mHealth Applications Research Articles

Health Literacy in Mobile Health Applications: A Choice Modeling Study

The mHealth applications (mHealth apps) are shown as a promising and scalable solution for addressing various healthcare challenges and improving overall health outcomes. This study employs additive utility theory and random utility and discrete choice modeling to investigate the role of health literacy and the key constructs proposed in the Health Belief Model (HBM), namely perceived benefits, perceived barriers, perceived susceptibility, perceived severity, and self-efficacy, in influencing mHealth apps preferences. This study was conducted using a sample of 353 participants in Malaysia who are aged above 21 years old and have an income. Results show that Health Services Apps (English) is the most preferred by respondents, with education level as the strongest predictor of choice. Besides, English is the most preferred language in each category of mHealth apps as compared to the other languages. The results provide useful insights for policymakers and app developers to develop appropriate strategies for the integration of mHealth apps with existing healthcare systems. At the theoretical level, this study tries to expand the dimensions of additive utility theory on research of mHealth apps preferences and further enriches the application areas of HBM.

Mobile health apps for skin cancer triage in the general population: a qualitative study on healthcare providers’ perspectives

BackgroundMobile health (mHealth) applications (apps) integrated with artificial intelligence for skin cancer triage are increasingly available to the general public. Nevertheless, their actual uptake is limited. Although endorsement by healthcare providers (HCPs) is one of the perceived facilitators for using this technology, the perceptions of key HCPs in skin cancer triage towards those apps have not been studied.ObjectivesTo explore key HCPs’ perceived risks, benefits, and preconditions for endorsement of mHealth apps for skin cancer triage in the general population.MethodsAn in-depth qualitative online focus group (FG) study was conducted consisting of six focus groups: three with dermatologists and three with general practitioners (GPs). Dutch dermatologists and GPs were selected using purposive sampling based on age, knowledge and previous experience with AI. A total of sixteen dermatologists and seventeen GPs attended 90-minute FGs. Data were analyzed by a multidisciplinary team in a thorough thematic content analysis using multiple phases of coding derived from Grounded Theory.ResultsA total of four main risks, three main benefits, and four main preconditions for endorsement were identified. Risks perceived by HCPs concerned incorrect diagnoses, exclusion of subpopulations, and loss of GP autonomy in clinical decision making and diagnostic experience. Perceived benefits were increased skin cancer awareness, facilitation of the early detection of skin cancer, and a streamlined patient journey. Preconditions for endorsement were evidence-based verification of accuracy, integration in clinical practice, clarity about liability in case of adverse events, and accessible and inclusive app design.ConclusionsAlthough HCPs perceive pivotal risks related to the implementation of mHealth apps, they also foresee important benefits when implemented successfully. In order for HCPs to endorse those apps, emphasis must be placed on integrating accurate mHealth apps with accessible and inclusive design and functionality into clinical practice, factors that currently appear to be largely unmet.

MHealth Applications for Childhood Anxiety Disorders: Current Landscape, Challenges, and Future Directions.

We review the literature on mHealth applications for childhood anxiety disorders, highlighting current use, limitations, and future directions. Although mHealth apps targeting childhood anxiety disorders have recently increased, most have not been evaluated for clinical effectiveness, data security, or quality standards. Many apps do not contain scientifically based content and do not adequately incorporate the principles of exposure-based cognitive behavioral therapy. In addition, many apps have significant deficiencies in age-appropriateness, data security, privacy, cultural sensitivity, and accessibility. Limitations remain in terms of the standards for evaluating apps in pediatric populations. While interest in mHealth applications for childhood anxiety disorders is increasing, more research is needed to develop effective, safe, and age-appropriate digital interventions. Priorities include scientific grounding, privacy, equitable access, gamification, and parental involvement. Studies in this direction will increase the quality of applications and strengthen equality in access to mental health services.

