TY  - JOUR
AU  - Van Baelen, Freek
AU  - De Regge, Melissa
AU  - Larivière, Bart
AU  - Verleye, Katrien
AU  - Schelfout, Sam
AU  - Eeckloo, Kristof
PY  - 2022
DA  - 2022/8/26
TI  - Role of Social and App-Related Factors in Behavioral Engagement With mHealth for Improved Well-being Among Chronically Ill Patients: Scenario-Based Survey Study
JO  - JMIR Mhealth Uhealth
SP  - e33772
VL  - 10
IS  - 8
KW  - mHealth app
KW  - engagement
KW  - social influence
KW  - app integration
KW  - well-being
KW  - Belgium
KW  - mHealth
KW  - behavioral
KW  - behavioral engagement
KW  - mobile health
KW  - mobile health apps
KW  - mobile phone
AB  - Background: The last decade has seen a considerable increase in the number of mobile health (mHealth) apps in everyday life. These mHealth apps have the potential to significantly improve the well-being of chronically ill patients. However, behavioral engagement with mHealth apps remains low. Objective: The aim of this study was to describe the behavioral engagement of chronically ill patients with mHealth apps by investigating (1) how it is affected by social factors (ie, physician recommendation) and app-related factors (ie, app integration) and (2) how it affects patient well-being. This study also considers the moderating effect of attachment to traditional health care and the mobile app experience among patients. Methods: We carried out a scenario-based survey study of chronically ill patients (N=521). A Bayesian structural equation modeling with mediation and moderation analysis was conducted in MPlus. Results: Both physician recommendations for mHealth app use and app integration have positive effects on the behavioral engagement of chronically ill patients with mHealth apps. Higher behavioral engagement positively affects the hedonic well-being (extent of pleasure) and the eudaemonic well-being (extent of self-efficacy) of chronically ill patients. Mobile app experience, however, positively moderates the relationship between app integration and behavioral engagement, whereas patient attachment to traditional care does not moderate the relationship between physician recommendation and behavioral engagement. Taken together, the proportion of variance explained (R²) equals 21% for behavioral engagement and 52.8% and 62.2% for hedonic and eudaemonic well-being, respectively, thereby providing support for the strong influence of app integration and physician recommendation via the mediation of the patients’ behavioral engagement on both patients’ hedonic and eudaemonic well-being. Conclusions: Physician recommendation and app integration enable behavioral engagement and promote well-being among chronically ill patients. It is thus important to take social and app-related factors into consideration during and after the development of mHealth apps. 
SN  - 2291-5222
UR  - https://mhealth.jmir.org/2022/8/e33772
UR  - https://doi.org/10.2196/33772
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36018618
DO  - 10.2196/33772
ID  - info:doi/10.2196/33772
ER  -