Acceptability of mHealth interventions amongst patients and healthcare workers

When scaling up mHealth interventions to benefit entire communities, the concept of “cultural lag” becomes exponentially relevant. Cultural lag addresses the reality that technological advances often evolve faster than the culture that is created around it (Woodard, 1934). Culture must adapt to fit new advancements, and therefore interventions may be met with some scepticism at first.

Notably, there are multiple groups that must be considered when determining the acceptability of an mHealth intervention. First, patients must be adherent to the mobile application or SMS intervention, and see value in its use beyond regular clinical treatment. Equally important, clinicians, nurses, and other healthcare professionals using the application must believe it will benefit the patients care as well as their own practice. Benefits may vary based on the purpose of the application.

Criterion for assessing mHealth acceptability will be inherently different, taking into account the “sick role” of the patient and the caretaking position of HCW’s. Perceived benefits, patient satisfaction, and patient preference of communication were used as patient acceptability criteria in a 2016 study assessing an eye care mHealth intervention in Kenya (Lodhia et al., 2016). A similar study on acceptability of an HIV-monitoring application used frequency and communication type preference and likelihood of future use as criteria (Shrestha et al, 2016). Notably, acceptability measures for healthcare workers seems to differ from patient criteria. One study assessing HCW acceptability of an electronic tracking mHealth intervention focused on rate of use, followed by perceived comfort levels and quality of documentation submitted to the record system (Chaiyachati et al, 2013).

Acceptability remains only one piece of the puzzle; even when measuredly high, uptake and upscale of new interventions may fail. Champions are needed to support both the general and healthcare communities to boost acceptability of new interventions. Healthcare providers that perceive strong benefits of an mHealth program may encourage others’ adherence to it. Community acceptance may be increased by government involvement, encouraging and training individuals for application use where needed (Lodhia et al., 2016). When scaling up new interventions for healthcare workers and patients, it is not just individual acceptability that matters, but a community belief in its benefit, as well.

  • Woodard, James W. “Critical Notes on the Culture Lag Concept.” Social Forces, vol. 12, no. 3, 1934, pp. 388–398. JSTOR, JSTOR,
  • Lodhia V, Karanja S, Lees S, Bastawrous A. Acceptability, usability, and views on deployment of peek, a mobile phone mhealth intervention for eye care in Kenya: qualitative study. JMIR Mhealth Uhealth. 2016 May 09;4(2):e30. doi: 10.2196/mhealth.4746.
  • Shrestha, R., Huedo-Medina, T.B., Altice, F.L. et al. AIDS Behav (2016).
  • Chaiyachati KH, Loveday M, Lorenz S, Lesh N, Larkan L-M, Cinti S, Friedland GH, Haberer JE. A pilot study of an mHealth application for healthcare workers: poor uptake despite high reported acceptability at a rural South African community-based MDR-TB treatment program. PLoS One. 2013;8:e64662. doi: 10.1371/journal.pone.0064662.
  • By Katie Gourlay