Theoretical Advancements in mHealth: A Systematic Review of Mobile Apps
Open accessAbstract
There are now few hundred thousand healthcare apps, yet there is a gap in our understanding of the theoretical mechanisms for which, and how, technological features translate into improved healthcare outcomes. In particular, the technological convergence, within mobile health (mHealth) apps, of the processes of mass and interpersonal communication, and human-computer interaction requires greater parsing in the literature. This paper analyzed 85 empirical studies on mHealth apps using the Input-Mechanism-Output model. We found in the literature that, firstly, there is a greater emphasis on technological inputs (87%) of accessibility, usability, usage, and data quality, than health outputs (52%) such as system process efficiencies and individual level behavioral or health outcomes. Secondly, there is little evidence of explanatory mechanisms (19%) of how the effects of mHealth apps are achieved. While we believe that successful apps would require research that incorporates technological inputs, theoretical mechanisms and health outputs, such studies are a rarity (n = 3). There is a minor increase in rigor with randomized control trials (n = 5), and a preponderance of discussion around social influence (n = 8) and gamification (n = 7), albeit in a scattered manner. We discuss the implications of the trend towards socialization and gamification findings in terms of future research, particularly in terms of study design guided by theoretical mechanisms.
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The I-M-O model is proposed by Chib and Lin for understanding the effects of mobile health app use.
“Chib and Lin propose the inputs-mechanism-outputs (I-M-O) model for understanding the effects of mobile health app use [20,21].”
From Enjoyment or Indulgence? Social Media Service Usage, Social Gratification, Self-Control Failure and Emotional Health (2023) · cites this paper as [21]
Cites
Methods for the thematic synthesis of qualitative research in systematic reviews
Thomas, J., & Harden, A. (2008) · BMC Medical Research Methodology · doi:10.1186/1471-2288-8-45 · Cited by 9,312 · see citing works
Behavior change interventions delivered by mobile telephone short message service
Fjeldsoe, B. S., Marshall, A. L., & Miller, Y. D. (2009) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2008.09.040 · Cited by 1,213 · cited 1× · see citing works
“…Yu, & Xiao, 2006). mHealth has since been characterized by a focus on mobile telecommunications in a variety of healthcare delivery services (Mechael et al., 2010; Nacinovich, 2011), with the emergence of voice and text messaging (Fjeldsoe, Marshall, & Miller, 2009; Krishna, Boren, & Balas, 2009).”
BackgroundText messaging as a tool for behavior change in disease prevention and management
Cole-Lewis, H., & Kershaw, T. (2010) · Epidemiologic Reviews · doi:10.1093/epirev/mxq004 · Cited by 1,190 · cited 1× · see citing works
“In the first group, reviews found text messages as a form of one-to-many (mass) communication for dissemination of health information (Cole-Lewis & Kershaw, 2010; Higgs et al., 2014).”
BackgroundHealthcare via Cell Phones: A Systematic Review
Krishna, S., Boren, S. A., & Balas, E. A. (2009) · Telemedicine and e-Health · doi:10.1089/tmj.2008.0099 · Cited by 882 · see citing works
Saeb, S., Zhang, M., Karr, C. J., Schueller, S. M., Corden, M. E., Kording, K. P., & Mohr, D. C. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4273 · Cited by 782 · see citing works
Design of an mHealth app for the self-management of adolescent type 1 diabetes: a pilot study
Cafazzo, J. A., Casselman, M., Hamming, N., Katzman, D. K., & Palmert, M. R. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2058 · Cited by 676 · see citing works
Almirall, D., Nahum-Shani, I., Sherwood, N. E., & Murphy, S. A. (2014) · Translational Behavioral Medicine · doi:10.1007/s13142-014-0265-0 · Cited by 453 · see citing works
Turner-McGrievy, G. M., Beets, M. W., Moore, J. B., Kaczynski, A. T., Barr-Anderson, D. J., & Tate, D. F. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-001510 · Cited by 373 · see citing works
Bricker, J. B., Mull, K. E., Kientz, J. A., Vilardaga, R., Mercer, L. D., Akioka, K. J., & Heffner, J. L. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2014.07.006 · Cited by 340 · see citing works
Banos, O., Villalonga, C., Garcia, R., Saez, A., Damas, M., Holgado-Terriza, J. A., Lee, S., Pomares, H., & Rojas, I. (2015) · BioMedical Engineering OnLine · doi:10.1186/1475-925x-14-s2-s6 · Cited by 321 · see citing works
Holmen, H., Torbjørnsen, A., Wahl, A. K., Jenum, A. K., Småstuen, M. C., Årsand, E., & Ribu, L. (2014) · JMIR mHealth and uHealth · doi:10.2196/mhealth.3882 · Cited by 294 · cited 4× · see citing works
“Examining diabetes apps, Holmen et al. (2014) and Torbjørnsen et al. (2014) found no group differences in hemoglobin A 1c levels.”
