Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 26, 2021
Date Accepted: Sep 17, 2021
Adoption and Appropriateness of mHealth for Weight Management in the Real World: A Qualitative Investigation of Patient Perspectives
ABSTRACT
Background:
Mobile health interventions (mHealth) for weight management result in weight loss outcomes comparable to in-person treatments. However, there is little information on implementing these treatments in real-world settings.
Objective:
This work aimed to answer two implementation research questions related to mHealth for weight management: 1) What are barriers and facilitators to mHealth adoption (initial use) and engagement (continued use)? and 2) What are patient beliefs about the appropriateness (i.e., perceived fit, relevance, or compatibility) of mHealth for weight management?
Methods:
We conducted semi-structured interviews among patients with obesity in an integrated health care system. All participants had been referred to a new mHealth program, which included access to a live coach. We used rapid qualitative analysis of interviews to identify themes related to the adoption, engagement, and appropriateness of mHealth for weight management.
Results:
We interviewed 24 Veterans, seven of whom used the mHealth program. Almost all participants were 45+ years of age and two-thirds were white. Rapid analysis identified three themes. 1) Coaching both facilitates and prevents mHealth adoption and engagement by promoting accountability, but causing guilt among those not meeting goals. 2) Preferences regarding treatment form and function were a barrier to mHealth appropriateness and adoption, including preferences for in-person care and a dislike of self-monitoring. 3) A single invitation is not sufficient to facilitate adoption of a new mHealth program. Themes were unrelated to participants age, gender, race, or ethnicity
Conclusions:
In one of the first studies to assess real world use of mHealth in a group of older adults, we found that despite free access to mHealth with a live coach, most did not complete the registration process. Further research on marketing mHealth and addressing feelings of guilt and shame is needed to ensure equitable implementation of mHealth for weight management. Clinical Trial: NA
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.