Preferences in the Willingness to Download an mHealth App: Discrete Choice Experimental Study in Spain, Germany, and the Netherlands

Abstract

Background Despite the worldwide growth in mobile health (mHealth) tools and the possible benefits for both patients and health care providers, the adoption of mHealth is low, and only a limited number of studies have examined the intention to download mHealth apps. Objective In this study, we investigated individuals’ preferences in the adoption of a health app. Methods We conducted a discrete choice experimental study in 3 countries (Spain: n=800, Germany: n=800, and the Netherlands: n=416) with 4 different attributes and levels (ie, price: €1.99 vs €4.99 [a currency exchange rate of €1=US $1.09 is applicable] vs for free, data protection: data protection vs no information, recommendation: patients’ association vs doctors, and manufacturer: medical association vs pharmaceutical company). Participants were randomly assigned. For the analyses, we used the conditional logistic model separately for each country. Results The results showed that price and data protection were considered important factors that significantly increased the probability to download an mHealth app. In general, the source of the recommendation and the manufacturer affected the probability to download the mHealth app less. However, in Germany and the Netherlands, we found that if the app was manufactured by a pharmaceutical company, the probability to download the mHealth app decreased. Conclusions mHealth tools are highly promising to reduce health care costs and increase the effectiveness of traditional health interventions and therapies. Improving data protection, reducing costs, and creating sound business models are the major driving forces to increase the adoption of mHealth apps in the future. It is thereby essential to create trustworthy standards for mobile apps, whereby prices, legislation concerning data protection, and health professionals can have a leading role to inform the potential consumers.

Biases in the Willingness to Download a mHealth App: A Discrete Choices Experimental Study Among Nigerian Healthcare App Subscribers

“…To begin with, participants were more inclined to download free applications. This is consistent with the findings of Folkvord where Dutch users exhibit less sensitivity towards priced apps (Folkvord et al,2023).…”

Quality Assessment of Smartphone Medication Management Apps in France: Systematic Search

“…Costs attributed to “all causes” nonadherence range from US $5271 to US $52,341 [ 49 ]. The high cost of a paid app is dissuasive and hidden costs have been demonstrated as one of the main reasons for discontinuation of the use of an app [ 20 , 21 ]. To our knowledge, the superiority of a paid medication management app over a free one has yet to be demonstrated.…”

“…In addition, users frequently report hidden costs as the main reason for discontinuation [ 20 ]. So, considering the price as a dissuading factor for the adoption of health apps, proposing a paid app to this population appeared inadequate [ 21 ].…”

Understanding rural women's preferences for telephone call engagement with primary health care providers in Nigeria: a discrete choice experiment

“…To overcome this challenge, some studies in high-income countries have employed DCEs to inform programme design and identify potential barriers and facilitators of uptake. [16][17][18][19] DCEs are surveybased methods that elicit user preferences and allow the estimation of user values in situations where observable markets are absent or services are provided for free. They can measure the strength of preferences for service attributes, such as mode of delivery, frequency of interaction and provider gender, independently.…”