JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) apps used for promotion raise important questions about privacy of sensitive personal health information and digital advertising literacy. Although it is common that different types of organizations support mHealth apps for promotional purposes (e.g., sponsorship, owned apps), there is little understanding of users’ perceptions regarding the safety of personal data stored in mobile apps. Persuasion knowledge, or recognition of a sponsor’s presence, characteristics, intents, competencies, and persuasion tactics, is crucial to investigate because the abundance of mHealth apps makes it difficult for users to identify their true purpose and estimate privacy-related risks.

Objective:

The aim of this study is to investigate smartphone users’ persuasion knowledge related to mHealth apps used as a promotional strategy by commercial, government, and non-profit/non-governmental organizations. This study also examines users’ willingness to share demographic and health information via those apps.

Methods:

In-depth semi-structured interviews were conducted at a large Midwestern university in the United States. Smartphone users (N = 25) were recruited from the local community.

Results:

Participants had a high level of persuasion knowledge regarding the types of app-supporting organizations and their promotional intents, but only after being probed. Participants expressed concerns about losing control over sharing personal information with mHealth apps supported by different organizations. They used alternative digital identities to protect themselves from privacy invasion, security risks, and advertising spam associated with mHealth app use. Yet, participants did not engage in reading privacy policies and statements when downloading such apps. Participants were prone to share greater amounts of personal information with the apps backed by non-profit and government agencies than by commercial companies. They were willing to “trade” some personal information for high quality and functionality of commercially supported mHealth apps. Participants inclined to share lesser than greater amounts of personal information with sponsored/branded mHealth apps and indicated that information for sharing should be more general than specific. There was a sense of fatalism in discussing health-related risks linked to mHealth app usage; and some participants did not perceive the risks to be serious.

Conclusions:

Despite high levels of persuasion knowledge related to using mHealth apps for promotion, smartphone users didn’t show a great effort in evaluating app providers and app financial sources. This may bring serious consequences related to privacy of personal and health information as it can be continuously collected and managed by the supporting organizations and third-parties. Discussion of and recommendations for safe and ethical uses of mHealth apps associated with organization/company promotional strategies and privacy protection are provided. Theoretical implications are discussed in the context of the persuasion knowledge model and dual-processing theories.