Weight Stigma and Fat‐Shaming in Weight Loss Apps: An Analysis of App Store Discourses

ABSTRACTMobile health (mHealth) applications for weight loss have become increasingly prominent, yet their role in perpetuating weight stigma and fat‐shaming remains underexamined in sociological research. This study investigates how the persuasive discourse within app store descriptions of 95 weight loss apps may contribute to stigmatizing narratives about fatness and body weight. Drawing on qualitative content analysis, we identify two primary mechanisms of stigmatization: (1) the lack of body diversity in app imagery, which reinforces narrow esthetic norms and ideals; and (2) the moralization of body weight, whereby fatness is implicitly or explicitly associated with personal failure and social undesirability. We also highlight how the commercial imperatives driving these apps often promote a neoliberal logic of individual responsibility and bodily optimization, framing health as a market‐driven pursuit. Recognizing the stigmatizing potential of commercial mHealth tools is essential for mitigating harm and promoting more inclusive and equitable representations of bodies in digital health culture and public health discourse.

Feasibility and usability evaluation of a gamified fatigue management mobile application for persons with multiple sclerosis in everyday life.

Feasibility and usability evaluation of a gamified fatigue management mobile application for persons with multiple sclerosis in everyday life.

Emerging Methods for Integrative Management of Chronic Diseases: Utilizing mHealth Apps for Lifestyle Interventions

Background/Objectives: Mobile health (mHealth) apps have become a revolutionary tool in managing and treating chronic diseases, providing numerous advantages for both patients and healthcare providers. These apps leverage technology to offer a variety of functions that support the monitoring, management, and enhancement of a patient’s health. Methods: We performed an observational study with 147 participants, using a questionnaire to evaluate the impact of mHealth applications on lifestyle changes in individuals managing chronic health conditions, including diabetes, obesity, and hypertension. Results: The study found that 40% of participants used the app daily, with a further 24.39% using it weekly and 14.63% using it occasionally. The positive health impact of the app was evident, with improvements in key health metrics such as glucose levels (73.42%), weight (62.02%), and adherence to dietary recommendations (71.31%). Conslussions: These findings aligned with studies on the effectiveness of mHealth apps in managing chronic conditions like diabetes. These broad health improvements reported by users suggested that the app was effective in promoting healthier behaviors. The high levels of user satisfaction and engagement highlighted how effective the app was. All in all, our study found that mHealth apps are valuable tools for people managing chronic health conditions, helping to motivate users and improve their health.

A scoping review of internet access, digital literacy, and health outcomes in adults with Type 2 diabetes

Objective The aim of this scoping review is to synthesize and review current evidence of how Internet availability, Internet adoption, digital literacy, and digital health services affect health outcomes in adults with Type 2 Diabetes. Methods The scoping review includes peer-reviewed articles published in English in the last 10 years including CINAHL, PubMed, and Scopus databases. Studies that met inclusion criteria were abstracted into a literature review matrix summarizing key findings and themes. Protocol pre-registered and available here. Results The 27 studies meeting inclusion criteria indicate a limited and heterogenous understanding of how digital inequities affect diabetic health. A few themes emerged including: (1) Higher educational attainment and higher income positively impacts rates of Internet adoption, (2) older adults and rural inhabitants face disadvantages in managing diabetes due to poor Internet adoption and limited digital literacy, and (3) many populations are willing and ready to use mHealth applications, independent of their ability to use the Internet. Evidence directly linking Internet adoption to diabetes prevalence in the United States was present in one study published in 2014. Discussion and Conclusion Internet and digital inequities can negatively impact knowledge and management of Type 2 diabetes due to barriers in accessing healthcare services, digital self-care management resources, and education published online. The direct effects of Internet availability, Internet adoption, and digital literacy on diabetes outcomes are underexamined. Current population-level data examining the relationships between these factors is warranted.

Design, development, and evaluation of an mHealth app to reduce stress and promote happiness through smiling

ABSTRACT The field of mental health application research is growing, yet comprehensive, long-term studies validating claims of stress reduction and mood enhancement are limited, with many apps lacking empirical evidence. The purpose of this study was to evaluate an mHealth application called SmileApp to promote positive mood as a means of reducing stress. The design of SmileApp is grounded in psychological theories and integrates artificial intelligence (AI) and persuasive technology (PT). To evaluate SmileApp, we conducted a two-week in-the-wild study involving 72 participants. This was followed by an optional semi-structured interview with 23 participants. Quantitative results suggest that SmileApp is usable, useful, and encourages users to smile more frequently. Furthermore, qualitative results suggest that SmileApp was a unique design to help users alleviate stress. These results offer valuable insights into innovative approaches for designing mHealth applications that promote positive mood. Moreover, the findings underscore the importance of utilising technology to support emotional well-being. We present a novel approach to promote desired behaviours by motivating users to read supportive messages and playing mobile games through the act of smiling.

