ScholarWorks@성균관대학교

초록

Background. Despite increased downloads and utilization of various mobile health (mHealth) apps emphasizing the significance of technology-based remote monitoring and diagnosis for further progress [1], a major barrier to patient care in the use of mHealth interventions is attrition [2]. In addition, many mHealth studies struggle with high participant dropout rates due to the fundamental challenge of maintaining participant engagement [3]. For instance, similar to other extensive mHealth investigations, the prominent MyHeart Counts study led by Stanford University encountered significant dropout rates; the average app engagement lasted only 4.1 days [4]. In addition to this, other previous studies have found that as many as 80% of participants in mHealth interventions may only minimally engage with the service, defined as logging in fewer than twice, and only a small percentage of users consistently use the intervention over the long term [5, 6]. Although clinical trials often report retention rates of 70% or higher, these trials are typically short-term, some lasting fewer than two months, and may not reflect real-world use [7]. Besides, an observational study of app usage in a large real-world cohort discovered that only 2% had maintained continuous usage which would likely lead to improved clinical outcomes [8]. These low retention rates may indicate the minimal benefit of mHealth. In addition, some people could not be able to access or adopt mHealth to manage their health, which varies significantly by country and target population, resulting in unequal opportunities for health [9, 10]. Therefore, scrutinization of factors related to low retention rates of mHealth apps or interventions in real-world settings and barriers that prevent people from accessing and adopting mHealth is a crucial precondition for better clinical or behavioral outcomes. The main purpose of the study is to identify factors related to inequalities in the use of mobile health in each phase by conducting a systematic review of previously published articles.

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