Psychosocial Determinants of mHealth Application Adherence for Healthy Eating: A Systematic Literature Review

<ns5:p>Objective This systematic review evaluates the psychosocial determinants of user adherence to mobile health (mHealth) applications for healthy eating published between 2020 and 2026. It synthesizes the interplay between internal psychological drivers, socioeconomic or life-stage vulnerabilities, and technological frameworks, mapping these factors to objective dietary compliance and clinical metabolic outcomes. Methods Following PRISMA 2020 guidelines, a systematic search was performed across Scopus, ScienceDirect, and Google Scholar. From 566 initial records, screening based on strict inclusion criteria (peer-reviewed, original empirical research, focusing on mHealth dietary adherence) yielded 14 high-quality primary core studies for qualitative thematic synthesis, supplemented by 10 contextual studies, totaling 24 integrated references. Results Synthesis reveals that long-term mHealth adherence is driven by intrinsic motivation and self-efficacy, but restricted by tracking fatigue and diabetes burnout. Socioeconomic barriers (data costs, food insecurity) and developmental stages heavily dictate engagement; adolescents require gamified visual rewards, whereas older cohorts need simplified interfaces to mitigate digital anxiety. In clinical and oncological settings, app usage serves as a vital lifeline but follows a volatile, symptom-dependent cycle. Structurally, "human-in-the-loop" architectures—integrating health coaching and family value co-creation—outperform fully automated AI systems by enhancing trust and compliance. Ultimately, sustained digital tracking directly correlates with improved biological outcomes, including optimized glycemic control (HbA1c), stabilized blood pressure, and weight maintenance. Conclusion User adherence to digital dietary interventions operates within a complex socio-ecological matrix where psychological intent continuously negotiates with life-stage vulnerabilities and technological constraints. While adaptive mHealth ecosystems demonstrate robust potential in securing long-term metabolic health, human-centered design frameworks and integrated public health policies are critically needed to mitigate digital inequities and achieve sustainable behavioral outcomes.</ns5:p>