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      Smartphone Users’ Persuasion Knowledge in the Context of Consumer mHealth Apps: Qualitative Study


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          Persuasion knowledge, commonly referred to as advertising literacy, is a cognitive dimension that embraces recognition of advertising, its source and audience, and understanding of advertisers’ persuasive and selling intents as well as tactics. There is little understanding of users’ awareness of organizations that develop or sponsor mobile health (mHealth) apps, especially in light of personal data privacy. Persuasion knowledge or recognition of a supporting organization’s presence, characteristics, competencies, intents, and persuasion tactics are crucial to investigate because app users have the right to know about entities that support apps and make informed decisions about app usage. The abundance of free consumer mHealth apps, especially those in the area of fitness, often makes it difficult for users to identify apps’ dual purposes, which may be related to not only helping the public manage health but also promoting the supporting organization itself and collecting users’ information for further consumer targeting by third parties.


          This study aims to investigate smartphone users’ awareness of mHealth apps’ affiliations with 3 different types of supporting organizations (commercial, government, and nonprofit); differences in users’ persuasion knowledge and mHealth app quality and credibility evaluations related to each of the 3 organization types; and users’ coping mechanisms for dealing with personal information management within consumer mHealth apps.


          In-depth semistructured interviews were conducted with 25 smartphone users from a local community in midwestern United States. Interviews were thematically analyzed using inductive and deductive approaches.


          Participants indicated that their awareness of and interest in mHealth app–supporting organizations were secondary to the app’s health management functions. After being probed, participants showed a high level of persuasion knowledge regarding the types of app-supporting organizations and their promotional intents. They thought that commercial companies sponsored mHealth apps mostly as entertainment tools, whereas noncommercial entities sponsored mHealth apps for users’ education. They assigned self-promotional motives to commercial organizations; however, they associated commercial mHealth apps with good quality and functioning. Noncommercial entities were perceived as more credible. Participants were concerned about losing control over personal information within mHealth apps supported by different organizations. They used alternative digital identities to protect themselves from privacy invasion and advertising spam. They were willing to trade some personal information for high-quality commercial mHealth apps. There was a sense of fatalism in discussing privacy risks linked to mHealth app usage, and some participants did not perceive the risks to be serious.


          The discussion of and recommendations for the safe and ethical use of mHealth apps associated with organizations’ promotional strategies and personal data protection are provided to ensure users’ awareness of and enhanced control over digitalized personal information flows. The theoretical implications are discussed in the context of the Persuasion Knowledge Model and dual-processing theories.

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          Using thematic analysis in psychology

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            What is an adequate sample size? Operationalising data saturation for theory-based interview studies.

            In interview studies, sample size is often justified by interviewing participants until reaching 'data saturation'. However, there is no agreed method of establishing this. We propose principles for deciding saturation in theory-based interview studies (where conceptual categories are pre-established by existing theory). First, specify a minimum sample size for initial analysis (initial analysis sample). Second, specify how many more interviews will be conducted without new ideas emerging (stopping criterion). We demonstrate these principles in two studies, based on the theory of planned behaviour, designed to identify three belief categories (Behavioural, Normative and Control), using an initial analysis sample of 10 and stopping criterion of 3. Study 1 (retrospective analysis of existing data) identified 84 shared beliefs of 14 general medical practitioners about managing patients with sore throat without prescribing antibiotics. The criterion for saturation was achieved for Normative beliefs but not for other beliefs or studywise saturation. In Study 2 (prospective analysis), 17 relatives of people with Paget's disease of the bone reported 44 shared beliefs about taking genetic testing. Studywise data saturation was achieved at interview 17. We propose specification of these principles for reporting data saturation in theory-based interview studies. The principles may be adaptable for other types of studies.
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              An Extended Privacy Calculus Model for E-Commerce Transactions


                Author and article information

                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                April 2021
                13 April 2021
                : 9
                : 4
                [1 ] Department of Public Relations and Advertising Beijing Normal University-Hong Kong Baptist University United International College Zhuhai China
                [2 ] Department of Advertising and Public Relations Michigan State University East Lansing, MI United States
                [3 ] Department of Journalism and Creative Media University of Alabama Tuscaloosa, AL United States
                [4 ] Department of Media and Information Michigan State University East Lansing, MI United States
                [5 ] Department of Sociology, Anthropology, and Criminal Justice Clemson University Clemson, SC United States
                [6 ] Department of Communication Clemson University Clemson, SC United States
                Author notes
                Corresponding Author: Eunsin Joo eunsinjoo@ 123456uic.edu.hk
                ©Eunsin Joo, Anastasia Kononova, Shaheen Kanthawala, Wei Peng, Shelia Cotten. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 13.04.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                Original Paper
                Original Paper

                mhealth app,personal health information sharing,mobile phone,mobile promotion strategy,persuasion knowledge


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