ArticlePLOS global public health2025
Examining the challenges in sustaining user engagement with a mobile app to enhance multidrug-resistant tuberculosis (MDR-TB) care in Vietnam and its implications for implementing person-centred mHealth interventions.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Conversational mHealth Platform Designed to Support Tuberculosis Treatment Adherence in Low-Income South African Patients: Pilot Cohort Study.JMIR formative research · 2026Article
- Mapping antimicrobial resistance interventions in ASEAN countries: a scoping review of implementation patterns, One Health integration, and evidence gaps.Tropical medicine and health · 2026Review
- Association of Positive mHealth Engagement with Knowledge, Attitude, Practice, and Total KAP Among Patients with Multidrug-Resistant Tuberculosis.Healthcare (Basel, Switzerland) · 2026Article
- A Cost Analysis of Implementing Asynchronous Video Directly Observed Therapy for Monitoring Treatment in Patients with Tuberculosis Disease in Uganda.Research square · 2025Article
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Authors and funding
11 authors.
Funding
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Abstract
Digital health technologies, especially mobile application (mHealth), offer great potential for enhancing person-centred care and managing MDR-TB. The rapid expansion of digital infrastructure in Vietnam presents a valuable opportunity for such interventions. This qualitative study examines user experiences to explain reported reduction in engagement with (i.e. use of) a smartphone app which is being trialed to improve early detection and management of adverse events (AEs) among MDR-TB patients in Vietnam (VSMART trial). We conducted 37 in-depth interviews with patients and healthcare workers (HCWs) and thematically analyzed the data. Initially, patients were motivated to use the app seeing it as a promise of the provision of 'good care' from trusted healthcare workers, and over-estimated its functional capacity. However, as patients realized its functional limitations for AE reporting and management they reverted to communicating with HCWs through existing communication channels. While the app empowered patients to communicate with HCWs for AE reporting, it inadvertently increased HCWs' workloads which became difficult to manage. This resulted in a paradox where the app was used because of its social value, in spite of its limited functional value. This study reveals how relational and socially mediated effects of technology may complicate mHealth design and implementation, illuminating why 'acceptable' technologies within pilot/projects could struggle to sustain engagement a scale. To support attention to this process, we propose an explanatory framework that captures the social-functional dynamics of mHealth interventions which can guide much needed qualitative evaluation to support the design of mHealth technologies to align with stakeholders' needs and suited for integration into local healthcare systems.
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Registered trials
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