Abstract
Objective
Although mobile health applications (mHealth apps) are widely used, few studies have explored their adoption from parents’ perspectives for early disease detection in toddlers.
Method
This study employs the Uses and Gratifications (U&G) theory to identify key adoption factors. Structural equation modeling (SEM) was conducted using AMOS SEM 26 and SPSS 22 for statistical analysis.
Results
A survey of 308 parents using mHealth apps revealed that intrinsic motivation does not moderate the relationship between information-seeking and satisfaction, whereas social interaction positively moderates this relationship. Parents with strong social interaction tendencies exhibit higher satisfaction in information-seeking.
Conclusion
This study contributes to the literature on mHealth adoption, offering insights for developers and policymakers to enhance early detection initiatives and improve parental engagement with mHealth apps.
Background
With the rapid growth of mobile technologies, mobile health (mHealth) applications have become an essential tool for parents seeking timely, reliable health information about their children’s well-being. 1 Parents frequently use mHealth apps to obtain information on child development, disease prevention, and health care decision-making, motivated by convenience, immediacy, and accessibility to expert-verified content. 2 As demonstrated in recent studies, these digital tools can enhance parents’ knowledge and health literacy, support decision-making, and facilitate effective communication with healthcare providers. 3
The quality and functionality of mHealth apps targeted at parents, however, vary considerably. A systematic review of publicly available mHealth apps for parents of medically complex infants found that while most apps offered accurate information and functional usability, they performed poorly in engagement, highlighting a critical gap between parental needs and app design. 2 Engagement closely linked to how well an app meets users’ psychological and social needs has thus become a vital factor in understanding parental satisfaction and continued app use.
The Uses and Gratifications (U&G) theory provides a robust framework for explaining why and how individuals adopt and engage with media technologies to fulfill specific needs for information, interaction, and satisfaction.4,5 In the context of mHealth, parents actively select and use digital resources to meet needs such as information-seeking, reassurance, and social connection. Recent research has demonstrated that parents’ satisfaction with mHealth apps is driven by their information-seeking behaviors and the social interaction opportunities these platforms afford, while intrinsic motivation plays a less central role. 6 This suggests that the relational and participatory aspects of app use such as connecting with other parents or interacting with health professionals enhance perceived usefulness and sustained engagement.
Building on prior empirical findings, this study applies the U&G theory to explore the psychological and social factors influencing Taiwanese parents’ engagement with mHealth apps. This research seeks to understand the mechanisms underlying parental adoption and satisfaction with mHealth technologies. Specifically, it examines how information-seeking, intrinsic motivation, and social interaction contribute to parental satisfaction and engagement, thereby offering evidence to guide future mHealth app development and public health promotion strategies.
mHealth apps have transformed healthcare by providing remote diagnostic tools, enhancing self-management, and increasing access to health information. 7 Prior studies have examined mHealth apps in the context of chronic disease management.8,9 Studies have explored parents’ applications on mHealth. Parents commonly seek information to support their children’s health and well-being. 10 Parents commonly use the internet to search for information about their child’s health-related symptoms and guide parental health-related decisions. 11 Parents combine all available information resources, including online sources, to enhance their knowledge or verify the validity of information received about their child’s health. 12 Even though health literacy could affect parents’ technology adoption, the study showed that parents’ desire for use of technologies for provider communication was overall high and did not differ by health literacy. 13 The study also suggested that the incorporation of eHealth literacy courses into parenting programs is crucial to promote the eHealth literacy of parents. 14 Moreover, trustworthiness and accessibility emerged as critical criteria for health resources. 15
Despite the proliferation of mHealth apps, few studies have examined how parental motivations, particularly intrinsic motivation and social interaction, influence engagement with mHealth apps. 6 This study seeks to bridge this gap by exploring factors influencing parental engagement in Taiwan using the U&G theory. 4
U&G theory posits that individuals adopt media technologies to fulfill specific needs, including entertainment, information-seeking, and social interaction.
5
Guided by this framework, we hypothesize that Figure 1: 1. 2. 3. 4. 5. Research model.

Method
Participants were recruited through the inclusion criteria required respondents to be parents or caregivers of children aged 0–3 who had experience using mHealth apps. Data collection occurred in May 2022, yielding 308 valid responses. Convenience sampling was adopted by questionnaires system, which invalid submissions were filtered out based on the predefined criteria of the online questionnaire system. The restriction to filter out invalid sample: respondents should be involved in babies’ care and visit the selected Apps for experience response.