Abstract 4900: Barriers and facilitators influencing the implementation of a mHealth (MeMoSA) oral cancer screening program in rural communities in a low- and middle-income country: Preliminary findings of a qualitative study

Abstract Introduction: Sixty-five percent of oral cancer cases in Malaysia are detected at late stages due to poor awareness and difficulties in accessing healthcare in remote communities. The early detection of oral cancer (OC) could be overcome through teleconsultation using mHealth applications that enable remote review of clinical data and oral lesion images. We determined the feasibility of healthcare volunteers (HCVs) using a mHealth application MeMoSA for oral cancer screening in rural communities in Malaysia by identifying the barriers and facilitators of implementation. Methods: This qualitative study was part of a larger mixed-methods single-arm feasibility study. HCVs were trained to capture oral images of villagers using MeMoSA. Dentists at the nearest public clinic reviewed images remotely to give a referral decision. Suspicious high-risk oral lesions were also reviewed by specialists via MeMoSA and where warranted, make a referral directly to the nearest tertiary center for biopsy. To identify implementation barriers and facilitators, in-depth interviews were conducted with HCVs in the Malay language, which were recorded and then transcribed and translated verbatim into English. The Consolidated Framework for Implementation Research (CFIR), was used to guide interviews, coding and data analysis. Results: Forty-seven HCVs screened 1865 individuals in 12 rural villages with 93% uptake. Thirty-one HCVs were interviewed. Main themes related to the innovation and implementation process domains of CFIR. Barriers encountered by the HCVs included limited telecommunications infrastructure for internet access and community perceptions. For instance, the community's poor oral symptom knowledge, fear of knowing and lack of motivation to engage in preventive behaviors that influenced uptake of screening and adherence to follow-up appointments. HCVs overcame issues with internet access by traveling to areas with an internet connection to transmit information for teleconsultation. Facilitators included the avoidance of travelling long distances and incurring high transportation costs to be checked at the clinic, and the simplicity and user-friendly design of MeMoSA which motivated HCVs to conduct screening. In addition, HCVs’ relationship and trust towards village leaders was a major facilitator for a well-planned implementation. Conclusion: This novel approach to oral cancer screening has good reach, with motivated HCVs and could be feasible in low- and middle-income countries. However, strategies to improve barriers such as adherence to follow-up appointments are required and facilitators should be leveraged for sustained implementation. Citation Format: Senthilmani Rajendran, Nur Dinie Junaidi, Davinna Satguna Rajah, Aliya Nabil, Nurshaline Kipli, Thaddius H. Maling, Roslina Mah, Ignatius Niap, Shirley Hui Hui Hu, Suzanne Scott, Rafdzah Ahmad Zaki, Sok Ching Cheong. Barriers and facilitators influencing the implementation of a mHealth (MeMoSA) oral cancer screening program in rural communities in a low- and middle-income country: Preliminary findings of a qualitative study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4900.

To adopt or not to adopt mobile health applications? A study among Generation X mobile phone users in a developing country.

This study utilizes the extended technology acceptance model (E-TAM) to explore the key factors influencing the behavioral intention of Generation X (Gen X) users in Malaysia to adopt mobile health applications (MHAs). A total of 252 responses were gathered from the Malaysian Gen X population through an online survey using a non-probability purposive sampling technique. Data were analyzed using SmartPLS software to validate the proposed framework and provide a logical foundation for achieving the study's objectives. The results reveal that perceived system quality (PSQ), perceived mobile experience (PXS), perceived ease of use (PEOU), perceived playfulness (PPF), perceived usefulness (PU) and attitude are all positively associated with behavioral intention to use MHAs. This research extends the TAM by introducing novel constructs - PSQ, PXS and PPF - forming the E-TAM framework to analyze MHA adoption, a perspective not previously explored in the Malaysian context. From a practical standpoint, this study provides actionable insights to enhance the adoption of MHAs among Malaysia's pivotal Gen X population. The findings aim to guide the development of engaging and user-friendly mHealth applications to improve self-care capabilities and increase user satisfaction.

Barriers to the utilization of the Sehaty mobile health application in Saudi Arabia: a cross-sectional survey of non-healthcare users.

