A Mobile Health Design Process to Improve User Engagement

It has been shown that less than 25 percent of people continue to use health and wellness apps after the first time they use them. Despite the importance of user engagement for the efficacy of such apps and mobile health (mHealth) systems, many of these interventions frequently do not incorporate user-engaging attributes. This is partly because user needs and other sociocultural contexts are overlooked during the mHealth design, development, and implementation stages. These sociocultural contexts influence users' behaviours, and thus it is critical to capture this across the various stages of mHealth design and development. Based on this, a research gap was identified, leading to the development of the following research question targeting community health workers in Global South settings: How can a design framework be developed to improve community health workers (CHWs) engagement in mHealth technologies? The aim is PhD thesis is to develop an mHealth design process (or framework) called the Design Process Engagement Enhancement System (DECENT) which takes account of socio-cultural contexts in the design process of mHealth systems and improves community health workers' engagement with the designed mHealth technology. This framework is intended to be used by mHealth designers and developers in the field of mHealth. There are three contributions from this thesis. First, the expansion of O'Briens and Toms' engagement model. The process of expanding the engagement model resulted in the identification of engagement themes that have an impact on stages of engagement with mHealth that end users encounter in an mHealth setting. Second, this work makes an important contribution to practice. The DECENT framework is intended to be used by NGOs and mHealth practitioners. Finally, the contribution to theory by developing an analytical and methodological framework for analyzing frameworks based on activity the (AT) and communicative ecology framework (CEF).