.053. Meanwhile, the newly developed EI models showed improved performance, with the best one achieving a mean squared error of 0.025, root mean squared error of 0.157, and R2 of 0.610. The existing EI exhibited significant associations: the click depth index (hazard ratio [HR] 0.49, 95% CI 0.29-0.84; P<.001) and loyalty index (HR 0.17, 95% CI 0.09-0.31; P<.001) were significantly associated with improved survival, whereas the recency index exhibited no significant association (HR 1.30, 95% CI 1.70-2.42; P=.41). Among the new EI models, the EI with a menu combination of menus available in the app's free version yielded the most promising result. Furthermore, it exhibited significant associations with the loyalty index (HR 0.32, 95% CI 0.16-0.62; P<.001) and the recency index (HR 0.47, 95% CI 0.30-0.75; P<.001). The newly developed EI model outperformed the existing model in terms of the prediction of long-term user engagement and compliance in a mobile health app context. We emphasized the importance of log data and suggested avenues for future research to address the subjectivity of the EI and incorporate a broader range of indices for comprehensive evaluation.

The regulatory status of health apps that employ gamification

Smartphone applications are one of the main delivery modalities in digital health. Many of these mHealth apps use gamification to engage users, improve user experience, and achieve better health outcomes. Yet, it remains unclear whether gamified approaches help to deliver effective, safe, and clinically beneficial products to users. This study examines the compliance of 69 gamified mHealth apps with the EU Medical Device Regulation and assesses the specific risks arising from the gamified nature of these apps. Of the identified apps, 32 (46.4%) were considered non-medical devices; seven (10.1%) were already cleared/approved by the regulatory authorities, and 31 (44.9%) apps were assessed as likely non-compliant or potentially non-compliant with regulatory requirements. These applications and one approved application were assessed as on the market without the required regulatory approvals. According to our analysis, a higher proportion of these apps would be classified as medical devices in the US. The level of risk posed by gamification remains ambiguous. While most apps showed only a weak link between the degree of gamification and potential risks, this link was stronger for those apps with a high degree of gamification or an immersive game experience.

Integration of a smartphone app with posttraumatic stress disorder treatment for frontline workers: a pilot study

ABSTRACT Objective Treatment of posttraumatic stress disorder (PTSD) is hindered by limited uptake, early drop-out and non-response. This pilot study aimed to explore the feasibility, acceptability, and usability of a mobile app as part of a blended approach to treating frontline workers experiencing PTSD. Method A single-group pre-post study was conducted with 10 adult frontline workers (firefighters, police, correctional workers) receiving trauma-focused cognitive-behavioural therapy for PTSD. Participants used an app (Support Base) designed to consolidate session content and encourage independent skills practice. At post-treatment, feasibility was assessed via app usage data and participant feedback, usability via the mHealth App Usability Questionnaire, and acceptability via items from the Mobile Application Rating Scale: user version. Results Usability ratings were above average and the app received an overall mean rating of 3.4/5. Despite generally positive attitudes towards using technology in therapy, participants had low levels of confidence/experience with wellbeing apps and almost half preferred using the standard treatment workbook. Clinicians highlighted a range of client barriers to app use, including difficulties in clinician/client collaboration. Overall, there was significant pre- to post-treatment improvement in clinical measures of PTSD and depression, but this change cannot be tied to app use. Conclusions Although Support Base was viewed by participants as usable and acceptable, there were feasibility issues which must be further considered in delivering this form of care. Due to the uncontrolled study design, any additive effects of the app beyond standard clinical treatment could not be assessed. The development of a more integrated blended care model is a potential avenue for future research.

Methodological approaches in developing and implementing digital health interventions amongst underserved women.

Minority populations are utilizing mobile health applications more frequently to access health information. One group that may benefit from using mHealth technology is underserved women, specifically those on community supervision. Discuss methodological approaches for navigating digital health strategies to address underserved women's health disparities. Using an intersectional lens, we identified strategies for conducting research using digital health technology and artificial intelligence amongst the underserved, particularly those with community supervision. We explore (1) methodological approaches that combine traditional research methods with precision medicine, digital phenotyping, and ecological momentary assessment; (2) implications for artificial intelligence; and (3) ethical considerations with data collection, storage, and engagement. Researchers must address gendered differences related to health, social, and economic disparities concurrently with an unwavering focus on the protection of human subjects when addressing the unique needs of underserved women while utilizing digital health methodologies. Women on community supervision in South Central Texas helped inform the design of JUN, the mHealth app we reported in the case exemplar. JUN is named after the Junonia shell, a native shell to South Texas, which means strength, power, and self-sufficiency, like the participants in our preliminary studies.

