Benefits for thee, not for me? mHealth engagement through the lens of privacy calculus theory and trust

Despite the pervasive accessibility of mobile health applications (mHealth apps), user engagement remains a challenge, especially when sensitive health information is involved. Perceived privacy risks, the lack of benefits to oneself (e.g. improved health management) or to others (e.g. advancement of scientific research), and the lack of trust, are commonly seen as impediments to widespread and sustained engagement. In this study, we build on Privacy Calculus Theory to examine the associations of these factors with mHealth app engagement. We collected survey and behavioural data from the users of a women's health mobile app. To test our research hypotheses, we performed hierarchical multiple linear and multivariable logistic regression analyses, utilising data from about 350 participants. Our results show that the perceived benefits to others are positively related to engagement (use duration and breadth of use), while no significant association of trust, perceived privacy risks and perceived benefits to self with engagement was found. We discuss the implications of our findings for managing engagement with mHealth apps, as well as for understanding the key predictors of sustained user interaction. Additionally, we suggest directions for further complementary research to build on these insights.