Theoretical Advancements in mHealth: A Systematic Review of Mobile Apps.
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There are now few hundred thousand healthcare apps yet there is a gap in our understanding of the theoretical mechanisms for which and how technological features translate into improved healthcare outcomes In particular the technological convergence within mobile health mHealth apps of the processes of mass and interpersonal communication and human computer interaction requires greater parsing in the literature This paper analyzed 85 empirical studies on mHealth apps using the Input Mechanism Output model We found in the literature that firstly there is a greater emphasis on technological inputs 87 of accessibility usability usage and data quality than health outputs 52 such as system process efficiencies and individual level behavioral or health outcomes Secondly there is little evidence of explanatory mechanisms 19 of how the effects of mHealth apps are achieved While we believe that successful apps would require research that incorporates technological inputs theoretical mechanisms and health outputs such studies are a rarity n 3 There is a minor increase in rigor with randomized control trials n 5 and a preponderance of discussion around social influence n 8 and gamification n 7 albeit in a scattered manner We discuss the implications of the trend towards socialization and gamification findings in terms of future research particularly in terms of study design guided by theoretical mechanisms