Statistical analysis
Descriptive statistics were calculated using SPSS 22. Structural equation modeling (SEM) was conducted using AMOS 26 to test hypothesized relationships. Confirmatory factor analysis ensured construct validity, and hierarchical regression was used to analyze moderation effects.
A structured questionnaire assessed four key constructs: information-seeking, intrinsic motivation, social interaction, and satisfaction. Items were adapted from prior validated studies.16,17 Responses were measured on a five-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree).
Results
Demographic profile of respondents.
Note. n = 308.
Figure 2 and Tables 2–4 illustrate estimated values for each construct, which is crucial in our research methodology. We initiated the confirmatory factor analysis to assess the suitability of measuring the constructs and items analyzed in our model. Figure 2 shows that they exhibit factor loadings on their respective constructs at >0.5 threshold.
18
The robustness of this factor loading underscores the suitability of the selected elements to measure the intended constructs. The confidence intervals developed for the paired correlations among constructs did not include the value of 1, consistent with the principles of discriminant validity,
19
confirming the soundness of our research model (Table 2). Relations between constructs and factors. Squared multiple correlations. (※Adopt Bias-corrected percentile method). Constructs properties. Assessment of normality.
Table 3 reveals that almost all Cronbach’s alpha values for the constructs were greater than the 0.7 threshold, indicating good internal consistency.20,21 When a construct is >0.6, it aligns with acceptance criteria, 22 which is deemed as acceptable when the values are>0.5. Experts asserted that a value <0.5 is unacceptable. 23
Additionally, the overall composite reliability values meet the 0.6 standard. 24 The average variance extracted (AVE) values are close to the reference value of 0.5 (Table 3), indicating that AVE values <0.5 but with composite reliability >0.6, still suffice for convergent validity. 25 This evidence indicates that all the constructs within our research model possess acceptable convergent validity.
Table 4 shows the normality assessment and reveals that the absolute values of the skewness indicators for all variables are <3 and the kurtosis values are <10; the pattern indicates a normal distribution. Furthermore, the multivariate value, 30.67, aligns with the criterion for the multivariate normal distribution, satisfying the condition (<the summary result of 12 × 12 + 2 = 146), as interpreted by scholars. 26 These findings affirm that our study variables exhibit characteristics consistent with a normal distribution.
Means, SD, Pearson correlations, and discriminant validity.
Note. n = 308; the square roots of AVE are located along the diagonal; **p < .01.
Direct effects coefficients.
Note. Dependent variable: satisfaction, IS: information seeking, IM: intrinsic motivation.
The mediation effects of intrinsic motivation.
Note. Dependent variable: satisfaction, IS: information seeking, IM: intrinsic motivation.
**p<.01, ***p<.001.
The mediation effects of social interaction.
Note. Dependent variable: satisfaction, IS: information seeking; SI: social interaction.
*p<.05, **p<.01, ***p<.001.
Figure 3 visually represents the interaction diagram, elucidating that when social interaction is high, the impact of information seeking on satisfaction is significant, whereas, in low social interaction, the impact is nonsignificant. This graphical representation provides a clear intuitive understanding of the nuanced dynamics at play, underscoring the conditional nature of the relationship between information seeking and satisfaction across varying levels of social interaction. • • • • • Interaction plot.

Discussion
This study highlights the crucial role of social interaction in enhancing parental satisfaction with mobile health (mHealth) applications. The findings indicate that while information-seeking behavior and intrinsic motivation are both significant predictors of satisfaction, only social interaction exerts a moderating effect on this relationship. In contrast, intrinsic motivation does not mediate the association between information-seeking and satisfaction. These results suggest that parents’ engagement with mHealth apps is shaped more by the social and relational gratifications they experience such as peer support, reassurance, and connection with other caregivers or professionals than by internal enjoyment or curiosity alone.
This result aligns with the standpoint of previous study, 2 which found that mHealth apps for parents of medically complex infants performed well in terms of accuracy and functionality but scored low in user engagement. Their systematic review emphasized that most apps fail to maintain sustained interaction once basic informational needs are met. Likewise, the other study 3 reported that parents who used a child healthcare information app demonstrated higher health literacy and confidence in making medical decisions. These findings collectively support the notion that parental engagement is driven by the perceived usefulness and interactive qualities of mHealth tools, especially when these tools enable parents to exchange information and emotional support.
