Bridging the Gap: Barriers and Facilitators to Mobile Health Use in Cardiovascular Prevention

Abstract Background The persistent burden of cardiovascular diseases (CVDs) underscores the need to improve prevention strategies. Mobile health (mHealth) technologies offer promising solutions to tailor preventive interventions. However, several factors may hinder or accelerate their real-world implementation. This scoping review aimed to map barriers and facilitators to the implementation of mHealth in CVD prevention in the context of a larger project, titled INNOvative personalized cardiovascular disease PREVention in high-risk adults (INNOPREV) (PNRR-MAD-2022-12375795), which aims to evaluate the use of Polygenic Risk Score and digital technologies in personalized cardiovascular prevention in Italy. Methods PubMed and Scopus were searched without geographical or temporal restrictions up to April 2024. Eligible studies reporting evidence on barriers and/or facilitators were analyzed using the Consolidated Framework for Implementation Research (CFIR), enabling their systematic classification across five major domains (intervention characteristics, outer setting, inner setting, characteristics of individuals, and process). Results Out of 2,923 records, 27 articles were considered. Most studies were conducted in the United States (44%) and Canada (15%). Most frequently reported barriers and facilitators were related to intervention and individuals’ characteristics domains. In respect to the intervention characteristics key barriers were technical difficulties and lack of user-friendly design, which might contribute to poor users’ adherence and engagement. For the individuals’ characteristics barriers were linked to gender and racial disparities, socioeconomic status, low digital literacy, and level of physical and psychological distress coming from mHealth use. Conclusions Effective implementation of mHealth in CVD prevention requires careful consideration of the role played by individual factors, as well as by mHealth design and characteristics. Key messages • Successful mHealth implementation in CVD prevention depends on aligning technology with user needs, clinical workflows, and organizational support. • Targeting key barriers and enablers may enhance adoption and impact of mHealth interventions in cardiovascular care.