JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) interventions can be effective for people living with human immunodeficiency virus, who are sensitive to privacy breach risks. Understanding the perceived experiences of intervention participants can provide comprehensive insights into potential users and predict intervention effectiveness. Thus, it is necessary to plan engagement measurement and consider ways to enhance engagement during the app development phase.

Objective:

To evaluate engagement with an mHealth app using the engagement index and time, and to examine differences in engagement according to participant characteristics.

Methods:

This observational study, conducted from March 27 to August 31, 2024, was based on an engagement evaluation framework. Two hundred and sixty-one people living with human immunodeficiency virus across 13 medical institutions and three related organizations in South Korea engaged in an app-based intervention for four weeks. Self-reported surveys were conducted before and after the app usage period, and usage data were collected during the intervention to assess user engagement. User engagement was evaluated using two measures: engagement index and engagement time. The engagement index represents a standardized percentage derived from five sub-indices: click-depth, loyalty, recency, feedback, and interaction index.

Results:

The mean engagement index and time was 64.34 ± 15.78% and 70.42 ± 121.10 minutes, respectively, with a statistically significant positive correlation between the two (r = .391, p < .001). The engagement index was higher among those with self-help group participation (t = 2.44, 95% confidence interval = 0.06 to 0.59, p = .015), and participants in their 40s showed significantly longer engagement times compared with those in their 20s (F = 4.36, 95% confidence interval = 0.01 to 0.10, p = .005). There were no differences in engagement index and time according to other personal characteristics.

Conclusions:

When developing mHealth apps for people living with human immunodeficiency virus, it is essential to track both objective indicators such as login data and subjective indicators such as patient experience for comprehensive intervention evaluation. Based on this study’s results, high engagement suggests that apps should prioritize user needs through rewards, privacy protection, tailored information, and aesthetic features. While the app in this study demonstrated inclusive usability, targeted support strategies may benefit users without self-help group participation. Clinical Trial: KCT0009213. Registered 06/02/2024, first recruitment 27/03/2024.