Mobile health (mHealth) applications have the potential to enhance healthcare accessibility and management. However, several barriers continue to hinder their widespread adoption. In Saudi Arabia, the Sehaty app plays a critical role in national digital health efforts, yet little is known about the challenges faced by non-healthcare users. A cross-sectional survey was conducted among 403 non-healthcare users of the Sehaty app. Data were collected using a structured, validated questionnaire assessing ten categories of barriers: technical limitations, usability challenges, accessibility constraints, privacy and security concerns, communication and interaction difficulties, functionality restrictions, user satisfaction deficits, cost-related issues, time and productivity constraints, and inadequate support and training. Descriptive statistics, correlation analysis, and group comparisons using one-way ANOVA and t-tests were performed. Technical issues such as frequent crashes and slow response times were reported as the most prominent barriers, significantly affecting user satisfaction. Usability challenges, including unintuitive navigation, were also widely reported. Privacy and security concerns-particularly regarding transparency and data protection-were major deterrents to app use. Accessibility constraints were more pronounced among older adults and those with disabilities, often compounded by limited support and training. Time inefficiencies and limited app functionality further reduced engagement. Cost-related barriers were minimal. Correlation analysis revealed strong associations among technical, usability, and functionality barriers, while demographic comparisons showed no significant differences across user groups. The findings underscore the need for comprehensive improvements to enhance the Sehaty app's usability, reliability, security, and accessibility. Addressing these challenges through technical optimisation, user-centred design, enhanced data protection, and targeted training can support broader adoption and align the app's development with Saudi Arabia's Vision 2030 digital health goals.

The core readiness of Sleman Region community on mobile health implementation: a qualitative study

Introduction: The innovation of healthcare technology has developed rapidly, including mobile health (mHealth). The success of mHealth implementation in community settings obtain influenced by core readiness factors, distinctly community needs towards mHealth. This study aims to explore the core readiness of the Sleman Region community on the use of mHealth, specifically the features needed and the determining aspects of acceptance.Methods: This study used a qualitative design and conducted in-depth interviews with 13 community members. Participants were chosen purposively by Public Health Centre with various characteristics from January-March 2020. The verbatim transcripts were analysed using the direct content analysis technique with peer debriefing.Results: There are five themes of core readiness that are identification of needs obtained feature needed, satisfaction and dissatisfaction when using existing applications, knowledge of mHealth potency including advantages and disadvantages, acceptance of aspects that determine the use of mHealth, and enthusiasm for future mHealth that including reasons whether using the application or not. Specifically, the following features needed in the community are health information, self-medication, online consultation, mapping of healthcare services, peer support group, health promotion, personal training, emergency, personal health record, and feature for specific groups. The eight determining aspects of mHealth influencing community acceptance are interface design, easiness, content delivery, cost, promotion, performance, safety, privacy, and sustainability.Conclusions: The findings indicate that the Sleman Region community stands ready to accept the implementation of mHealth based on core readiness exploration. These findings can become a consideration in the development of future mHealth applications.

Examining Healthcare Practitioners' Perceptions of Virtual Physicians, mHealth Applications, and Barriers to Adoption: Insights for Improving Patient Care and Digital Health Integration.

