Reconceptualizing Patient Engagement with Mobile Healthcare Apps: A Computationally Intensive Theory Development for Patient Engagement Networks

Mobile healthcare apps are increasingly used to enhance patient engagement, yet research has rarely examined the underlying mechanisms that shape this engagement. Addressing this gap, the present study adopts a computationally intensive theory development approach to explore how mobile healthcare apps afford patient engagement. To this end, rather than focusing on isolated app affordances, we examine affordance networks – interconnected patterns of app usage by patients and clinicians – and their association with diverse engagement goals. Through empirical analysis and an abductive reasoning process, we reconceptualize patient engagement with mobile healthcare apps as Patient Engagement Networks (PENs): linked sets of collaborative digital actions between patients and/or clinicians, enacted by mobile healthcare apps, that support the pursuit of healthcare goals. We propose four distinct modes of PENs, such as emergent, time-deliberate, supportive, and self-service, each reflecting a unique configuration of engagement. These findings offer valuable theoretical and practical insights into the evolving nature of digital healthcare interactions.