A mobile health design process to improve community health workers' engagement with mobile health

Despite the significance of user engagement for the efficacy of mobile health systems, many such interventions frequently do not include user-engaging attributes. This is because, users' needs and sociocultural contexts of users' groups are frequently not considered in detail during mHealth design, implementation, and operation stages. As users' activities are influenced by their sociocultural contexts, it is important to capture such sociocultural contexts during various stages of mobile health designs. The aim of this paper is to develop a framework that improves user engagement with designed mobile health technology. This framework is intended to be used by mobile health designers and developers and it facilitates specific consideration of any sociocultural context existing. Thirty semi-structured interviews were conducted with end users and mobile health designers to investigate factors that facilitate or hinder user engagement with mobile health technologies. The results of this research show that to understand why and how users engage, continue to engage, disengage, and re-engage with previous mobile health technologies during designs of mobile apps, capturing sociocultural contexts of users during designs of mobile health apps and involving end users in designs of mobile health apps all play significant roles in improving user engagement with mobile health. This research proposes a new sociocultural framework called the Design Process Engagement Enhancement System (DECENT) that enables mobile health designers to incorporate users' values as well as the sociocultural contexts of end users into the design process of mobile systems. Global South was the setting in which DECENT is tested.