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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
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)
Complex registration process