New Publication on Factors Influencing Adherence to mHealth Apps for the Prevention or Management of Noncommunicable Diseases

With their research article titled “Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review,” Robert Jakob et al. aim to help stakeholders develop more effective digital health interventions by identifying factors influencing the continued use of mHealth apps targeting NCDs. They further derived quantified adherence scores to validate the qualitative findings and explore adherence benchmarks for various health domains.

The research team conducted a comprehensive systematic literature search, screening 2862 articles, of which 99 studies were included in the final data synthesis. Data on intended use, actual use, and adherence factors were extracted. Intervention-related and patient-related factors with a positive or negative influence on adherence are presented separately for the health domains of NCD self-management (diabetes, respiratory diseases, cardiovascular diseases, cancer, medication adherence), mental health, substance use, nutrition, physical activity, weight loss, multicomponent lifestyle interventions, mindfulness, and other NCDs. Quantified adherence measures, calculated as the ratio between the estimated intended use and actual use, were derived for each study and compared with the qualitative findings.

The findings indicate that the following intervention-related factors positively influence mHealth app adherence: user-friendly and technically stable app design, customizable push notifications, personalized app content, passive data tracking, an integrated app tutorial, offering the app free of charge, and the integration of personal support into the mHealth app. Furthermore, gamification and social features show promising effects but may be limited to specific health domains. Time delays within the intervention, long intervention durations, low engagement of other participants, and the competitive effects of other mHealth apps were associated with low mHealth app adherence.

Furthermore, the following user characteristics were associated with low mHealth app adherence: lack of technical competence, low health literacy, low self-efficacy, low education level, mental health burden, lack of experience with mHealth apps, privacy concerns, low expectations of the app, low trust in health care professionals conducting the intervention, and lack of time on the users’ side. Age, gender, and pre-existing condition were frequently mentioned factors but differed across and sometimes conflicted within the health domains. Furthermore, personal user recruitment appeared to positively influence adherence as opposed to web-based user recruitment.

For further details on this research article by Robert Jakob, Samira Harperink, Aaron Maria Rudolf, Elgar Fleisch, Severin Haug, Jacqueline Louise Mair, Alicia Salamanca-Sanabria, and Tobias Kowatsch, please refer to the full research article.


Jakob R, Harperink S, Rudolf A, Fleisch E, Haug S, Mair J, Salamanca-Sanabria A, Kowatsch T. 2022. Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review. J Med Internet Res 2022;24(5):e35371. URL: DOI: 10.2196/35371

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