Design Processes for User Engagement with Mobile Health: A Systematic Review

Despite the importance of user engagement in mHealth system efficacy, many such interventions fail to engage their users effectively. This paper provides a systematic review of 10 years of research (32 articles) on mHealth design interventions conducted between 2011 and 2020. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) model was used for this review with the IEEE, Medline EBSCO Host, ACM, and Springer databases searched for English language papers with the published range. The goal of this review was to find out which design process improves user engagement with mHealth in order to guide the development of future mHealth interventions. We discovered that the following six analytical themes influence user engagement: design goal, design target population, design method, design approach, socio-technical aspects, and design evaluation. These six analytical themes, as well as 16 other specific implementations derived from the reviewed articles, were included in a checklist designed to make designing, developing, and implementing mHealth systems easier. This study closes a gap in the literature by identifying a lack of consideration of socio-cultural contexts in the design of mHealth interventions and recommends that such socio-cultural contexts be considered and addressed in a systematic manner by identifying a design process for engaging users in mHealth interventions. Based on this, our systematic literature review recommends that a framework that captures the socio-cultural context of any mHealth implementation be refined or developed to support user engagement for mHealth.