H_pe for mHealth: More “y” or “o” on the horizon?
Open accessAbstract
Objective Efforts in the domain of mobile health, or mHealth, have been criticized for the unfettered proliferation of pilots and a lack of a rigorous evidence base to support these strategies. In this letter, we present the response of a group of researchers in the mHealth community to the recent calls for evidence issued by global health and funding agencies. We support our conclusions through a summary of the numerous ongoing mHealth studies listed in the US federal clinical trial registry. Methods We conducted a search on the US federal clinicaltrials.gov database using the keywords “mHealth”, “mobile” or “cell AND phone” to obtain 1678 results of studies. We manually inspected each result to check if it fit the purview of an mHealth study. Studies that were terminated or withdrawn prior to submission were excluded. Results We identified 215 unique mHealth studies that were registered in the clinicaltrials.gov database, of which 8.4% (n = 18) were observational in nature while the remaining 91.6% (n = 197) were interventional. Of the 215 studies, 81.8% (n = 176) studies used a classical randomized trial design and 40 new studies were added to the database between May and November 2012 alone. Based on these results, we posit that the field is entering a new ‘era’ where a body of rigorous evaluation of mHealth strategies is rapidly accumulating. Conclusions The transition into an era of evidence-based mHealth supports our position that innovation in this domain can be evaluated with the same rigor as other public health strategies, attenuating some of the hype previously associated with mHealth.
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Equipping frontline health workers with mobile phone applications may enhance the delivery of maternal, neonatal, and child health services as well as the accuracy of data capture and recording.
“Equipping frontline health workers with mobile phone applications may enhance the delivery of maternal, neonatal, and child health services as well as the accuracy of data capture and recording [16, 26, 35, 36].”
From Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana (2016) · cites this paper as [36]
The Conclusions (page not provided) say mHealth may improve health-service delivery, the timeliness of data collection, and documentation of client interactions. They do not specifically address frontline health workers delivering maternal, neonatal, and child health services, or improved accuracy of data capture and recording. (LLM, conf=0.85)
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“In recent years, this approach has been deeply criticized due to the rapid proliferation of pilot mHealth projects that have failed to achieve efficacy and impact in real-world conditions (Labrique et al., 2013).”
BackgroundGonsalves, L., Wangari, W., Schroeder, M., Mwaisaka, J., & Gichangi, P. (2019) · JMIR mhealth and uhealth · doi:10.2196/13005 · Cited by 8 · see citing works
“Although the quantity and general quality of evidence appear to be increasing in recent years [21,22], RCTs in particular can pose challenges for the digital health field; for example, blinding participants to the intervention they receive is extremely difficult [20].”
BackgroundmHealth, Health, and Mobility: A Culture-Centered Interrogation
Dutta, M. J., Kaur‐Gill, S., Tan, N. Q. P., & Lam, C. (2017) · Mobile communication in Asia · doi:10.1007/978-94-024-1251-2_6 · Cited by 8 · see citing works
Approaches to Mobile Health Evaluation: A Comparative Study
Dick, S., O’Connor, Y., & Heavin, C. (2019) · Information Systems Management · doi:10.1080/10580530.2020.1696550 · Cited by 7 · see citing works
“However, so little evidence is available on the feasibility, acceptability, and effectiveness of mHealth, that many have not been taken to scale, remaining at the pilot phase (Hall et al., 2014; Labrique et al., 2013; Shuchman, 2014).”
BackgroundMethodBLANDFORD, A. E., Bindman, J., Bradbury, K. J., Cooper, B., Costanza, E., Edwards, S. J., Hamilton, F. L., Heightman, M., Hurst, J. R., Hylton, H., et al. (2025) · ACM Transactions on Computer-Human Interaction · doi:10.1145/3711839 · Cited by 5 · see citing works
Rangachari, P., Dellsperger, K. C., & Rethemeyer, R. K. (2019) · PubMed Central · Cited by 5 · see citing works
Baulch, E., Watkins, J., & Tariq, A. (2017) · Mobile communication in Asia · doi:10.1007/978-94-024-1251-2 · Cited by 7 · see citing works
Carral, M. D. R., Roux, P., Bruchez, C., & Santiago-Delefosse, M. J. (2016) · International Journal of Psychological Studies · doi:10.5539/ijps.v8n4p26 · Cited by 5 · see citing works
ICT4D Sustainability as Generativity
Sanner, T. A. (2017) · IFIP advances in information and communication technology · doi:10.1007/978-3-319-59111-7_41 · Cited by 5 · see citing works
“Pilotitis can be articulated as “the unfettered proliferation of lightweight mHealth ‘solutions’ which fail to translate or scale into health systems” (Labrique et al., 2013, p. 2).”
BackgroundVasudevan, L., Zeller, K., & Labrique, A. B. (2018) · Health informatics · doi:10.1007/978-3-319-61446-5_2 · Cited by 5 · see citing works
Self-citationThe coming of age of digital technologies in global health within the Indian context: a review
Vivek, N. (2024) · Journal of the Egyptian Public Health Association · doi:10.1186/s42506-024-00169-5 · Cited by 4 · see citing works
“Early in the development of digital health, there was little financial backing and enthusiasm for rigorously evaluating the effects of these interventions [13].”