Abstract P186: Current practices and interest in mobile health among individuals with or at risk for hypertensive disorders of pregnancy

Background: The integration of smartphones, mobile health (mHealth) apps, and digital therapeutics into healthcare has transformed remote monitoring and patient-provider communication. Such technologies are currently underutilized, but could provide value to those in need of more frequent monitoring. Pregnant individuals with or at risk for hypertensive disorders of pregnancy (HDP) could potentially benefit from this technology. Methods: Pregnant individuals, ages 20-50, with a diagnosis of or risk factors for HDP, were recruited from a large academic medical center from June 2020 to January 2024 to complete an electronic survey. Data on sociodemographic variables, smartphone/wearable device use, health app and patient portal (MyChart) use, and interest in mHealth apps were collected. Statistical analysis was done using STATA/BE 18.0. Results: Of the 103 participants, the mean age was 31.9 (SD 5.5) years, 44.6% were Hispanic or Black, and 98.1% used smartphones ( Table ). Individuals over age 30 had lower smartphone use than those under 30 (p=0.04) and most with a smartphone had mhealth apps (64.4%). Interest in wearing a smartwatch for remote monitoring and communicating with providers via a secure mhealth app was high among participants (88.3% and 78.6% respectively). No significant differences in these interests were observed by race, age, and residence (urban/suburban vs. rural). Conclusion: Pregnant individuals with or at risk for HDP demonstrated high interest in using mhealth applications and smartwatches for communication with providers and remote monitoring. Effectively integrating these technologies into patient care may enhance access to and increased engagement with care among individuals with high-risk pregnancies.

Evaluation criteria for lifestyle applications – The role of MAUQ factors in satisfaction

Abstract The most common health-related apps are lifestyle apps, i.e., fitness, nutrition, diet, and meditation apps, which account for half of all m-health apps on the market. Mobile app-based interventions have been shown to be effective in improving diet-related health outcomes. The aim of this study is to map the usage patterns of lifestyle apps (fitness, diet, and relaxation apps) and identify the role of each factor in the usability of MAUQ (m-Health App Usability Questionnaire) factor - ease of use, interface satisfaction, and usefulness - in overall satisfaction. Data were collected through an online survey in Hungary with 348 users of various lifestyle applications, i.e., fitness (30.2%), nutrition (31.3%), and mindfulness (38.5%) apps. Respondents showed a preference for free apps over paid ones and predominantly used iOS operating systems. The partial least squares structural equation modelling (PLS-SEM) method was used to identify the role of usability dimensions in overall satisfaction. The satisfaction of lifestyle app users is positively influenced by ‘Ease of Use’ and ‘Interface and Satisfaction’. However, effectiveness (positive physical and mental health outcomes) negatively influences satisfaction. Research can be particularly useful for app developers, as usability and design (features) play a particularly important role in satisfaction, so these are primary considerations in development.

O42 USABILITY AND EFFECT OF A HYPERTENSION MOBILE APPLICATION IN KNOWLEDGE AND GUIDELINES ADHERENCE OF FAMILY AND COMMUNITY MEDICINE RESIDENTS

