JMIR Publications

ABSTRACT

Background:

81% of youth globally do not meet the physical activity guidelines. Youth of families with a low socio-economic position (SEP) are less likely to meet the recommended physical activity guidelines. mHealth interventions are preferred by youth over traditional in-person approaches and are in line with media preferences of youth. Despite the promise of mHealth interventions in promoting physical activity, a common challenge is to engage users in the long-term or effectively. Earlier reviews highlighted the association of different design features (e.g. notifications, rewards) with engagement among adults. However, little is known on which design features are of importance to increase engagement among youth.

Objective:

In order to inform the design process of future mHealth tools it is important to investigate design features that can yield effective user engagement. This systematic review aimed to identify which design features are associated with engagement in mHealth physical activity interventions among youth, aged 4 to 18 years old.

Methods:

A systematic search was conducted in EBSCOHOST (Medline, APA PsychInfo, Psychology & Behavioral sciences collection) and Scopus. Qualitative and quantitative studies were included, if they documented design features associated with engagement. Design features and relating BCTs and engagement measures were extracted. Study quality was assessed according to the Mixed Method Assessment Tool and one-third of all screening and data extraction was double coded by a second reviewer.

Results:

Studies (n=21) showed that various features were associated with engagement, such as a clear interface, rewards, multiplayer game mode, social interaction, variety of challenges with personalized difficulty level, self-monitoring, variety of customization options, among others including self-set goals, personalized feedback, progress and a narrative. In contrary, various features need to be carefully considered while designing mHealth PA interventions, such as sounds, competition, instructions, notifications, virtual maps, or self-monitoring, facilitated by manual input. Besides, technical functionality can be considered as a prerequisite for engagement. Research addressing youth from low SEP families is very limited with regard to engagement in mHealth apps.

Conclusions:

Mismatches between different design features in terms of target group, study design, and content translation from BCTs to design features are highlighted and set up in a design guideline and future research agenda.