ABSTRACT
Germany introduced prescription-based mobile health (mHealth) apps in October 2020, becoming the first country to offer them fully reimbursed by health insurance. These regulated apps, known as DiGAs, undergo a rigorous approval process similar to pharmaceuticals, including data protection measures and sometimes clinical trials. This study compares the user experience of DiGAs with non-prescription mHealth apps in Germany, analyzing both average app store ratings and written reviews. Our study pioneers the use of BERTopic for sentiment analysis and topic modeling in the mHealth research domain. The dataset comprises 15 DiGAs and 50 comparable apps, totaling 17,588 German-language reviews. Results reveal that DiGAs receive higher contemporary ratings than non-regulated apps (Android: 3.82 vs. 3.77; iOS: 3.78 vs. 3.53; p < 0.01; non-parametric Mann-Whitney-Wilcoxon test). Key factors contributing to positive user experience with DiGAs are customer service and personalization (15%) and ease of use (13%). However, challenges for DiGAs include software bugs (24%) and a cumbersome registration process (20%). Negative user reviews highlight concerns about therapy effectiveness (11%). Excessive pricing is the main concern for the non-regulated group (27%). Data privacy and security receive limited attention from users (DiGAs: 0.5%; comparators: 2%). In conclusion, DiGAs are generally perceived positively based on ratings and sentiment analysis of reviews. However, addressing pricing concerns in the non-regulated mHealth sector is crucial. Integrating user experience evaluation into the review process could improve adherence and health outcomes.
ABSTRACT
BACKGROUND: Although organ transplantation is a very effective clinical solution to save the lives of patients suffering from organ failure, the supply of donated organs still cannot meet its growing demand. Educating the society about organ donation is a critical success factor in increasing donation rates, especially in countries that require potential donors to proactively register and opt-in (e.g., Germany). While social media has emerged as an effective tool for disseminating health information, recent evidence suggests that published organ donation content (both online and offline), aimed at raising awareness, still lacks effectiveness. To develop recommendations for optimizing organ donation messaging via social media, this study not only examines the current state of organ donation communication on Instagram, but also identifies factors that contribute to message effectiveness. METHODS: We conducted a retrospective content analysis to in-depth assess organ donation-related content published on Instagram in Germany between January and March 2022. Systematic coding allowed to identify common themes, sentiments, and communication strategies, which were analyzed for their effectiveness using linear regression analyses. RESULTS: Of the 500 organ donation posts, 57% were published by institutional authors while the remainder was shared by private accounts. Most content was aimed at the general population and shared neutral (80%) or positive sentiments (17%). Transformative messages, positive emotions, posts published by the transplant recipient and the image of a human served as predictors for post effectiveness measured in terms of likes (p < 0.001) and comments (p < 0.01). Sharing personal experiences (p < 0.01) and highlighting the meaning of organ donations (p < 0.05) resulted in significantly higher audience engagement than any other topic discussed. CONCLUSION: Our findings highlight the need for health officials to work closely with organ transplant recipients to publicly advocate for organ donations by sharing personal and transformative messages. The high share of posts published by transplant recipients indicates a certain openness to share personal experiences with broad audiences. Different message characteristics served as predictors for message effectiveness (i.e., increased audience engagement) which can likely be extrapolated to other health-related use cases (e.g., cancer screening).
Subject(s)
Organ Transplantation , Social Media , Tissue and Organ Procurement , Humans , Retrospective Studies , Tissue DonorsABSTRACT
The study aims to (1) investigate current levels of patient acceptance of mHealth in Germany; (2) determine the influencing factors of patients' intention to use, and (3) test the influence of prescription and reimbursement status on patient acceptance. Online survey with 1349 participants, of which 1051 were complete and included for statistical analysis, from a broad cross-section of the German population, addressing both users of mobile health (mHealth) applications and people without prior experience. SEM modeling based on a combination of two theoretical frameworks: the extended Unified Theory of Acceptance and Use of Technology and Health Protective Behavior Theories were used to assess acceptance. Users of mHealth in Germany are mostly patients between the ages of 30 - 50 with mental health or endocrine conditions. General willingness to use mHealth apps / DiGAs (mHealth apps fully reimbursed by social health insurance) is high at 76%, especially if they are governmentally certified, however only 27% of respondents were willing to pay out of pocket. With the exception of a spike in performance expectancy and data security, DiGAs lack a clear differentiation from mHealth apps. Perceived self-efficacy and performance expectancy are significant predictors of willingness to use digital health interventions; with age, attitude, and e-literacy being key demographic predictors. A key takeaway for regulators, providers of mHealth apps/ DiGAs, and other stakeholders involved in mHealth adoption is the importance of addressing negative beliefs early on, targeted communication around effortless usage of mHealth services across age groups and demographics, and focus on highlighting expected benefits of mHealth app/ DiGA usage.
