A Health App Platform Providing a Budget to Purchase Preselected Apps as an Innovative Way to Support Public Health: Qualitative Study With End Users and Other Stakeholders

Abstract

Background eHealth has the potential to improve health outcomes. However, this potential is largely untapped. Individuals face an overload of apps and have difficulties choosing suitable apps for themselves. In the FitKnip experiment, individuals were given access to a health app platform, where they could purchase reliable preselected health apps with a personal budget of €100 (US $107.35). By conducting a prospective study, we aimed to scientifically evaluate the FitKnip experiment as an innovative way to improve population health. Objective The aim of the experiment was to scientifically evaluate the FitKnip experiment as an innovative way to improve population health. More specifically, we conducted an in-depth qualitative evaluation of the concept and acceptability of FitKnip, its perceived impact on health empowerment, as well as the roles of stakeholders for the future implementation of a health app platform through focus group interviews. Methods This study followed a phenomenological research design and included 7 focus group interviews with end users and 1 with stakeholders, held between July and December 2020. End users were recruited through various institutions in the Netherlands, for example, insurance companies and local governments. All focus groups were semistructured using interview guides and were held via videoconferencing due to the COVID-19 pandemic measures. Each participant received access to a health app platform where they were enabled to purchase reliable, preselected health apps with a budget of €100 (US $107.35). The budget was valid for the entire research period. The health app platform offered 38 apps. A third party, a health care coalition, selected the apps to be included in FitKnip. The analyses were conducted according to the principles of the Framework Method. Results A priori formulated themes were concept, acceptability, health empowerment, and outcomes, and the roles of stakeholders for the future implementation of a health app platform. Both end users (n=31) and stakeholders (n=5) were enthusiastic about the concept of a health app platform. End users indicated missing apps regarding physical health and lifestyle and needing more guidance toward suitable apps. End users saw health empowerment as a precondition to using a health app platform and achieving health outcomes depending on the purchased mobile apps. End users and stakeholders identified potential providers and financing parties of FitKnip. Stakeholders recommended the establishment of a reputable national or international quality guidelines or certification for health and wellbeing apps, that can demonstrate the quality and reliability of mobile health applications. Conclusions This study showed the need for a personalized and flexible platform. Next to this, a deeper understanding of the roles of stakeholders in such initiatives is needed especially on financing and reimbursement of health promotion and digital health services. A personalized, flexible health app platform is a promising initiative to support individuals in their health.

Feasibility and Acceptability of a Health App Platform Providing Individuals With a Budget to Purchase Preselected Apps to Work on Their Health and Well-Being: Quantitative Evaluation Study

“…A health app platform is meant to guide individuals to suitable health apps; however, in current initiatives, this process is not sufficiently supported [ 32 , 33 ]. Facilitating the selection process for individuals might be the key to higher app downloads.…”

“…Other factors that increase app downloads and user engagement on health app platforms are the incorporation of personalized reminders and personal contact or coaching [ 30 - 32 ]. Indeed, the results of a follow-up study of Intellicare suggest that personal coaching through a phone call and SMS text messages, aimed at encouraging engagement with the hub app and individual health apps, can indeed be an effective strategy for increasing app downloads [ 31 ].…”

“…Indeed, the results of a follow-up study of Intellicare suggest that personal coaching through a phone call and SMS text messages, aimed at encouraging engagement with the hub app and individual health apps, can indeed be an effective strategy for increasing app downloads [ 31 ]. Participants in the qualitative study also suggested incorporating contact with professionals into future health app platforms [ 32 ].…”

“…These studies conclude that individuals with poor health, a chronic disease, or a family history of disease are more willing to work on their own health care [ 43 , 45 , 46 ]. More generally, by understanding different types of users and their motivations for using health apps, developers can create platforms that are better tailored to meet the needs of end users, or they can even create separate platforms for specific target groups and improve engagement accordingly [ 32 , 44 ].…”

“…The current quantitative study is part of a mixed methods study with a prospective pre-post interventional design ( Figure 1 ). The qualitative results (ie, focus group interviews) are reported elsewhere [ 16 ]. This study used web-based user data and questionnaires as obtained over 5 measurements over a period of 8 months: T0 (baseline), T1 (60 days), T2 (120 days), T3 (180 days), and T4 (240 days) after baseline, respectively.…”