[Participatory development of digital public health: tension between user perspectives and evidence]

Digital public health promises not only more comprehensive medical care, but also individual health promotion and support for positive lifestyle changes. Mobile digital health devices and services, also called mobile health (mHealth), play a key role in this. They include health-specific hardware and software applications such as smartphone apps and wearable technology for recording, monitoring, and evaluating specific health parameters. Although there is scientific evidence for the effectiveness of individual applications, most often applications are used for a relatively short amount of time. In order to achieve a higher acceptance and utilization rate, evidence is needed that is more practice oriented.This paper explains how participatory development approaches take into account the individual needs and preferences of users and can improve the quality and effectiveness of mHealth services. The sociodemographic characteristics of the target group as well as individual, social, linguistic, and cultural barriers should be considered. The wishes of users, for example personalization, transmission of real-time information, and transparency in terms of privacy should also be considered. In the co-design approach, users are therefore included directly in the product concept. However, the study situation is still limited and there are no methodical approaches.In order to increase the use of mHealth services in the future, participation processes should be systematized. In addition, a framework for classification and certification as well as procedures for promoting effective applications should be developed.