gms | German Medical Science

Background: In the use of mobile health (mHealth) services, Germany is still behind in a European comparison [1]. Although the barriers towards an implementation of such is being researched [2], the experiences on the part of integration into everyday practice are only available in isolated cases. One of which is the FeverApp [3] which will be the subject of this research. The FeverApp is a mHealth app that allows parents to record, track, and manage children's fever events and symptoms. By providing scientific information based on current guidelines of the leading pediatric societies in Germany (BVKJ e.V. and DGKJ e.V.), the FeverApp helps parents better understand and safely manage fever.

Aim Record and determine the distribution factors of mHealth applications in Germany using the example of FeverApp.

Methods: Data from the FeverApp Registry (DRKS ID: DRKS00016591), which has included over 22,000 app users since its inception in early 2020 through January 2023, spread across more than 650 pediatric and adolescent practices, were used for analysis.

To record the recruitment process, it was observed when a profile was created and with which doctor's practice, it corresponded. The practice code can be extracted from the respective family code. The variable of the creation of the profile is used as the measurement time. Together with the practice code, a recruitment history can be generated, which shows in which month how many profiles were created by how many practices. From the difference, an indicator can be generated that shows how many recruits per practice. To differentiate between intrinsicly and extrinsicly motivated practices data is used from three states where a proportion of all practices that were not already cooperating at that time were cold acquired and sent a "starter package". Furthermore, a time series model in the form of Seasonal Autoregressive Integrated Moving Average (SARIMA) was created that explicitly supports univariate time series data with a seasonal component [4].

Results: The general recruitment trend of the FeverApp project is steadily increasing, with a clear increase in quarter four of 2020. The total number of practices increases over time, but the recruitment coefficient seems to decrease, i.e. more practices recruit overall, but the individual recruits fewer people on average. Furthermore, cold acquired practices have significantly smaller recruitment numbers than those who have actively engaged themselves in the FeverApp project. The SARIMA shows distinctive seasonal differences: Between November and March, we see an increased increase in profiles created, which then levels off again in the summer months.

Discussion: The wide range of recruitment coefficients shows that there are many factors in play when distributing a mHealth application in Germany, which are to be evaluated further. There are general implications, which can be derived from this research, which can lead to better understanding in distribution of mHealth in general. Especially the intrinsic and extrinsic motivational factors of the practices seem to have a big impact on distribution. Seasonal impact factors are to be observed depending on the field in which the mHealth product is applied.

The authors declare that they have no competing interests.

The authors declare that a positive ethics committee vote has been obtained.