Mobile health (mHealth) applications have transformed healthcare by enhancing access to medical information, facilitating remote consultations, and improving patient engagement. Despite their potential, adoption challenges persist, particularly concerning usability, integration with existing healthcare systems, and user trust. The Sehhaty application, a national digital health platform in Saudi Arabia, exemplifies these challenges. Identifying the barriers that hinder healthcare practitioners' engagement with mHealth applications is crucial for optimising their implementation and ensuring equitable access to healthcare services. This study examines healthcare practitioners' perceptions of mHealth applications, with a specific focus on the Sehhaty app, to identify key adoption barriers. It further aims to provide recommendations for enhancing usability, accessibility, and integration within existing healthcare infrastructures. A cross-sectional study was conducted among 574secondary healthcare practitioners (SHCPs), including physicians, nurses, and administrative staff, working in secondary healthcare centres across Saudi Arabia. Data were collected using a structured questionnaire assessing ten primary barriers to mHealth adoption, including technical, usability, training, integration, privacy, organisational, communication, financial, and productivity-related challenges. The reliability of the instrument was evaluated using Cronbach's alpha, and descriptive statistics (frequencies, means, standard deviations) were computed. Correlation analysis was conducted to examine interrelationships among the identified barriers, providing insights into how different factors influence adoption. Data analysis was performed using SPSS (version 29) and R software. The questionnaire demonstrated excellent internal consistency (Cronbach's α = 0.95). The most significant barriers identified included Technical Barriers (Mean = 3.32), Usability Barriers (Mean = 3.05), and Integration and Workflow Challenges (Mean = 3.20). Participants reported frequent technical glitches, slow system performance, and poor compatibility with existing healthcare platforms. Usability concerns, such as complex navigation and excessive steps required to complete tasks, further hindered adoption. Integration challenges, including lack of interoperability with electronic health records, were also highlighted. Privacy and security concerns (Mean = 3.26) emerged as a significant factor affecting trust in the application. Correlation analysis revealed strong interdependencies among barriers, with Technical Barriers correlating with Usability Barriers (r = 0.69) and Integration and Workflow Barriers (r = 0.62), underscoring the compounded effect of these challenges on user adoption. Healthcare practitioners encounter multiple barriers in adopting the Sehhaty app, predominantly related to technical performance, usability, and system integration. Addressing these challenges requires targeted improvements in interface design, system interoperability, and technical support. Future research should incorporate patient perspectives, examine long-term adoption trends, and evaluate the impact of mHealth applications on clinical efficiency and patient outcomes. The study's findings provide critical insights for policymakers, healthcare institutions, and technology developers seeking to enhance mHealth usability, digital health integration, and healthcare accessibility in Saudi Arabia's evolving healthcare landscape.

Systematic review of tracking-based technology for patients with claudication.

Peripheral artery disease (PAD) typically presents with claudication. Although supervised exercise therapy is recommended, many hospitals do not have a program and therefore patients are unable to receive optimal therapy. Tracking-based technology (TBT), including activity monitors and mhealth applications, have stimulated the expansion into PAD management. This systematic review evaluates the effectiveness of TBT for claudication based on walking performance, perceived walking impairment, and quality of life (QoL). A multidatabase search was undertaken using the terms PAD OR intermittent claudication AND wearable devices OR mobile health applications. This systematic review was conducted according to PRISMA guidelines.ResultsA literature search identified 586 studies, of which 18 were eligible for inclusion. This totaled 1055 patients, with 15 randomized controlled trials and three cohort studies. Patients in the TBT group showed improvements in all walking ability parameters (including 6-minute walking distance, claudication onset time, maximum walking time, maximum walking distance, and claudication distance), QoL, and in the self-reported walking impairment questionnaires. There is evidence for supporting the introduction of TBT into the management of PAD as TBT improves walking performance, functional status, and QoL in patients with PAD. However, further information regarding adherence and compliance rates, as well as long-term outcomes, are imperative in assessing the effectiveness of TBT due to limited existing studies. PROSPERO Registration No.: CRD42022307731.

Assessing the usability of Accessercise to increase physical activity in adults with physical disabilities: A qualitative think-aloud study.

Mobile health (mHealth) applications (apps) offer a convenient way to increase physical activity to people with disabilities. While several mHealth apps have been developed for this population, there is limited evidence assessing app usability and how this might impact physical activity. To investigate the usability of a novel mHealth app, Accessercise, that aims to increase physical activity in people with physical disabilities. Twelve adults with different physical disabilities participated in a face-to-face think-aloud interview. Interviews were analysed using deductive content analysis based on the User Version of the Mobile Application Rating Scale (uMARS). Data mapped onto 12 uMARS domains; most participants expressed positive views concerning Accessercise, namely, entertainment, customisation, tailoring to the target group, ease of use and navigation, and visual information. Some additional elements were viewed positively but required modification to improve usability, perceived credibility, and relevance, including the app's layout, visual appeal, interactivity, and quality/quantity of information. This study provides an example of how the think-aloud method can be employed to evaluate mHealth apps that aims to increase physical activity in people with physical disabilities. Therefore, developers and researchers could use this study to inform future usability evaluations in this area.

