Exploring the determinants of engagement in the context of mHealth and social media among young people: A systematic literature review
Moses Private Mbetse, Bester Chimbo, Lario MalunganaObjectives
Integration of social media (SM) with mobile health (mHealth) platforms presents significant potential to address the persistent challenge of disengagement in digital health interventions among young people. However, empirical evidence supporting this combined approach remains limited, as SM and mHealth are often examined in isolation. This systematic review aimed to identify and synthesise the determinants influencing the participation in SM and mHealth interventions for behaviour change among young people aged 14 to 35 years.
Methods
A systematic search of Scopus, Web of Science, PubMed, and the ACM Digital Library was conducted to identify peer-reviewed empirical studies published between 2019 and 2024. The review followed the PRISMA framework. Eligible studies examined health behaviour interventions that employ mobile or web-based platforms accessible via smartphones or wearables. Thematic synthesis drew on constructs from the Unified Theory of Acceptance and Use of Technology (UTAUT) and the Expectation-Confirmation Model (ECM) to interpret determinants of engagement.
Results
Twenty studies met the inclusion criteria, representing diverse geographical contexts, with 35% from the USA and 15% each from South Africa and Australia, while other regions contributed 10% and 5% each. Sexual and reproductive health (55%) was the most common intervention focus above other health domains. Determinants of sustained engagement were identified at three levels: (i) user-level (ii) intervention-level and (iii) contextual-level factors. Engagement was highest when interventions aligned with behavioural readiness, provided peer-reinforced support, and offered user-centred adaptive design. Conversely, digital inequities, privacy concerns, and commercial algorithmic bias constrained participation in low-resource settings.
Conclusion
Sustained engagement depends on user motivation, health awareness, cultural and gender sensitivity, and equitable digital access. While integration improves behavioural adherence through social reinforcement and personalisation, risks linked to data privacy, misinformation, and commercial exploitation necessitate robust ethical governance. Context-responsive, rights-based, and gender-inclusive digital health strategies are essential to ensure equitable participation and sustained behavioural outcomes among young people.