BackgroundInfluentialSemple, J. L., Sharpe, S., Murnaghan, M. L., Theodoropoulos, J., & Metcalfe, K. A. (2015) · JMIR mHealth and uHealth · doi:10.2196/mhealth.3929 · Cited by 190 · see citing works
Developing mental health mobile apps: Exploring adolescents’ perspectives
Kenny, R., Dooley, B., & Fitzgerald, A. (2016) · Health Informatics Journal · doi:10.1177/1460458214555041 · Cited by 175 · see citing works
Ahtinen, A., Mattila, E., Välkkynen, P., Kaipainen, K., Vanhala, T., Ermes, M., Sairanen, E., Myllymäki, T., & Lappalainen, R. (2013) · JMIR mhealth and uhealth · doi:10.2196/mhealth.2596 · Cited by 173 · see citing works
The SmartCAT: An m-Health Platform for Ecological Momentary Intervention in Child Anxiety Treatment
Pramana, G., Parmanto, B., Kendall, P. C., & Silk, J. S. (2014) · Telemedicine and e-Health · doi:10.1089/tmj.2013.0214 · Cited by 162 · see citing works
Helander, E., Kaipainen, K., Korhonen, I., & Wansink, B. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3084 · Cited by 143 · see citing works
Higgs, E. S., Goldberg, A. B., Labrique, A. B., Cook, S. H., Schmid, C., Cole, C. F., & Obregón, R. A. (2014) · Journal of Health Communication · doi:10.1080/10810730.2014.929763 · Cited by 124 · see citing works
Chib, A., Wilkin, H., Ling, L. X., Hoefman, B., & Van Biejma, H. (2012) · Journal of Health Communication · doi:10.1080/10810730.2011.649104 · Cited by 118 · see citing works
Self-citationTorbjørnsen, A., Jenum, A. K., Småstuen, M. C., Årsand, E., Holmen, H., Wahl, A. K., & Ribu, L. (2014) · JMIR mHealth and uHealth · doi:10.2196/mhealth.3535 · Cited by 117 · see citing works
Feature-level analysis of a novel smartphone application for smoking cessation
Heffner, J. L., Vilardaga, R., Mercer, L. D., Kientz, J. A., & Bricker, J. B. (2015) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2014.977486 · Cited by 103 · cited 1× · see citing works
“Indeed, further investigation revealed that the in-app features of acceptance and commitment therapy and cognitive behavioral therapy were associated with smoking abstinence (Heffner, Vilardaga, Mercer, Kientz, & Bricker, 2015).”