BackgroundMngadi, K. T., Maharaj, B., Duki, Y., Grove, D. I., & Andriesen, J. G. (2018) · JMIR Research Protocols · doi:10.2196/resprot.9396 · Cited by 4 · see citing works
“Mobile health (mHealth) is the practice of medicine and public health supported by mobile devices, which have the potential to facilitate alerts, reminders, and data collection, substantially reducing the burden on health care systems [8-11].”
BackgroundDigital Health in Low- and Middle-Income Countries
Seneviratne, M. G., & Peiris, D. (2019) · Revolutionizing Tropical Medicine · doi:10.1002/9781119282686.ch32 · Cited by 3 · see citing works
Schoenberg, N. E., Sherman, D. L., Pfammatter, A. F., Roberts, M. K., Chih, M., Vos, S. C., & Spring, B. J. (2022) · BMC Public Health · doi:10.1186/s12889-022-14475-0 · Cited by 3 · see citing works
“While our iterative formative research and pilot testing has set the stage for culturally appropriate adaptation of this evidence-based intervention, it remains undetermined whether programs such as MBC2, developed and implemented in an urban environment, can remain efficacious when implemented in rural communities [4…”
MethodFunding Global Health Projects
Morley, K., Morley, M., & Beratarrechea, A. G. (2020) · Springer eBooks · doi:10.1007/978-3-030-47994-7_5 · Cited by 3 · see citing works
“Many of these apps never make it past the pilot stage because they lack proof of usability and acceptability, clinical impact, and value (Roess 2017; Labrique et al. 2013).”
BackgroundPerspectives Piece: Realizing the Potential for Digital Health Technology in Behavioral Medicine
Aylward, B. S., Nelson, T. D., & Hommel, K. A. (2017) · Journal of Mobile Technology in Medicine · doi:10.7309/jmtm.6.1.7 · Cited by 2 · see citing works
Azimi, N. A., Hakim, B. N. A., Mohamed, H. J. J., Ismail, T. A. T., Zamh, Z.-H., Kueh, Y. C., Sukeri, S., & Mohamad, P. (2024) · Malaysian Journal of Medicine and Health Sciences · doi:10.47836/mjmhs.20.3.46 · Cited by 2 · see citing works
Medical Devices and Information Communication Technologies for the Base of the Pyramid
Friedman, Z., & Karlen, W. (2015) · Springer eBooks · doi:10.1007/978-3-319-16247-8_11 · Cited by 2 · see citing works
“A limited number of projects, however, manage to pass the pilot testing stage (Labrique et al. 2013) and go on to achieve impact at scale.”
BackgroundCommunity Health Workers (CHWs) as Innovators
Prentiss, T. C., Zervos, J., Tanniru, M. R., & Tan, J. (2017) · International Journal of Healthcare Information Systems and Informatics · doi:10.4018/ijhisi.2018010102 · Cited by 2 · see citing works
Asangansi, I. (2016) · The Electronic Journal of Information Systems in Developing Countries · doi:10.1002/j.1681-4835.2016.tb00524.x · Cited by 2 · see citing works
“The significant focus so far, though, has been on technical development, piloting, and more recently on finding and understanding the evidence of its efficacy (Labrique et al., 2013; Tomlinson et al., 2013; WHO, 2011).”
BackgroundMonitoring Quality-of-Life Parameters in Wearable Environments
Angelidis, P. A. (2018) · Inventions · doi:10.3390/inventions3010016 · Cited by 2 · see citing works
Using mHealth interventions to promote cardiovascular health
Huffman, J. C., Smith, D. M. Y., Ibrahim, N. E., Duque, L., Moskowitz, J. T., & Celano, C. M. (2018) · Acta cardiologica. Supplementum · doi:10.1080/00015385.2018.1501139 · Cited by 2 · see citing works
ICTs as catalysts in child protection programmes
Godara, B., Kumar, N., Boursin, F., Jobit, G., Amara, A., & Agagliate, T. (2019) · International Conference on Information and Communication Technologies and Development (ICTD) · doi:10.1145/3287098.3287151 · Cited by 2 · see citing works
Mpfubhusa, F. L., Lihawa, R. M., & Mbwambo, S. K. (2026) · Health Education · doi:10.1108/he-09-2025-0164 · Cited by 1 · see citing works
- Authors
- Labrique, A., Vasudevan, L., Chang, L. W., & Mehl, G.
- Affiliations
- Johns Hopkins University (US)
- World Health Organization (CH)
- Corresponding author
- Labrique, Alain
- Venue
- International Journal of Medical Informatics
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 82
- Issue
- 5
- Pages
- 467-469
- ISSN
- 1386-5056 (ISSN-L)
- PMC
- PMC3849805
- OpenAlex
- W2025562154
- Semantic Scholar
- a635a86475437c0f9f794a64e0e8db034051b2c8
- Cited by
- 111
- References
- 3
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 7 · 2021: 3 · 2020: 9 · 2019: 12 · 2018: 13 · 2017: 18 · 2016: 14 · 2015: 9 · 2014: 11 · 2013: 6
- FWCI
- 14.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Medical Informatics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH086338)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Physical Sciences › Computer Science › Information Systems › Mobile Learning in Education
- Keywords
- mobile health, evidence-based medicine, clinical trial registries, ClinicalTrials.gov, randomized controlled trials, observational studies, research evaluation, evidence base
- MeSH terms
- Humans, Quality of Health Care, Outcome Assessment, Health Care, Telemedicine, Biomedical Technology, Quality Improvement
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