Engagement and Use of a Blended mHealth Intervention for Health Behavior Change.

Background: Blended mHealth interventions (mHealth interventions including a facilitator) promote user engagement and increase effectiveness of health behavior change interventions. Little is known about how blended mHealth interventions are used outside the research context.

Methods: In the present work, we characterized patterns of app use among users of a blended mHealth intervention in real-world conditions. Program users were Veterans Health Administration (VHA) primary care patients (n = 56) who received an invite code for a blended mHealth intervention between 2019 and 2021. Cluster analysis was used to examine user engagement with health coach visits and program features.

Results: Of patients who received an invite code, 34% initiated the program. Most users were men (63%) and white (57%). The mean number of health conditions was 5 (68% with obesity). The mean age was 55. Cluster analysis suggested that most users did sustain engagement at either moderate (57%) or very high levels (13%). The remaining 30% of users were low engaged users. Users completing any health coach visit (about half) reported more overall engagement than their counterparts who did not. Weight was the most frequently tracked metric. Of users entering weights in the first and last month of the program (n = 18), the mean percent body weight change was 4.0% (SD = 3.6).

Conclusions: A blended mHealth intervention may be a scalable option to extend the reach of health behavior change interventions for those that use it. However, a significant portion of users do not initiate these interventions, choose not to use the health coach feature, or engage at lower levels. Future research should examine the role of health coaching visits in promoting sustained engagement.