Fighting Resistance With Data: Leveraging Digital Surveillance to Address Antibiotic Misuse in Nigeria

Antimicrobial resistance (AMR) represents a growing public health challenge in Nigeria. The pervasive misuse of antibiotics, insufficient regulatory frameworks, and inadequate surveillance systems exacerbate this issue. The existing methods for antibiotic monitoring are fragmented and inefficient, hindering the ability to detect real-time resistance patterns. This review delves into the role of digital surveillance technologies in combating AMR, taking advantage of electronic medical records (EMRs), mobile health (mHealth) applications, AI-powered analytics, and cloud-based databases to enhance data collection, prescription tracking, and policy interventions. Research conducted in low- and middle-income countries (LMICs), including India and Kenya, demonstrates digital tools' efficacy in addressing antimicrobial resistance (AMR). Despite these advantages, Nigeria continues to face significant challenges related to data privacy, infrastructure limitations, financial sustainability, and a digital divide between urban and rural regions. Addressing these limitations requires implementing strategic investments in health technology, establishing robust regulatory frameworks, and fostering multi-sectoral collaboration among government agencies, private sector stakeholders, healthcare institutions, and research organisations. In this review, we strongly advocate for an approach that integrates a data-driven antimicrobial resistance (AMR) surveillance system, facilitating real-time monitoring and policy-driven strategies. Nigeria can enhance antibiotic stewardship, mitigate resistance, and protect public health by evolving into a robust digital health ecosystem.

The Impact of Digital Health Interventions on Antiretroviral Therapy Adherence among Adolescents Living with HIV in Sub-Saharan Africa

Adherence to antiretroviral therapy (ART) is critical for managing HIV, yet adolescents in sub-Saharan Africa (SSA) face significant challenges in maintaining consistent treatment due to developmental, social, and structural barriers. Digital health interventions (DHIs), including SMS reminders, mobile applications, telemedicine, and remote monitoring tools, have emerged as promising solutions to improve ART adherence in this vulnerable population. Leveraging the widespread penetration of mobile phones and increasing internet access across SSA, DHIs offer personalized, accessible, and cost-effective support to address key barriers such as forgetfulness, stigma, and limited healthcare access. This review synthesizes evidence on digital health interventions’ impact on ART adherence among HIV-positive adolescents in sub-Saharan Africa, evaluating SMS reminders, mobile apps, telemedicine, peer support, and remote monitoring tools. Studies demonstrate that SMS reminders enhance adherence rates, mobile apps empower adolescents with self-management tools, and telemedicine bridges gaps in healthcare access. Peer support networks foster community and reduce isolation, while remote monitoring enables proactive intervention. However, challenges such as the digital divide, privacy concerns, and the need for healthcare provider integration remain. This review highlighted the potential of DHIs to improve ART adherence among adolescents in SSA, emphasizing the importance of context-specific, culturally appropriate interventions and addressing systemic barriers to digital access. Future research should focus on long-term impacts, scalability, and strategies to maximize the benefits of digital health technologies in advancing HIV care for adolescents in the region. Keywords: Digital Health Interventions (DHIs), Antiretroviral Therapy (ART) Adherence, Adolescents Living with HIV, Sub-Saharan Africa (SSA), Mobile Health (mHealth) Applications.

Gendered Insights into Continuance Intention for Mobile Health Applications in Indonesia: A Post-Pandemic Study on Perceived Disease Threats and Self-Efficacy

The sustained use of mobile health applications (mHealth) in the post-pandemic era is increasingly relevant due to ongoing health concerns and perceived disease threats (PDT). This study addresses significant gaps in understanding how self-efficacy and gender differences influence continuance intention (CI) to use mHealth applications. Guided by the Protection Motivation Theory (PMT), the research examines therelationships between PDT, self-efficacy, and CI, with gender as a moderating variable. Data from 415 mHealth users in Indonesia were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The findings reveal that PDT significantly influences CI, while self-efficacy directly enhances CI. Gender moderates the PDT-CI relationship, with female users showing a stronger connection. However, self-efficacydoes not mediate the PDT-CI relationship. The study highlights practical implications for mHealth developers, including the need for user-friendly and gender-sensitive designs to enhance self-efficacy and engagement. Limitations include the cross-sectional design and focus on Indonesian users, suggesting future research should adopt longitudinal approaches and explore diverse demographic and cultural contexts. The findings extend PMT's theoretical application and provide actionable insights for improving mHealth application adoption and retention in diverse populations.

