JMIR Publications

ABSTRACT

Background:

Interest in mHealth or the use of use of mobile computing and communication technologies in health care, public health and personal wellness has increased significantly recently. Initial research suggests that health outcomes can be improved by use of brief messaging communications.

Objective:

Lacking from our current understanding however is knowledge about content suitability for such mHealth technology that can be applied in a targeted manner across multiple consumer groups, with the aim of achieving sustained consumer engagement.

Methods:

With this in mind this paper reports on a two-study research approach using observations and in-depth interviews at three time points each, investigating mHealth engagement with solo (single person) technology use and mHealth engagement in a social (group) context. O’Brien and Toms (2008) was used as a departure point to investigate the engagement stages.

Results:

In addition to the four stages of engagement identified by O’Brien and Toms (2008); point of engagement, period of engagement, disengagement and reengagement, we identified two additional stages of engagement; self-management and limited engagement. Self-management refers to a stage where users had completely disengaged from their technology, however, were still engaged with their health activity whereas limited engagement refers to when group mHealth users who had very minimal interaction with their mHealth technology but engaged to contribute to the group. These six engagement stages are non-linear with users skipping stages based on motivation and accountability to engage. The results revealed that each engagement stage was characterized by communication themes of varying importance. These nine communication themes included: usability, features, aesthetics of the technology; use motivation, health awareness, goal setting and social support of the user and positive experiences, negative experiences and interruptions when engaging with the mHealth itself. Themes were found to have more relevance at different stages in engagement for example at the point of engagement, aesthetics of the technology and features were very important whereas specific goals and positive experience was not as important. These nine communication themes were underpinned by 56 attributes relating to mHealth engagement such as an attractive interface, ergonomic device and unobtrusive being attributes of technology aesthetics.

Conclusions:

This research supports a five-step process to help develop effective brief communication content across a broad application of mHealth relevant contexts, utilizing the engagement stages identified in this research, the communication themes and relevant attributes.