Background: Mobile health (mHealth) applications have become integral in medical education and information access, yet effectiveness varies, and barriers to engagement persist. OBJECTIVE: This study aimed to assess the usability and effectiveness of the mHealth application entitled Hypertension Now in increasing knowledge and guideline adherence among residents. Methods: A before-and-after educational intervention study was conducted among residents of the Department of Family and Community Medicine (DFCM), Philippines General Hospital from January to August 2023. The intervention was a newly developed medical reference app for managing hypertension based on the latest local and international hypertension guidelines. Usability, knowledge score, and adherence rate were measured using a questionnaire, pre- and post-intervention examinations, and medical chart audits. Results: All 32 DFCM residents participated in the study. The app was rated high on ease of use and usefulness for practice by the residents. It was also rated high on interface and overall satisfaction. It significantly increased the knowledge scores of the residents by 1.6 points (p=0.001). The proportion of those who passed the exam significantly increased post-intervention (37.5% vs. 59.4%, p=0.035). Moreover, the app increased the adherence of the residents to proper physical examination (82% vs. 91%, p=0.024), diagnosis (80% vs. 90%, p=0.012), and pharmacologic treatment (53% vs. 83%, p=0.001). There was no increase in adherence to proper risk assessment (83% vs. 78%, p=0.371), laboratory examination (35% vs. 40%, p=0.329), and non-pharmacologic treatment (77% vs. 81%, p=0.470). Conclusion: The mHealth app for hypertension management was usable and effective in increasing the knowledge of family and community medicine residents in managing hypertension. While the app increased guideline adherence to physical examinations, diagnostics, and pharmacological treatments for hypertension, it did not increase adherence to risk assessment, laboratory examination, and non-pharmacologic treatment.

Exploring User Experiences with a Persuasive mHealth App for Breastfeeding: An Empirical Investigation

Women are increasingly turning to mHealth apps as primary sources for breastfeeding education and support. The rising prevalence of mHealth apps presents a unique opportunity to explore their impact on women’s breastfeeding experiences. Understanding user perspectives of these apps, especially focusing on their persuasive design aspects, can offer valuable insights for enhancing maternal and child health outcomes. These insights can optimize these technologies to align with user values and promote sustained healthy behaviors. This study aimed to undertake an empirical exploration of users’ experiences with the persuasive design features employed in the Milky Way mHealth app and align the findings with human values within the value-sensitive design (VSD) framework. Semi-structured interviews were conducted with a group of women who had used the Milky Way app. Interview data were analyzed using an inductive thematic approach. To provide insight into users’ values mediated by the app, a deductive analysis complemented by a data-driven inductive approach was performed. Data analysis was supported by NVivo data-management software. Findings from the study demonstrate that the persuasive design elements in the Milky Way app significantly influence users’ experiences. The analysis provided four primary themes: Informative, Easy to use, Credible, and Social connection. Overall, participants praised the app’s trustworthy educational content and support features as valuable resources for addressing breastfeeding challenges and obtaining reliable support. Participants expressed concerns about information overload and emphasized the importance of personalized support and evidence-based tailored recommendations. The results demonstrated that users’ values were expressed and embedded within the app. The analysis indicated an alignment between the app design features and the values and opinions of the users within the VSD framework. This study interprets women’s perspectives utilizing the Milky Way app and highlights the significance of its evidenced-based educational and support features. Further investigation into potential user values like privacy, remains crucial for a comprehensive user-centered app design. The empirical insights gained from this study contribute to future research, informing the development and design of ethically considerate persuasive mHealth apps to maintain their relevance in promoting positive user experiences and facilitating meaningful behavior change.

From resistance to acceptance: developing health task measures to boost mHealth adoption among older adults: mixed-methods approach and innovation resistance

PurposeThere are two main objectives in this study. First, we aim to develop a set of constructs for health task management support (HTMS) features to evaluate which health-related tasks are supported by mobile health application (mHealth app) functions. Second, drawing on innovation resistance theory (IRT), we examine the impacts of the newly developed HTMS dimensions on perceived usefulness, alongside other barrier factors contributing to technology anxiety.Design/methodology/approachUsing a mixed-method research design, this research seeks to develop new measurement scales that reflect how mHealth apps support older adults’ health-related needs based on interviews. Subsequently, data were collected from older adults and exploratory factor analysis was used to confirm the validity of the new scales. Partial least squares structural equation modeling (PLS-SEM) was used to analyze survey data from 602 older adults.FindingsThe PLS-SEM results indicated that medical management task support, dietary task support, and exercise task support were positively associated with perceived usefulness, while perceived complexity and dispositional resistance to change were identified as antecedents of technology anxiety. Perceived usefulness and technology anxiety were found to positively and negatively influence adoption intention, respectively.Originality/valueThis study enriches the information systems literature by developing a multidimensional construct that delineates how older adults’ health-related needs can be supported by features of mHealth apps. Drawing on IRT, we complement the existing literature on resistance to innovation by systematically examining the impact of five types of barriers on technology anxiety.