Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 22, 2021
Date Accepted: Mar 17, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Challenges in Participant Engagement and Retention using Mobile Health Apps: A Literature Review
ABSTRACT
Background:
Mobile health (mHealth) apps are revolutionizing the way clinicians and researchers monitor and manage the health of their participants. However, many studies using mHealth apps are hampered by substantial participant drop-out, or attrition, which may impact the representativeness of the sample and the effectiveness of the study. It is therefore imperative for researchers to understand what makes the participants stay with mHealth apps and/or studies using mHealth apps.
Objective:
This study aimed to review current peer-reviewed research literature in order to identify notable factors and strategies used in participant engagement and retention of adults.
Methods:
We conducted a systematic search of PubMed, MedLine, and PsycINFO databases for mHealth studies that evaluated and assessed issues and/or strategies to improve engagement and retention of adults from 2015 to 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Notable themes were identified and narratively compared amongst different studies. A binomial regression model was generated to examine factors affecting retention.
Results:
Of the 389 identified studies, 62 were included in the review. Overall, the majority of studies were at least partially successful in maintaining participant engagement throughout. Factors related to particular elements of the app (e.g., feedback, appropriate reminders, and in-app support from peers or coaches) and strategies for research (e.g., compensation and niche samples) that promote retention were identified. Factors that obstruct retention were also identified (e.g., lack of support features, technical difficulties, and usefulness of app). The regression model results showed that a participant is more likely to not be retained than they would be retained.
Conclusions:
Retaining participants is an omnipresent challenge for mHealth studies. The insights from this review should help inform future studies about factors and strategies to improve participant retention.
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Copyright
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