Evaluating the combined effects of mobile computerized CBT and post-learning oscillatory modulation on self-esteem: a randomized controlled trial

Self-esteem, crucial for psychological well-being, can be enhanced through targeted interventions like cognitive behavioral therapy (CBT). However, traditional CBT faces various accessibility barriers. Digital health interventions such as computerized CBT and mobile health (mHealth) applications offer potential solutions. Recent research suggests that brain oscillations, particularly theta rhythms, play a key role in memory consolidation. Combining computerized CBT with post-learning theta rhythm modulation may optimize and stabilize improvements in self-esteem and promote neuro-wellbeing. This six-month longitudinal study aimed to evaluate the synergistic effects of a computerized CBT intervention (GGSE) combined with post-training theta rhythm brain modulation on improving self-esteem in young adults with low self-esteem. Participants were randomly allocated to three groups: GGSE + theta audio–visual entrainment (AVE) with Cranio-Electro Stimulation (CES), GGSE + beta AVE + CES (active control), and GGSE only (control). The intervention lasted three weeks. Assessments of self-esteem, maladaptive beliefs, and mood were conducted at baseline, 21 days, 42 days, and six months post-baseline. Although post-treatment oscillatory entrainment did not enhance the long-term efficacy of the intervention, significant treatment effects persisted for six months across all groups. These results support the potential long-term efficacy of brief, game-like, digital CBT approaches for improving self-esteem.

Insights Into How mHealth Applications Could Be Introduced Into Standard Hypertension Care in Germany: Qualitative Study With German Cardiologists and General Practitioners.

Mobile health (mHealth) apps provide innovative solutions for improving treatment adherence, facilitating lifestyle modifications, and optimizing blood pressure control in patients with hypertension. Despite their potential benefits, the adoption and recommendation of mHealth apps by physicians in Germany remain limited. This reluctance may be due to a lack of understanding of the factors influencing physicians' willingness to incorporate these digital tools into routine clinical practice. Understanding these factors is crucial for fostering greater integration of mHealth apps in hypertension care. The aim of this study was to explore the relationship between physicians' information needs and acceptance factors, and how these elements can support the effective integration of mHealth apps into daily medical routines. We conducted a qualitative study involving 24 semistructured telephone interviews with physicians, including 14 cardiologists and 10 general practitioners, who are involved in the treatment of hypertensive patients. Participants were selected through purposive sampling to ensure a diverse range of perspectives. Thematic analysis was conducted using MAXQDA software (Verbi GmbH) to identify key themes and subthemes related to the acceptance and use of mHealth apps. The analysis revealed significant variability in physicians' information needs regarding mHealth apps, particularly concerning their functionalities, clinical benefits, and potential impact on patient outcomes. These informational gaps play a critical role in determining whether physicians are willing to recommend mHealth apps to their patients. Key determinants influencing acceptance were identified, including the availability of robust knowledge about the apps, high-quality and reliable data, generational shifts within the medical profession, solid evidence supporting the effectiveness of the mHealth apps, and clearly defined areas of application and responsibilities within the physician-patient relationship. The study found that acceptance of mHealth apps could be significantly increased through targeted educational initiatives, enhanced data quality, and better integration of these tools into existing clinical workflows. Furthermore, younger physicians, more familiar with digital technologies, demonstrated greater openness to using mHealth apps, suggesting that generational changes may drive future increases in adoption. The successful integration of mHealth apps into hypertension management requires a multifaceted approach that addresses both the informational and practical concerns of physicians. By disseminating comprehensive knowledge about the variety, functionality, and proven efficacy of hypertension-related mHealth apps, health care providers can be better equipped to use these tools effectively. This approach necessitates the implementation of various knowledge transfer strategies, such as targeted training programs, peer learning opportunities, and active engagement with digital health technologies. As physicians become more informed and confident in the use of mHealth apps, their acceptance and recommendation of these tools are likely to increase, leading to more widespread adoption. Overcoming current barriers related to information deficits and data quality is essential for ensuring that mHealth apps are optimally used in routine hypertension care, ultimately improving patient outcomes and enhancing the overall quality of care. German Clinical Trials Register DRKS00029761; https://drks.de/search/de/trial/DRKS00029761. RR2-10.3389/fcvm.2022.1089968.