User-engagement in digital health applications: a scoping review

Abstract

Background Participation has moved from political protest to active engagement in a number of areas health. Patient engagement has transformed healthcare, and mHealth has put mobile technology at the service of health promotion. Research links user engagement to effective interventions. This review aims to understand the attributes, methods and barriers to this user engagement in mHealth. Methods This scoping review used a systematic approach to map the evidence on mHealth interventions for health promotion and prevention in accordance with the PRISMA-ScR guidelines. Scopus, Web of Science and PubMed databases were searched using keywords appropriate to each database. A two-stage selection process was used and the analysis focused on attributes of participation, methods of engagement and barriers/facilitators. Results The study analysed mHealth interventions for health promotion and prevention. From 1,533 articles, 782 were obtained and 41 were selected for analysis on the basis of pre-defined inclusion and exclusion criteria. There are different definitions and attributes of engagement, depending on the discipline and the author. There are also scales and gradations of engagement that qualify engagement according to its intensity or within the mHealth tool. User engagement methods included theory-based interventions, behaviour change techniques, user-centred design, personalisation, autonomy, peer support, motivation and gamification. Challenges included barriers to technology adoption, lack of theory-based interventions, personalisation, autonomy, peer support, motivation and gamification. Conclusion The current understanding of user participation in digital interventions reveals complexity and diversity, lacking consensus. Definitions vary among intervention providers, reflecting distinct objectives and methodologies. The absence of clear concepts and attributes emphasizes the need to refine definitions in digital health, guiding intervention evaluation and development methodologies.