Backgroundvan Drongelen, A., Boot, C. R., Hlobil, H., Twisk, J. W., Smid, T., & van der Beek, A. J. (2014) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.3447 · Cited by 101 · see citing works
Reaching Remote Health Workers in Malawi: Baseline Assessment of a Pilot mHealth Intervention
Lemay, N. V., Sullivan, T., Jumbe, B., & Perry, C. P. (2012) · Journal of Health Communication · doi:10.1080/10810730.2011.649106 · Cited by 96 · see citing works
Lin, T. T. C., & Bautista, J. R. (2017) · Journal of Health Communication · doi:10.1080/10810730.2017.1296508 · Cited by 89 · see citing works
Goldstein, C. M., Gathright, E. C., Dolansky, M. A., Gunstad, J., Sterns, A., Redle, J. D., Josephson, R., & Hughes, J. W. (2014) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x14541039 · Cited by 86 · see citing works
Usability and Feasibility of PIERS on the Move: An mHealth App for Pre-Eclampsia Triage
Lim, J., Cloete, G., Dunsmuir, D. T., Payne, B. A., Scheffer, C., von Dadelszen, P., Dumont, G. A., & Ansermino, J. M. (2015) · JMIR mHealth and uHealth · doi:10.2196/mhealth.3942 · Cited by 73 · see citing works
Predictors of utilization of a novel smoking cessation smartphone app
Zeng, E. Y., Vilardaga, R., Heffner, J. L., Mull, K. E., & Bricker, J. B. (2015) · Telemedicine and e-Health · doi:10.1089/tmj.2014.0232 · Cited by 71 · see citing works
How Willing Are Adolescents to Record Their Dietary Intake? The Mobile Food Record
Boushey, C. J., Harray, A. J., Kerr, D. A., Schap, T. E., Paterson, S., Aflague, T., Bosch Ruiz, M., Ahmad, Z., & Delp, E. J. (2015) · JMIR mHealth and uHealth · doi:10.2196/mhealth.4087 · Cited by 67 · see citing works
King, C., Hall, J., Banda, M., Beard, J., Bird, J., Kazembe, P., & Fottrell, E. (2014) · Global Health Action · doi:10.3402/gha.v7.25878 · Cited by 62 · see citing works
mHealth app for cannabis users: satisfaction and perceived usefulness
Monney, G., Penzenstadler, L., Dupraz, O., Etter, J.-F., & Khazaal, Y. (2015) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2015.00120 · Cited by 60 · see citing works
Jaensson, M., Dahlberg, K., Eriksson, M., Grönlund, Å., & Nilsson, U. (2015) · JMIR mHealth and uHealth · doi:10.2196/mhealth.4649 · Cited by 59 · see citing works
Parker, R. M., Dmitrieva, E., Frolov, S., & Gazmararian, J. A. (2012) · Journal of Health Communication · doi:10.1080/10810730.2011.649162 · Cited by 53 · see citing works
Tablet computers in support of rural and frontier clinical practice
Anderson, C., Henner, T., & Burkey, J. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2013.08.006 · Cited by 45 · see citing works
Martinez-Brockman, J. L., Harari, N., & Pérez-Escamilla, R. (2018) · Journal of Health Communication · doi:10.1080/10810730.2017.1401686 · Cited by 32 · see citing works
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Lau, N., O'Daffer, A., Colt, S., Yi-Frazier, J. P., Palermo, T. M., McCauley, E., & Rosenberg, A. R. (2020) · JMIR mhealth and uhealth · doi:10.2196/17798 · Cited by 174 · see citing works
Overcoming the Mental Health Stigma Through m-Health Apps: Results from the Healthy Minds Study
Kim, H. M., Xu, Y., & Wang, Y. (2022) · Telemedicine and e-Health · doi:10.1089/tmj.2021.0418 · Cited by 31 · see citing works
Liu, Y., Yi, H., & Jiang, C. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021002 · Cited by 9 · see citing works
“Chib and Lin propose the inputs-mechanism-outputs (I-M-O) model for understanding the effects of mobile health app use [20,21].”
BackgroundDesigning Disease-Specific mHealth Apps for Clinical Value
Keshavjee, K., Johnston-Jewell, D., Lee, B., & Kyba, R. (2022) · Smart and Pervasive Healthcare · doi:10.5772/intechopen.99945 · Cited by 6 · see citing works
- Authors
- Chib, A., & Lin, S. H.
- Affiliations
- Nanyang Technological University (SG)
- Corresponding author
- Chib, Arul
- Venue
- Journal of Health Communication
- Publisher
- Informa UK Limited
- Published
- 2018-11-02
- Volume
- 23
- Issue
- 10-11
- Pages
- 909-955
- ISSN
- 1081-0730 (ISSN-L)
- 1087-0415
- OpenAlex
- W2900899757
- Cited by
- 107
- References
- 33
- Citations by year
- 2026: 4 · 2025: 18 · 2024: 10 · 2023: 16 · 2022: 18 · 2021: 23 · 2020: 14 · 2019: 4
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Journal of Health Communication (publishedVersion)
- PubMed (publishedVersion)
- DR-NTU (Nanyang Technological University) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
- Keywords
- mobile health apps, mobile health, theoretical mechanisms, health outcomes, social influence, gamification, socialization, human-computer interaction, app usability, app accessibility, research design
- MeSH terms
- Telemedicine, Mobile Applications
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