Determinants of mHealth Effectiveness: Evidence from a Large-Scale Experiment

Abstract

mHealth, the use of mobile technologies for healthcare management and delivery, offers great promise to promote health and improve care. However, to date, most mHealth treatments have failed to demonstrate a significant impact on clinical outcomes, and there is surprisingly little knowledge of factors that drive its efficacy. This study examines mHealth effectiveness by investigating both mHealth design and social support. To do so, we leverage one of the world’s largest field experiments on improving the health of expectant mothers and reducing the rate of cesarean sections. We hypothesize that 1) the combination of both self-directed mHealth and provider-directed mHealth ensures the highest mHealth effectiveness; 2) the husband, as one of the most significant social supports for expectant women, can be an important moderator of mHealth effectiveness. Our analyses show that the combined mHealth design achieves significant reduction in cesarean section use. In addition, a husband’s healthy behavior is pivotal in enabling mHealth interventions to be effective we find that the cesarean section reduction rate of women whose husbands engage in healthy behavior is four times higher than it is for those whose husbands do not fully engage in healthy behavior. Further analyses reveal that the husband’s healthy behavior has a stronger influence on mHealth effectiveness when the wife has higher status in the marriage. Our findings represent the first study to examine the effectiveness of these two mHealth designs (self-directed and provider-directed) and the critical role of social support in determining mHealth effectiveness. The study has important implications for both academic research and the practice of mHealth.