Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies

Siobhan O’Connor; Peter Hanlon; Catherine A. O’Donnell; Sonia Garcia; Julie Glanville; Frances S. Mair

doi:10.1186/s12911-016-0359-3

BMC Medical Informatics and Decision Making

Table 4 Factors affecting digital health engagement and recruitment

From: Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies

Barriers		Facilitators
Themes 1: Personal Agency and Motivation
Barrier Subtheme 1.1: Lack of Motivation	Lack of motivation to understand or improve health	Facilitator Subtheme 1.1: Personal Motivation	Motivation to understand and improve health
Barrier Subtheme 1.2: Awareness and understanding	Unaware of or lacks understanding of how a DHI could be helpful	Facilitator Subtheme 1.2: Awareness and understanding	Ability to understand a DHI and personal health data
Barrier Subtheme 1.3: Personal Agency (choice and control)	Alternative ways of documenting health information and managing illness	Facilitator Subtheme 1.3: Personal Agency (choice and control)	Ability to choose time and location of interaction with a DHI Ability to control electronic personal health data
Themes 2: Personal Life and Values
Barrier Subtheme 2.1: Personal lifestyle	Busy lifestyle with competing priorities	Facilitator Subtheme 2.1: Personal lifestyle	DHI fits with personal lifestyle
Barrier Subtheme 2.2: Skills and equipment	Poor digital literacy	Facilitator Subtheme 2.2: Skills and equipment	Good digital literacy
	Lack of access to equipment and the Internet		Has or can afford computer equipment or mobile device, network connectivity and a data plan
	Cost of a DHI
Barrier Subtheme 2.3: Privacy and security	Concern over the security and privacy of DHI information or interaction	Facilitator Subtheme 2.3: Privacy and security	Values the privacy and anonymity of DHI information or interaction
Theme 3: Engagement and Recruitment Approach
Barrier Subtheme 3.1: Recruitment strategy	Difficulty understanding the recruitment message	Facilitator Subtheme 3.1: Recruitment strategy	Active promotion and engagement strategies
Barrier Subtheme 3.1: Recruitment strategy	Difficulty understanding the recruitment message	Facilitator Subtheme 3.1: Recruitment strategy	Health professional acts as a gatekeeper
Barrier Subtheme 3.2: Direct support	Lack of support from family members, friends or peers	Facilitator Subtheme 3.2: Direct support	Support from family members, friends or peers offline
Barrier Subtheme 3.3: Personal advice	Lack of advice and recommendations from trusted sources	Facilitator Subtheme 3.3: Personal advice	Recommended by family members, friends or peers
Barrier Subtheme 3.4: Clinical endorsement	Lack of clinical endorsement and support for a DHI	Facilitator Subtheme 3.4: Clinical endorsement	Clinical accreditation and support for a DHI
Theme 4: Quality of the Digital Health Intervention
Barrier Subtheme 4.1 and 4.2: Negative digital health experience (quality of information or interaction)	Impersonal DHI (poor quality information or interaction)	Facilitator Subtheme 4.1 and 4.2: Positive digital health experience (quality of information or interaction)	Open, honest digital interaction with healthcare provider
	Lack of trust in DHI information or interaction		Previous negative experience of health services without a DHI
	Digital health interaction could be abusive		Social support from peers online
Barrier Subtheme 4.3: Usability of the DHI	DHI is difficult to use	Facilitator Subtheme 4.3: Usability of the DHI	DHI is easy to enrol in and use (automated and integrated)
Barrier Subtheme 4.3: Usability of the DHI	Complex registration process	Facilitator Subtheme 4.3: Usability of the DHI	DHI is easy to enrol in and use (automated and integrated)

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