Perceptions of factors influencing engagement with health and wellbeing apps: a qualitative study using the COM-B model and Theoretical Domains Framework

Abstract

Objectives. User engagement with health and wellbeing apps is typically poor. Understanding factors that influence engagement can inform the design of more engaging apps. This study explored users’ experiences of and reasons for engaging and not engaging with health and wellbeing apps. / Methods. UK-based adults (N=17) interested in using a health or wellbeing app took part in a semi-structured interview to explore experiences of engaging with these apps. Data were analysed with the framework approach, informed by the Capability, Opportunity, Motivation – Behaviour (COM-B) model and the Theoretical Domains Framework, two widely used frameworks that incorporate a comprehensive set of behavioural influences. / Results. Factors to influence capability included accessible information (e.g. user guidance, statistical and health information), reduced cognitive load, well-designed reminders, self-monitoring features, features that help to establish a routine, features that offer safety netting and stepping-stone app characteristics. Tailoring, peer support and embedded professional support were identified as important factors that enhance users’ opportunities for engagement. Feedback, rewards, encouragement, goal setting, action planning, self-confidence and commitment were judged to be motivation factors that affect engagement. / Conclusion. Multiple factors were identified across all components of the COM-B model that may be valuable for the development of more engaging health and wellbeing apps. Engagement appears to be influenced primarily by features that provide user guidance, promote minimal cognitive load and support self-monitoring (capability), provide embedded social support (opportunity), and goal setting with action planning (motivation)

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