The observed importance of information-seeking corroborates prior research showing that parents frequently turn to online resources to locate, compare, and validate health information regarding their children.2,10,11 Within the Uses and Gratifications (U&G) theoretical framework,4,5 such behavior represents a cognitive gratification—where users actively adopt digital technologies to satisfy their informational and problem-solving needs. In this context, mHealth apps serve not merely as repositories of medical facts but as interactive environments that address multiple parental needs, including reassurance, social belonging, and perceived competence.
The moderating role of social interaction underscores that user satisfaction increases when mHealth apps facilitate community participation and dialogue. Parents are more likely to feel confident and emotionally supported when they can interact with others experiencing similar concerns. This observation corresponds with a specific research, which found that emotional connection and relational bonding significantly enhance sustained engagement with mHealth apps. 6 Furthermore, it resonates with local research in Taiwan, 14 which demonstrated that higher eHealth literacy among parents leads to more effective and confident online health information-seeking behaviors. Together, these findings suggest that mHealth apps that foster trust, encourage feedback, and provide peer reassurance can substantially improve satisfaction and engagement.
The social component of mHealth also carries important essential cultural implications. In many Asian contexts, parents may hesitate to openly discuss their children’s health conditions due to stigma or social expectations. 27 Digital health platforms provide a discreet and accessible channel for these parents to share experiences and seek guidance without fear of judgment. By enabling supportive social exchanges, mHealth apps can alleviate isolation and foster a sense of belonging. This finding explains why social interaction, rather than intrinsic motivation, emerged as a significant factor in this study.
From a practical perspective, the results offer several actionable implications: 1. For Developers: Incorporate interactive and socially oriented features such as discussion boards, experience-sharing spaces, or direct messaging to strengthen engagement. These tools can transform apps from static information portals into dynamic, community-driven platforms. 2. For Healthcare Organizations: Collaborate with mHealth platforms to provide verified information and facilitate professional consultation. Studies highlighted that maintaining consistent communication channels between users and healthcare providers promotes adherence, trust, and satisfaction.8,9 3. For Policymakers: Establish guidelines ensuring content accuracy, privacy protection, and equitable access. Research emphasized that policy support is crucial to sustain app quality and reach vulnerable or underserved parent groups.7,15
Limitations and future research
This study’s findings should be interpreted in light of certain limitations. First, data collection relied on an online self-administered survey, which may introduce sampling bias by over-representing tech-savvy parents. Future studies could adopt mixed methods, combining quantitative surveys with in-depth interviews to capture richer user insights. Second, the research focused on parents of infants and toddlers in Taiwan; thus, cultural or demographic differences may limit generalizability. Comparative studies across different populations could clarify whether the observed relationships hold in other cultural settings.
Third, satisfaction and engagement were assessed through self-reported measures. Future research should integrate objective behavioral data (e.g., app usage logs) to verify reported engagement levels and identify behavioral patterns. Finally, although this study applied U&G theory, additional constructs such as trust, privacy concerns, and habit formation could be incorporated into future models to enhance explanatory depth.
Conclusion
This study identifies critical factors influencing parents’ engagement with mHealth apps, and emphasizes the moderating role of social interaction. Findings suggest that policymakers and developers should consider social elements to improve parental satisfaction. Moreover, our research results indicate that using a specific mHealth app to monitor infants for potential retinoblastoma risks can facilitate early disease detection and inform suitable treatment actions to prevent disease progression. The mHealth app provides a more friendly channel for Asian parents who are not good at expressing themselves regarding concerns of their children’s disease status, aiming to detect and treat the disease early. Future research should also extend this framework to diverse healthcare technologies.
Supplemental material
Supplemental Material - The impact of intrinsic motivation and social interaction on parents’ engagement with mobile health apps in Taiwan
Supplemental Material for The impact of intrinsic motivation and social interaction on parents’ engagement with mobile health apps in Taiwan by Chia-San Chang, Ying-Chun Li and Tsuang Kuo in Health Informatics Journal.
Footnotes
Acknowledgements
The author wishes to thank the participants in the study.
Ethical considerations
This study was approved by the ethical Institutional Review Board [Kaohsiung Veterans General Hospital, Kaohsiung V. G.H Institutional Review Board] (Approval No. [KSVGH21-CT7-08]). Data collection adhered to ethical guidelines ensuring confidentiality and voluntary participation.
Consent to participate
All participants provided written informed consent before participation.
Author contributions
Chia-San Chang
Dr. Ying-Chun Li
Dr. Tsuang Kuo
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Declaration of generative AI in scientific writing
During the preparation of this manuscript, the authors used Grammarly to assist in correcting the grammar. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.
Supplemental material
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References
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