Engagement and Mobile Health. Are Solutions Measuring Up?

mobile_health.jpgContributor: Connie Mester, MPH
To learn more about Connie, click here

Engagement Is a Top Priority. Today, most people rely on mobile technology for day-to-day needs, including engaging with their health. mHealth tools provide an effective way to access quality health support, keeping people engaged with their own health outcomes. Are the mHealth programs you are recommending or using empowering people to thrive?

You don’t need to see statistics to know that more and more people are using their mobile devices and online channels to search for and access health information and support. But the actual numbers may surprise you. In 2014, 247 million health-related smartphone apps were downloaded,1 with an estimated 500 million people using mobile healthcare applications in 2015.2

Mobile health (mHealth) holds great promise for transforming healthcare delivery and improving outcomes. Currently, there are thousands of mHealth apps available for a variety of uses and conditions ranging from battling cancer, dealing with diabetes, or managing stress.3 Unfortunately, not all of these tools are designed with knowledge of the human-computer interface or health behavior change theories.

By taking the time to carefully consider these guidelines, you can be sure you’re choosing an effective mHealth solution that sustains engagement and influences behavior change for users, while also delivering measurable business improve-ments.  By exploring industry standard measures proven in literature, research, and available industry reports,4-8 and also reviewing the best practices, tactics, and techniques from apps outside of healthcare, our team combined that with primary research and user interviews to establish five key criteria that can help guide your evaluation process and outline meaningful differences.

1. WHAT [content]: Personally tailored information and resources
People expect mobile solutions and applications to be personalized to their specific needs. mHealth is no different. Content must be targeted and tailored to its audience in order to deliver an appropriate and engaging experience. More than that, information must be simple and understandable so individuals can immediately begin using the tool without becoming overwhelmed. If content isn’t well written or the app is poorly organized, users will consider it a waste of time and move on.

As with any health solution, the quality of information is also critical to effectiveness. Resources should be comprehensive, concise, accurate, and credible. Check to make sure links take users to information that enhances the program and that information is updated in light of new evidence. Finally, verify the content quality to make sure the program is grounded in theory, built on evidence-based principles, and has been outcomes-tested with positive results.

2. HOW [engage]: Responsive, multi-media environment with intuitive interface
Today’s consumers demand more than words on a screen. An effective app must include multi-media content that’s cleanly integrated with relatable messages. Users should feel as if the app was built for them, speaking their language and offering a variety of connectivity options.

The functionality and interface should be responsive and intuitive. If things aren’t logically sequenced and a person can’t pick it up and start using it quickly and easily, they won’t stick with it. The program should be straightforward to navigate and provide shortcuts for ease of use. Performance should be polished and clean, free from any bugs or glitches. And gestural design — swipes, taps, pinches, etc. — should be consistent throughout the entire app allowing a user to confidentially perform actions.

3. WHO [focus]: Patient is active, engaged participant in health and wellness
Users expect digestible information delivered in aesthetically appealing ways. Visual charts, images, infographics, videos, and photography can help tell a story and provide meaning to shared information. Stylistic consistency, color use, size presentation, and layout should be clean and professional while conveying a personality that resonates with targeted individuals.

The look and feel draws users in, while a carefully crafted experience inspires action. The program should adapt to different learning styles and engage users with techniques, tips, measurable goals, and other elements that make them active participants in their own growth and success.

4. WHERE & WHEN [integrate]: Guided strategies readily available to incorporate into daily life
What happens beyond the app is just as important as what happens within. Users should be given tools and strategies that enable them to put what they’ve learned into practical application. These tools should be easy to find and simple to incorporate into personal routines.

Keys to continued use include making strategies stimulating and fun. The appropriate use of entertainment can grab interest, encourage use, and inspire repeat engagement. The more users can tailor strategies to their own lives, the better. Build an environment that fosters trust and enables a person to see their progress through direct and timely feedback. A variety of interactive channels also enhance mHealth solutions, giving users a number of ways to share their voice (forums and community), link support (peer connections), and personalize the experience (user options and customizable strategies).

5. WHY [outcomes]: Proactive, responsive, and prevention focused
Finally, it’s critical to remember the intended impact of the solution and what users want or need to get out of the program. As users progress through the program, it should be responsive to their personal progress and growth, empowering them to guide their intended outcome if possible. This enables users to stay on track and achieve success on an individualized basis. When a program “feels right,” it stimulates repeat use and deeper engagement.

Users can’t feel like they’re in a void. Service and support must be easily available and fit with the busy lifestyles and schedules of users. Help lines, FAQs, tips, and other support deliver a greater sense of encouragement and involvement. And don’t forget about privacy, safety, and compliance. If an app hasn’t taken these key details into account, it could mean a careless interface at best or future legal problems for you at the worst.

Use this tool [http://thrive47.com/checklist] grounded in research, best practices, and user feedback, to help you determine strengths and weaknesses of your programs, identify areas of opportunity, and support your planning efforts. With the right mHealth solutions in place, you can sustain engagement and influence behavior change for users while delivering measurable value and results.

Contact Connie at:
[email protected]
Thrive 4-7
[email protected]
(o) 919.650.2173



  1. Get Real Health. mHealth Tools are Transforming Healthcare. Get Real Health. 2014. Available at http://www.getrealhealth.com/mhealth/. Accessed Oct. 7, 2015.
  2. Jahns RG. 500m people will be using healthcare mobile applications in 2015. research2guidance. 2010. Available at http://research2guidance.com/500m-people-will-be-using-healthcare-mobile-applications-in-2015/. Accessed Oct. 7, 2015.
  3. Vollmer Dahlke D, Fair K, Hong YA, Beaudoin CE, Pulczinski J, and Ory MG. Apps Seeking Theories: Results of a Study on the Use of Health Behavior Change Theories in Cancer Survivorship Mobile Apps. JMIR mHealth and uHealth. 2015;3(1):e31.
  4. Mendiola MF, Kalnicki M, and Lindenauer S. Valuable Features in Mobile Health Apps for Patients and Consumers: Content Analysis of Apps and User Ratings. JMIR mHealth and uHealth. 2015;3(2):e40.
  5. O’Grady L, Witteman H, Bender JL, Urowitz S, Wiljer D, and Jadad AR. Measuring the Impact of a Moving Target: Towards a Dynamic Framework for Evaluating Collaborative Adaptive Interactive Technologies. Journal of Medical Internet Research. 2009;11(2):e20.
  6. Pricewaterhouse Coopers PwC. Building mHealth business models that work. PwC. n. d. Available at http://www.pwc.com/gx/en/industries/healthcare/mhealth/business-strategies.html. Accessed Oct. 7, 2015.
  7. Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, and Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR mHealth and uHealth. 2015;3(1):e27.
  8. Su W-C. A Preliminary Survey of Knowledge Discovery on Smartphone Applications (apps): Principles, Techniques and Research Directions for E-health. 2014 ICME International Conference on Complex Medical Engineering; June 26, 2014; Taipei, Taiwan.