JMIR Publications

ABSTRACT

Background:

Mobile health applications for weight and glycemic control support self-monitoring and behavior change but declining engagement has been observed over time. While relapse in diet and exercise is common, there is a lack of understanding on how users experience relapse within digital contexts or how applications should respond during these periods.

Objective:

To explore how users of mobile health apps for weight and glycemic control experience, manage, and wish to be supported during dietary and exercise relapses.

Methods:

A descriptive qualitative design was adopted in this study. Semi-structured online interviews were conducted with 26 adults who had used weight or glycemic control applications for at least three months and experienced at least one relapse. Interview data was analyzed using inductive thematic analysis.

Results:

Seven themes emerged, which include Relapse Catalyst; Cultural, environmental, and contextual disruptions; Psychological disengagement and avoidance mechanisms; Social influence and interpersonal dynamics; Relapse: an emotional disengagement rather than a behavioral failure; Informal relapse management, Self-driven recalibration; and Desire for compassionate, context-aware support. Stress (42%) and cultural or contextual disruptions (31%) were key relapse triggers. Psychological avoidance (54%) amplified disengagement. Most participants (69%) described relapse as emotional disengagement rather than behavioral failure. Management was largely self-driven (58%), and 85% desired compassionate, context-aware digital support.

Conclusions:

Relapse in mHealth contexts is emotionally mediated and cyclic. Integrating adaptive, non-judgmental, and relapse-responsive features may enhance sustained engagement and chronic disease self-management.