How to make an app-based program work and show how it works

Bibliographic Data

ID19593142
AuthorsRicky Janssen (0000-0002-4485-1152, Maastricht University), Nora Engel (0000-0002-1823-3908, Vrije Universiteit Amsterdam), Anja Krumeich (0000-0001-5399-3868, Maastricht University), Aliasgar Esmail (0000-0002-1835-9252, University of Cape Town), Keertan Dheda (0000-0001-7709-5341, University of Cape Town), Réjean Thomas (0000-0002-9112-3561, CHI Health Immanuel), Nitika Pant Pai (0000-0002-4672-0500, McGill University Health Centre)
EditorsBuna Bhandari (0000-0002-0102-8844)
Year2025
Volume5
Issue9
Pagese0005034
Publication date2025-09-10
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0005034
PMID40929026
OpenAlexW4414111647
LanguageEN
References cited18

For digital health interventions, the “gold standard” of evaluating effectiveness is the randomized control trial (RCT). Yet, RCT methodology presents issues such as precluding changes to the technology during the study period as well as the use of study settings that do not reflect “real world” contexts. In this paper, we draw on empirical material from our ethnographic research on an app-based program called HIVSmart!, which is a digital strategy designed to support people in the process of HIV self-testing. We explore how this digital health approach was made to work in different contexts, and what this means for monitoring and evaluation of digital health interventions. Our analysis reveals that making technology which is “ease to use” depends on various user practices developed over time and the multiple, shifting users who define this ease of use. Furthermore, it shows that asking whether an app is “working” provides different answers at different moments, as the technology, as well as the human and physical supports around it, change and adapt over time. Therefore, questions around the feasibility of the technology, as well as ongoing monitoring efforts, need to be developed in a way that capture this fluctuation in the technology and its surroundings. Based on our insights, we contribute to implementation science approaches in the field of digital health by putting forward recommendations regarding how we can assess the effectiveness of digital health tools

Digital health · Empirical research · Usability · Focus Groups and Qualitative Methods · HIV/AIDS Research and Interventions · Mobile Health and mHealth Applications

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Open DOIOpen Access